DEPARTMENT OF SURGERY. 
45 
until it is possible to make a correct estimate of the lesion. In 
no case should such injuries be slighted or spoken of as trivial. 
Treatment.—Old Ventral Her nice in the small animals gen¬ 
erally respond nicely to the palliative operations already recom¬ 
mended for exomphalos. Those having only a narrow fissure 
may even be treated with very good results by radical herni¬ 
otomy. But in the large animals the usual wide opening, the 
strong muscular contraction, the weight of the viscus and the 
great danger of sepsis all serve to place old ventral among the 
incurable conditions, whether treated with palliative or radical 
surgery. Furthermore we are hardly warranted in performing 
a dangerous herniotomy for a condition that is neither un¬ 
sightly nor harmful. The majority are not specially unsightly 
and they seldom strangulate. We are only justified in making 
the attempt in animals kept for their physical appearance. Ex¬ 
cept in a ventral hernia having an elongated narrow fissure (a 
rare entity) herniotomy in the horse and ox is both a dangerous 
and useless operation. In any event it is not an indication for 
“ barn-yard ” surgery and in view of the meagre result to be 
attained the veterinarian is foolish to risk a reputation on such 
unsatisfactory operations. To succeed at all there must first be 
an urgent demand from the owner, second, proper preparation 
of the patient, third, suitable appointments, and fourth, accurate 
surgery. 
Given a patient suffering from an old ventral hernia that is 
submitted with the command to “ kill or cure ” he is first given 
an oleaginous purge and fed with bran for twenty-four hours 
after purgation has ceased. The peristalsis is suspended by 
giving two ounces of laudanum 12 hours before operation. Dur¬ 
ing this preparatory treatment the region over and a liberal sur¬ 
face around the hernia is repeatedly washed and disinfected un¬ 
til the day of operation. When the patient is cast he is placed 
in a position to encourage the blood to run outward rather than 
into the abdominal cavity. If the bowels had not been properly 
emptied and the peristalsis not arrested there would always be 
considerable pressure against the sac to hinder the subsequent 
steps with the patient in this position. On the other hand if 
the hernia is turned uppermost the unavoidable hsemorrhage 
will find its way into the cavity. Between the two evils choose 
the former, and then there need be 110 delay to arrest all the 
capillary oozing. It is essential that all large vessels be ligated 
or twisted as the operation proceeds, but as the surgical position 
favors outward flow of blood oozing need not hinder rapid pro- 
