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Title: Animal Castration
Author: Alexandre François Augustin Liautard
Release date: May 20, 2019 [eBook #59560]
Language: English
Credits: Produced by deaurider, Harry Lamé and the Online Distributed
Proofreading Team at http://www.pgdp.net (This file was
produced from images generously made available by The
Internet Archive)
*** START OF THE PROJECT GUTENBERG EBOOK ANIMAL CASTRATION ***
Produced by deaurider, Harry Lamé and the Online Distributed
Proofreading Team at http://www.pgdp.net (This file was
produced from images generously made available by The
Internet Archive)
Transcriber’s Notes
Texts between _underscores_ and between =equal signs= are
transcriptions of texts printed in italics and boldface, respectively.
Small capitals have been transcribed as ALL CAPITALS.
More Transcriber’s Notes may be found at the end of this text.
ANIMAL
CASTRATION.
BY
A. LIAUTARD, M.D., H.F.R.C.V.S.,
Professor of Anatomy, Operative Surgery and Sanitary Medicine to the
American Veterinary College, New York,
Foreign Corresponding Member of the Société Centrale de Médecine
Vétérinaire, Paris,
Member of the Société Vétérinaire d’Alsace-Lorraine,
Member of the Société Vétérinaire Pratique, Paris,
Member of the U. S. Veterinary Medical Association,
Etc., etc.
With Forty-four Plates embodied in the Text.
[Illustration]
NEW YORK
WILLIAM R. JENKINS
VETERINARY PUBLISHER AND BOOKSELLER
850 SIXTH AVENUE
LONDON: BALLIÈRE, TINDALL & COX
1884
Copyright, 1884.
W. R. JENKINS.
PRESS OF W. R. JENKINS,
860 SIXTH AVE., N. Y.
TO
HENRY BOULEY,
MEMBER OF THE INSTITUTE OF PARIS,
This little practical work is respectfully dedicated in testimony of the
continued esteem and respectful remembrance of one who was fortunate in
being numbered among his former students, by
THE AUTHOR.
INTRODUCTION.
In presenting this concise treatise upon castration of the domestic
animals, it is not intended to offer new modes of operation, but merely
to collect together the various methods in use and leave the reader to
appreciate them at their value. It is a work which, it is believed, has
not yet been done in English veterinary literature, and on this account
it is hoped will prove of interest and use to those engaged in that
specialty of veterinary surgery.
In gathering the material, advantage has been taken of several of the
most recent works of French and German writers on the subject, and
plates have been obtained from the original and excellent wood cuts of
Zundel, and Peuch, and Toussaint.
In presenting this volume to the indulgence of veterinarians, it is with
pleasure that the author acknowledges and offers his sincere thanks to
Dr. Holt for the great assistance he has kindly given in revising the
manuscript.
THE AUTHOR.
ANIMAL CASTRATION.
ANIMAL CASTRATION.
CHAPTER I.
DEFINITION -- ITS VARIOUS PURPOSES -- AN OLD OPERATION -- ITS HISTORY
-- CASTRATION OF NECESSITY -- CASTRATION OF FASHION AND CONVENIENCE --
ITS EFFECTS -- UPON THE GENERAL ORGANISM -- UPON SOME SPECIAL FUNCTION
-- UPON THE DEVELOPMENT OF THE ANIMAL -- AGE AT WHICH IT OUGHT TO BE
PERFORMED -- SEASON MOST FAVORABLE -- PREPARATION OF THE PATIENT --
MODES OF RESTRAINT -- CASTING -- STANDING UP -- ANATOMY OF THE PARTS.
Of all the operations pertaining to the domain of Veterinary Surgery,
without doubt the practitioner is most frequently called upon to
perform--more especially in breeding districts--that of castration, the
destruction or removal of the essential organs of generation in our
domesticated animals. It is, however, not nearly so often resorted to
for purely surgical reasons as for purposes closely related to questions
of agricultural and industrial economy, by reason of its effect upon the
individuals of the various species of animals subjected to it, in order
to improve their value and increase their usefulness to mankind. And
that this is its practical effect is no modern discovery. As far back in
antiquity as seven centuries preceding the Christian era, it was known
and practised upon various animals. Of this we may find ample historical
proof in the writings of Roman, Greek, and Oriental authors, where
specific mention appears of the various methods employed, including the
processes of excision, of crushing and of tearing. Even the castration
of females was known to our less remote ancestors, the Danes having in
the sixteenth century performed it on sheep, swine, cows, and even
mares. The spaying of cows, however, seems to have been forgotten about
the beginning of the present century, and it was not until the year 1831
that Thomas Winn, of Natchez (Louisiana), and afterwards Levrat (of
Lausanne), brought it to the attention of veterinarians, as a means for
the improvement of the milky secretion in cows.
The operation may be considered under two distinct heads. Under the
first it is to be considered as one of _necessity_, as when performed
with a therapeutic object in view; as, for example, when it constitutes
one of the first steps involved in the surgical treatment of
strangulated hernia, or of diseased conditions of the testicles or
ovaries, such as orchitis, epididymitis, sarcocele, hydrocele, cyst,
etc. In the other case it is resorted to for reasons of mere _fashion_
and _convenience_, and has for its object the production of such a
modification of the general organism as shall increase the adaptedness
of the animals subjected to it to the uses to which they are applied;
when, of course, the economic becomes the paramount and exclusive reason
for thus interfering with the obvious creative purpose. It is the
operation as performed under this general heading that we shall now
principally consider.
In relation to this latter object it must be borne in mind that the
operation is followed by certain peculiar effects, which may either
manifest themselves upon the entire organism, or upon some special
functions only. In the first instance it is quite evident that the
primary and most obvious effect of the mutilation is to be discovered in
the character and disposition of the animal, which at once becomes in a
double sense an “altered” creature, docile and submissive, and entirely
willing to become the obedient and useful servant of his human master.
But it is not alone that we find the vicious stallion, the
uncontrollable bull, the kicking jackass, the dangerous boar, and even
the hysteric mare and cow transformed into the useful gelding, the quiet
ox, the patient donkey, and the “fatherly” barrow, the quiet working
mare and the productive cow, as the result of the change which the
character--the nervous system, in fact--has undergone. Besides this,
other marked changes are to be observed of a more distinctly physical
character, such as a modification of the entire organism, manifested in
the external symmetry, and the expressive physiognomy of the creature,
when deprived of its virility.
The animal becomes more quiet, and its general form is modified. If
altered at an early age, the skeleton will be arrested in its growth,
and the mass of muscles attached to it will participate in the defective
development; the head will become elongated, the legs will continue to
be lighter, and the body will show a corresponding lack of development.
In other words, the male animal will tend to assume the characters of
the female, in form and feature, the gelding, indeed, resembling the
mare, not only in the _ensemble_ of his appearance, but in his voice,
which loses the resonance of the stallion’s, and his physiognomy, which
becomes milder and less expressive; while his neck is lighter and his
mane more scanty, with the hairs which compose it more fine and silky.
A like tendency exists in other male animals to acquire a resemblance to
the female as an effect of the operation of castration. The altered bull
has a weak and feminine voice; his head is narrower and elongated; his
horns become lengthened and more curved; he has exchanged his wild and
threatening aspect for a mild and gentle visage; his neck also is
lighter and his chest narrower; his bony structure is less massive; and
he has, besides all the rest, acquired a quality of essential importance
to mankind in a dietetic view, that of accumulating fat. This last
phenomenon shows us that besides the other changes referred to, there
is an important modification of the nutritive forces of the animal, or
at least a change in the direction of their action.
When thus deprived of his virile functions the animal ceases, in effect,
to exist as one of a species, but maintains an essentially individual
life, in which the assimilable nutriment which he absorbs, instead of
being in part appropriated to the office of reproduction of his kind, is
all devoted to his own individual conservation. In animals not used for
draught purposes, or in other labor, when the food received is nearly
always in excess of the amount required for the support of the organism,
the result follows that the surplus of nutritive substances (found
sometimes in great abundance) becomes stored in the connective tissue
and intermuscular structure, and that in this way the flesh assumes
superior and more nutritious qualities than that of the unaltered
animal, while, at the same time, it loses the strong and peculiar odor
frequently communicated to it by the presence of the testicular
apparatus and secretion in the entire animal.
This property of modification of function is probably still better
illustrated in the effect of the operation upon cows, where we shall
find not only the power of accumulation of fat increased by castration,
but, above all, the milky secretion improved both in quality and
quantity, and also in the duration of the flow.
AGE.
The question, “at what age can an entire animal be altered?” admits of a
simple answer, to wit, “as soon as the testicles can be easily
reached--as soon as they appear outside of the abdominal cavity, and are
found in the inguinal canal.” But although it can be performed at that
epoch, or deferred to any period of after life, it must be remembered
that it is easier and less dangerous in young than in older animals, and
that with the former it is a simple operation, producing, ordinarily, no
noticeable alteration in the other functions, and but rarely followed by
accidents.
A period between eighteen months and two years is generally preferred
for horses, though, according to some authors, even a much earlier date
may be chosen, some English veterinarians being accustomed to operate at
as early a date as ten days from birth. It is immaterial, however, at
what precise time the operation may be performed, since it is a conceded
point that the earlier it is done the better.
SEASON.
When it is possible to choose the season most favorable for the
operation, and for securing the best chances of recovery, the spring, or
the early stages of the fall, are those to which the operator should
give the preference, provided the atmospheric temperature is moderate
and not susceptible to sudden variations. It is to be remembered that at
some periods of the year, without any known or apparent cause, a
tendency appears in wounds to take on gangrenous or septicemic
complications which are not so generally observed in the mild weather of
spring and early fall. Another essential condition which surgeons will
do well to take into consideration is the general health of the subject,
as in all cases of surgical interference, any diseased tendency already
existing (perhaps latent) in the patient, such as an anæmic condition, a
gourmy predisposition, or typhoid susceptibility are likely to give rise
to the development of serious and perhaps fatal sequelæ to an operation
which, simple as it may be in itself, is nevertheless not without
danger, or of possible complications of its own.
PREPARATIONS.
The preparations to which the animal is to be subjected previous to
undergoing the operation are the same as those which are required in
other cases of surgical manipulation. Some portions of the preparations
are, perhaps, of even greater importance, and may not, on any account,
be overlooked, when we take into consideration the peculiar position in
which the animal must frequently be secured in order effectually to
control his movements. Hence, a low diet for twenty-four hours preceding
that appointed for the operation, and an empty stomach at the time of
castration, with a thorough washing of the sheath, are precautions which
no surgeon entitled to the name will overlook or neglect, especially
when a soliped is to be subjected to the knife. We shall discuss
hereafter the indications in the case of the castration of large
females.
