DEPARTMENT OF SURGERY. 
47 
to operate immediately, by opening the sac, returning the con¬ 
tents and approximating the fissure. This is always a mistake 
unless the skin is injured sufficiently to expose the viscera to 
extraneous influences. Then, of course, the life of the patient 
will depend upon prompt surgical interference. In all other 
cases herniotomy is unnecessary and dangerous. A conserva¬ 
tive and successful method of treating recent hernia is to 
promptly support the viscera with a firm wad of oakum or cotton 
large enough to fit the orifice, and held in place with strong 
bandages encircling the body, until a truss can be provided to 
carry out the subsequent steps of the treatment. A suitable 
truss for this purpose is made with a rounded piece of soft wood, 
just large enough to fit loosely into the orifice, and nailed to a 
piece of sole leather and held in place with several strong 
elastic bands passed around the body. As fast as the orifice. 
grows smaller the wooden piece is reduced in size until the 
fissure is obliterated. If the inflammatory action subsides too 
soon it is augmented with injection of salt water at several 
points around the fissure. Should a small hernia still persist 
after thirty days, the procedure is completed by strangulating 
the remaining tumor with skewer and cord as above recom¬ 
mended for old hernise. An essential precaution in carrying 
out the steps of this method is to prevent the intestines from 
protruding into the sac when the truss is removed for the pur¬ 
pose of reducing its size. During August, 1900, we had occasion 
to examine an exceptionally large ventral hernia that was being 
treated by this method at the hospital of Dr. Derr, of Wooster, 
Ohio. Recently we made inquiry as to the results of the treat¬ 
ment, and received the following reply : “ The case of ventral 
hernia you saw at my hospital was in a bay trotting horse, six¬ 
teen and a half hands high, eight years old, and weighing about 
thirteen hundred pounds. He contracted a ventral hernia July 
29th by accidentally jumping astride a hitching post. The 
post, which was two inches by eight inches in size, penetrated 
the abdominal walls between the sheath and umbilicus in the 
median line. The horse was held fast in that position until the 
post was removed by sawing it at its base. When released, a 
sac the size of a gallon measure immediately appeared. I 
placed a temporary bandage around his body and had him 
removed to my hospital, one and a half miles away. I then 
made a truss out of sole leather, six by ten inches, upon which 
I nailed a rounded piece of wood, slightly smaller than the 
orifice. I then returned the bowels and adjusted the truss, 
