THE ACCIDENTS FOLLOWING CASTRATION. 581 
double silk or thread, is tied round the end of the cord which 
projects from the clam, which is immediately detached and 
removed. The cord being then firmly held by means of the silk, 
the surgeon endeavours to return the hernia ; but he often finds 
this a very difficult matter, from the continual spasmodic bear- 
ing down, which not only opposes the re-entry of the intestine, 
but causes the protrusion of fresh portions. In these serious 
and embarrassing circumstances, the operator cannot, without 
some danger, introduce his hand into the rectum, in order to aid 
in the reduction of the hernia, and he must only attempt it in 
some moment of calm. If every attempt, in however varied a 
manner, and attended by whatever precautions, is without avail, 
recourse must be had to bleeding, practised while the horse is 
still lying down, and to emollient fomentations of the part ; and 
these means united will so far remove the pain, and produce so 
much relaxation of the parts, that a reduction may be effected. 
When they produce no change in the state of the patient, the 
diagnostic is in the highest degree unfavourable, and he may be 
considered as lost. 
When the hernia is strangulated, it is necessary to enlarge the 
opening; but this does not always succeed. When the abdo- 
minal contractions are strong and frequent, the dilatation of the 
sac only facilitates the protrusion of more intestine, and which 
soon forms a voluminous mass, the return of which is impracti- 
cable. This will shew the necessity of avoiding incisions as 
much as possible, and using every means calculated to remove 
inflammation and relieve spasm. 
When the intestine has been returned to the abdominal cavity, 
the peritoneal membrane must be separated, and likewise the 
dartos; and this being effected, the vaginal tunic and the sper- 
matic cord must be drawn down together, the one upon the 
other, sufficiently low to permit the replacing of the clams, 
as in the covered way, and a little above the place where 
the first compression of the cord was made. If, however, the 
clams cannot be applied the second time above their first situa- 
tion, they must at least be placed as high ; and if that cannot be 
accomplished, a ligature with waxed silk must be used instead of 
them, and which can be fixed nearer to the inguinal ring. 
The horse must receive the same care and treatment as if he 
had been operated upon for recent strangulated hernia, and the 
bleeding must be repeated, if it is in the slightest degree indi- 
cated. The reduction of the hernia of castration can only be 
attempted with any hope of success when the patient is calm, and 
free from abdominal spasms, or when the hernia is recent and 
VOL. IX. 4 H 