RESTRAINT.
Two modes of restraint are employed in securing the animals during the
manipulations for the removal of the testicles, one which is applied to
all the various methods yet to be described, and the other applicable
principally to the method of amputation of the cord by the use of the
_écraseur_. In the former, the animal is thrown down and secured with
one of his hind legs fixed in a position in which the inguinal region is
fully exposed. In the latter he is allowed to remain in a standing
posture, and is kept quiet by the application of a twitch upon his upper
lip. As the first mode of securing the patient is the safest for all
parties engaged in the undertaking, and from the further fact of its
applicability in all methods of operating, we shall first consider it
somewhat in detail.
[Illustration: FIG. 1.
Condition of the horse in lying posture. Steps to bring one of the hind
legs upon the corresponding front one.]
By veterinarians who employ the old method of casting with four hobbles,
the animal, being properly prepared, is thrown upon whichever side
corresponds with the operator’s habit of manipulation, whether with the
right hand or the left, and the leg opposite to that on which he is
lying being released from the hobble, is carried forward upon the
corresponding shoulder, as far as it can be safely done. To effect this
a loop of rope or platelonge is passed around the coronet, below the
fetlock, the free end being carried forward over the dorsal border of
the neck, under the neck, towards its anterior border, and is then
carried back under the same hind leg, between the hinder extremities and
over the hock, from the posterior border, where an assistant, stationed
at the back of the animal, is ready to receive it (Fig. 1). By careful,
gradual and steady pulling upon the rope the foot is brought forward
upon the external surface of the shoulder, and there secured by two or
three turns of the rope around the coronet.
But it often occurs that in this position the inguinal region is not
sufficiently exposed, and some of the steps of the operation may thus be
rendered difficult, even when the surgeon has taken the precaution to
pose the body of the patient and place him partly on his back, by means
of bundles of straw pressed under the side upon which he lies. Many
operators prefer the use of the double side line, with which, when the
animal is thrown, both hind legs are brought forward together, and he is
fixed squarely upon his back, and the inguinal region thus brought
distinctly into view. The manipulation is thereby made easier for the
surgeon, and, it is claimed, safer for the patient. The possibility of
danger attending these methods has led many veterinarians in Europe, and
in the United States as well, to prefer the operation with the animal in
the standing posture. But it is to be considered that the same
complications may rise in all instances, with the exception of
apprehended injury to the vertebral column, which, though possible, is
almost unknown, in fact, at the usual age of the castrated animal. It is
to be considered, likewise, that the animal, on his feet, is free to
struggle as violently as he wishes, and is thus exposed to the risk of
the pulling and laceration of the spermatic cord, and a resulting
predisposition to enlargements of that body and the formation of
champignons. When it is considered, again, that by the traction of the
cord the superior opening of the inguinal canal is necessarily
dilated, and the formation of a hernia of castration is liable to take
place, we submit the point to the intelligent judgment, whether, in the
presence of these possibilities of extremely dangerous accidents, it
does not become the duty of the veterinarian to prefer the mode of
securing his patient in the supine position, both in his own behalf and
that of his employer.
[Illustration: FIG. 2.
1. Testicular envelope. 2. Posterior serous septum. 2′. White muscular
fibres of Bouley. 3. Serous membrane--portion of the tunica vaginalis.
3′. 3″. Visceral layers of the tunica covering the cord and the
testicles. 4. The testicle with its peritoneal covering. 5. The
epididymis. 5′. Globus major. 5″. Globus minor, the tail. 6. Deferent
canal. 7. Spermatic blood vessels and nerves.]
ANATOMY.
We now pass rapidly in review the anatomical structure of the inguinal
region and of the testicular organs. A knowledge of these is of course
essential to a proper understanding of the description of the various
modes of operation, and of some of their sequelæ, upon which we shall
soon enter.
The testicular envelopes, passing from the surface inwards, are
represented by the scrotum, the dartos, the cellular coat, the tunica
erythroida, formed by the cremaster, and the fibrous and serous or
vaginal sac (Fig. 2). The scrotum is a continuation of the skin, and
forms a complete bag, common to both testicles, which it contains and
covers; the skin being here thin, vascular and nervous, usually black in
color, almost hairless, and soft and unctuous to the touch. It is
divided into two lateral halves by a raphæ or median line. It is very
elastic, and easily yields to the efforts of distention, to which it is
subjected, and when stretched over the organs it contains, presents a
shining aspect, due to the sebaceous secretion which covers it. It
easily contracts to its shrunken condition, and may be closely drawn up
into the inguinal canal, when it assumes a thickly wrinkled surface.
The second envelope, the dartos, is a prolongation of the tunica
abdominalis, and is a yellow, fibrous structure, forming two distinct
sacs resting upon each other, and lying on the inside of the scrotum, to
which it is intimately adherent.
In the lateral and superior parts the adhesions are looser, and in front
it becomes continuous with the suspensory ligament of the sheath, which,
like itself, forms a portion of the abdominal tunic. Under the dartos is
a layer of very loose cellular tissue, the lamellæ of which are so
formed that it may be divided into several superimposed layers. This
formation endows the testicle with great mobility in the dartoid sac;
and these layers may be easily separated with the finger from the
external surface of the fibrous coat beneath, except posteriorly, where
it forms a strong band which sometimes requires even the aid of an
instrument to divide.
The next envelope is represented by the tunica erythroida which is the
cremaster muscle, and from the lumbar region extends itself downwards
into the inguinal canal along the outside of the cord, and terminates
towards the superior part of the testicle in fibres spreading only over
its external face. This muscle, by its deep surface, rests upon the
fibrous coat--another envelope of the testicle and of the cord--and to
which it is closely adherent. To the powerful contraction of this muscle
is due the retraction of the testicle into the depth of the groin,
which condition sometimes it is so difficult to overcome in the first
stages of the operation.
The fibrous testicular envelope which we have just seen giving
attachment to the cremaster, is a thin membranous bag, elongated like
the neck of a bottle around the spermatic cord, which it envelopes, and
dilated below, in order to enclose the testicle. Lined internally by the
serous coat, to which it intimately adheres, this last membrane is a
duplicature of the peritoneum, drawn downwards by the testicle when it
descends from the abdominal cavity into the inguinal canal. This serous
envelope has, therefore, two coats, one lying on the inside of the
fibrous tunic, and called the parietal, and that which covers the cord
and the testicle and is known as the visceral. These two layers
approximate towards the posterior border of the cord, and, as they
unite, form a sort of fold, band, or septum which divides into two parts
the posterior portion of the vaginal cavity, and becomes a means of
solid adhesion between the tail of the epididymis and the bottom of the
sac.
The testicles, thus covered by the visceral layer of the serous coat,
are suspended at the end of the spermatic cord, and surmounted upon
their superior border by the epididymis, the first part of the deferent
canal, which is folded upon itself, while at its posterior
extremity--the “tail,” so called--it continues in a straight course, and
conveys the product of the secretion of the testicles into the vesiculæ
seminales, lodged in the pelvic cavity.
The spermatic cord is formed anteriorly by the spermatic or great
testicular artery, which forms, in that portion, a large number of
flexuosities, causing its length greatly to exceed that of the cord to
which it belongs. It contains a network of veins, and lymphatic vessels
in abundance, which are united to the curves of the artery by a somewhat
loose cellular tissue. A large number of nervous branches, given off by
the solar plexus, surrounds the whole.
Between the lamellæ of peritoneal structure which forms the posterior
septum, and which unites the parietal with the visceral layer, there is
found a band of grey muscular fibres--first discovered, I believe, by H.
Bouley--which exerts a powerful agency in the retraction of the testicle
towards the inguinal ring. Behind this muscle, and situated on the
internal face of the septum, are found the deferent canal and the
circumvolutions of the small testicular artery.
Having thus considered the essential points of the anatomical structure
of these organs, we shall next seek to enforce the importance of their
careful study in reference to the intelligent and skilful performance of
the important operation which we are discussing.
CHAPTER II.
CLASSIFICATION OF THE METHODS -- THREE CLASSES -- FIRST, IMMEDIATE
AMPUTATION -- SECOND, AMPUTATION AFTER APPLICATION OF HEMOSTATIC MEANS
UPON THE CORD -- THIRD, WITHOUT AMPUTATION, BUT DESTRUCTION OF
SECRETING POWER OF THE ORGAN -- SIMPLE EXCISION -- SCRAPING -- TEARING
AND TORSION -- TORSION -- FREE AND LIMITED -- ABOVE OR BELOW THE
EPIDIDYMIS -- LINEAR CRUSHING -- FIRING.
The methods of performing the operation of castration may be variously
classified, though in each class a varying number of modes will come
under our notice.
The first class will include the operations by which, the envelopes
having been cut through, the vaginal sac opened and the testicle
exposed, the organ is separated by an immediate section of the cord. A
number of different processes are included under this head, among which
are those of _scraping_, of _tearing_, of _torsion_, of _linear
crushing_, or by the _ecraseur_, and of _firing_, or the actual
cautery.
The second class has also for its first or preliminary step, that of the
first, viz., the incision of the bags, the opening of the vaginal sac,
and the exposure of the testicle. But instead of removing the organ by
the division of the cord, we proceed as a second step, to the
application of an apparatus designed to operate by producing compression
along the length of the cord, and in this are included but two modes of
operating, that by the _ligature_ and that by the _clamps_.
The third class, according to our category, presents to our view two
further operations, both of which are essentially bloodless and dispense
with the incision of the bags, consisting of certain peculiar
manipulations which insure the destruction of the testicular structure,
and consequently of its secreting power. They comprehend the process of
the _crushing of the spermatic cord_, and that of _subcutaneous double
twisting_--the _bistournage_ of the French.
We now enter upon the consideration of each of the separate modes we
have thus enumerated.
SIMPLE EXCISION.
This is claimed to be one of the oldest modes of operating, and though
to a great extent discarded by practitioners of the present day, still
finds its application in the treatment of the smaller animals. With
larger patients, however, though still strongly recommended by some
practitioners, it is not generally employed on account of the profuse
hemorrhage which necessarily follows the amputation of the cord. Still
it is conceded that this hemorrhage, as in many cases of the clean,
transverse section of arterial blood vessels, will cease spontaneously
by the contraction of the vessels on themselves, and the formation of a
clot at the divided end, as well as in the surrounding cellular tissue.
