INGUINAL HERNIA. 389 



being in the power of the operator to prevent it — M. Renault conceived 

 a notion, in a case where the strangulation was recent, the hernia not 

 large, nor the tumefaction great, that it would be better to make an in- 

 cision at the upper part of the flank, by the side of the hernia, and to 

 endeavour manually to return the gut, even though it should have 

 descended into the scrotum ; nothing, then, would remain for treatment 

 but a wound into the abdomen ; and surgical experience has shown us 

 that simple incised wounds, like this, may be generally managed. It is 

 true that the method has proved in one case unfortunate ; but then, there 

 were two strangulated hernias present ; strangulation had existed twenty- 

 two hours ; and more than two feet of small intestine had entered the ^ 

 scrotum, and this was already distended with gas. 



The Bowel being returned^ the propriety of castration is to be decided 

 on by the states of the cord, epididymis, and testicle. Should they be 

 engorged, livid, and marked with purple spots, the operation becomes 

 indispensable ; because it may, performed in time, prove a preventive of 

 congestion, peritonitis, and gangrene. It is to be practised only on the 

 side affected, and in the ordinary manner, with the clams, a testicule 

 convert. Under other circumstances, although the parts may evince 

 compression, still, so long as there be no signs of mortification, castration 

 is not called for. 



After the Operation, the animal is to be kept down, as prescribed 

 after the reduction by the taxis ; only the limb drawn up to the beam 

 may have a little liberty given to it, and thereby the body allowed to 

 incline somewhat to the opposite side (to that operated on), which will 

 give the animal some relief. Every precaution is to be taken to prevent 

 him from struggling or flinging 'about at the time he is released to rise 

 up. He will require the same subsequent care and treatment as has 

 before been detailed, in speaking of the operation for chronic hernia ; 

 only observing that this is a case in which relapse of the hernia is more 

 to be dreaded. 



Result. — By the chirurgical means stated, we can at all times succeed 

 in reducing the strictured hernial viscus; but the result can prove 

 favourable only in cases free from sphacelus : whenever the hernial pro- 

 duction has become gangrenous, the operation can neither prevent, 

 arrest, nor retard death ; an event which commonly happens some hours 

 after the reduction. In man, in many cases, we can establish an artificial 

 anus ; and indeed, afterwards, by Dupuytren's procedure, sometimes 

 succeed in again restoring the natural passage. It is submitted, without 

 conceiving it necessary to state the reason, that such practice is not 

 available in the horse. This teaches us that the operation for a recent 

 strangulated enterocele cannot be delayed but with the utmost danger. 

 In fine, a gut once strangulated becomes the seat of pains rapidly 



