HERNIA. 413 



to that of the testicular sac in which they are contained, the in- 

 guinal oscheocele being pyriform, with its contracted portion 

 resting in the groin. 



Vermicular movements of the intestines and borborygmus are 

 symptoms easily detected in large hernias. The tumor of a 

 chronic hernia is painless, or nearly so. Rectal examination 

 furnishes evident indications of the possibility, and of the 

 presence of the hernia by the degree of the dilatation of the ring 

 and the size of the organ engaged in it. In such a case, the dila- 

 tation may be so great, even notwithstanding the presence of the 

 intestines, that the hands, placed respectively, one in the rectum 

 and the other in the inguinal region, can be brought in such near 

 proximity as to touch each other. All these symptoms, taken to- 

 gether, or even isolated, are sufficiently characteristic to establish 

 a positive diagnosis of simple chronic hernia. 



The serous exudation which necessarily exists in chronic 

 hernia, may, when it is excessive, render the natm-e of a hernial 

 tumor more obscure, and give it the appearance of a case of true 

 hydrocele, the serous sac in these cases being so full as to render 

 it impossible to discover, either by sight or feeling, the presence, 

 of the intestines contained in it, even the elastic resistance of its 

 walls being undetectable. But here a rectal exploration will help 

 to solve the question ; and, again, by placing the animal in the 

 dorsal position, the gravitation of the liquid into the abdomen 

 will readily reveal the truth by leaving the intestine alone in the 

 sac. 



Great caution is necessary in these doubtful cases, in which 

 a misdirected stroke of the bistoury, thoughtlessly or accidently 

 made, might prove certainly fatal, by incising the intestinal 

 knuckle, which it really is, instead of simply opening the mere 

 serous sac which it was supposed to be. The formation of a 

 sarcocele may also render the diagnosis difficult. In these cases 

 the testicle, considerably tumefied, rough on its surface, and hard 

 and painful, is felt at the bottom of the sac, and thus conceals the 

 character of the hernia. Still, with sarcocele hernia coexistent, 

 the scrotal tumor acquires an appearance and proportions differ- 

 ent from those of its uncomplicated state. In this last case, the 

 testicle constitutes the principal mass, and the elongated cord, 

 stretched by the weight of the oi'gan, can be easily traced with the 

 fingers quite up into the groin. If, on the contrary, both hernia 



