330 



HERNIA. 



may either be one or both horns; in some cases the gravid uterus 

 may form the hernia. 



Cad6ac saw a great accumulation in a bitch which was affected 

 by double-sided inguinal hernia. Each pouch had attained the 

 size of a child's head; the right side contained the whole intestinal 

 tube ; the left side contained the epiploon, spleen, uterus, and blad- 

 der. The hernial covering was formed by one-half of the mam- 

 mary glands and the external membrane. 



This condition is easily distinguished. In the posterior sections 

 of the mammary glands we find an elastic, painless swelling which 

 disappears generally after manipulation, when the animal is placed 

 on its back ; provided, of course, that we find the uterus which is 

 located in the hernia is not gravid. In that case the progeny may 

 be distinguished by manipulation externally. It is hardly possible 

 to confound this form of hernia with hypertrophic conditions of 

 the round ligaments, or the so-called false inguinal hernia. A 

 radical operation of double-sided hernia is to be performed accord- 

 ing to the general rules already described. 



Umbilical Hernia. 

 ( Hernia Umbilioalis. ) 



The hernial ring is formed by the umbilical ring. The contents 

 may consist of the omentum, duodenum, and in rare cases part of 

 the large intestine. In the hereditary form the intestines are 

 located in the umbilical cord, and are not covered by the abdominal 

 membrane (hernia of the umbilical cord). In accidental hernia 

 of the umbilicus we always have a hernial pouch, originating 

 from the peritoneum. As a rule, umbilical hernia occurs a few 

 days after birth. It may increase gradually and become eventu- 

 ally strangulated, but it often disappears without any surgical inter- 

 ference. Hernia of the omentum we see occasionally, but, gener- 

 ally, it cures itself by an adhesion between the hernial pouch and 

 the hernial ring. Umbilical hernia is easily recognized. We find 

 a swelling under the umbilical ring, which may vary in size from 

 a hazelnut to a walnut. Treatment consists, as a rule, in replacing 

 the contents of the umbilicus into the abdominal cavity and ligat- 

 ing the umbilical cord. 



