284 
DIAGNOSIS OF INGUINAL HERNIA. 
or replaced. In several of such cases the epididymis has appeared very 
prominent close to the testicle. 
Diagnosis of inguinal and scrotal hernia and of strangulation is there¬ 
fore seldom difficult. The conditions most resembling it are :— 
(1) So-called interstitial inguinal hernia. This disease will later be 
referred to. 
(2) Sarcocele, though the greater hardness of the entire swelling 
scarcely allows of mistake. 
(8) Hydrocele. Collection of fluid in the vaginal sac may be recog¬ 
nised by the swelling being easily displaced and more confined to the 
lower portions of the scrotum. Hydrops of the spermatic cord may be 
at once recognised by its greater firmness and immobility, and can only 
be mistaken for incarcerated hernia. 
(4) Hsematocele, that is, distension of the scrotum, or of the tunica 
vaginalis, with blood, presents the same appearances as hydrops, but is 
often associated with oedema of the scrotal skin. 
• (5) Inflammation of the skin covering the scrotum may, under certain 
circumstances, give rise to suspicion of inguinal hernia, and in all such 
doubtful cases examination per rectum must be resorted to, when it is 
at once easy to determine both the size of the abdominal ring and the 
condition of viscera which have entered it. 
(6) Tumours of the spermatic cord and testicle develop slowly, and 
are not dissipated by pressure. 
(7) In geldings fistula or other diseased swellings of the spermatic cord 
may lead to mistakes, unless a careful examination be made. 
Course. In foals, spontaneous recovery often occurs, though seldom 
later than the first year of life. Gross believes that good feeding 
favours recovery, by producing a better muscular tone; and distension 
of the intestine with firm contents, consequent on hard diet, certainly 
assists reduction. On the other hand, the rupture may gradually 
increase, particularly if work is heavy and the food bulky, and in such 
cases incarceration often occurs. Cases like Brinhall’s in a three year 
old stallion are, however, very rare. He saw a scrotal hernia suddenly 
develop, and two weeks later break, in consequence of necrosis of the sac. 
An intestinal fistula was thus produced, but closed again in a month 
without any assistance. Perhaps this was a case of strangulation, but 
the result was certainly very extraordinary. In exceptional cases inguinal 
hernia appears in old animals (“ hernies inguinales recentes,” in oppo¬ 
sition to the “ hernies inguinales anciennes ” of the French) and generally 
soon becomes strangulated. Such cases are probably often due to a 
simple inguinal hernia developing into the scrotal form, the former 
having been overlooked. In stallions scrotal herniae may become so 
large as even to interfere with movement of the hind-limb, or be injured 
