OPERATIONS FOR HERNIA, 375 



time should be lost. Sliould the nnimal quietly submit, the ope- 

 ration should be performed while he is standing, by introducing 

 one hand into the rectum, and drawing up the protruded gut ; in 

 cases of resistance or dif^culty, however, it is best to cast our 

 patient, and then we may work with both hands at the sam3 

 time, — one in the rectum drawing up the gut, and the other in 

 the sheath gently forcing it into the abdomen. The operator 

 will only recollect that force in drawing up the gut is to be 

 avoided as much as possible, the consequences too often being 

 inflammation, gangrene, and rupture. 



Ventral liernia. — When hernia occurs at birth it is called con- 

 genital. Umbilical hernia is often found in foals, and should be re- 

 duced by the following method, which ISlr. Simonds has found suc- 

 cessful : — " I first cast the animal, and, placing him on his back, 

 grasp the hernial sac between my fingers, drawing it up from the 

 belly, and being careful not to include any portion of the pro- 

 truding intestine, of which there is little fear, except (which is not 

 likely in so young an animal) adhesion has taken place between 

 the peritoneum covering the intestine and that portion of the 

 membrane lining the sac. Being safe with regard to these things, 

 I take a strong waxed cord or string and place it round the sac, 

 as near as possible to the abdomen, and, pulling it tightly,^ I 

 pass it round the sac two or three times, and securely fasten it. 

 The patient may then be permitted to rise ; and in a majority 

 of cases no after-treatment will be necessary. In the course of 

 a few days the parts included in the ligature begin to slough, 

 and the healing process taking place, the sac is entirely got rid 

 of, and the cure is perfected." 



Mr. Simonds concludes the valuable paper before alluded to 

 by the relation of two cases in which he operated successfully 

 for ventral hernia. One, by the plan before advised for colts ; 

 the other, by a more severe operation. In the latter case, the 

 patient was an old black mare that had been injured by falling 

 in the shafts six days before the operation, Mr. S. says: — 

 " The most extensive rupture I had ever seen presented itself on 

 the left side. The sac formed by the skin, which was not broken, 

 nor even the hair rubbed off, extended as far forwards as the 

 cartilages of the false ribs, and backwards to the mammai. A 

 perpendicular line drawn from the superior to the inferior part 

 of the tumour measured more than twelve inches. It appeared, 

 from its immense size and weight, as if by far the larger part of 

 the colon had protruded. To my surprise, there was compara- 

 tively little constitutional disturbance. The pulse was 45, and 

 full, with no other indication of fever, and no expression of 

 pain on pressing the tumour. She was bled until the pulse was 

 considerably lowered. A carthartic was given, and the sac or- 



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