However, there is a possibility of the continuance of the hemorrhage for
some length of time, and the bad effects of excessive depletion are not
to be overlooked, especially in an animal whose general constitution has
from any cause suffered impairment. If there is any one of the various
modes of operating in which the standing position is allowable, this, in
our opinion, is the one, the steps of the process being so few and so
short, and admitting such simplicity and rapidity. These consist in
making a free opening in the bag, reaching with a single stroke of the
knife into the vaginal cavity; grasping the testicle and pulling it
gently downwards; and cutting the cord right across, from the front
backwards, above the epididymis, the cord returning of itself into the
vaginal sac--the division being made, of course, on both sides. The
animal is then kept quiet in his stall and left alone until the
hemorrhage subsides.
SCRAPING.
This operation, which is said to have originated in India, is but a
modification of the preceding. Instead, however, of using a sharp edged
instrument to divide the cord, the surgeon, on the contrary, employs a
dull knife, with which the coats of the artery and portions of the cord
are scraped until the separation takes place. They are thus placed in
good condition for their temporary closure. This method is probably
attended with a diminished amount of hemorrhage, and if carefully
performed, it may be entirely absent, the clot closing the artery, and
the condition of the lacerated threads of the vessel acting favorably,
as well, in preventing it. The manipulations are similar to those
accompanying the simple excision, though it is better and more safely
effected when the animal is on his back. The testicles being exposed by
the incision through the envelopes, the posterior septum of the cord is
cut through by a transverse section, and the scraping of the anterior
fasciculus of the cord then performed, by a slow movement from above
downwards, along a certain extent, in order to effect a solution of
continuity by a sort of wearing through the tissues. This operation is
slow and requires a careful hand for its execution. But as it may in
some cases be followed by severe hemorrhage, it cannot, for that reason,
be recommended for large animals, for solipeds especially.
TEARING AND TORSION.
These two modes of operation may, to a great extent, be considered as
identical. Indeed, the mode of torsion may be said to have arisen
principally as a modification of that of tearing, which is the older. In
tearing, the cord was subjected to a certain amount of torsion _by the
hand_, and then torn apart at a given point in its length; while in the
process of simple torsion, as properly performed, we obtain a division
of the cord by twisting it _with instruments_, which enables the
operator to effect the separation at a definitely determined spot.
Tearing differs, then, from torsion only in the fact that after giving
several twists to the cord in order to gather its fibres into a more
compact mass, and to diminish the resistance of the more superficial
layers, it is divided in its continuity by a violent traction upon its
fibres in the direction of its length.
In this process, especially applied to ruminants, the testicle being
exposed, the operator secures the cord firmly with the thumb and index
finger of one hand, to prevent the traction from taking effect too far
upwards when being made by the other hand, after the cord has been
twisted a few times on itself.
TORSION.
In this method of castration the cord is twisted with sufficient force
to cause it to break of itself at the point of the greatest violence.
Its design is to accomplish the removal of the testicle without dragging
or excessive traction upon the cord, and thus to avoid the hemorrhage
following the torsion of the spermatic artery, as a mode of hemostasis
sufficient to prevent the flow of blood attendant upon the rupture of
the cord. The operation may be performed either above or below the
epididymis, or may consist simply in the torsion of the artery alone. At
first the hands only were called upon to act in the manipulations, and
the operation was from this cause known as _free torsion_, until about
fifty years ago, when instruments were introduced into general practice,
and gave rise to the plan of _limited torsion_.
FREE TORSION.
_Free torsion_, or that in which the hands alone are employed in the
operation, may be performed, as before stated, either above or below the
epididymis.
_Above the Epididymis._--The first is one of the oldest modes of
castration known; one which must have been practiced contemporaneously
with the use of clamps, or in the first age of surgery. The first steps
of the operation required for the exposure of the testicles are the same
as have already been detailed. When this is accomplished the steps of
torsion and rupture are then performed in the following manner: The
operator, grasping the testicle, carefully draws out the spermatic cord,
and with a pointed bistoury makes a transverse incision, above the tail
of the epididymis, through the posterior septum of the cord, involving
what we know as the white muscle of Bouley, the efferent canal, and the
small testicular artery. He then seizes the anterior fasciculus of the
cord between the thumb and index finger of the left hand, squeezing it
as tightly as possible, and having with the other hand secured the cord
at a short distance below the point where the left hand has already been
placed, performs the torsion by a rotatory movement given to the
testicle itself, the motion having for its result the twisting and
tearing of the cord when long enough continued to overcome the tenacity
of its fibres. Fifteen or twenty turns of the organ will usually be
found sufficient to effect the rupture. A considerable degree of
strength in the fingers is required in this movement, and for this
reason the torsion may take effect further up than may be desired, and
beyond the point designed, which may result in an unnecessary amount of
irritation and injury. When the torsion has gone so far that the rupture
of the cord has been effected, the stump is released, and retracts in
the inguinal canal to a certain height limited by the presence of the
posterior septum, which holds it in place, and to a great extent
prevents its return through the superior orifice of the inguinal canal.
_Below the Epididymis._--This, the fourth step of the operation,
consists in the separation of the testicle from the epididymis and the
torsion of one upon the other. The testicle being exposed, the operator,
taking hold of its appendix, the epididymis, with the left hand, and of
the gland with the right, their cellular serous attachment is divided by
the thumbs from the posterior to the anterior extremity, from the tail
to the head of the twisted efferent canal. If this cannot be done with
the hand, the convex bistoury must be called into action. This
accomplished, the head of the epididymis is firmly secured with the
fingers of the left hand, and the right hand, left free, gives to the
testicle the number of rotatory motions necessary to separate it from
its excretory canal--that is, from eight to ten. When the testicle is
thus severed, the stump of the end, with the epididymis, is pushed back
into the vaginal sac, where it is confined by the application of a
suture upon the middle of the edge of the scrotal wound.
LIMITED TORSION.
_Limited Torsion Above the Epididymis._--As we have seen, this is the
operation by which the division of the spermatic cord is effected by
torsion made upon a given point in its length, and limited by the use of
special instruments.
[Illustration: FIG. 3.
FIXING FORCEPS FOR TORSION.
A.--Renault and Delafond pattern.
B.--Perier.
C.--Reynal.]
We have already called attention to the difficulty of the operation of
free torsion, which requires a great deal of strength, and which,
besides, may be accompanied by a serious inflammatory condition of the
parts, through rough manipulations of the cord. It is for this reason
that this mode of procedure must have been reserved for small animals,
as, if performed upon the larger kinds, it can only be by men whose
muscular force is sufficient to enable them to overcome and bring into
subjection the struggling subjects of their operations.
[Illustration: FIG. 4.
MOVING FORCEPS FOR CASTRATION BY TORSION.
Renault and Delafond pattern. Reynal pattern.]
It was in 1883 that two French veterinarians, Renault and Delafond, of
the Alfort school, introduced the use of instruments in the operation,
as an improvement upon the manual methods and their effects on the
sequelæ, though it is said to have been already practiced in Germany as
far back as the last century. The instruments employed are two forceps
of peculiar construction, and which were more or less modified, one of
which (_fixing_ forceps, Fig. 3,) is to be applied upon a fixed point of
the cord, where it is suffered to remain, and the other (_moving_
forceps, Fig. 4,) is employed to accomplish the rotation of the testicle
and the lower end of the cord. Those of Renault and Delafond or of
Reynal are now in general use. Those of Beaufils (Fig. 5) are, we
believe, too complicated for general use.
[Illustration: FIG. 5.
COMBINED FORCEPS OF M. BEAUFILS.]
_Modus Operandi._--In the first step of the operation, the ordinary
manipulations of the division of the envelopes, the opening of the sac
and exposure of the testicle being accomplished, and the envelopes being
carefully pushed upwards, the torsion and excision of the cord are
effected in the following manner: The entire cord is embraced by the
fixing forceps (see Fig. 6), or only its anterior fasciculus if the
posterior septum has been cut, as in the process by free torsion above
the epididymis. An assistant, seizing it from before backwards between
its open branches and strongly closing them, holds it firmly, without
pulling upon the cord. The operator then grasps the cord with the moving
forceps above the testicle, and a little below the point held by the
assistant, leaving a small space between the instruments, and closing
his own tightly, begins the movement of torsion, which he directs from
left to right. For this he sometimes requires both hands, one of them
keeping the instrument in place, while the other continues the
rotation as described. Ten or fifteen turns of the forceps are usually
sufficient to complete the rupture of the cord, the artery, owing to its
facility of elongation, being the last part to give way. The testicle
then separates, being held in the branches of the moving forceps; the
fixing forceps are removed, and the cord is drawn upwards into the
vaginal sac. It is important in this operation to caution the assistant
against drawing on the cord during the struggles of the animal,
consequent upon the pain caused by the first application of the
instruments, and the pressure upon the parts when held between their
inflexible iron jaws; but on the contrary, to maintain it as closely as
possible against the inguinal region.
[Illustration: FIG. 6.
OPERATION OF LIMITED TORSION.]
This process of castration is one of the most rapid of all the forms of
operating. The only hemorrhage likely to occur is merely that of the
small testicular artery, if it should happen to be divided when the
torsion is confined to the front portion of the cord.
_Below the Epididymis._--This process differs from the preceding only in
the fact that instead of holding the cord between the fingers, it is
held by the fixed forceps, the use of the moving instrument being
rendered unnecessary by the slightness of the adhesion of the seminal
gland to its appendix.
[Illustration: FIG. 7.
VARIOUS KINDS OF ECRASEURS.]
LINEAR CRUSHING.
The originator of the use of that peculiar instrument, the ecraseur
(Fig. 7), so valuable an adjunct in the operation of castration, is Mr.
H. Bouley, who brought it into use at a date as early as the year 1857.
It is not, therefore, an American invention, as has sometimes been
claimed. The function of this instrument is to effect the division of
living parts without hemorrhage. The original ecraseur of Chassaignac
has received many modifications, all of which, however, operate upon the
same principle The essential design of all is to produce a general
constriction of the blood vessels, by which their internal and middle
coats being first divided, may contract within the cavity of the vessel
in such a manner as to close their cavity and form a sort of stopper to
the artery, while the external cellular covering, the last to undergo
division, is so stretched, under the action of the instrument, and so
closely adapts itself by its ends, that insufflation through the free
ends of the vessels fails to remove the closing arrangement of the two
coats first divided.
[Illustration: FIG. 8.
HOUSE CLAMPS.]
