Veterinary Practice in India

Veterinary Practice m India.

39 1

VETERINARY PRACTICE IN INDIA. BY STAFF VETERINARY SURGEON VETERINARY SURGEON,

J.

COLLINS, LATE INSPECTING

BO~BAY

PRESIDENCY.

(Contillued .frOIl/ pa;;e 333-)

TH E sooner the patient is attended to the better, for every mome:lt is of importance, and the H ernia will not reduce itself. The horse should be cast, turned on its back, and secured as if for castration; care being taken to raise the hind parts well with slort litter, so as to throw the abdominal viscera well forwarc from the pelvis. In an early case, if the constriction is not too great, or the incarcerated intestine not much distended, th e operator can often su:ceed in reducing the H ern ia by patient manipulation. In all Clses the attempt should be mad e. To effect this, a firm grasp nust be taken immediately above th e t esticle of the affected side with one hand, the other hand seizes the cord immedia:ely above this aga in, and so on, hand over hand, so as to force the distention upwards in the axis of the canal, an assistant at the same time applying a little pressure at the sides. The opc~ator in these cases mu st n ot hesitate to use a certain amount of force- half measures are of no use ; a strong pair of thumbs are r equ isite, and the pressure must be firm and pers istent. It may t ake te n minutes or so, when the distention of theng uinal canal is felt sudd enly to collapse, and the testicle and cord at once resume their normal flaccid condition, as on the )ther side. TIlis is the most favourable operation for the reduction of He-nia, if successful. Th e horse is at once relieved from pain, the Hernia will not recur at that time, at all events, and he can :esume his work. A piece of tape, or a handkerchief, is sometimes tied moderately tight immediately above the t esticle, and left on for a few hours, but th ere is no absolute necessity for this. By pressure, the intestine, with its impri so ned gases, acts as a pneumatic dilator to the internal ring; and when once the air

39 2

The Veterinary 7ournal.

is forced through the constriction, the "gut" readily follows. There is little danger of a lesion; for the tunica vaginalis reflexa, which encloses the intestin e, is very strong, d ense, a nd fibrou s, and little di spos ed to g ive way; whil st the" gut" itself is not likely to suffer, if not actually pinched and its walls bruised and crushed by any ha rd substa nce. The writer cannot help thinking that an instrument ill the form of pad ded clams, worked by a screw, might be inv:!nted, so as to materially aid the ope rator in these cases ; for to one unaccustomed to manual labour, the thumbs soon l:ecome cramped and p owerl ess, as considerable force is requis ite. As an illustrati on, the wri te r recalls a case in which 1lc certainly would have used th e knife, the taxis having fail~ d, hac! not a farri er major b ee n pres ent, whose powerful thun'bs succeeded in reducing the H erni a. The da nge r to b e apprehen d ed in using a cla m is, tha: fearing lest, wh en a pply in g it, a p ortion of th e wall of th e ntestin e might be includ ed in its g-rasp; although this accid ent " 'o uld b e highly improba ble, from the rotundity and elas tici:y of th e viscus. An oth er method for its r ed uction is to forcibly witl:draw the " g ut" from the ing uin a l canal, by introducing the a rm p er 1·CCtlt1lZ. Th e "!riter confesses that he never once succeeded in this way; but h e is credibly informed that it can and :las often been so redu ced, th ough g reat force, almost violence, is n ecessary. A handful of intestine is forcibly grasped, and the mass p..111ed bodily away from the fl ank of th e affect ed sid e, and y et faTourable results ensue. Should these method s p rove ineffectual, the only resource left is the knife. Th e operato r proceed s as if for castrati on, and cuts down to the last covering, the tunica refl exa. H e had better strip thi s d own clean to the cord, as if going to perform the covered op era tion; which ope rati on, in fact, usually concludes th e business, but not necessarily, for he will find it much easier to d Q this b efore than a fte r opening the scrotal sac. Th e strangulatec intestin e ca n usually be see n as a dark-coloured mass throug ll the di stenclcd and se mi-transparent tunica refl exa, in front of th e testicle and co rel. This, the last tunic, is now cut through, care,

Veterz"1laty Practice in India.

