616 HERNIiE, ETC. 



and prove fatal a few hours later. The remarks as to diagnosis 

 in the inguinal form apply here, excepting that the scrotum is 

 full of bowel and the canal distended by it. Nevertheless, 

 examination per rectum is absolutely necessary to confirmation. 



Chronic scrotal hernia is undoubtedly more common than 

 suspected, and where the ring has gradually become very much 

 dilated, is accompanied by very little inconvenience to the animal; 

 simply rolling on his back being sufficient to reduce the hernia, as 

 it slips back by gravitation into the abdomen. There was a har- 

 ness-horse which, after trotting a few miles, always stopped, and 

 could not be prevented lying down, but after having a roll would 

 get up and go on with his work for a time, and then repeat the act, 

 — all explained by a scrotal hernia. Animals that escape pain 

 escape also observation and detection of the affection. There is 

 always danger of ingesta passing with the bowel into the 

 scrotum, producing distension and strangulation ; but the more 

 usual consequence is gradual enlargement of the scrotum, a 

 succession of attacks of abdominal pain, gradual vital depression, 

 wdth loss of condition, emaciation, and inability to work. Then 

 operative intervention is imperative. 



Treatment of the acute and strangulated form must be early 

 and decisive, and the operation is one of our greatest triumphs 

 in veterinary surgery, as the patient not only recovers, but is 

 positively saved from a most painful death. 



To proceed, give internally a powerful sedative, then secure 

 the horse on his back, his feet being raised by a rope thrown 

 over a beam ; draw the hind-leg on the affected side away from 

 the body, and forwards, so as to relax the ring and muscles of 

 the groin ; hold the testicle, and manipulate along the cord, so 

 as to force the bowel back, if possible, into the abdomen. Valu- 

 able assistance may be afforded by dragging on the bowel per 

 rectum; if the case be chronic, and the canal and ring large, 

 reduction is readily effected in this way. If, on the contrary, 

 the hernia is fixed immoveably, opening the scrotum and ampu- 

 tating the testicle will, in some cases, assist reduction, but is not 

 recommended, as the bleeding makes the operation a very dirty 

 one. The simplest and most effectual method is to cut down 

 on to the inguinal canal close to the internal ring, making a 

 small opening through its peritoneal tunic just to admit a finger 

 (beware of wounding the bowel immediately beneath). The 



