Chapter 5

First prepare a bandage (must be of strong material), about 10 yards long and between 3 and 4 inches broad, and a flexible and solid piece of pasteboard adapted in size to the surface of the hernia. The protruding organ must then be replaced in the abdomen and maintained in that position during the application of the bandage. This being done, a layer of melted pitch and turpentine is quickly spread on the skin covering the seat of the hernia, so as to extend somewhat beyond that space. This adhesive layer is then covered with a layer of fine tow, then a new layer of pitch and turpentine is spread on the tow, and the piece of pasteboard is applied on the layer of pitch, its outer surface being covered with the same preparation. Lastly, the bandage, adhering to the piece of pasteboard, to the skin, and to the different turns which it makes around the body, is carefully applied so as to form an immovable, rigid, and solid bandage, which will retain the hernia long enough for the wound in the abdominal walls to heal permanently.

If the hernia is old and small it may be treated by injecting a strong solution of common salt about the edges of the tear. This causes swelling and inflammation, which, respectively, forces the protruded organ back and closes the opening. There is some risk attached to this method of treatment.

In small, old, ventral hernias the method of compressing and sloughing off the skin has been used successfully. If the hernia is large a radical operation will be necessary, and this is also true when the symptoms indicate that a hernia is strangulated. This operation is performed by cutting down on the hernia, restoring the organ to the abdominal cavity, and then closing the wound with two sets of stitches; the inner stitches, in the muscular wall, should be made with catgut and the outer stitches, in the skin, may be made with silk or silver wire. The strictest surgical cleanliness must be observed. Bleeding vessels should be tied. Then a compress composed of ten or twelve folds of cloth must be placed smoothly over the seat of injury and a bandage applied around the body, the two ends being fastened at the back. In the smaller kinds of hernia, nitric acid may sometimes be applied with success. This treatment should not be applied until the swelling and inflammation attending the appearance of the hernia have subsided; then, the contents of the hernia having been returned, the surface of skin corresponding to it is sponged over with a solution composed of 1 part of nitric acid to 2 of water. This treatment acts by exciting considerable inflammation, which has the effect of causing swelling, and thus frequently closing the hernial opening and preventing the contents of the sac from returning. A second application should not be made until the inflammation excited by the first has subsided. In what is termed spontaneous hernia it is useless to apply any kind of treatment.

UMBILICAL HERNIA.--The umbilicus, or navel, is the aperture through which the blood vessels pass from the mother to the fetus, and naturally the sides of this aperture ought to adhere or unite after birth. In very young animals, and sometimes in newborn calves, this aperture in the abdominal muscles remains open and a part of the bowel or a portion of the mesentery may slip through the opening, constituting what is called umbilical hernia. The wall of the sac is formed by the skin, which is covered on the inner surface by a layer of cellular tissue, and within this there is sometimes, but not always, a layer of peritoneum. The contents of the hernia may be formed by a part of the bowel, by a portion of the peritoneum, or may contain portions of both peritoneum and bowel. When the sac contains only the peritoneum it has a doughy feel, but when it is formed by a portion of the bowel it is more elastic on pressure.

_Causes._--In the new-born animal the opening of the navel is generally large, and may sometimes give way to the pressure of the bowel on account of the weak and relaxed condition of the abdominal muscles. This defective and abnormal condition of the umbilicus is frequently hereditary. It may be occasioned by roughly pulling away the umbilical cord; through kicks or blows on the belly; through any severe straining by which the sides of the navel are stretched apart. We may mention in this connection that it is best in new-born calves to tie the umbilical cord tightly about 2 inches from the navel, and then to leave it alone, when in most cases it will drop off in a few days, leaving the navel closed.

