HERNIA. 417 



dissection should be carefully made with the knife until the ad- 

 hesions are completely divided and the fibrous coat fully exposed. 

 The reduction must then be attempted without opening the sac, 

 and in the absence of any adhesions this is effected without diffi- 

 culty, the inguinal opening being so large that, through the force 

 of mere gravitation, the dorsal position in which the animal is 

 placed is often sufficient in itself to cause the return of the intes- 

 tines into the abdominal cavity, even the testicle and the hernial 

 sac often following it in its inward movement. 



If the reduction does not take place in this manner, or in con- 

 sequence of the position of the animal, the taxis, both scrotal 

 and rectal, is then indicated to be performed in the same manner 

 as for acute hernia. Difficulties in effecting this reduction may 

 arise from three causes — either, first, the bulk of the mass repre- 

 sented by the protruding intestines ; or second, its obstruction ; 

 or third, the adhesions which it may have contracted with the 

 walls of the sac or with the spermatic cord. 



To obviate the first difficulty, while the manipulations of the 

 taxis, scrotal and rectal are simultaneously continued, it will 

 be weU to relieve the position of the animal, and instead of keep- 

 ing him lying absolutely on his back, to allow him to turn 

 shghtly, and to rest on the side opposite the hernia. In this 

 way the mass will not be so heavy to manipulate, and wiU be in a 

 better position to follow the dependent dii-ection in which it 

 must be pushed by the scrotal taxis, while at the same time, by 

 the rectal manipulation, it can be more easily unfolded and drawn 

 from the cavity in which it was imprisoned. But if, notwithstand- 

 ing aU these precautions, this diffictdty in the reduction cannot be 

 overcome, the indication of opening the sac still remains. 



The incision of the sac is performed as in cases of recent 

 hernia, the bed-sheet already mentioned being held in readiness 

 to receive the intestinal mass as it will be exposed. Then the 

 animal being completely under the influence of ether, and in the 

 dorsal position, an assistant grasps the edges of the sac and 

 stretches them apart, funnel-wise, using both hands alternately, 

 gradually pushes the intestines towards the hernial opening, an 

 assistant at the same time slowly unfolding the mass and permit- 

 ting it to slide into the abdominal ca\dty. 



Rectal taxis may largely assist in this step of the operation. 



If the redviction is rendered impossible by the interposition of 



