426 OPERATIONS ON THE DIGESTIVE APPAEATUS. 



and varying in dimensions from the size of a hen's egg to that of 

 a child's head — dimensions which may vary according to the con- 

 dition of vacuity or fullness of the intestine ; the position of the 

 animal, whether standing or lying, or according to the length of 

 time it may have existed. The consistency of the tumor is very 

 variable. It may be soft, easily depressed by the finger ; elastic, 

 when distended with gases ; or soft and puffy when containing 

 alimentary matter — these changes being accounted for by the na- 

 ture of the organ. An enteromphalus will give the sensation of 

 an elastic mass, while the epiplomphalus will form a pufify swell- 

 ing. This species of hernia is almost always painless, and exhib- 

 its as one of its peculiar and constant symptoms the character of 

 being reducible. In the generality of cases, it can be made to 

 disappear temporarily by the taxis and by forcing the protruding 

 portion back into the abdomen, but only to reappear at once as 

 soon as the pressure is vnthdrawn, especially if the animal is on 

 his feet. On being thus reduced, the opening of the ring can 

 readily be detected, and the fingers may be freely introduced 

 through its diameter and its form and dimensions ascertained 

 shewing it to be sometimes elliptic, sometimes circular, and some- 

 times irregular, the originating cause of the hernia itself deter- 

 mining the difference. 



Besides these more common symptoms of umbilical hernia, 

 there are others which can be detected by more careful examina- 

 tion. For iastance, on applying the hand over the tumor, the ver- 

 micular motions of the intestines may be recognized, and by feel- 

 ing in the hernial sac, the presence of f PBcal masses may be discov- 

 ered ; and it may be possible by auscultation even to detect the 

 presence of borborygmus through the displaced intestines, and 

 even to observe its true nature, by reason of the transparency of 

 the sac and its envelopes. These are the most ordinary symp- 

 toms of an exomphalus, although it is subject to complications, 

 and the symptomology wiU vary accordingly. 



There are cases, but they are rare, in which the hernia be- 

 comes irreducible. The most serious of these are such as are 

 found to have become so in consequence of the formation of ad- 

 hesions between the protruding organ and the hernial sac — a very 

 infrequent occurrence. The most common cause vsdll be the pres- 

 ence of undigested masses of food accumulated in the intestines, 

 such as hard balls of fseces or sand. 



