INGUINAL HEENIA. 289 



formation, and the wound heals in a short time " (Dollar's transla- 

 tion of MoUer's " Veterinary Surgery "). These precautions will 

 prevent the bowel or its. connecting membrane from becoming 

 exposed, in the event of its again descending through the canal. 

 Removing the testicle or cutting down on the constriction, will, 

 however, so far obviate the risk of a. recurrence of the hernia, that 

 the use of a clam may be dispensed with, the presence of which 

 will be apt to give rise to blood poisoning, on account of its 

 unavoidable interference with the drainage of the part. A clam 

 cannot, of course, be used, when trying to preserve the testicle. 

 The action of the clam is to cause strangulation of the part 

 imprisoned between its branches, with subsequent inflammation 

 and union by granulation. To accomplish this, the pressure of the 

 clam should be regulated, so as to effect adhesion without causing 

 such rapid mortification that the clam would drop off before the 

 f)pposing surfaces had united, in which case, the action of the clam 

 would be nullified. 



When deciding the question whether it was the disease or tbe 

 treatment which had killed the patient in case of death after 

 liernia had been reduced by taxis, remember that there have been 

 many instances of recovery after the intestine had become almost 

 black. If, before treatment, inflammation had advanced to such 

 an extent as to suggest the probability that its action had 

 weakened the strength of the tissues, the operation of freeing the 

 constriction by means of a knife should be at once performed in 

 preference to more hazardous efforts at reducing the rupture solely 

 by manipulation. 



Chronic Inguinal Hernia. 



This term may be applied to inguinal hernia which is not 

 necessarily followed by strangulation, and consequently can exist for 

 a long time without giving rise to acute symptoms. It is made 

 manifest by a soft and generally painless swelling in the scrotum, 

 which, if grasped with one or both hands, softly but closely, and 

 then let another person " cough " the horse, will be found to 

 suddenly expand under the effort, and to recede as quickly again. 

 The practice known as coughing a horse consists in making him 

 cough by compressing his larynx, with a finger and thumb, one on 

 each side. This chronic form of hernia is accompanied by the 

 transudation into the scrotum of a greater or less amount of serum, 

 which, when in excess, causes dropsy of the scrotimi (hydrocele). A 

 certain degree of chronic inflammation set up in the part, will lead 

 -to thickening of the tissues, and to the formation of adhesions. 

 The tumour sometimes attains an enormous size : in fact I have 



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