393

of course, being taken not to wound the "gut." The testicle escapes, and the strangulated intestine is exposed; this is of a da rk colour, sometimes nearly black, and more or less inflated. An attempt m ay be made t o return the Hernia by means of the taxis ; but there is little chance of doing this, if it could not be done previously, when the opera tor had the collateral aid and support of th e dense tunica refl exa, whi ch, now bein g opened, becomes useless for the purpose. If it can b e so reduc ed, well and good. It is b etter, howeve r, t o p roceed at once to ope n th e intern al rin g w ith the knife. A n assista nt holds th e testicl e bac k; th e opera tor t ak es the " g ut " in hi s right ha nd , and, without using a ny force, keeps it straig ht; he now passes the forefinger of hi s left ha nd in front of it, clown to the intern al ring . This is much easier to d escribe th an t o perform; for th e space is so cramped and confin ed , th e folds of the intestines, moist with blood and serum, so much in the way and so sl ippery, th at p a tience and persevera nc e are necessary. Still, with ordinary d ext erity and manipulation, there is no g reat d ifficulty. On reaching the ring, it will b e found t o barel y adm it the tip of th e fin ge r. The rinR itself will feel hard, ti ght, a nd t endinous. An attempt at forcible dilatati on causes g reat paill a nd vi olent struggles, and does no go od. An ass ista nt now h olds the" gut " back; the opera tor passes down a concealed bistoury, g uid ed by th e palm and forefin ger of th e left h and, whi ch now acts as a director; its p oint is passed th rough th e rin g in place of th e tip of the finger, care being· ta ken th a t it is \vell in front of the " gu t," th oug h there is no d iffic ulty in this, if the knife is passed as directed ; the blade is th en s prung, directing it forwa rds and outwards t owa rds the fl a nk. N o cutting on th e part of the op erator is req uired ; for the constri cti on is so g reat, that the bl ade makes a way for itself. H av ing done this, the knife is withdrawn. I t will now be found tha t one or t wo flll gers can enter the ring; but no dilatati on should be a ttempted, for the part where the incision has been mad e is apt t o t ear. The gut is taken in both h and s, a nd firmly but gently pressed up. Presently the welcome g urg ling noise is heard, due to the imprisoned air rushing throu gh the stricture, and the intestine disappears. The great object to be achieved in this operation is to m ake

394

The Veterinary Journal.

an opening of only such a width as will allow the" gut" to pass through; for if no larger, the intestine is retained in the abdominal cavity, and the Hernia will not recur. If, on the other hand , the opening- is too great and the" g ut ,. again descends, no power will keep it up; the clam m ay be placed on as high as possible, yet it will not retain the intestine in the abdomen. On this point those veterinary authors are mistaken, who assert that the covered operation must, as a matter of positive necessity, be at once performed, so as to keep up the intestine; but it need not on this account be performed at all, a nd in the majority of cases it is unnecessary. All the covered operation ca n do is kceping th e intestine in the inguinal canal, should it redescend throu gh the rin g. Castration, of course, eventu ally prevents a recurrence, simply because in the gelding the canal and ring contract, and become t o a g reat extent obliterated; but that is th e remote, not the immediate effect. So that whether the operation is performed o r not mu st dep end upon circum stances. If the operation has gone on well, and the inner ring has not been much cnlarged, it is opti onal; in the case of stud horses it is obviously desirable not to perform it. As a rule, it does not agai n descend. The veterinary surgeo n usually, however, decides upon performing the covered o peration, so as to prevent th e accident rec urring at a remotc period; but principally to keep the intestine at all haza rds under cover and ou t of sight, should it again protrude, when the case must th en t ake its chance,-usually a very poor one. The after-treatment is simple enough. The h orse should be k ept on his back for a time, and icc-cold water squeezed from a sp onge over the fl an k and groin. \ Vhen allowed to rise, he should be mad e to stand with his hind feet well raised on short litter, and his head kept tied up for a few days. The success of the operation depends in a great measure on its b eing undertaken as early as possible. In a case of many hours' duration, the result is usually fatal, thoug h not always so. The writer remembers an instance in which the hors e had been in great pain for upwards of twelve hours, and on opening the scrotum the intestine \vas found to be quite black; yet the animal recovered perfectly.

