402 OPERATIONS ON THE DIGESTIVE APPARATUS. 



fiat of a compassionate master. But a fatal prognosis need not 

 be unnecessarily volunteered. Timely and vigorous measures, es- 

 peciaUy emphasizing the " timely," may stiU prevent the strangu- 

 lation and defer the sentence of mortahty, and the sooner, there- 

 fore, the means of rehef are applied, the more certaia will be then- 

 effect. Every minute's delay increases the force of the disease and 

 lessens the chances of success. It is rarely the case that the lapse 

 of fifteen hours leaves any room for confidence, though it is not 

 yet time to abandon hope. Within that period there are many 

 chances for saviag the patient, but after the earUer periods of the 

 attack a single hour's neglect may be fatal — that hour may prove 

 to be the turning-point of the conflict. 



The treatment of recent inguinal hernia assumes two forms, 

 consisting of the taxis, and the operation of herniotomy, or the en- 

 largement of the neck of the vaginal sheath with a cutting instru- 

 ment. The first mode is indicated at once, or as soon as the her- 

 nia is recognized. The reduction must be accompHshed in the 

 shortest time possible, the danger of strangulation becoming more 

 imminent and threatening with the lapse of every moment. The 

 taxis may give immediate rehef, and may be materially assisted by 

 douches of cold water. 



In this case the taxis consists in the manipulation of the part 

 with the hands, by pressure and otherwise, for the purpose of re- 

 placing the protruding intestine in its proper cavity ; technically, 

 the reduction of the hernia. This manipulation is apphed either 

 by simple pressure over the external surface of the diseased part, 

 or, if practicable and necessary, by supplementing it with a proper 

 traction apphed upon the intestine from within through the rectal 

 walls. This manipulation may be apphed by two processes, first 

 the subcutaneous, medial or indirect; and second, the direct taxis. 

 1st. The Indirect Taxis. — In the first or indirect method, the 

 animal is placed in a standing position, with the hind legs secured. 

 Then the hand and arm of the operator, well oiled, are introduced 

 into the rectum, using the right, if he is to operate on the left side, 

 and vice versa. "When in the rectal cavity, the hand is carried to 

 the anterior border of the pubis, while with the other, passed in 

 front of the patella, pressure is apphed upon the scrotal sac, and 

 the intestine pushed toward the superior opening. The hand in 

 the rectum then grasps the loops of the hernia, through the rectal 

 walls, and at the same time pulls them upward. Through these 



