ABDOMINAL HERNIA 385 



cardboard upon the hernial orifice. This will have to extend over the 

 borders of the hernia far enough to entirely cover the opening. Now 

 fix small pieces of adhesive plaster across the cardboard and attach 

 them in a circle around the piece of cardboard. These will adhere easily 

 if the skin has l)een cleansed and any fat or other material has been 

 removed by means of ether or benzine. [Ordinary shoemaker's wax 

 made liquid is put on the end of the plaster strips.] We now place a 

 gauze bandage around the adhesive-plaster dressing and the whole 

 posterior part of the body, in order to protect the dressing from being 

 torn or shifted by the animal. The dog should be fed on light, easily 

 digested food, avoiding any that has a tendency to flatulency or consti- 

 pation, at the same time assisting defecation by means of laxatives. The 

 safest and most certain method, however, of removing hernia is the 

 operation of herniotomy, or hernial section. 



Where we have strangulated hernia we must attempt to reduce it 

 by pushing the contents of the hernia back into the abdominal cavity. 

 This may be accomplished either by means of taxis or by hernial section. 

 The former method is only to be used when the strangulated intestines 

 have not yet undergone any serious alterations, namely, when they are 

 not affected by gangrene, and when there are no serious symptoms of a 

 local or general character. In the operation of taxis the patient must 

 be placed in such a position that the hernia occupies the highest region 

 in the abdomen and assists the relaxation of the abdominal covering 

 and the orifice of the hernia as much as possible. We first try by manip- 

 ulation upon the orifice of the hernia with one hand, and by pressure of 

 the flat of the other upon the periphery of the swelling to push the contents 

 of the hernia back into the abdominal cavity. When the animals are 

 under the influence of ether or a narcotic, the reduction is easier. Taxis 

 must be considered successful when the swelling of the hernia has dis- 

 appeared and when the aperture of the hernia can be felt, and also when 

 the symptoms of distention have gone. If the latter still continue, 

 notwithstanding the fact that the contents of the hernia seem to have 

 disappeared, we have a false reduction — that is to say, the hernial con- 

 tents and pouch have been shoved entirely through the orifice into the 

 al)dominal cavity, or we have to deal with a volvulus or invagination 

 of the intestinal portion in the cavity; or it may be that the hernial 

 contents are crowded between layers of the abdominal muscles. In the 

 first instance the orifice of the hernia seems free, and in the latter instance 

 it is closed. 



If the attempts at taxis to produce reduction fail, or if the above- 

 mentioned contraindications are present — that is, where the hernia has 

 been left too long — we must proceed at once to perform herniotomy, 

 which must be done under the strictest antiseptic rules. 