Veterinary Practice £n India.

395

It may be said, and with truth, that there is less chance of a recovery after using the knife, if, as is recommended, the taxis is forcibly employed, and the intestine thus subj ected to rough handling previously, in an attempt so to reduce it. But there is this to be sa id, on the other hand, for the taxis, that it often succeeds; and if so, there are no unfavourable results, and th e h orse is alm ost imm ediately fit for work. S o that it is good practice to attempt it, particularly in an early stage. The operator is fortunate if h e can save three out of fiv c pati ents after using the knife. The mos t fatal mistak e he can make is indecision. The mortality from Strangulat ed H ernia amongst the stallions of the Bombay a rmy reach ed, in some years, nearly one p er cent. Th e loss t o th e army from thi s cause exceeded considerably the subsequent losses from castration. And it is probable that, in the absen ce of a vet erinary su rgeon, ma ny horses so affect ed were return ed as having died from " I nflamm ati on of th e Bowels." vVhen ope ratin g for S trangulated H e rnia, care sh ould be t ak en that th e p roper kind of knife is employed . The ord inary probe-pointed bistoury is useless and dangerous-that is, one made t o clos e like a clasp knife-fo r it is necessary, when introdu cin g it, to press backwards, a nd this cannot be done if th e knife closes. A ga in, it is necessary that the blade should b e concealed, oth erwise th e intesti ne m ay be wounded. The ordina ry concealed bistou ry fu rni shed by government to veterinary surgeons in I nd ia a nswe rs pretty we ll ; but a n improvement Dl!ght be made by length ening the sheath t\\·o or three inch es bey ond what is usually found. The b lade and sh eath sh ou ld be six inch es in length, a nd slightly curved. It would also b e an improvement if the cutting portion were only one in ch in length from the point, instead of the whole being sharp, as is now the case; as only a small cutting edge at the point is requisite, a nd an additional exposed edge uncovered might d o ha rm by wounding the" g ut. " It should be re membered that th e space is very confined; the fin gers are also apt to become cra mped, and th e knife to slip. Veterinary surgeons serving in I ndia should always h ave a concealed bistoury at hand, as it may be wanted at any moment.

The Veterinary 7oumal. As all stallion troopers are now castrated on joining the regu lar corps, practitioners will not meet with so many cases as formerly; but still entire horses, as chargers, race-horses, etc., often of g reat value, as well as country-bred horses and ponies, are common; there are al so the horses of many irregular regim ents. The writings of vet eri nary authors on th is subj ect are defective. A sim ple, straightforward account of the affection, as usually m et with, is wanting; and its cha racte ri stic sym ptoms are often entirely omitted. Th ey a re generally too di scursive, overlaid with collateral a nd extran eous matter, and t oo g reat prominence g iven t o out-of-the-way and exceptional complications, which, after all, the practitioner will probably never m eet with, a nd which only t end t o bewild er the student. Although the Veterin ary D epartment in India has of late years b een greatly increased, yet veterin a ry surgeons are u sua lly hundred s of miles apart, and left to their own resourc es. Young m en proceeding t o that country have had no opp ortuni ty of seei ng the disease before they j oin, and th ey may be brought fac e to face with it on a rrival-as likely as not on th e line of m a rch, and in the middle of the nig ht. Th ey sh ould, t herefore, be able to recogn ize it without any difficulty, and be prepared t o act at once, and with confid ence.

I I DIGESTION. BY

" F I VE

l'OIXTS. "

I HAVE seen a g reat many cases of indigestion in th e ho rse, and have made not a few post-mortem examinations, but such an one as I a m about to describe briefly, I have no direct recollection of. On the 5th of May last, I was request ed t o visit a marc, said to b e very ill, the property of a master of hound s, who resid es about a dozen miles from my residence. The symptoms on my arrival were as follows: Tympanitis, obstinate constipation, r ete nti on of urine, pulse 80, and the respiration much accelerated, with other symptoms which are certain attendants upon these, such as