FISTULOUS UMBILICAL HERXIA, 601 



those which follow. The whole drop off, along with the tumour, 

 in- from ten to twelve days. The place from which the pouch 

 is detached is neither raised nor excavated. It is a flat, granu- 

 lating surface, as large as a halfpenny, and seldom broader than 

 a half-crown. No further treatment is required, save, perhaps, 

 a little astringent 'lotion to hasten cicatrisation, or an ointment 

 CO exclude flies." 



VENTRAL HERNIA. 



Ventral hernia differs from the umbilical and inguinal forms, 

 from the circumstance of the protrusion occurring through an 

 artificial opening in the abdominal walls, produce«l by violence, 

 and not through natural apertures, as in the other instances. 



A ventral hernia may be situated on any part of the abdominal 

 parietes, except the navel, and is caused by Idoeration of some 

 of the muscular or tendinous fibres composing the abdominal 

 walls. The size of the tumour varies greatly in different cases ; 

 and strangulation of this hernia rarely occurs. Sometimes a 

 partial or incomplete ventral hernia is met with, namely, rup- 

 ture of the outer layer of the abdominal muscles, the internal 

 layer being intact. 



Large ventral herniae are rarely curable, but should the mus- 

 cular gap be small, the methods recommended for umbilical 

 hernia may be employed with success. In the generality of 

 cases there is, however, no necessity for adopting any kind of 

 treatment. 



A case of ventral artificial anus is recorded in the Veteri- 

 narian for 1837, by Mr. Karkeek, V.S., Truro, which is highly 

 interesting, both on account of its rarity and the successful issue 

 of the treatment adopted. Mr. Karkeek says : — 



" Two years since a pony mare received an injury from the 

 horn of a bullock on that portion of the abdomen situated be- 

 tween the cartilages of the false ribs, inclining a little to the 

 left side, producing a ventral hernia about the size of a cricket 

 bhlL From a kick received upon the place from the toe of tlio 

 shoe of a boy, very serious injury resulted, which terminated 

 in an opening through the lacerated muscles into the colon 

 itself; being that portion of its second flexure which forms 

 the upper and anterior arch, and the liquid and pulpy contents 

 soon issued freely from the aperture. The mare continued for 



