288 
DEPARTMENT OF SURGERY. 
cause a hernia, leaving a permanent blemish if not treated 
properly, but in most cases these bruises are characterized by a 
hard firm swelling, caused by the rupture of tissues and blood 
vessels in the part injured. If the large blood vessels are di¬ 
vided in the abdominal walls, the enlargement which follows is 
usually a hsematoma, but often resembles a hernia, and at times 
it is difficult to make a proper diagnosis in such instances. 
Mistakes made in this way are very embarrassing, and it is 
therefore necessary that no blunder be made in the diagnosis of 
such cases. * 
1. Subcutaneous Rupture of Abdominal Walls. In herbiv¬ 
orous animals the abdominal walls are always tense, and a for¬ 
cible blow often divides one or more of the muscular or apo¬ 
neurotic layers, which may permit the remaining layers and the 
peritoneum to pass through the rupture ; this, however, is more 
common in the tunica abdominalis than the muscles. A forcible 
blow, a kick from a horse, or a horn thrust from an ox, will 
often divide the abdominal tunic, and at times, when the swell¬ 
ing has partly disappeared, a fluctuating mass remains ; it is 
sometimes difficult to determine whether the enlargement is a 
hernia or an abscess. These enlargements should receive prompt 
attention. If a hernia, it should be reduced as soon as possible, 
and if an abscess, should be opened early, and all possible care 
taken to prevent the formation of a fistula. 
2. Solution of Continuity in Blood Vessels. —Bruises of the 
abdominal walls often destroy the continuity of both small and 
large blood vessels; the swelling is usually located in. the part 
injured if the injury is not severe ; but if the injury is serious 
the swelling may extend to neighboring tissues, and be 
characterized by a firm, painful area, 01 a fluctuating mass asso¬ 
ciated with oedema, which gravitates downward to the lower 
part of the abdomen; but when the larger blood vessels are 
ruptured the enlargement that follows is usually a hsematoma, 
which often has the appearance of a hernia. These hsematoinata 
are more obstinate than inflamatory enlargements, less liable to 
be absorbed, and should be treated surgically. 
Treatment. —Swellings of recent origin should be treated 
with cold applications, followed by hot application (fomenta¬ 
tions). The cold applications are used to diminish the quantity 
of blood carried to the part injured; prevent the extravasation 
and arrest the inflammatory process. The fomentations are 
to allay pain, reduce swelling and to increase absorption. 
Disinfectants may be used to prevent infection, and if suppura- 
