Diaphragmatic Hernia of the Reticulum. 375 



may be meanwhile manipulated to favor the return of the hernial 

 mass by gravitation. Large animals should be placed in a stall 

 having an inclination downward and backward for the same 

 reason. When it can be ascertained that the hernia consists of a 

 loop of small intestine only, it is permissible, especially in cattle, 

 carnivora and omnivora, to make an incision in the flank and with 

 the disinfected hand to attempt the reduction of the hernia and 

 the placing of a bulky viscus, like the rumen, stomach or liver 

 in the way of its return. In case of violent abdominal pain 

 Bouley advises active counter-irritation over the abdomen, but as 

 strangulation is usually present in such cases, this measure may 

 be held to be inferior in .value to gravitation, anodynes, antisep- 

 tics, unloading of the gastro-intestinal organs and absolute rest 

 or surgical interference. 



DIAPHRAGMATIC HERNIA OF THE RETICULUM. 



Anatomical reasons. Gullet, weight of stomach, riding, dystokia. Symp- 

 toms. Tendency to chronicity. Treatment. 



In ruminants this is the most common phrenic hernia of a hollow 

 abdominal viscus. On the right side the gastric and intestinal 

 organs are separated from the diaphragm by the flat mass of the 

 liver. A laceration in this region must therefore be extensive to 

 allow of the protrusion of any abdominal organ into the chest. 

 The left half of the diaphragm, however, comes in direct contact 

 with the reticulum and any opening large enough to admit of 

 this viscus is likely to entail hernia of the second stomach. The 

 lesion is further favored by the fact that the gullet passes through 

 this part of the diaphragm and is connected with the stomachs in 

 the furrow between the first and second stomachs. In case, 

 therefore, that the gullet is violently dragged upon by the weight 

 of the contents of the overloaded or tympanitic paunch, or 

 when the animal rises on its hind limbs, in riding its fellow, the 

 foramen sinistrum is liable to be enlarged by laceration, and the 

 second stomach most naturally protrudes through the opening. 

 The strain thrown on the diaphragm in violent abdominal con- 

 traction, as in difficult parturition, is mainly expended on this 