_Modus Operandi._--The operation is comparatively a very simple one. The
testicle being exposed, as in all the other methods, the chain of the
instrument is so placed around the cord that the pressure takes place
upon the greater mass of tissue, in order that it may continue the
longer; which being done, the lever of the instrument is brought into
action, and the constriction caused by the chain slowly kept up until
the definite division of the tissue is accomplished. The essential
condition of success in the operation, having in view the desired
hemostatic effect, is to _act slowly_. According to Prof. Bouley, an
interval of several seconds should be suffered to elapse after each
rotation of the wheel which moves the chain. If the tissues are divided
too rapidly, the section of the artery is apt to be too clean, and a
hemorrhage is likely to be the result. This objection, however, though
made by one of the highest authorities in veterinary surgery, does not
seem to be justified by the results obtained by American operators, most
of whom both recommend and practice its execution as rapidly as
possible; and according to their own statements, a serious hemorrhage is
seldom encountered. The fact that it has been observed in any case,
however, confirms the wisdom of the recommendation of Prof. Bouley, and
as most of our American _confrères_ prefer the operation with the animal
in the standing posture, the reason of their neglect of the prudent and
more truly surgical process can be readily appreciated. To avoid the
hemorrhage Dr. House invented a clamp which he applied upon the cord
previous to the amputation with the ecraseur (Fig. 8). This mode of
castration is not very extensively practiced by European practitioners.
The reason of this is probably to be looked for in the essential
necessity of safety which so protracts its performance.
FIRING.
This mode of castration consists in the application to the cut end of
the testicular cord--previously divided with the bistoury, or by the
cautery--as a means of hemostasis, of an iron heated to a white
heat--the actual cautery. This is claimed to be one of the oldest modes
of operating, Vegetius and Absyrtus describing it as a common process
of castration. It is much in favor in England, and in some parts of
Germany, though less practiced in some other parts of Europe. The
instruments essentially needed for the operation of castration by firing
are two; the first, a peculiar forceps for holding the cord and securing
it while the application of the cautery is being made; and the second,
the iron or cautery itself.
[Illustration: FIG. 9.
SINGLE FORCEPS FOR CASTRATION BY FIRING.]
[Illustration: DOUBLE FORCEPS FOR CASTRATION BY FIRING.]
These forceps, or nippers, are either single or double (Fig. 9), and may
be made either of wood or of iron, and more or less modified in form,
according to the fancies of the different operators. But they all work
on the same principle, and effect the same object. With the single
forceps but one cord can be treated at a time, but with the double
instrument both cords may be secured at once, and may be divided and
cauterized at one step. In this way the possibility of disturbing the
eschar caused by the cauterization of one cord while manipulating the
second, is quite obviated.
When the testicles, either or both, have been exposed, the mass of the
cord is fixed between the jaws of the forceps, from before backwards, at
about one inch above the tail of the epididymis, and firmly secured.
This may be effected either by tying it tightly with a string wound
about the handles, or by means of a spring crank with which some
instruments are furnished. The testicle is then amputated, either by a
stroke of the bistoury, or with the sharp edge of the cautery carried
across and at a right angle with the direction of the cord. This done,
the operator applies the broad portion of the iron over the entire
surface of the stump of the spermatic cord, and cauterizes (or sears)
the part thoroughly. It must be remembered that to insure the safety of
the cauterization, the iron must be very hot. Otherwise, when it is
removed, if it has cooled off, it may adhere to the carbonized surface,
and the scab formed at the end of the blood vessel may accompany the
instrument. The application of pulverized rosin to the end of the cord,
previous to the cauterization, is recommended by some practitioners.
A very proper precaution, and one on no account to be omitted, is the
protection of the surrounding parts from the radiating heat by covering
them with wet cloths.
When the operation is completed, the forceps should be opened with great
care, in order to ascertain whether all hemorrhage has ceased, and the
cord may be allowed to retract. If any oozing of blood appears at the
point of the operation, the cauterization must be repeated at the point
indicated.
A free application of cold water, in the form of a _douche_, after the
operation, will contribute to the formation of a clot in the cauterized
artery.
CHAPTER III.
METHODS OF THE SECOND CLASS -- CLAMPS -- COVERED AND UNCOVERED
OPERATION -- INSTRUMENTS -- FOUR VARIOUS STEPS -- OBJECTION TO THIS
METHOD -- TIME TO REMOVE THE CLAMPS -- LIGATURE -- OF THE CORD AND ITS
ENVELOPES -- OF THE CORD ONLY -- OF THE SPERMATIC ARTERY -- OF THE
EFFERENT CANAL -- SUBCUTANEOUS OPERATION.
Having completed the consideration of the various methods included in
the first class, we propose next to examine those entering into the
second, which embrace those in which certain means of pressure are
applied and suffered to remain upon the cord previous to the amputation
of the testicle. These are two in number, and consist of the process
known as that of the clamps, and that which involves the use of the
ligature.
THE METHOD BY THE CLAMPS.
This is an ancient mode of operating, having been transmitted to us
through many ages. It has received the sanction of long practice, and,
if not absolutely superior to all others, is possessed of qualities and
advantages which all who have employed it will freely acknowledge.
It is performed in two ways. One is the process of the _covered_, the
other of the _uncovered_ testicle. The covered operation is that in
which only a portion of the testicular envelopes are divided, the
scrotum and the dartos, the gland being left covered with the other
envelopes. On the other hand, in the uncovered operation, all the
enveloping membranes are divided, and the testicle is made to protrude
outside of the vaginal sac. The first three steps of this mode of
operating are understood to have been performed in the methods which we
have already considered as generally preliminary in all cases, in order
to obtain access to the cord.
[Illustration: FIG. 10.
ORDINARY CLAMP.]
[Illustration: INTERNAL FACE OF CLAMPS.]
The instruments necessary to operate in this case are a very sharp
convex bistoury, a pair of clamps, some strong twine, a castrating
forceps and a pair of scissors. The clamps are wooden or metallic
pincers, formed to embrace the cord and to be applied firmly upon it, in
order to hold it securely, and to confine the artery tightly enough to
prevent the occurrence of hemorrhage. The form most ordinarily used, and
probably most convenient, is made of wood, and consists of two
semi-cylindrical pieces (Fig. 10) joined at one end and resting together
by a flat and sometimes grooved surface, and measuring about six inches
in length. The material is a light but strong wood. They are rounded at
the extremities, in order to avoid chafing the soft tissues. A groove at
each end is designed to receive the twine, which is part of the
appliance. Before being used they are tightly tied together at one end,
in such a manner that they spring open if closed. This point is one of
the first importance. It requires considerable exercise of strength to
place them tightly enough on the cord they are to hold, but this firm
juxtaposition, so obtained, facilitates their removal, when that is
required. The groove which they carry on their flat surface is sometimes
filled with some merely lubricating greasy substance, usually simple
ointment, fresh lard, butter, or cream, though some veterinarians use a
caustic paste. This last mode of proceeding is strongly opposed by some
authorities, as likely to induce unnecessary inflammatory action,
through the formation of a scab, which may require for its removal a
process of sloughing, which may in some cases give rise to serious
complications. As I have stated, the clamps are not always made of wood,
and very many alterations and improvements, so called, have been from
time to time brought forward. In Fig. 11 a few of these clamps are
presented. The oldest form is the simplest, and possesses the further
advantage of being always easy to be obtained, while the more
complicated contrivances are not always easy of access.
[Illustration: FIG. 11.
VARIOUS SHAPES OF CLAMPS.
Screwed Clamp. Spring Clamp of Brandt. Hinge Clamp.]
[Illustration: FIG. 12.
FORCEPS TO HOLD THE CLAMP TOGETHER. VISE FOR THE SAME.]
The castrating forceps (Fig. 12) are used for bringing the clamps
together while they hold the spermatic cord between their branches.
There are several kinds of these, but in default of obtaining them
readily, the operator may find an eligible substitute in the
blacksmith’s nippers or the gasfitter’s tongs. We have used this latter
for a good many years, and have found it very well adapted to the
purpose required, by the presence of its set of double curved and
grooved jaws. The twine which it is necessary to use to keep the clamps
closed when they have been brought into perfect contact with the
castrating forceps, must be soft and strong. A piece of fishing line,
previously waxed, will answer the purpose very well. In order to
facilitate the traction which may be necessary to keep the clamps in
place, it is a good precaution to attach the ends of the twine to small
wooden handles to protect the hands from cutting by the string. It is
well, also, to prepare a reserve of clamps and twine against accidents
from breakage or the mislaying of these articles.
COVERED OPERATION.
_Modus Operandi._--The animal being thrown on either side, as already
described, and kept as nearly as possible on his back by bundles of
straw packed under him on the lower side, and the right hind leg secured
in its proper position, and the instruments placed within easy reach,
the surgeon proceeds with the fourfold steps of the operation,
consisting first, in the prehension of the left testicle, or lowest in
position; second, the incision through the envelopes; third, the
enucleation of the testicle; and fourth, the application and
constriction of the clamps.
_First step._--The operation must always begin with the prehension of
the gland which corresponds with the side--the lower--upon which the
animal is lying. This obviates any danger of interference by any little
hemorrhage which might occur, and so facilitates the application of the
clamps. Then, placing himself toward the back of the patient, the
operator reaches over and grasps the lower testicle with both hands,
bringing it downwards in such a manner as to stretch the scrotum over
its surface. This manipulation is not always of easy performance, the
contraction of the cremaster muscle being sometimes so powerful that the
gland successfully resists all the operator’s efforts of traction. It is
sometimes necessary to divert the attention of the animal, in order to
facilitate this part of the process, by pricking him with a pin on the
lips or about the anus, the effect of the new sensation being such that
his opposition is withdrawn, and the contraction ceasing, he suffers
passively the traction of the envelopes over the organ. Or, the same
advantage may be obtained by the inhalation of a little ether or
chloroform. Then grasping the cord with the left hand and bringing the
organ well forward, the surgeon proceeds to the
_Second step_, or that of the incision of the envelope. Holding the
sharp convex bistoury in his right hand, he takes, with the thumb, a
_point d’appui_ upon the prominent organ, and carries it carefully over
the surface of the scrotum in a direction parallel with the median raphè
(described in the first chapter), and following the great curvature of
the testicle, and being careful with the first movement of the
instrument to divide only the scrotal skin and the dartos, until the
most superficial layers of the cellular tissue of the third testicular
envelope are reached. The skin and the dartos being divided, the edges
of the wound separate, and the testicle, still pressed downwards and
outwards with the left hand, protrudes more or less, still included, as
it is, within its fibrous covering. A careful dissection, with a few
light strokes of the bistoury, or laceration with the thumb nail of the
hand, now suffices for the separation of the fibrous envelope from its
external covering, an entire separation of both of which can thus be
easily obtained by pressing the most external layer upwards through the
laceration of the cellular coat which unites them.
