STRANGULATED VENTRAL HERNIA. 
303 
the sac. The sudden appearance of the swelling and its compressibility 
must arouse suspicion of a rupture. In any case, caution is required in 
operative interference, and, in doubtful cases, sharp instruments should 
not be used before making certain of the absence of hernia. Lectal 
examination is sometimes useful, and, if needful, the parts can be 
punctured with a trochar, under antiseptic precautions. . 
Particular caution is indicated in presence of colic, which may proceed 
from incarceration, but in fresh injuries may also be caused by the pam 
associated with peritonitis; though the latter is the exception, the former 
the rule. 
Strangulation is not at all common ; some have denied its occurrence 
altogether; but undoubtedly both recent and old ventral herm® do 
occasionally become strangulated, though the danger is much less than 
in either the umbilical or inguinal forms. The symptoms are similar 
in all. The necessary conditions are a small opening and a large sac. 
The immediate cause may be heavy work, tympanites, colic, or partuii- 
tion, and it is common experience that the small intestine becomes moie 
readily strangulated than the colon. Small ventral hernia; sometimes 
disappear spontaneously, and even large ones diminish with lapse of 
time 
Ventral are thus usually more hopeful than inguinal hernia, though 
they may seriously interfere with the use of hard-worked horses, and are 
always a danger in the event of the animal suffering from colic or tym¬ 
panites, or becoming pregnant; and, for this reason, female animals with 
ventral hernia should not be used foi bleeding. 
Treatment is best confined, in recent eases, to counteracting inflam¬ 
matory symptoms, unless strangulation has occurred. Under favourable 
circumstances, the hernial contents may be retained, or further egiess 
prevented, by a carefully applied compress; but it must not be forgotten 
that any considerable pressure may cause necrosis of the skin and favour 
prolapse. Old ventral herniae seldom receive treatment, unless they 
interfere with the animal’s work, when the same means may be 
employed as were formerly described (vide “ Umbilical Hernia ). Tiusses 
can seldom be used, and treatment is then practically confined to the 
(1) Application of irritants or mineral acids. The same principles 
apply here as were described in umbilical herniae. Bademachei lecom- 
mends sulphuric acid. . 
(2) Simple or multiple ligation, or the application of clams. I his 
method presupposes the absence of adhesion, which, as already stated, 
is somewhat rare. Simple ligation is seldom successful, on account 
of the large base of the hernia, and therefore recourse must be had 
either to multiple ligation or to clams, after making sure of the 
