(EDEMA OF THE r.]f/!fLTCrs. Tl-'i 



Sutures are frequently employed, and there are various ways of using 

 them. One method is the " twisted " suture, which is applied as 

 follows : The hernial sac is included between two round })ieces of hard 

 wood or iron, which are drawn ti^'htly together by whipcord passed 

 round their extremities before and behind ; double sutures are then 

 passed through the sac, one of which is tied to the piece of wood on one 

 side, and the other to that on the other side — so that the sac is com- 

 pletely invested between the wood and ligatures, which divide it into 

 two portions. Another procedure by suture is to make a thick longi- 

 tudinal fold of the skin covering the hernia, to pass the suture needle — 

 armed with a waxed thread or cord — as near to the muscles as possible, 

 and about three to four inches from the ring, from before to behind, or 

 one side to the other ; the needle is again passed through in the con- 

 trary direction, about half an inch from the first perforation, and the 

 two portions of suture firmly tied, so as to draw the skin together like 

 the mouth of a sac. Sutures are then passed through the sides of the 

 pedicle and tied, so as to include the whole of the skin in the multiple 

 loops. A cure by this procedure is usually effected in al)out fifteen days. 

 The only objection to the operation appears to be the danger of wound- 

 ing the intestine by the needle. To obviate this, some operators, after 

 reducing the hernia, pull the empty sac well away from the abdomen, 

 and pass it through a partially split piece of lead which is applied close 

 to the belly ; then the needle can be used without risk, as the lead — 

 which is secured in situ — forms a shield as well as a truss, and prevents 

 the descent of the intestine until adhesion has taken place. 



When the hernia is irreducible or strangulation has taken place, then 

 it will be necessary to carefully open the sac. Should adhesion have 

 taken place between the latter and the intestine, or between the skin 

 and peritoneum, this must be broken up ; if the umbilical ring has to be 

 incised in order to return the viscus, this may be effected by a probe- 

 pointed bistoury. The incision should be no longer than is absolutely 

 requisite. 



The after-treatment of operation for hernia must be conducted on 

 surgical principles, and according to the necessities of the case. Easily 

 digested food, in small quantity and frequently, should be given until 

 the cure is effected. 



CHAPTER V. 

 (Edema of the Umbilicus. 



TuMEF.vcTioN, or rather " u tlema " of the umbilical region, is not at all 

 uncommon. Often it is simply due to an effusion of serum in the 

 connective tissue of the umbilical cord, and sometimes to an infiltration 

 of blood in this pai-t and the surrounding connective tissue. 



The accident is usually produced by contusion and laceration during 

 birth, though at times it may also be caused by the young creatures, 

 when two or more are together, sucking and pulling at the remains of 

 the umbilical cord. It may also be due to chronic inflammation of this 

 part, or the formation of abscess in the umbilical ring. 



The accident is readily recognised ; the swelling is often very con- 

 siderable, and always cold to the touch. It often persists a long time 

 in Bovine animals ; and Zundel says that it then constitutes a grave 