_Third step._--The operator now relieves himself of his instrument--not,
we may venture to suggest, by placing it between his teeth, as some
careless surgeons are apt to do, but by handing it to an assistant--and,
changing his position, places himself in front of the inguinal region,
and facing it. He then proceeds to the enucleation of the testicle, by
separating the adhesion which exists between the internal face of the
dartos and the external surface of the cremaster muscle and of the
fibrous tunic. The separation being completed, and the scrotum and
dartos being carefully pushed upwards, the patient is now ready for the
last step of the operation.
_Fourth step._--The testicle, well enucleated from its superficial
envelopes, but still covered by the fibrous coat, and the vaginal sac
still remaining intact, the operator, facing, as before, the inguinal
region, proceeds to the application of the clamps. The cutaneous
covering and the dartos being pushed well upwards, the clamp is placed
upon the cord above the epididymis, from before backwards, the
assistant, armed with the castrating forceps, taking both of its
branches between the jaws of that instrument, carefully bringing them
together, and closing them as tightly as possible. The instant of the
pressure of the clamp upon the cord is marked by very severe pain, and
the suffering animal is excited to powerful struggling. It is important
that the assistant should be aware of this, and he should be forewarned
to refrain from pulling on the cord, and reminded, in order to avoid
injury from this accident, to keep the clamps and the forceps steadily
in contact with the inguinal canal. It is probably with a view to the
avoidance of this possible injury that the use of a peculiarly
constructed vise or forceps has been recommended. The forceps being in
place, and tightly confining the branches of the clamps, well adjusted,
the operator now applies the twine, and after taking several turns
around the grooves of the free ends of the clamps, secures it carefully
with a double knot.
The operation is then repeated on the right or uppermost testicle in the
same manner, and with the same precautions.
UNCOVERED OPERATION.
The four steps of this operation are the same as those of the previous
method, the first requiring the same manipulations and observing the
same order, but the second involving some variations. In this the same
careful dissection is dispensed with, and one free incision suffices,
including all the various envelopes, in order to expose the testicle
freely and at once. The incision is made with one free stroke of the
bistoury extending from the posterior to the anterior extremity of the
testicle, and dividing at once scrotum, dartos, and the fibrous and
serous coats. Though this is to be done without hesitation, it is by no
means necessary to adopt the practice of some operators, who not only
divide the envelopes, but even make a large incision in the testicular
structure itself, inflicting thus an unnecessary amount of pain from
which the animal might, with a little care, have been spared.
When the surgeon reaches the third step of the operation, and seizes the
testicle with the right hand, in order to draw it downward and outside
of the vaginal sac, he may encounter great resistance to his traction,
from the powerful opposition of the white muscular tissue running along
the posterior septum of the cord. He must then slowly and steadily draw
the testicle down, and at a given moment, with a single stroke with a
sharp pointed bistoury, divide the serous band of the posterior septum,
cutting at once the muscular fibres, the efferent canal and the small
testicular artery. This being effected, the resistance will terminate,
and the testicle may be drawn down without further difficulty. The
division of the septum is not always resorted to. Still, the verdict of
experience is strongly in favor of the measure. The application of the
clamps (Fig. 13) is effected in the same manner as in the covered
operation, but in this instance the clamp is placed higher on the cord.
For this reason the assistant must be especially careful during the
struggles of the patient when the clamps are tightened, the danger of
inguinal hernia at this point being too serious to be overlooked. The
clamps being in place, and properly secured, the testicles are either
left in place and allowed to slough away, or are amputated a short
distance below the clamps, as the case may be. The parts being carefully
washed out, the animal is allowed to rise, and is returned to his stall.
[Illustration: FIG. 13.
CASTRATION WITH UNCOVERED TESTICLE.]
An objection frequently urged against this mode of operation is that it
requires a second visit of the surgeon when the time has arrived for the
removal of the clamps. Estimating this objection at its proper value,
we consider that it is more than balanced by the advantages attendant
upon this special mode of castration, and while we fully appreciate the
difficulty and inconvenience to which the surgeon may be subjected by
this second visit, we cannot approve of its omission, either from a
surgical point of view or in that of the interests of the employers, in
whose behalf all care and responsibility should be exercised, until the
patient is at least enjoying a fair prospect of recovery.
The question now arises, at what time can the clamp be removed with
safety? It must be understood that there may sometimes be peculiar
surgical conditions under which their removal is contra-indicated, and
when they must be allowed to slough off without further interference on
our part. But even in ordinary cases and under favorable circumstances,
this time appears to vary. By some they are removed after thirty-six
hours, while others allow them to remain for a period of four or five
days. Taking a fair average, we are of opinion that it may be safely
done on about the third day, and that at that period the closing of the
artery is sufficiently assured to remove all further pressure.
If the clamps have been secured with twine, and especially if they were
properly prepared previously to their application, the process of
removal is a very simple one. The assistant, raising one of the
patient’s hind legs, the operator places himself directly behind the
animal, and bending down, with a sharp sage-knife, cuts the twine where
it has secured the posterior ends of the clamp. If it retains the
springiness it ought to have possessed at the time of its original
application, the branches readily spring open, and it falls to the
ground. If this does not occur, or if they should be held by adhesions
with some dried parts of the cords which have been pressed between the
branches of the clamps, they must be carefully separated by moving from
below upwards, when they will easily become detached. But this last
manipulation must be very carefully performed, if we would escape a
hemorrhage which might require serious measures to control. When clamps
of another make are used, the process of removal will vary according to
existing peculiarities in the construction of the instrument. The clamp
having been removed from one side, the separation from the other will,
of course, be managed in a similar manner.
THE LIGATURE.
This method of castration consists in the application of a circular
ligature upon the entire cord, or a portion of it, for the purpose of
completely closing it, with the various parts entering into its
formation. It was in practice so long ago as 1734. The operation is
divided into several varieties, viz., that of the cord with its
envelopes; that of the cord only, either by the covered or uncovered
method; that of the spermatic artery alone; that of the efferent canal;
and that by the subcutaneous process.
The ligature used in these various modes of operation is formed of
waxed silk; sometimes of strong twine, as fishing line, for example; or,
as more recently introduced in surgery in the removal of living growths
and tumors, an elastic cord.
_Ligation of the cord and its envelopes._--This process is principally
used upon small animals, although, since the elastic cord has been
brought into use, a few attempts have been made to make it applicable to
the larger kinds. The experiments, however, have been as yet so few, and
the results so unsatisfactory, and in so many cases fatal, that it can
scarcely be recommended, except for small subjects. The application of
this is very simple. It consists, after securing the patient, in
bringing the testicles as far down into the scrotum as may be thought
needful, and after applying the ligature two or three times around the
cord, a short distance above them (Fig. 14), slowly and steadily
tightening it until a sufficient amount of force has been employed to
close the calibre of the blood vessel and cut off the circulation from
the parts situated below the point of ligation. This mode of operating
has, in our hands, proved very successful in small animals, and when the
elastic ligature has been used. Mortification has taken place in a few
days, the testicles slowly detaching themselves at the point of
ligature, and when falling off leaving but a very small superficial,
cutaneous scab, and healing in a short time.
[Illustration: FIG. 14.
CASTRATION BY LIGATION OF THE CORD AND ENVELOPES.]
_Ligature of the cord only; covered operation._--The first three steps
of the operation having been accomplished, and the testicle enucleated,
the ligature is placed around the cord, still covered by its fibrous
envelopes and the cremaster muscle. A piece of twine or an elastic
ligature may be employed for this purpose. In this operation the
testicles are allowed to remain not less than twenty-four hours, before
amputation is performed, in order that if the pressure has been
insufficient, and the parts should fail to exhibit symptoms of loss of
vitality after that time, another ligature may be applied.
_Uncovered operation._--The only variation between this method and the
one last considered is found in the fact that in this, the testicle and
cord being exposed as in the process of castration with the clamp, the
ligature is applied either on the cord as a whole, or only on its
anterior fasciculus. In this case the testicle is amputated immediately
after the application of the ligature. But as there is a possibility of
the slipping off of the ligature, great care must be taken lest the
amputation be performed too near the point where the constriction is
made. And again, as there is a possibility of the truncated cord being
drawn too far up, even up into the abdominal cavity, it becomes a
precaution of prudence, as recommended by Mr. Bouley, to leave a
sufficient length of the ligature hanging outside of the scrotal wound,
and even to secure it on the edges of the skin.
_Legation of the spermatic artery._--This is a mode of castration which,
if we are not mistaken, was held in high estimation by certain
practitioners in the city of Boston. It consists simply in the
application of a ligature of silk to the spermatic artery. The cord
being exposed, and the posterior septum being divided, a curved needle
armed with the ligature is made to pass around the whole mass of the
anterior fasciculus, and the entire vascular cord is surrounded by the
ligature and firmly tightened. The fact of the various and irregular
flexuosities peculiar to the spermatic artery, with both ascending and
descending portions, explains the necessity of including the entire
arterial mass under the ligature, since, if only the simple cord of the
artery were ligated, it might be an ascending portion only, and the
amputation of the testicle might be followed by a troublesome hemorrhage
from one of the descending loops.
_Ligation of the efferent canal and the subcutaneous ligation of the
cord._--These two modes of operating have not yet yielded sufficient
evidence in the form of satisfactory results to be entitled to more than
passing mention at the present time. We may say further, moreover, that
among all the methods of castration by ligation, none of them have been
subjected to a sufficient amount of practical test to be accepted as a
process which will justify a strong recommendation or unqualified
approval.
CHAPTER IV.
THIRD METHOD OF CASTRATION -- CRUSHING OF THE TESTICULAR CORD --
DOUBLE SUBCUTANEOUS TORSION -- BISTOURNAGE -- FOUR STEPS OF THE
OPERATION -- SYMPTOMS FOLLOWING -- CASTRATION OF CRYPTORCHIDS --
INGUINAL CRYPTORCHIDY -- ABDOMINAL CRYPTORCHIDY -- MODUS OPERANDI --
FIVE STEPS IN THE OPERATION -- EFFECTS FOLLOWING THE OPERATION OF
CASTRATION -- MODE OF CICATRIZATION -- HYGIENIC AND SUBSEQUENT
ATTENTIONS OR AFTER CARES.
As I have before stated, the third method of castration embraces the
processes in which the testicular envelopes are left intact, while it is
the gland or cord which is submitted to the peculiar manipulations by
which their structure, and therefore the secreting powers of the
testicle, are so essentially modified. In treating of this method, two
special operations present themselves for our consideration, to wit: the
_crushing of the testicular support_, and the _double subcutaneous
twisting_, or _bistournage_ of the French. These are employed
principally in the castration of ruminants, though efforts have been
made to apply the latter in the case of solipeds. The modes of operating
which we have already described are, however, also applicable to the
ruminants.
