374 SURGICAL OPERATIONS. 



Bistoiiri Cache. 



The bistoiiri lies concealed in the groove of tlie director, and is elevated when re- 

 quired by pressing on the spring handle, the screw below limiting the action of 

 the knife as may be required. 



takes the testicle of the affected side in both hands, and, 

 manipulating it so as carefully to bring it in close contact with 

 the scrotum, leaves it in the left hand. Tightening the skin, 

 and guided by the raphe, he makes a free incision through the 

 integuments, and then through the tunic, which latter he dilates 

 to the extent of three or four inches by means of the scissors or 

 scalpel, first introducing one of his fingers as a guide. If the 

 operator has a knowledge of the parts, he needs not to be afraid 

 of opening the scrotum by free incisions, made with caution. 

 On opening the scrotum, a quantity of serum, depending on the 

 length of time the strangulation has existed, will escape. 



if the operator takes the testicle firm in his hand, there will 

 be little danger of wounding the gut. 



After liaving opened the scrotum, by putting aside the testicle, 

 he may generally obtain a view of the intestine. 



" He next attempts to introduce the index finger of his left 

 hand into the stricture ; but this is sometimes difficult, as the 

 spermatic cord becomes occasionally enormously enlarged, the 

 stricture preventing the return of blood by the veins, but allow- 

 ing it to proceed to the testicle by the arteries. In such a case 

 it is an advantage first to castrate, and to get this distension out 

 of the way. 



" Having carefully passed the finger into the stricture, he then 

 introduces the bistoury, and having taken great cai'e to avoid 

 the intestine, very carefully dilates the stricture; but this is to be 

 done with the greatest caution, so as just to enable him to return 

 the gut and no more, for if he much enlarges the opening he 

 will, in all probability, have a return of the hernia, and lose his 

 patient. Having reduced the hernia, and removed the testicle, 

 he dresses the scrotum with turpentine liniment, and allows the 

 animal to rise." 



The Taxis. — In cases where these severe symptoms are not pre- 

 sent, M. Girard recommends what is called reduction by the taxis, 

 by which is meant the return of the hernial part, by the hand, into 

 the cavity of the belly. If, after a thorough examination of tlio 

 parts, reduction be considered i)racticable and profitable, no 



