364 VETERINARY SURGICAL OPERATIONS 



pearance of fever three to five days after the operation, is the 

 most likely untoward complication. Its prevention is found 

 in cleanly methods and its treatment consists of local irriga- 

 tions of the wound and appropriate internal remedies, — qui- 

 nine, echinacea, aconite, etc. 



2. Recurrence of the hernia is possible after the ligature 

 has sloughed off and the orifice has failed to close up with 

 cicatricial tissue. This occurrence is met in hernias having 

 exceptionally large orifices, and especially when the sac near 

 the internal ring is constituted of a delicate, stretched-out 

 membrane that sloughs off hurriedly and then gradually al- 

 lows the intestines to gravitate into the scrotum. This acci- 

 dent sometimes leads to a delayed complication in the form 

 of a subacute peritonitis, local enteritis or peritoneal ab- 

 scesses. 



3. Shock sometimes supervenes, although this sequel is 

 most likely to follow operations for strangulated hernjas 

 where the subject is already in a delicate condition before the 

 operation began. 



OTHER METHODS— (I)— The covered operation, so- 

 called, has the advantage of not exposing the tissues to ex- 

 ternal influences. The modus operandi consists of reducing 

 the hernia by gravity and manipulations and then pinching 

 up the sac, — skin and all, including the testicle, — with a 

 strong clamp, which is allowed to remain until it sloughs off. 

 In this method, if the hernia is irreducible, the sac is incised 

 and the orifice enlarged anteriorly with the bistoury, after 

 which the scrotum is pinched up as above mentioned. 



2. The uncovered operation consists of pinching the tun- 

 ica vaginalis with a clamp after having dissected it out, as in 

 Vanlaw's operation. The testicle and redundant parts of the 

 sac are cut off one inch below the clamp, which is not re- 

 moved until the third or fourth day. 



Operation for Strangulated Hernia. 



INDICATIONS. — Operation for strangulated hernia is 

 an emergency intervention. When indicated, that is to say, 

 when strangulation of a hernia exists, it must not be delayed. 

 In the treatment of colic co-existing with scrotal hernia it is 

 important to determine without delay whether or not the her- 

 nia is playing any part in the cause of the intestinal pain, and 

 when it is once incriminated it is essential to constantly scru- 

 tinize the developments in view of deciding to operate before 

 incurable damage has been done. 



