556 CRURAL HERNIA. 



though the latter appeals as a hard eord connected with the anterior 

 border of the os pubis. In doubtful cases the vagina must be 

 examined. Where the uterus lies in the hernial sac the vagina appears 

 lengthened, narrowed or drawn towards the affected side or down- 

 wards, and often scarcely admits the finger, whilst its anterior portion 

 is less movable than usual. 



Incarceration and other complications threatening life are seldom 

 met with. Even delivery is usually easy. Strangulation, however, 

 when occurring, produces symptoms similar to those in other animals. 

 Vomiting is occasionally seen. 



Treatment by regulation of diet and the application of a bandage 

 when not harmful is useless. The hernia remains or recurs, and there 

 is danger of adhesions forming and even of incarceration. Surgical 

 treatment should be adopted as soon as possible. The operation 

 is not difficult and generally safe. It consists in reduction of the 

 hernia and ligation of the sac. The patient is anaesthetised and placed 

 in the dorsal position. The region is washed, shaved and disinfected. 

 An incision is then made through the skin over the hernia ; the sac 

 is isolated up to the inguinal ring ; and reduction having been 

 effected, a silk ligature is applied as near the abdominal opening as. 

 may be possible. The sac below the ligature is excised, the wound, 

 carefully disinfected and sutured, is covered with an adhesive plaster 

 or a bandage. If the hernial opening is large it should be sutured, 

 and if the uterus cannot be reduced after enlarging the hernial ring 

 by shallow incision, directed forwards and outwards, partial ampu- 

 tation should be performed, or the abdomen may be opened and 

 the entire uterus removed. In omental hernia that offers much 

 difficulty in reduction, the sac may be opened, the omentum drawn 

 forward, ligatured and excised. When the herniated uterine horn 

 contains a foetus or more than one, and reduction or delivery is 

 impracticable, the uterus should be incised and the foetus removed, 

 and instead of closing the incision and reducing the hernia, partial 

 hysterectomy may be practised by ligation of the base of the horn 

 and amputation. Before returning the womb the wound should 

 be lightly cauterised and any projecting mucous membrane carefully 

 excised. Operation is not advisable during oestrum, or soon after 

 delivery. 



VIII.— CRURAL HERNIA. 



Crural hernia is so rare that Girard altogether doubted its 

 occurrence in the horse, and in spite of extensive experience, neither 

 Moller nor Cadiot has met with a case. The elder Lafosse, Hertwig, 