CRUSHING OF THE TESTICULAR CORD.
This consists in crushing the spermatic cord with a hammer, the vessel
continuing, meanwhile, to be covered with its envelopes. It was first
described in the year 1826, and is most commonly practised in some
French districts. The instruments used are two cylindrical pieces of
wood, each about one yard in length and two inches in diameter; and a
hammer or mallet formed of hard and heavy wood. The animal being
properly secured in the standing position, the testicles being drawn
well down into the bottom of the envelopes, the sticks are placed, one
behind and one in front of the cord, close to the upper extremity of the
gland. When in that position they are moved in such a manner that
instead of remaining, one in front of the other, one becomes so
superimposed upon the other that the spermatic cord becomes twisted in
the form of the letter S (Fig. 15). While held together in this position
by an assistant, the operator, placing himself in front of one side of
the hind quarter, with repeated blows of the hammer or mallet, crushes
the cord at the point where it rests upon the wood which occupies the
inferior position, of course guaging the force and frequency of the
blows by the effect observed, until the crushing of the organ is
satisfactorily accomplished. As a measure of caution, it will be well,
upon the completion of the process of crushing, to surround the cord
with a ligature moderately tightened, in order to guard against the
drawing up of the cord into the inguinal canal, an accident not likely
to occur, however, if the operation has been well performed.
[Illustration: FIG. 15.
CASTRATION BY CRUSHING OF THE CORD.]
DOUBLE SUBCUTANEOUS TORSION; BISTOURNAGE.
In this mode of operating, principally in vogue in the southern parts of
France, the position of the testicle is so changed that its lower
extremity is made to take the place of the upper, the cord is subjected
to a certain degree of torsion, and then the testicle is restored to its
normal position, to undergo a process of atrophy which destroys its
power of secretion by a physiological action. The great length of the
cord and the greater laxity of the cellular tissue situated between the
dartos and the fibrous coat, render this operation much easier in the
ruminants than in the solipeds. Simple in its manipulations, although
still involving a certain degree of dexterity, and followed by
comparatively no symptoms of reactive fever, the only instrument
necessary for its performance is a piece of cord, twine, or rubber,
sufficiently strong to secure the testicular envelopes when the gland
has been subjected to the double displacement, and the cord to the
torsion it has undergone. In this operation, no special preparation
being demanded, the animal is usually treated on his feet.
The late Mr. Serres, of the veterinary school of Toulouse, divides the
operation into four steps, viz., _first_, the softening of the bags and
separation of the dartos from the fibrous tissue; _second_, the
displacement (dislocation) of the testicle; _third_, the torsion of the
cord; and _fourth_, the pushing up of the testicles into the inguinal
region, with the application of the ligature to keep them in place.
[Illustration: FIG. 16 (A).
DOUBLE SUBCUTANEOUS TORSION IN CATTLE.
Softening the bags--first position of the hands.]
[Illustration: FIG. 16 (B).
DOUBLE SUBCUTANEOUS TORSION IN CATTLE.
Softening of the bags--second position of the hands.]
The first step is the most difficult for the surgeon as well as the most
painful to the horse, though the contrary is the fact where the subject
is an ox. The operator, stationing himself behind the animal, grasps
the testicles with both hands (Fig. 16) and quickly draws them down into
the scrotum. Holding them there with the right hand, with the left he
raises the scrotum by the lower part, firmly pulling upon it downwards
and slightly from before backwards. The testicles are then moved upward
and downward in the sac, carrying with them the fibrous covering. During
this time a peculiar crackling sound is heard, which is caused by the
tearing apart of the fibres of the cellular tissue lying between the
dartos and the fibrous coat. This laceration is sometimes difficult to
effect, especially in aged animals, in which case the up and down motion
of the testicles will require a greater number of repetitions before the
adhesions are torn.
[Illustration: FIG. 17.
DOUBLE SUBCUTANEOUS TORSION IN CATTLE.
Position of the left hand at the beginning of the second step.]
[Illustration: FIG. 18.
DOUBLE SUBCUTANEOUS TORSION IN CATTLE.
Second step.]
The second step consists in the displacement or dislocation of the
testicle, which is accomplished in the manner following: The testicles
being pushed well upwards in the vaginal sac, one of them, the left, for
example, is drawn well downwards with the left hand, which grasps the
cord above the epididymis (Fig. 17), the thumb resting on the back of
the cord, and the remaining fingers in front of it, while the right
hand, placed in pronation, pinches the inferior part of the scrotum.
Maintaining these dispositions, the testicles are displaced by the
simultaneous action of both hands, the left pushing the cord from above
downwards and from before backwards, in such a manner as to depress as
much as possible the superior extremity of the gland, while with the
fingers of the right hand, resting by their dorsal face against the
posterior part of the testicle (Fig. 18), the inferior extremity of that
organ is pushed upwards. Without losing hold of the envelope, the
movement of this hand gives way to these opposite and simultaneous
pressures, that of the left hand tending to lower the head of the
testicle, and that of the right elevating its tail, and the gland is
being flexed upon the cord from which it is suspended, backwards and
upwards. At the moment when the testicle forms an acute angle with the
cord, the thumb of the left hand, resting upon the cord, comes into
action to aid in the displacement by making a _point d’appui_ upon the
inferior extremity of the organ, which now occupies the superior
position, in such a manner that the spermatic gland is placed parallel
with the cord. The manipulations are completed by pushing the testicles
upwards towards the inguinal ring, to break up whatever adhesions of
cellular tissue may remain. This second step of the operation being
completed, the two organs are found to be so placed that they are
parallel one with the other, the testicle being posterior to the cord.
[Illustration: FIG. 19.
DOUBLE SUBCUTANEOUS TORSION IN CATTLE.
Third step. Position of the hands when the torsion is about being made.]
[Illustration: FIG. 20.
DOUBLE SUBCUTANEOUS TORSION IN CATTLE.
Third step. Position of the hands during the torsion.]
The third step, or that of the torsion of the cord, now presents itself
to our notice. To effect this, the testicle must be firmly held at the
bottom of the envelopes (Fig. 19), the left hand placed forward upon the
cord, and the right behind and upon the testicle. The operator then
gives to the organ a twist with the right hand by a motion of rotation
from left to right and from without inwards, while with the other he
draws upon the cord in the opposite direction. The result of this
manipulation is to give to the gland half a turn around the cord (Fig.
20), which thus becomes displaced and takes a posterior position. By a
change in the action of the hands, but a repetition of the same
movement, the right hand now acting on the cord, while the left is
applied to the testicle, the remaining portion of the motion of rotation
is performed, and a complete torsion of the spermatic support
accomplished. By repeating this action, of course as many turns of the
cord as may be thought necessary, can be secured, two, however, being
generally found sufficient, although, in a few instances as many as four
or five may be required--never more than that. The length of the cord is
the principal controlling circumstance. When these several steps have
been completed with one testicle, their repetition is, of course, in
order with the other. And when both have been treated, the consummation
of the operation is called for by entering upon the fourth step, or that
of the application of the ligature.
[Illustration: FIG. 21.
DOUBLE SUBCUTANEOUS TORSION IN CATTLE.
Position of the testicles and ligature en masse of the bags when the
operation is finished.]
To accomplish this both testicles are firmly seized with both hands,
and pressed upwards as far as possible against the inguinal ring (Fig.
21). It is necessary to be very careful to ascertain that they rest on
the same level, in order to be secure against the possibility of
untwisting. The ligature is then applied by passing three or four turns
of it around the scrotal envelopes, immediately below the testicles,
with not more than a sufficient degree of tightness to assure it against
slipping off.
The symptoms which succeed the operation are not commonly of a very
serious nature, and subside within a period of time varying from two to
six hours. Following the operation an inflammatory swelling takes place
in the bags, and after one or two days assumes large dimensions. The
ligature can now be removed, and the animal left to himself, without
further treatment, the testicles undergoing a slow process of atrophy
readily recognized by their appearance and the position they always
thereafter occupy in the vaginal sac.
CASTRATION OF CRIPTORCHIDS.
The abnormal development of animals in which the testicles have failed
to make their appearance by descending through the inguinal canal into
the bags, is quite commonly met with in solipeds, the animal being then
known by the designation of ridglings or originals. The position assumed
by the organ in relation to its normal situation being so altered that
it may be found either partly engaged in the inguinal canal (Fig. 22),
or only remaining close to its superior opening (Fig. 23), is one of
these inequalities, constituting what is called inguinal criptorchidy;
another being when it remains floating in or adherent to some parts of
the abdominal cavity--a condition known as abdominal criptorchidy (Fig.
24). As this condition has usually a peculiar effect on the temper of
the animal so affected, often rendering him unfit for general use, it
necessitates, on that account, the act of castration, with some changes
in the manipulations described for the operation upon animals exempt
from such an infirmity. In these cases the operation presents more
difficulties, and is of a more serious character than the former,
demanding on the part of the operator all the skill and knowledge which
can be acquired from its frequent performance and extensive study. That
the operation is one which is largely performed on the Continent there
is no doubt, and many European operators have made for themselves an
extensive reputation in connection with it. Among these the name of
Professor Degives, of the Brussels school, merits mention.
[Illustration: FIG. 22.
TESTICLE ENGAGED IN THE INGUINAL RING.
B--Testicle. C--Gubernaculum testis. D--Inguinal ring.]
But there is probably, on this Continent at least, no better accredited
authority, in this branch of surgery, than a gentleman, a layman, of
Illinois, known very widely as FARMER MILES, who has for many years not
only sustained an eminent repute in his specialty as a gelder, but I
believe, has devoted a large share of study specially to the castration
of ridglings. He has not only traversed large portions of the
United States in the practice of this interesting branch of veterinary
surgery, but has likewise achieved much renown and appreciative
criticism from foreign sources, having travelled extensively in various
European countries, and earned much honor from those who have watched
his methods, and received ocular proof of his dexterity and success
within the sphere of his special field of usefulness.
[Illustration: FIG. 23.
TESTICLE CLOSE TO THE RING.
C′--Internal portion of the gubernaculum testis.
C--Its external portion.
B--Testicle.
D--Inguinal ring.]
[Illustration: FIG. 24.
TESTICLE FLOATING IN THE ABDOMEN.
A--Peritoneal ligament attached to the lumbar region.
B--Testicle.
C--Gubernaculum testis.
D--Inguinal ring.]
The method of procedure, which has in his hands proved so exceptionally
successful, though no doubt essentially original with him, is still, we
believe, based upon the same principles which govern the operation as we
find it described and illustrated in the works of the classical writers
who have given their attention to the subject.
