MANAGEMENT OF THE FOAL 
91 
there is violent straining, as seen in parturition or immediately follow¬ 
ing it . . . In uterine or vaginal rupture in difficult parturition, 
where the intra-abdominal pressure is enormously increased by the strain¬ 
ing, a portion of the intestine frequently passes into the uterus or vagina, 
and finally behind the vulva. 
“The indications usually are to at once destroy the patient, since the 
prognosis must necessarily be extremely bad. The protrusion generally 
occurs before the expulsion of the fetus, and it then becomes almost im¬ 
possible to extract the fetus without incidental injury to the intestine 
and infection of the peritoneal cavity. If it be possible to return the 
intestines with hope of saving the life of the patient, this should be done, 
and measures taken to keep the intestines out of the way until the fetus 
has passed beyond the point of injury. After the fetus has been re¬ 
moved, it may in some cases be possible to suture the wound in the 
uterus or vagina in order to guard against further prolapse and decrease 
the danger of infection.” Williams. 48 
Umbilic Hernia, Exomphalus, Omphalocele, Havel Hernia 
“Umbilic hernia consists of the non-closure of the umbilic ring in 
the abdominal floor, while the skin closes over the region in the normal 
manner. 
“During the earlier periods of fetal life, the abdominal cavity is com¬ 
paratively small, while the abdominal viscera are so voluminous that 
there is not sufficient room within the cavity to accommodate them. They 
consequently press, or grow outward through the wide umbilic ring into 
the navel cord, so that, in fetuses of an early age, a large part of the 
intestinal mass, omentum and liver, may lie outside the abdominal cavity, 
lodged in the umbilic cord. As the fetus develops and approaches ma¬ 
turity, the abdominal cavity increases in size, while the umbilic ring 
gradually contracts, until finally the opening becomes virtually occluded 
and the margins of the ring adhere closely to the umbilic vessels. For 
reasons unknown to us, the normal closure of the umbilic ring may not 
occur and when the young animal is born there persists a variable sized 
opening through the abdominal floor, usually elongated from before to 
behind as an oval slit, wider at the anterior end. In some cases the 
opening is almost circular in form. The diameter of the opening may 
vary from so small a size as to be barely distinguishable, up to six or 
eight inches. The resutling hernial sac corresponds in size. 
“Some writers recognize a congenital and acquired umbilic hernia. 
Only the congenital defect is of interest to us . . . We have observed 
from time to time that umbilic herniae, which were comparatively in¬ 
conspicuous at the time of the birth of the young animal, later became 
more conspicuous, and were increased in size to such a degree as to at¬ 
tract attention. When umbilic hernia exists at the time of the birth, 
anything which may increase the ultra-abdominal pressure, such as 
severe expulsive efforts due to the retention of the meconium, or to con¬ 
stipation of the bowels, may cause a marked increase in the size of the 
hernial sac. The same increase in size may be caused by the allowance 
of large quantities of bulky food. 
“Fleming cites Zundel and others in support of his belief that environ¬ 
ment, and especially the character of food, tends to induce the disease. 
He believes that the young of animals kept upon low and marshy pastures, 
or subsisting upon soft, luxuriant herbage during a rainy season, are 
especially subject to herniae. 
“The majority of writers with whom we are in full accord, consider 
the defect to be chiefly hereditary. 
“Symptoms. There is present at the umbilicus, a tumor, which may 
be either spherical or pyriform or may be more or less elongated from 
