418 OPERATIONS ON THE DIGESTIVE APPARATUS. 



obstructions, the first indication will be to evacuate the intestines 

 by a methodical pressure which will displace the alimentary mass 

 and return it toward the abdomen. The puncture made with the 

 aspirator has proved very beneficial in these compHcations. 



The adhesions require the most careful dissection, especially 

 when they are short, and when both the visceral and parietal 

 layers of peritoneum are closely imited. The separation must be 

 done by a succession of short, limited incisions, at the expense of 

 the thickness of the parietal layer. 



A\Tien strangulation of chronic hernia occurs, it is due not to 

 want of room at the hernial ring, but to the enlarged bulk of the 

 protruding organ, which constitutes the obstruction. Conse- 

 quently the indication for herniotomy is not present. On the 

 contrary, as serious eventration is always to be feared, the only 

 indication is the removal of the obstruction as akeady indicated. 



"SMien the reduction has been completed, the occlusion of the 

 vaginal sac is to be obtained by the application of the clamp, 

 ajDplied as high up as possible, as in cases of strangulated acute 

 hernia. 



In cases of inguinal, complicated with ventral hernia, attempts 

 at reduction may be made by placing a long clamp over the cov- 

 erings of the latter, invohing with them the hernial sac and its 

 cutaneous envelope, as practiced in some cases of the umbilical 

 form. 



"We need but briefly to refer to certain different modes of treat- 

 ment of the various forms of hernia by the use of bandages, rec- 

 ommended by Petard, Grau, Klinger and Marlot, together with 

 the application of sutures upon the edges of the inguinal canal, 

 patronized by Hertwig and Dieterichs, to say that none of these, 

 any more than some others, borrowed from human surgery, can 

 give more satisfactory results, or be employed with greater safety, 

 and effect a radical cure better than the use of the clamp and the 

 castration by the process of the covered testicle. 



Inguinal Hernia in Geldings. 



Although inguinal hernia in the gelding is certainly less com- 

 mon than in the staUion, it is not, therefore, of impossible occur- 

 rence. But from the fact of its rare appearance it is far more 

 likely to be overlooked, and therefore neglected, with similar fatal 