We now turn to the consideration of the _modus operandi_, as observed in
the two forms of cryptorchidy, the inguinal and the abdominal.
INGUINAL CRYPTORCHIDY.
The preliminary steps in this case are the same as those which are
necessary in the castration of animals under normal conditions. The
instruments required are a convex bistoury, one or two clamps, or a
ligature, and an actual cautery, or the ecraseur most commonly in use.
To these is sometimes added a pair of long forceps of peculiar
construction, with jaws terminating in two spoon-shaped extremities,
designed to grasp the testicle when placed high in the inguinal canal,
or if only partly engaged in the ring. Prof. Degives divides the
operation into five steps.
_First; the incision of the scrotum and the dartos._--The operator, with
or without the aid of an assistant, makes a straight longitudinal
incision upon the scrotum at the place where the testicle is nominally
situated, carefully dividing, also, the yellow fibrous layer which
represents the dartos, being especially careful at this point to avoid
the large venous branches which abound in the region involved. A sort of
hooked bistoury is, we understand, preferred by some veterinarians for
this incision, on the score of the additional safety secured by the use
of an instrument of that form.
_Second step; exposure of the external inguinal ring._--To accomplish
this the loose cellular tissue which lies under the dartos is torn and
divided by the fingers until the ring is felt. The
_Third step is the dissection of the vaginal sheath._--The sheath being
situated at varying depths, the dissection is effected by carefully
introducing the hand into the inguinal canal, and separating it as much
as possible by passing the fingers around its external surface.
_Fourth step; opening the sheath._--The opening is made lengthwise, and
of sufficient width to allow of the passage of the testicle. When this
organ is situated high up in the ring, it is frequently difficult to
grasp it and keep it sufficiently steady in position to permit the free
use of the bistoury. The sheath being opened and all the testicular
envelopes divided, we complete the operation by perfecting the
_Fifth stage, or the removal of the testicle._--There are two ways of
accomplishing this, viz.: the direct and the indirect division of the
cord. In the former case the amputation is effected either by the
process of cauterization, by limited torsion, or with the ecraseur. In
the latter the testicle is removed either by a ligature or by the
process of the clamps. The process by the ecraseur is at once that which
is most generally preferred and the easiest of application.
ABDOMINAL CRYPTORCHIDY.
In this severe form of the trouble under consideration, the various
steps of the operation demand careful study. Indeed, so common, so
serious, and so frequently fatal are the complications which the surgeon
may expect to encounter, that many operators habitually discourage the
interference with this peculiar violation of normal conditions.
The first two steps of the operation are similar to those which belong
to castration in inguinal cryptorchidy. Following on we have for the
_Third step, the perforation of the inguinal canal_, or the
establishment, by the operator, of an artificial communication from
without, with the abdominal cavity within. To effect this the surgeon
introduces his hand, with the fingers united in the form of a cone, into
the external inguinal ring, and carefully forces them upward towards the
external angle of the ilium, resting them upon the crural arch. He soon
reaches the closed superior inguinal ring, feeling only the peritoneal
membrane, where it is readily torn. Then tearing it sufficiently to
permit the passage of the entire hand, or as large a portion of it as is
necessary, he has reached the
_Fourth step, or the seizure and removal of the testicle._--The hand, or
three fingers, are then passed into the abdominal cavity, in order to
feel for the organ or its appendages, until the location is determined,
whether of testicle, epididymis, vas deferens, or blood vessels. These
are usually found floating not far from the torn opening of the
peritoneum. But if not so readily discovered, the hand must be carried
above the neck of the bladder, towards the end of the deferent canal,
which must be followed until the epididymis or testicle is found. It is
then carefully brought outwards by a slow and steady traction upon the
testicle itself, or upon a portion of the epididymis, or even upon the
extremity of some of the testicular blood vessels.
_Fifth step._--The removal of the organ is always much more safely
effected with the ecraseur than by other means. The operation is
completed by the application of a suture upon the external wound, in
order to guard effectually against the possibility of ventral hernia
occurring subsequently.
Abdominal cryptorchids are sometimes treated by removal through the
flank--an operation intrinsically more dangerous, as well as less
promising of success than that in the inguinal region.
EFFECTS FOLLOWING THE OPERATION OF CASTRATION.
These will vary more or less in extent and severity, according to the
method employed in its performance, and in any case they may be
considered in two divisions; as primary or immediate, and secondary or
consecutive.
Amongst the first phenomena most commonly observed is, of course, a
manifestation of pain, characterized by symptoms of colic, exhibited by
the animal in a more or less marked degree, being the result of the
unavoidable irritation arising from the manipulations practised upon the
organs of generation, whose nerves rise from the sympathetic as well as
from the cerebro-spinal nervous system; and from the pain excited in the
spermatic cord by the pressure of the clamps, for example. These colicky
pains, which are more severe under the bloodless method than in those of
the other mode, usually subside after the first hour following the
operation, and as a rule require but little treatment more than that of
the walking exercise. This sort of pain having subsided, the only
further trouble likely to be noticed is the local trouble resulting from
the lesion to which the testicular region has been subjected. Resulting
from this local lesion, as well as from the rough manipulations
attending the various steps of the different procedures, a peculiar
stiffness will be observed in the motion of the animal. This may be
referred either to the local pain proper, to the dragging to which the
cord has been subjected, or to the presence of the clamps, which,
resting closely in the groin, necessarily more or less impede the action
of locomotion.
Hemorrhage may also occur immediately after the operation, either while
the patient is still on the ground or as soon as he regains his feet.
This may be due either to the solution of continuity at the edges of the
wound of the envelopes, or may proceed from the small testicular or the
spermatic artery. The first two causes of hemorrhage need not engage our
attention, usually ceasing spontaneously, and never being attended with
serious inconvenience. It is not so, however, in the case of hemorrhage
proceeding from the spermatic blood vessel proper, occurring after those
methods of operating which dispense with the closing of the artery by
artificial appliances, as is done with the clamp or the ligature, or
which may be observed in castration by torsion, cauterization, the use
of the ecraseur, or especially by the process of simple excision. Though
not necessarily fatal, the hemorrhage in these instances may require
prompt and effectual interference by the surgeon for its suppression.
It is not rare for castrated animals to become more or less tympanitic,
a condition which may be due, more or less, to the introduction of
atmospheric air into the abdominal cavity during the performance of the
operation. This condition of things is usually remedied by the unaided
action of natural causes.
The secondary effects also vary according to the manipulations of the
method which they follow. The development of reactive fever is an event
which in many cases requires close watching, and while it is true that
many castrated horses will manifest no subsequent illness, even to the
extent of a slight elevation of temperature, others, on the contrary,
show unmistakable signs of a general inflammatory condition and this is
the more marked and definite as the condition of the wound has been left
in a more or less complicated state. The presence of the ligature or of
a portion of the cord which has yet to complete the sloughing action,
following the method by cauterization and by the clamps, are sufficient
to encourage the inflammatory tendency.
MODES OF CICATRIZATION.
The cicatrization of the wound of castration takes place in two ways.
While the upper part heals by adhesive inflammation at and above the
point where the amputation has been performed, it is below that point in
a process of cicatrization by the second intention, the parts filling up
by the development of granulations, and being accused by an abundant
suppurative process. The first fact observed is that the parts become
more or less swollen. The swelling is at first limited to the edges of
the wound, but increases and spreads to the scrotum, then to the sheath,
or even extends forwards and backwards to the perineal region. A flow of
serosity will be observed almost immediately following the operation, at
first thin and yellowish, but will, before the second or third day,
become thicker and more purulent in character, so progressing that after
that period it will become a laudable, creamy pus, in evidence of the
process going forward towards the establishment of sound and healthy
cicatrization. This cicatrization will proceed until the healing is
complete--that is, for a period varying between thirty and forty
days--the swelling slowly subsiding from the moment when the suppuration
becomes established.
THE HYGIENE AND THE SUBSEQUENT ATTENTION.
The moment the patient has risen from his bed and has been thoroughly
cleansed from the blood that has soiled his legs, it becomes necessary,
if the clamps have been used, to apply the necessary means to prevent
their removal by the action of the tail. This is done by braiding the
hairs shortly, and sometimes tying it up on the side. Even when this is
not necessary, from the clamps not having been used, it is better to
have the tail tightened up short, in order, when the suppurative process
is established, the more easily to preserve the cleanliness of that part
of the body. It is recommended by some veterinarians, also, as soon as
the animal is on his feet, to have him thoroughly rubbed and dried,
lest, as is not uncommon, he should have perspired excessively during
the operation. He may be warmly blanketed if he has been accustomed to a
covering, or in any case, placed in a quiet stall and tied up. If quiet
and unexcited, and exhibiting no immediate ill consequences of the
operation, he may, after an interval, be allowed to go loose in a box
stall. If there are any manifestations of pain, or colicky symptoms,
walking exercise may be given. Quietness, protection from changes of the
weather, moderate diet, varying according to his condition, are
included in the only general instructions that can be given.
The wound simply requires to be kept clean. Washing with cool water and
soap when the discharge is well established, will fulfil this
indication. The closing of the edges of the wound is to be carefully
prevented by the introduction of the finger between them, care being
taken to avoid the laceration of any points where union has already
taken place in the upper part of the wound.
It is not an unusual thing to find even these simple measures of caution
overlooked by gelders, some of them even recommending that the animal
should, immediately after the operation, be violently exercised--even
put in harness and made to draw a wagon. It is true that a little and
gentle exercise may be beneficial, with a view to the removal of the
soreness and pain of the newly castrated animal; it must be admitted
even that Professor Bouley recommends slow exercise to be carried to the
extent of fatiguing the animal. But when we take into consideration how
seriously some animals, at least, are affected by the operation, and the
serious complications which may follow it--even laying aside the
humanitarian view of the question--we must necessarily conclude that
such directions and such a practice is in violation of all the laws of
true surgery, and even if justified by the strongest statistics, is
condemned if confronted by a single fatal case.
CHAPTER V.
COMPLICATIONS AND TREATMENT OF THE OPERATION -- COLICS -- TEARING OF
THE CLAMPS -- HEMORRHAGE -- SWELLING OF THE SCROTAL REGION -- GANGRENE
-- ABSCESSES -- CHAMPIGNON -- EXTRA SCROTAL -- INTRA SCROTAL -- INTRA
ABDOMINAL -- VARIOUS TREATMENTS -- FISTULA OF THE SCROTUM -- INGUINAL
HERNIA -- PERITONITIS -- TETANUS -- AMAUROSIS -- COMPARATIVE VIEW OF
THE VARIOUS MODES OF CASTRATION.
