Another method of treatment is, after the contents of the sac have been returned into the abdomen, to tie a piece of strong waxed cord round the pendulous portion which formed the outer covering of the hernia. The string is apt to slacken after two or three days, when a new piece of cord should be applied above the first one. The constriction of the skin sets up inflammation, which generally extends to the umbilicus and causes the edges to adhere together, and by the time the portion of skin below the ligature has lost its vitality and dropped off, the umbilicus is closed and there is no danger of the abdominal organs protruding through it. This is what takes place when this method has a favorable result, though if the umbilicus does not become adherent and the skin sloughs, the bowels will protrude through the opening.
Gut-tie (peritoneal hernia).—In peritoneal hernia of the ox a loop or knuckle of intestine enters from the abdomen into a rent in that part of the peritoneum which is situated at the margin of the hip bone or it passes under the remains of the spermatic cord, the end of which may be grown fast to the inner inguinal ring. The onward pressure of the bowel, as well as the occasional turning of the latter round the spermatic cord, is the cause of the cord exercising considerable pressure on the bowel, which occasions irritation, obstructs the passage of excrement, and excites inflammation, which terminates in gangrene and death.
The rent in the peritoneum is situated at the upper and front part of the pelvis, nearer to the sacrum than the pubes.
Causes.—Among the causes of peritoneal hernia considerable importance is attached to a method of castration which is practiced in certain districts, viz, the tearing or rupturing of the spermatic cord by main force instead of dividing it at a proper distance above the testicle in a surgical manner. After this violent and rough method of operating, the cord retracts into the abdomen and its stump becomes adherent to some part of the peritoneum, or it may wind around the bowel and then the stump becomes adherent, so that strangulation of the bowel results. The rough dragging on the cord may also cause a tear in the peritoneum, the result of which need not be described. The severe exertion of ascending hills and mountains, drawing heavy loads, or the straining which oxen undergo while fighting each other may also give rise to peritoneal hernia.
Symptoms.—The ox suddenly becomes very restless, stamps with his feet, moves backward and forward, hurriedly lies down, rises, moves his tail uneasily, and kicks at his belly with the foot of the affected side. The pain evinced may diminish but soon returns again. In the early stage there are frequent passages of dung, but after the lapse of 18 or 24 hours this ceases, the bowel apparently being emptied to the point of strangulation, and the passages now consist only of a little mucus mixed with blood. When injections are given at this time the water passes out of the bowel without even being colored. The animal lies down on the side where the hernia exists and stretches out his hind feet in a backward direction. These two particular symptoms serve to distinguish this affection from enteritis and invagination of the bowel. As time passes the animal becomes quieter, but this cessation of pain may indicate that gangrene of the bowel has set in, and may, therefore, under certain circumstances, be considered a precursor of death. Gangrene may take place in from four to six days, when perforation of the bowel may occur and death result in a short time.
Treatment—In the first place the ox should be examined by passing the oiled hand and arm into the rectum; the hand should be passed along the margin of the pelvis, beginning at the sacrum and continuing downward toward the inguinal ring, when a soft, painful swelling will be felt, which may vary from the size of an apple to that of the two fists. This swelling will be felt to be tightly compressed by the spermatic cord. It very rarely happens that there is any similar swelling on the left side, though in such cases it is best to make a thorough examination. The bowel has sometimes been released from its position by driving the ox down a hill; by causing him to jump from a height of 2 feet to the ground; the expedient of trotting him also has been resorted to with the hope that the jolting movement might bring about a release of the bowel. If the simple expedients mentioned have been tried and failed, then the hand being passed into the rectum should be pressed gently on the swelling in an upward and forward direction, so as to endeavor to push the imprisoned portion of the bowel back into the abdomen. While this is being done the ox's hind feet should stand on higher ground than the front, so as to favor the slipping out of the bowel by its own weight, and at the same time an assistant should squeeze the animal's loins, so as to cause it to bend downward and so relax the band formed by the spermatic cord. If the imprisoned portion of gut is freed, which may be ascertained by the disappearance of the swelling, the usual sounds produced by the bowels moving in the abdomen will be heard, and in a few hours the feces and urine will be passed as usual. If the means mentioned fail to release the imprisoned portion of the gut, then an incision about 4 inches long must be made in the right flank in a downward direction, the hand introduced into the abdomen, the situation and condition of swelling exactly ascertained, and then a probe-pointed knife inserted between the imprisoned bowel and band compressing it, and turned outward against the band, the latter being then cautiously divided and the imprisoned gut allowed to escape, or, if necessary, the bowel should be drawn gently from its position into the abdomen. The wound in the flank must be brought together in the same way as in the case of the wound made in operating for impaction of the rumen.
WOUNDS OF THE ABDOMEN.
A wound of the abdomen may merely penetrate the skin; but as such cases are not attended with much danger, nor their treatment with much difficulty, we will consider here merely those wounds which penetrate the entire thickness of the abdominal walls and expose to a greater or less extent the organs contained in that cavity.
Causes.—Such accidents may be occasioned by falling on fragments of broken glass or other sharp objects. A blow from the horn of another animal may penetrate the abdomen. Exposure and protrusion of some of the abdominal organs may also be occasioned by the incautious use of caustics in the treatment of umbilical or ventral hernia. The parts which generally escape through an abdominal wound are the small intestine and floating colon.
Symptoms.—When the abdominal wound is small, the bowel exposed presents the appearance of a small round tumor, but in a few moments a loop of intestine may emerge from the opening. The animal then shows symptoms of severe pain by pawing with his feet, which has the effect of accelerating the passage of new loops of intestine through the wound, so that the mass which they form may even touch the ground. The pain becomes so great that the ox now not only paws but lies down and rolls, thus tearing and crushing his bowels. In such cases it is best to slaughter the animal at once; but in the case of a valuable animal in which tearing and crushing of the bowels has not taken place the bowels should be washed with freshly boiled water reduced to the temperature of the body and returned and the wounds in the muscle and skin brought together in a manner somewhat similar to that described in speaking of ventral hernia.