VENTRAL HERNIOTOMY. 563 



recovery occurs even in severe cases in which previous treatment 

 had failed. 



(3) Herniotomy. This only succeeds where the rupture is slit- 

 like, and can be sutured. Jurgens reported several successes — in one 

 the cow calved without any difficulty soon after operation ; in another 

 cow, showing symptoms of incarceration, Meyer sutured a recent 

 ventral hernia in the -neighbourhood of the udder. In old ventral 

 hernia? extensive adhesions often exist between the contents and the 

 sac, and occasion great difficulty to the operator ; and whilst he 

 must be prepared for this, he should use the greatest care in breaking 

 them down. External Herniotomy sometimes succeeds, but not 

 always, the inner hernial envelope, which has been retained in the 

 hernial opening by means of the purse-string suture, sometimes failing 

 to become adherent and the hernia reappearing later. In general, 

 the larger the aperture the slighter is the hope of cure. 



Incarcerations may sometimes be reduced by steady pressure 

 from without, and assistants may even be entrusted with the treat- 

 ment. It has been stated that in ruptures occurring in the posterior 

 portion of the abdomen, reposition may be assisted in large animals 

 by passing the hand into the rectum. 



Gerlach and Schmiele operated on a dog suffering from fractured ribs, 

 and a hernia containing part of the liver. A firm but compressible swelling, 

 almost as large as a man's fist, had suddenly appeared in the left subcostal 

 region. The hernial sac was divided, one lobe of the liver, which was found 

 between the ribs, was replaced, the wound sutured, and a cure effected. 



The mare shown in Fig 399 foaled without any help, in spite of the ex- 

 tensive nature of the rupture, the animal instinctively lying on the abdomen ; 

 it was then, however, killed, and the post-mortem showed that the straight 

 abdominal muscle was ruptured a hand's-breadth in front of the os pubis, 

 and that an aperture existed, measuring 20 inches in one, and 24 inches 

 in the other direction. Both the oblique and transverse abdominal muscles 

 were torn away. In the rupture lay a great part of the caecum, its point 

 directed backwards. Connective tissue had formed in all directions in 

 large quantities, and the fascia of both thighs was greatly thickened as 

 far down as the hocks ; lameness had not been observed during life. 



Guittard operated on a ventral hernia containing a portion of the 

 abomasum, by incision through the flank. After thrusting back the 

 abomasum the muscles were brought together, a dressing and compress 

 applied and the case terminated successfully. 



Cadiot and Dollar describe a ventral hernia in the left flank caused by 

 a blow from the handle of a windlass. The abdominal tunic was ruptured 

 opposite the stifle, and slightly above this point the muscles were torn 

 through, leaving the herniated small intestine only covered by skin. 

 After incision the hernia was reduced, the muscles and aponeuroses united 

 by two separate lines of silk sutures, the skin was brought together and a 

 dressing applied. In less than a month the wound had healed and the 

 hernia was cured (" Clinical Veterinary Medicine and Surgery "). 



