UMBILICAL HERNIA 131 



long enough. The acid is then painted with moderate 

 generosity over the enlargement itself. The colt is al- 

 lowed to arise immediately. There is now and then a 

 colt that will give slight evidence of pain from the appli- 

 cation, but this is rare. 



Within a day there appears a diffuse sweUiag in and 

 around the hernial enlargement. This remains for vari- 

 able periods of time, usually a few weeks, and when it dis- 

 appears it is noted that the hernia is also gone. There 

 is usually a necrotic area in the skin where the acid has 

 been applied. This area requires no attention, and as the 

 location is always in a place where it can not be noticed, 

 the slight scar that remains is no reason for objection to 

 the treatment. One application is all that is required. 

 Cases that do not yield to this application will not yield 

 to any other form of medicinal treatment that I know of. 

 This treatment is especially to be remembered because 

 of its 



1. Ease of application. 3. Safety. 



2. Practicability. 4. Regularity of cure. 

 Hernias that have not entirely disappeared when the 



swelling caused by the nitric acid is gone, should not be 

 turned over to the surgeon with too much haste. Some 

 that at first apparently have not been cured will yet 

 slowly reduce in size during the following weeks. If, 

 then, at the end of another two weeks no improvement 

 is evident, surgical measures are in order. Such cases 

 that stiU show some degree of hernia when the swelling 

 from the acid treatment has disappeared will, if exam- 

 ined, be found to contain in the bottom of the hernial 

 sac a hardened disk of consolidated effusion. This should 

 not be disturbed by manipulation, as on its endurance 

 depends the beneficial action that may yet ensue. If no 

 improvement has resulted when this disk has been en- 

 tirely absorbed, none is to be expected later. 



