UMBILICAL HERNIA. 729 



Hertwig, as has been mentioned, recommends sulphuric instead of 

 nitric acid, and applies it in lines, night and morning, for two days, by 

 means of a glass rod. CEdema soon sets in, and it may be increased by 

 rubbing the cauterized surface with oil of turpentine and oil (one to 

 two). The sulphuric acid, however, appears to be less prompt than the 

 nitric. Strong blistering ointment applied at intervals of three days ; 

 chromate of potass ointment (one to three) rubbed in once a day for 

 five minutes at a time, on two consecutiv^e days ; solution of bichloride 

 of mercury, and other topical irritants, have all been more or less suc- 

 cessfully employed. Even the. actual cautery, in lines and points, has 

 been resorted to j but the beneficial effect to be derived from it is uncer- 

 tain, and at best it is very painful. 



Bouley {Recueil de Med. Veterinaire^ July, 1877) draws attention to 

 Luton's method of subcutaneous injections for the cure of congenital 

 herniae in infants, and believes it will be found more advantageous than 

 any other treatment yet attempted 'for umbilical hernia in animals. Lu- 

 ton's method consists in the subcutaneous injection of a few drops of 

 common salt solution around the hernial tumor, by means of the ordinary 

 subcutaneous injection syringe. 



Under the irritating influence of this injection, oedema sets in, and this 

 mechanically repels the contained viscus, the margins of the abdominal 

 opening come into apposition, and, with the connective tissue, are inflamed 

 and soon unite. 



The needle of the syringe must not pass beyond the subcutaneous con- 

 nective tissue. 



3. Constriction. — Constriction of the hernial sac has been largely re- 

 sorted to for the cure of umbilical hernia, with the view of destroying it 

 by mortification, causing adhesion above the part where this has taken 

 place, and inducing secondary cicatrization when the sac has sloughed 

 away. The constriction is produced by ligature, dams, and suture. To 

 apply these, the animal must, in nearly all cases, be thrown ; but before 

 this is attempted, the tumor should be well examined, in order to ascer- 

 tain if it is reducible, if there are adhesions, the extent of the abdominal 

 opening, and the limits within which the constricting apparatus should be 

 applied. 



The best position for reduction and constriction is the dorsal. The 

 animal, if a foal, should be cast on a good bed of litter, and placed on 

 its back. Very often the change of position reduces the hernia ; if not, 

 gentle manipulation and pressure will effect this, and then the empty sac 

 is pulled away from the body, and the operation completed. 



The oldest procedure is ligaturing the entire mass of the hernial sac 

 by a piece of cord tied firmly round it, close to the body. This produces 

 at first a merely mechanical occlusion, but subsequently this is physiologi- 

 cal — exudation and organization of the plasma thrown out by the inflam- 

 matory process set up, producing adhesion of the peritoneal surfaces. A 

 piece of whipcord answers very well for this ligature, but it must be 

 drawn very tight around the neck of the sac, in order to produce its im- 

 mediate and consecutive effects. 



To keep the ligature in place, some practitioners pass one or two 

 wooden pegs through the sac where it is encircled by the ligature ; these 

 prevent the twine being displaced by the swelling which quickly super- 

 venes. Sometimes a ring is employed^ which is less in diameter than the 



