438 OPERATIONS ON THE DIGESTIVE APPARATUS. 



left hand, and with the right, introduces a strong needle which is 

 pushed through and through at each extremity of the sac, and 

 an elastic hgature passed three or four times aroiind its base. 

 Towards the tenth day the slough is completed, and only a small 

 wound remains, which cicatrizes rapidly. 



Direct Suture of the umbilical ring. — Director Degive recom- 

 mends for the treatment of umbilical hernia in young dogs, the 

 direct interrupted sutures of the ring, the number of stitches 

 varying with its dimensions. After bringing the threads together 

 the wound is left open until they have safely eliminated themselves. 

 We have employed this mode of operation for many years in the 

 hospital of the American Veterinary College, using antiseptic pre- 

 cautions, and with the best results. Making a longitudinal line 

 on the median Hne of the sac, and having carefully pushed back 

 the intestines, the edges of the ring are sewed together with two 

 or three stitches of cat gut ligature. The parts were then thor- 

 oughly washed with a solution of bichloride of mercury, and the 

 edges of the skin brought together with silk sutures and a com- 

 pressing bandage appHed for the protection of the wound from the 

 patient's own teeth. Complete cicatrization follows in a few days. 



Whatever may be the original mode of treatment the secondary 

 effects are about the same in each case. They consist of ii'ritation 

 of the parts, more or less marked, and betrayed by the patients by 

 varying degrees of restlessness, and possibly, in some cases, by 

 abdominal pain or cohcs. 



After a few hours the swelling of the j)art begins. A diffused 

 oedema takes place above the point of comj)ression, and the hernial 

 sac is shghtly swollen and warm and becomes covered with little 

 phlyctenoids, indicating a commencing necrosis. Perhaps a little 

 fever is manifested and there is great thirst. By the third day 

 the swelling is quite large, and in males it may involve the sheath. 

 The sac then becomes cooler, the fever subsides, the appetite re- 

 turns, and the animal which has instinctively kept his feet, rests 

 himself by lying down. On the fourth or fifth day the skin of the 

 sac is insensible, cold and flabby, and the sloughing process between 

 the Hving and the dead skin has begun. Little by little this pro- 

 cess becomes more active, and the separation becomes more and 

 more marked, the secretion around its opening a purulent character, 

 and from the sixth to the tenth day the complete sloughing will 

 have taken place. The wound that remains is now granulating. 



