A TREATISE ON INGUINAL HERNIA. 31 
provided are—straight and curved bistouries and directors ; dis¬ 
secting forceps; curved scissars; clams, ligatures, and forge- 
pincers ; a sponge, and a pail of water. 
“ The animal being east upon his back, there will arise many advantages 
if we can manage to pass the hobble-rope coming from the hind leg of the 
hernial side over a beam or through a ring, whereby we may have the power 
of extending it at pleasure, and abducting it from the opposite limb. 
Every thing ready, and the assistants properly posted, the operator retain¬ 
ing the most handy of them in attendance on him, he will extend an inci¬ 
sion, begun about opposite to the external ring, down along the middle ot 
the anterior surface of the chord, for the space ot two or three inches ; at the 
same time, provided there be no intestine actually within the scrotum, the 
testicle may be drawn out. The skin being thus divided, the operator will 
next carefully cut through the dartos, by which he will expose the vaginal 
tunic, now the hernial sac, which is recognised at once by its dense abbu- 
gineous texture. The most scrupulous nicety is required in opening the 
sac, to guard against wounding the gut, and especially when the parts are 
much distended. The best mode of proceeding is, first, with the middle of 
the blade, to scrape through some of the exterior fibres, and afterwards, 
with the forceps, dissect up, layer by layer, until we arrive at the inner¬ 
most serous layer, immediate!}' enveloping the gut; into this a hole is to be 
made only large enough to admit the director, by the aid of which, either 
with a bistouri or the scissars, the opening is to be sufficiently dilated. The 
incarcerated intestine, evolving under the knife, is now to be drawn out ot 
the sac, and maintained extended by the pressure of a linen cloth moisten¬ 
ed with some simple mucilaginous liquid, in order to facilitate getting at the 
stricture. The operator is now to pass one or two fingers into the hernial sac, 
and carry them onw'ard to the seat of stricture, against which he must keep 
them steadily maintained, so that they may serve as a director to a probe- 
pointed bistoury, which is to be passed flatwise along them, with its edge 
turned outwards, and thus insinuated within the stricture. Being certain 
that the bistoury has passed the neck of the hernia, he has nothing further to 
do than to turn its edge forwards, still keeping it inclined outwards ; and 
immediately he finds the stricture divided, the liberated gut slips back into 
the belly, either all at once or by degrees. Some cases will be found to re¬ 
quire an extension of the incision, or some further division of the stricture : 
much discretion, however, is requisite in these secondary cuts, inasmuch as 
the return of the hernia is always to be less apprehended after small inci¬ 
sions. Should the gut not spontaneously recede, a little dexterous mani¬ 
pulation may accomplish its return : it will never be required, however, to 
pass the hand into the rectum. 
“ The bowel having returned, the propriety of castration will be decided 
on by the state of the chord, epididymis, and testicle. Should they be in- 
gorged, livid, and marked with purple spots, the operation becomes indis¬ 
pensable; because it may, performed in time, prove a preventive of conges¬ 
tion, peritonitis, and gangrene. It is to be practised only on the side affect¬ 
ed, and in the ordinary manner, with the clams cL tcsticule convert. Under 
other circumstances, although the parts may evince compression, still, so 
long as there are no signs of mortification, castration is not called for. 
“ After the operation, the animal is to be retained down, as prescribed 
after the reduction by the taxis; only the limb drawn up to the beam may 
have a little liberty given to it, and thereby to allow the body to incline 
somewhat to the opposite side (to that operated on), which will give the ani¬ 
mal some relief. Every precaution is to be taken to prevent him from 
