34 
A CASE OF STRANGULATED HERNIA. 
firmation of my diagnostic, but there was evidently no need 
of it. 
I explained to its master the nature of the disease his horse 
laboured under, its grave importance, and the fearful con- 
sequences of it. At the same time, placed in the most 
favorable light the prospect of an operation, so long as the 
hernia was recent and free from many complications, and I 
engaged to operate immediately. He consented at once. 
I therefore lost no time in making the necessary prepara- 
tions. Having first largely bjed the horse, I had him cast 
and placed in position upon his back, with his fore-legs 
united, and suspended from a beam running above them, the 
posterior parts being raised by trusses of straw placed under- 
neath them. These details are not needless, since the success 
of the operation for hernia depends, in a great measure, on the 
position the patient is placed in, upon the restriction opposed 
to his struggles, especially when violent and inordinate. 
All being ready, I proceeded to my work. I introduced my 
arm well up the rectum, and proceeded by a methodical taxis 
to reduce the hernia. The knuckle of intestine, incarcerated, 
was already tumified, and opposed, great resistance to my 
efforts. Nevertheless, I continued the double manoeuvre of 
taxis through the rectum, as well as the external surface of 
the hernial sac, when, all on a sudden, at a moment the 
animal unexpectedly made a violent struggle, on which I 
found the internal oval of the gut my hand was in give way 
under the pressure of my fingers, and laceration following, 
leaving my hand to roam about among the intestines. 
This appeared to me an exceeding serious affair. I thought 
that, although I should succeed in reducing the hernia, the 
animal would no less sink under the mischief done to his 
colon. However, not abandoning all in despair, I continued 
my work of taxis, and obtained at last by repeated efforts the 
disengagement of the knuckle of intestine out of the inguinal 
canal. 
Notwithstanding this result was arrived at, still, apprehen- 
sive of the consequence which might supervene to diminish 
the hopes of the owner, now founded upon the success of my 
operation, I felt I ought to apprise him of accidents which 
might befal the patient yet, such as the possibility of gangrene 
from pressure continued upon the gut. 
I thus managed for myself a back door to creep out of in 
case anything should happen to justify my fears, based upon 
complications which had supervened on the operation, and 
which were known to me alone. 
The taxis occupied me three hours. 