_Treatment._--It is well to bear in mind that many, and especially the smaller, umbilical hernias heal spontaneously; that is, nature effects a cure. As the animal gets older the abdominal muscles get stronger and possess more power of resistance to pressure, the bowels become larger and do not pass so readily through a small opening, so that from a combination of causes there is a gradual growing together or adhesion of the sides of the navel. In cases of umbilical hernia in which there are no indications that a spontaneous cure will take place, the calf should be laid on its back; immediately on this being done the hernia will often disappear into the abdomen. If it does not, its reduction may be brought about by gentle handling, endeavoring, if need be, to empty the organs forming the hernia before returning them into the abdomen. After the hernia has been returned, the hair should be clipped from the skin covering it and a compress composed of 10 or 12 folds of linen or cotton should be applied, first smearing the skin with pitch and then a bandage about 3 inches wide should be passed round the body so as to retain the compress in position. The lower part of the compress should be smeared with pitch, and also those portions of the bandage which pass over it, so as to keep it solid and prevent it from shifting. In some cases it will be found that the contents of the sac can not be returned into the abdomen, and this generally arises from the fact that some part of the contents of the sac has grown to or become adherent to the edges of the umbilical opening. In such a case the skin must be carefully laid open in the long direction, the adhesions of the protruding organs carefully separated from the umbilicus, and after the protruding parts have been returned into the abdomen, the sides of the umbilicus must be freshened if necessary by paring, and then the edges of the opening brought together by catgut stitches; the wound in the skin must then also be brought together by stitches. The wound must be carefully dressed every day and a bandage passed round the body so as to cover and protect the part operated on.

In small hernias nitric acid has been used successfully in the same manner as has been described in the treatment of ventral hernia. Sulphuric acid has also been used for a similar purpose, diluting it to the extent of 1 part of acid to 3 or 5 of water. In thin-skinned animals the weaker preparations ought to be preferred, and caution must be exercised in using such preparations so as not to destroy the tissues on which they are applied.

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.

DISEASES OF THE LIVER AND SPLEEN.

JAUNDICE (THE YELLOWS, OR CONGESTION OF THE LIVER).

When jaundice exists, there is a yellow appearance of the white of the eyes and of the mucous membrane of the mouth. A similar aspect of the skin may also be observed in animals which are either partly or altogether covered with white hair. Jaundice is then merely a symptom of disease and ought to direct attention to ascertaining, if possible, the cause or causes which have given rise to it. A swollen condition of the mucous membrane of that part of the bowel called the duodenum may produce jaundice, as that mechanically closes the orifice of the biliary duct. In constipation there is an inactive or torpid condition of the bowel, and the bile which passes into the intestine may be absorbed and cause the yellow staining of jaundice. Jaundice is one of the symptoms of Texas fever. It may also arise from the presence of parasites or gallstones in the ducts, forming a mechanical obstruction to the onward flow of bile. The conditions under which jaundice most commonly calls for treatment are when cattle have been highly fed and kept in a state of inactivity. At such time there is an excess of nutritive elements carried into the blood, which is associated with increased fullness of the portal vein and hepatic artery. When continued high feeding has produced this congested state of the liver, the functions of that organ become disordered, so that a considerable portion of the bile, instead of being excreted and passing into the intestine, is absorbed by the hepatic veins.

The structure of the liver is shown in Plate IV.

_Symptoms._--This disease, although rare, occurs most frequently among stall-fed cattle. Pressure along the margin of the short ribs on the right side produces pain; the appetite is poor and the animal shows hardly any inclination to drink; the mucous membranes of the eye and mouth are yellow, the urine has a yellow or brown appearance, the animal lies down much and moves with reluctance, moans occasionally, and has a tottering gait. The ears and horns are alternately hot and cold; in cows the secretion of milk is much diminished, and that which is secreted has a bitter taste; sometimes the animal has a dry, painful cough and presents a dull, stupefied appearance.

_Treatment._--In such cases it is advisable to produce a free action of the bowels, so as to remove the usually congested condition of the portal vein and liver. For this purpose the administration of the following dose is recommended: Sulphate of soda, 16 ounces; molasses, 1 pint; warm water, 1 quart. The sulphate of soda is dissolved by stirring it up in tepid water. Following this the animal should have a heaping tablespoonful of artificial Carlsbad salt in the feed three times daily. This treatment may be assisted by giving occasional injections of warm water and soap. The diet should be laxative and moderate in quantity and may consist of coarse bran mash, pulped roots, grass in the season, and hay in moderate quantity.

HEPATITIS (INFLAMMATION OF THE LIVER).

Hepatitis is an inflammation of the liver and usually occurs as a complication of some infectious disease. It may also occur as a complication of gastrointestinal catarrh or in hot weather from overheating or damaged (putrid or fermented) feeds.

_Symptoms._--The symptoms are sometimes obscure and their real significance is frequently overlooked. The most prominent symptoms are yellowness of the white of the eye and of the membrane lining the mouth; the appetite is poor, the body presents an emaciated appearance, the feces are light colored, while the urine is likely to be unusually dark; there is thirst, and pain is caused by pressing over the liver. The gait is weak and the animal lies down more than usual, and while doing so frequently rests its head on the side of its chest.

