HORSE MANAGEMENT, ETC. 389 



steady, firm, and forcible pressure ought to be maintained against 

 it for such length of time as appears to afford any chance of suc- 

 cess, augmenting the force used whenever there be any remission 

 of the straining. Should the first efforts of this description fail, 

 the protruded mass may have its bulk lessened and constricted as 

 much as possible by local application of some sort, than which 

 none offers a better chance of succeeding than such as follows 

 frorr. sudden and intense cold, though to a part so sensitive and 

 VJtsoular the practice is not devoid of danger. Ice may be pow- 

 dered and inclosed in a linen bag, so as to form a sort of bolster, 

 that may be held or braced with firmness upon the tumefaction. 

 The contrary of aucn treatment as this, however, though the ob- 

 ject be the same, is generally preferred — namely, fomentation, 

 medicated or not, with scarification of the exposed membrane — 

 though in other cases astringent applications are employed, with 

 a view of causing contraction and diminution of the mass, such as 

 lime-water, decoction of oak bark, solution of alum, etc.; and 

 while such proceedings are going on, it is advisable to have the 

 hind parts raised. Supposing we succeed in accomplishing the 

 reduction, the chances are in favor of the relapse of the prolapsus, 

 and these chances seem great in proportion to the facility with 

 which the return of the inverted gut has been effected. Indeed, 

 50 constant and troublesome does the return in some of these cases 

 become, that it is necessary to contrive some sort of truss to op- 

 pose the descent, the same as is done for rupture in man. Mr. 

 Dycer's truss consisted of 'a new wet chamois leather, a breast- 

 plate, and a hip (human) truss.' Should constipation be thought 

 to operate against reduction, in addition to clysters, we may ex- 

 hibit cathartics and aloes in solution, and should there .be plethora 

 and great irritability in the membrane of the rectum and anus, a 

 blood-letting will be advisable, while an opiate or belladonna clys- 

 ter will be advantageously administered, in order to allay all local 

 irritation as much as possible. 



As a dernier and effective mode of procedure in prolapsus 

 ani, when the case proves either irreducible, or, after return, con- 

 tinually protrudes on any slight effort, such as coughing afresh, 

 we have recourse, with safety and certainty, to an operation con- 

 sisting in excision of more or less of the inverted membrane en- 

 veloping the protruding portion of the gut. This is an oj)eration 

 of ancient date, though to Dupuytren is ascribed the credit of 



