712 DISEASES AND ABNORMALITIES OF THE YOUNG ANIMAL. 



or one of iron, either hinged at one end or tightened by screws. To 

 render the coaptation of the two branches of the clam more perfect, and 

 to prevent the instrument shpping when tumefaction sets in, as well as 

 to produce more prompt inflammation, adhesion, and gangrene, various 

 contrivances are in use. Borhauer has used a clam, in the branches of 

 which are a number of holes placed opposite each other, through which 

 wooden or metal pins can be passed when the instrument is fixed on the 

 sac. Other practitioners employ a clam with toothed branches, the 

 teeth perforating the walls of the sac. Armatage. recommends an iron 



rig. 225. 

 Umbilical Clam. 



screw clam, one branch of which has a long deep groove, and into this 

 fits a narrow projecting ridge on the opposite branch (Fig. 226). To 

 apply the clam, he gives the following directions: "The animal is 

 secured and placed on its back. The skin over the rupture is drawn 

 together by the fingers in aflat fold, corresponding w'ith a central longi- 

 tudinal line through the abdomen {linea alba), and elevated from the 

 parts beneath, in order to cause the intestines or omentum to descend. 

 The clam is then put over the skin, as close to the abdomen as possible, 

 and the screws tightened. The pressure must not be too severe, or the 



Fig. 226. 

 Armatagk'8 Iron Umbilical Clam. 



parts will drop off too soon, and possibly the intestines may escape. 

 The operation, therefore, requires to be carefully w^atched." 



Degive^ has improved upon this method, by introducing two strong 

 steel needles through the skin and margins of the umbilical opening — 

 guiding their points so as to prevent injury to the intestine, by a finger 

 passed through a small incision at the base of the tumour. Above these 

 needles, i.e., closer to the body, the clam is applied; this can be 

 tightened to the necessary degree by the screw at each end. In order 

 to prevent displacement of the clam when the needles are withdrawn, 

 some small steel pins are passed through the skin immediately beneath it. 

 ^ 7'Ae Ve.ierip.ary Journal, 1894, p. 156. 