_Treatment._--Give a purge of Glauber's salt and after it has operated give artificial Carlsbad salts in each feed, as advised under "Jaundice." Give green feed and plenty of water. Oil of turpentine should be rubbed in well once a day over the region of the liver. The skin on which it should be applied extends from the false ribs on the right side to 6 inches in front of the last one, and from the backbone to 12 inches on the right side of it.

FLUKE DISEASE.

[See chapter on "The animal parasites of cattle," p. 502.]

SPLENITIS (INFLAMMATION OF THE SPLEEN).

This disease occurs almost solely as a result of the existence of some infectious disease, and the symptoms caused by it merge with the symptoms of the accompanying causative disease. The spleen is seriously involved and becomes enlarged and soft in Texas fever, anthrax, and blood poisoning.

DISEASES OF THE PERITONEUM.

PERITONITIS.

Peritonitis consists of an inflammation of the peritoneum, which is the thin, delicate membrane that lines the abdomen and covers the abdominal organs.

_Causes._--Wounds are the usual cause in cattle. The wound may be of the abdominal wall or of the intestines, stomach, or uterus; or inflammation may extend from one of the organs of the abdominal cavity to the peritoneum; so this disease may complicate enteritis or inflamed womb. A sharp metal body may perforate the second stomach and allow the gastric contents to escape, irritating the peritoneum. This disease may follow castration or operation for hernia.

_Symptoms._--A continuous or occasional shivering; the animal lies down, but appears uneasy; it frequently turns its head toward its belly and lows plaintively; pressure on the flanks produces pain; has no appetite; muzzle is dry and no rumination; while standing, its legs are placed well under its body; pulse small and hard. The evacuations from the bowels are dry and hard. If this disease is complicated by the presence of inflammation of the bowels, the pain is more severe and the animal is more restless. The skin is cold and dry in the early stage of this disease, but in a more advanced stage this condition may be succeeded by heat of the skin and quick breathing. The fits of trembling, uneasiness, small and hard pulse, and tension of the left flank are symptoms the presence of which would enable one to reach the conclusion that peritonitis exists.

_Post-mortem appearance._--The membrane lining the abdomen and covering the surface of the bowels is reddened to a greater or less extent, and there is usually considerable serous, or watery, fluid collected in the abdomen.

_Treatment._--When we have to do with the form of peritonitis resulting from an injury, as when the horn of another animal has been thrust through the abdominal walls, this lesion must be treated in accordance with directions before given, but the general treatment must be similar to that which follows. Peritonitis resulting from castration or from parturient fever must also be treated in connection with the special conditions which give rise to it, as the general treatment of this disease must be modified to some extent by the exciting cause.

The aim must be to discover and remove the cause. The cause must be treated according to its nature. Harms strongly recommends borax in the treatment of peritonitis. He gives 6 ounces in the first 24 hours, divided into three doses, and afterwards he gives 6 drams three times daily. Opium in doses of 2 to 3 drams may be given. To bring on evacuations of the bowels it is better to give rectal injections than to administer purges. The strength may be sustained by coffee or camphor.

The body should be warmly clothed, and it is advisable, when practicable, to have a blanket which has been wrung out of hot water placed over the abdomen, then covered by several dry blankets, which are maintained in position by straps or ropes passing round the body. The wet blanket must be changed as it cools--the object of treatment being to warm the surface of the body and to determine as much blood to the skin as possible. The diet should consist of laxative food and drinks, such as linseed tea. If peritonitis assumes chronic form the diet should be nutritious, such as selected clover hay, linseed cake, grass, etc., and iodid of potassium should be given three times a day in gram doses dissolved in a pint of water.

DROPSY OF THE ABDOMEN (ASCITES).

In this disease there is a serous, or watery, effusion in the cavity of the abdomen.

_Causes._--When old animals are fed on innutritious feed or when reduced by disease, they become anemic; in other words, their blood becomes impoverished and dropsy may follow. An innutritious and insufficient diet produces the same effect in young animals. It is one of the results of peritonitis, and may also arise from acute or chronic inflammation of the liver, such as is of common occurrence when flukes are present in the liver in large numbers. Heart disease and chronic lung disease may be followed by ascites. It is sometimes, in calves, a symptom of infestation with worms.