488 HERNIA. 



by passing a sterilised thread through it and through the mass of 

 tissue ; the hernial sac should be divided immediately below. In order 

 to ensure greater security, it may even be desirable to pass a suture 

 through the margins of the inguinal ring. 



Umbilical Hernia. 



Umbilical hernia is less common in young animals of the bovine, 

 ovine and porcine species than in the foal, and when existing almost 

 always disappears at the period of w^eaning. The rumen then assumes 

 its full development, the loops of intestine are displaced and thrust 

 towards the sublumbar region, and the hernia disappears. The same 

 is true of the young pig, the development of the "stomach producing 

 the same favourable result. 



In the rare cases where this hernia is not reduced spontaneously, it 

 may be necessary to utilise the methods so frequently employed in the 

 foal, and, despite the number of these, there are only two which can 

 thoroughly be relied on to give good results. 



In the first, irritants are employed. 



Subcutaneous injections of concentrated solution of common salt, 

 filtered and sterilised, or 10 per cent, solution of chloride of zinc pro- 

 duce enormous engorgement of the connective tissue, which thrusts 

 back the herniated loop of intestine and later causes the development 

 of very resistant fibrous tissue, which prevents the hernia returning. 



To ensure this result, however, it is indispensable that perfect 

 asepsis should be observed in the injections, for if germs are intro- 

 duced severe suppuration occurs at the point of injection. The 

 injections are made at four opposite spots in the subcutaneous tissue 

 surrounding the hernia, 1 to 2 drachms of saline solution being 

 injected at each spot ; of the chloride of zinc solution half a cubic 

 centimetre is used. This method is only of value in small herniae, 

 which may sometimes be cured by the application of sinapisms alone. 



The second method is applicable to larger herniae, and aims at 

 destroying the hernial sac. 



The application of clams is simplest, and can be recommended. 

 The patient is placed on its back, reduction is effected, the hernial sac . 

 is drawn upwards vertically, and the clams placed as near the 

 abdominal wall as possible, after care has been taken that no portion 

 of the intestine is included in the sac. The clams are kept in place 

 by a suture passed through the neighbouring tissues. 



In other cases where a radical cure is necessary, because of adhesions 

 within the hernial sac, the patients are similarly placed on their backs, 

 the hernial sac is opened aseptically, the adherent parts liberated, the 

 herniated portions of intestine reduced, and the hernial ring sutured 



