384 HERNIAL RUPTURE 



twenty-four to forty-eight hours after strangulation first appears. The 

 temperature can hardly be said to have any diagnostic value, as we very 

 often find it normal or even subnormal up to the time of death. 



In rare instances we have the formation of a fsecal abscess; this is 

 caused by the sloughing of a certain portion of the intestine, allowing 

 the contents of the intestine to escape into the sac; this is due to the 

 circulation being cut off and subsequent mortification of the part; this 

 is quickly followed by purulent inflammation of the hernial covering. 

 If an incision is made in the hernial swelling, faecal matter and pus flow 

 out externally without being followed by any grave symptoms, except 

 that it may svibsequently form a false anus in the cavity. 



Fsecal fistula, intestinal fistula, or preternatural rectum is seen in 

 very rare instances. The expression "fsecal fistula" or "intestinal 

 fistula " is used where there is an external intestinal orifice, but the greater 

 mass of fsecal matter is passed through the rectum. The term " preter- 

 natural rectum" (anus praeternaturalis) is used when all the fsecal matter 

 passes through this opening. Such an opening may also be produced 

 by penetrating wounds or the entrance of foreign bodies. 



In strangulation of the omentum the symptoms are less marked, 

 but there is great pain on pressure. We frequently find adhesions 

 between the omentum and the orifice of the hernia. This inflammation 

 produces a complete immobility of the hernia and gangrene, followed 

 by the formation of an abscess, and finally the escape of pus externally. 

 Death is rare in such conditions, and if it should occur it is caused by 

 septicsemia. 



The prognosis of irreducible hernia depends greatly on the length 

 of time that the strangulation has been present and also on the character 

 of the contents of the hernia. In cases where a loop of intestine is strangu- 

 lated and is gorged wuth fsecal matter the results are generally serious; 

 but, on the other hand, strangulation of the omentum is not serious. 



Therapeutics of Hernia. — In cases of reducible hernia we cannot 

 use a truss, which is the favorite mode of treatment in man, it being 

 impossible to keep a hernial bandage steady in any position for any length 

 of time on the dog. AVhen hernia has been caused in a traumatic way, 

 and followed by a subcutaneous rupture of the abdominal wall, or in 

 umbilical hernia of very young animals, we may close the orifice in such 

 cases by means of a dressing, and the hernia may be entirely removed 

 by the following method: 



Place the animal on its back or in such a position that the hernia 

 is placed as high as possible. Then reduce the sac by working the con- 

 tents back into the abdomen. In some cases this is accomplished very 

 easily, but in others it requires a certain amount of careful and patient 

 manipulation. Then place a tampon of wadding or a small piece of 



