INFLAMMATION OF THE SPERMATIC CORD. 679 



which is simple, and, if precautions against bleeding are taken, not 

 dangerous. 



The horse is cast, the feet of the affected side fastened together, 

 and the animal placed on its back. The operator then kneels behind 

 it. The seat of operation is cleansed, and an elliptical piece of skin, 

 sufficiently large to allow of the growth passing easily through the 

 opening, removed with the knife. Any skin adherent to the growth 

 mast also be taken away, and care taken to provide for drainage. 



A tape, passed through the subcutis of the isolated piece of skin 

 and through the growth, is held by an assistant, who pulls gently 

 on the spermatic cord. The operator now breaks down the tissues 

 surrounding the diseased cord, which is covered by the tunica 

 vaginalis. Any bleeding vessels are at once ligatured. The cord 

 must be exposed if possible beyond the diseased part, or, in cases 

 where the disease extends within the abdomen, as far as the external 

 inguinal opening. When the growth is small the tunica vaginalis 

 must be exposed at least as far as it is adherent to the spermatic 

 cord, and, if a clam is to be applied over it, up to the highest point 

 the disease has attained. This method is preferable, and as soon as 

 the upper limit of the growth is reached, a strong ligature or clam 

 is applied over the spermatic cord and tunica vaginalis. One then 

 proceeds as in castration, by the covered method. In dealing with 

 extensive growths, a short clam, which can be introduced into the 

 operative wound, should be applied to the cord, so that, after removal 

 of the diseased part, it may remain, as in the operation for inguinal 

 hernia (which see). 



Where the disease extends so far upwards as to prove beyond 

 easy reach, the tunica vaginalis is divided where it seems movable 

 over the swelling ; the spermatic cord can then be drawn down, 

 and the clam applied above the diseased portion. In other cases a 

 ligature or the ecraseur may be used. It is best to tranfix the cord 

 with a stout ligature, tying it as tightly as possible, and allowing 

 the ends to hang below the skin wound, so that it may be removed 

 if it does not fall away of itself. The elastic ligature is also valuable. 

 Carefully used, the ecraseur and the torsion method also prevent 

 bleeding. To prevent post-operative haemorrhage, the wound, when 

 cleansed, is powdered with iodoform-tannin and stuffed with 

 carbolised jute, a few sutures being inserted to retain the tampons 

 in position. 



Dressing and clam remain in position for at least forty-eight 

 hours ; on removing them, the parts are washed out with sublimate 

 or carbolic solution, again powdered with iodoform-tannin and 