COMPLICATIONS AND THEIR TREATMENT.
Though the operation of castration is comparatively simple in its
various methods and is generally successful in its results, still it is
not entirely free from accidents or complications. Indeed, among those
likely to meet our notice, there are some of quite a serious character,
which will develop themselves independently of the skill and care with
which the operation may have been performed or whatsoever attention may
have been bestowed upon the patient. Among these may be enumerated
_colics_, _hemorrhage_, _swelling_ of the scrotum, _gangrene_,
_abscesses_, _champignon_, _fistula_, _hernia_, _peritonitis_,
_tetanus_, and _amaurosis_.
COLICS.
This, we have already seen, usually appears a short time after the
completion of the operation, the suffering animal becoming uneasy,
restless in his stall, pawing the ground with his fore feet, and
sometimes lying down and rolling. As I have before stated, these
symptoms, as a rule, are of short duration, and subside without other
treatment than a little walking exercise. It is rarely the case that
they fail to yield to an anodyne, or a dose of chloral may be demanded
before the symptoms are subdued.
TEARING OF THE CLAMPS.
When this accident occurs it is commonly attributable to the omission of
a careless operator to secure the tail of the animal in such a manner as
to prevent its interference with those implements by its entanglement,
and tearing them from the end of the cord, as a consequence. The result
of this is the appearance of a hemorrhage from the spermatic artery,
which can only be controlled by either a reapplication of the clamps to
the end of the cord--if it can be thus secured--or by other means, which
will be considered when we reach the subject of bleeding in general as
connected with other causes.
HEMORRHAGE
May be primary or secondary. In the first instance it occurs in
consequence of the insufficiency of the means of hemostasis applied to
the end of the cord, as in the case of the operation by simple excision,
by cauterization, the too rapid crushing of the cord, torsion, or the
accident before referred to--when the clamps have been torn off and the
cord lacerated about the point of their application.
Secondary hemorrhage manifests itself after a longer interval following
the operation. It may occur, for example, after the removal of the
clamps, or when, during their removal, the mortified end of the cord is
too much interfered with by the sharp end of the instrument used in
cutting the string which confines them together, or from too forcibly
pulling upon the cord itself; and in some instances without any
assignable cause other than a diseased condition of the coats of the
artery. This secondary hemorrhage is usually, by reason of the
inflammatory condition of the blood vessels, of more threatening aspect
and more difficult to control than the primary variety. The treatment
indicated varies. When caused by the tearing of the clamps, or at the
time of their removal, it may be checked by the reapplication of the
instrument. But if the cord is retracted within the inguinal canal and
cannot be reached, and if it is already adherent to the surrounding
tissues, by granulations recently formed, the checking of the flow may
be very difficult. In many cases the application of cold water, either
in the shape of the cold douche over the part, or iced sponges, may
prove sufficient. But in other cases the cavity of the wound must be
packed with balls of oakum, wet either with water alone or any styptic
agent, such as a solution of perchloride of iron, the whole being kept
in place by a suspensory bandage, or if necessary, a few points of
suture.
These measures may be put in practice while the animal is on his feet;
but if they fail in their effect, the surgeon must at once proceed to
cast his patient and ligate the artery--an operation of delicate
execution, and not always easy to perform, by reason of the deep seated
position of the vessel. The use of the actual cautery has also been
recommended, but even when successful there are many objections to this,
one of which is the complication such an operation may bring on by the
introduction into the wound of a scab which must necessitate for its
expulsion a serious amount of inflammatory action. As a rule, however,
the operation of packing is all that is required, the oakum being left
undisturbed for twenty-four or even thirty-six hours. Its removal must
be undertaken with great caution.
SWELLING OF THE SCROTAL REGION.
This, as we have seen, is an almost necessary consequence of the
operation, the swelling making its appearance a short time after the
alteration is accomplished. It usually first affects the parts
immediately around the edges of the wound, and spreads forwards and
upwards in such a manner that the entire scrotum and sheath become the
seat of it. It is somewhat warm, tense, and slightly painful. If there
is no increase beyond these limits, there is no occasion for alarm, as
by exercise, fomentations, and scarifications, with the administration
of diuretics, it ordinarily subsides. But if it continues to increase,
and extends upwards and backwards, involving the inside of the thighs
and the perineum, loses its character of heat and soreness, to become
cold and painless, crepitating under pressure, we must prepare to
encounter the most severe of all complications, that of gangrene,
requiring the most prompt and vigorous treatment, as we shall presently
see. It may also happen that even while retaining the characteristics of
healthy œdema, it may assume such dimensions that the penis becomes so
involved that phymosis and paraphymosis may supervene, to add to the
other complications. These, however, are not serious sequelæ, as by
proper care, with fomentations or scarifications, and the use of a
suspensory bandage, they may be readily overcome.
GANGRENE.
This accident may be looked for from the fourth to the eighth day,
manifesting itself not only by the extent which the œdema of the
scrotal region assumes, and by its characteristics of coldness, loss of
sensibility, and crepitant feeling, but by the fœtid odor proceeding
from the wound, and by a change in the character, or the disappearance
of the suppuration, which is succeeded by a sanious, bloody and
offensive discharge. To this series of symptoms are to be added a marked
increase of the general disturbance, manifested by increased thirst,
anorexia, fœtid mouth, change of color in the mucous membrane to a livid
hue, increase of pulse, with weakening, increased respiration,
temperature at first elevated and then diminished, and after five or six
days a final termination in the death of the patient.
The progress of this complication is so rapid, and the chances of
recovery are so few, that the necessity for prompt treatment becomes at
once obvious. All the diseased and mortified parts must be removed at
once, and means instantly employed to prevent the absorption of
gangrenous matter. Friction with ammoniacal and turpentine liniments
must be used over the swelling; the parts must be subjected to the
actual cautery at white heat, and disinfecting agents of all kinds must
be freely used, as chloride of lime, carbolic acid, and permanganate of
potash, while internal treatment must immediately be instituted by the
administration of stimulants and antiseptics in the form of ammonia and
phenic acid, or its preparations.
ABSCESSES.
When these are likely to result from a too rapid closure of the edges of
the scrotal envelope, the premature union may be readily prevented, as
we have before stated, by the careful introduction of the finger into
the wound while it is still suppurating. But notwithstanding this
precaution they will sometimes occur as the result of the infiltration
and accumulation of the suppurative matter. A free incision and proper
attention to the cavity of the abscess, is all that this accident
requires. A careful examination of the parts will, however, reveal
another cause for the formation of these abscesses. It is then against
these causes that the therapeutic treatment must be directed. We refer
now to the complication known as the formation of a
CHAMPIGNON.
This name is applied to an indurated condition of the end of the cord,
or in its thickness, of a tumefied character, varying in size and
extent, and slow in its growth. It results from an excess of
inflammatory action, attributable to the manipulations which become
necessary during the performance of the operation. The name “champignon”
(or mushroom) is applied to it by the French, on account of the
pedunculated appearance which it sometimes assumes, and which causes it
to greatly resemble that fungus in its outward figure. It is also known
as schirrous or indurated cord. The tumor is sometimes situated on the
outside of the envelopes, when it is known as _extra-scrotal_, but more
commonly it is found covered by the skin, in which case it is better
known as _intra-scrotal_. In this latter condition it may be merely a
growth at the end of the cord, becoming, as determined by its location,
of an _extra-inguinal_ character, or if the diseased process extends as
far as the upper inguinal opening, or beyond it, it becomes, and is so
denominated, _intra-abdominal_. There is also an _extra-intra-scrotal_
growth, when it is partly within and partly external to the scrotum.
This tumor will vary greatly in size, being sometimes very small in
dimensions, and at others having those of a man’s fist. We have
ourselves observed it equalling a child’s head in size.
The causes from which it originates are obscure, and cannot be very well
defined. Still, they may be arranged under the heading of any of the
morbific causes which may excite an excess of inflammatory action at the
end of the cord. Amongst these may be enumerated all violent tractions
upon the cord at the time of the operation; all unnecessary
manipulations during the process of cicatrization, such as the too
frequent introduction of the finger into the wound with destruction of
the granulations already adherent to the cord, and the application of
the appliances for its division too low down upon it, leaving that organ
hanging too much, and the retraction of the organ being insufficient to
retain it in the inguinal sac. Still, as a champignon may be developed
in the absence of all these causes, it would seem that their growth may
be attributed also to some specific idiosyncrasy in the animal affected,
the true nature of which cannot be very accurately or easily understood.
It is held, however, by certain German and Russian authors that
exposure to cold exercises a great deal of influence in the development
of this affection, and observation has largely established the fact of
its greater prevalence during cold seasons.
_Symptoms of extra-scrotal champignon._--This is otherwise known in the
terminology of some pathologists as _true_ or _superficial champignon_.
It develops itself at the cut extremity of the cord as a granulating
mass, of a red color, varying in size, its growth, nevertheless,
allowing the cicatrization of the skin to progress in such a manner that
it forms a point of attachment from which the tumor seems to proceed.
This form of it is usually of little account, as it may easily be
removed before it has attained to troublesome dimensions. When of
considerable proportions, however, it may interfere materially with the
act of locomotion by causing pain in the cord, upon which it drags more
or less. It is not often or necessarily accompanied by constitutional
disturbance, excepting in cases of excessive suppuration, which may
sooner or later undermine the general health by exhausting the stamina
of the patient.
If instead of showing its greatest development on the surface of the
scrotum, it occurs beneath it, a greater or less degree of swelling will
appear on one or both sides of the inguinal region, the swelling being
somewhat hard, possibly the seat of one or more fistulous tracks
resulting from abscesses which have at times opened, discharged, and
closed; the animal showing a certain amount of stiffness in the action
of the hind legs. In this case we shall have to adapt our treatment to
the _deep champignon_ of Zundel, under one of its three forms of
_extra-inguinal_, _intra-inguinal_, and _intra-abdominal_.
Under the first head we shall often discover, upon inquiring into the
history of the case, that for a length of time, varying from months,
perhaps, to years, the animal had been affected with a swelling which
would gather, break, and slowly heal, leaving no mark as an apparent
indication of a diseased condition, excepting that a certain degree of
lameness would have been observed to be present. Upon exploring the
testicular region it would then be observed to be the seat of a tumor,
either spherical or pysiform, seldom painful, and more or less adherent
to the envelope that covered it. Above this the end may be felt free
from diseased process, and this is the champignon in its chronic form.
In this condition it is not incompatible with the general health of the
animal affected, and forms no hindrance to his usefulness. This
condition of extra-inguinal growth will sometimes dissolve away by an
abscess-formation, and quite disappear. But if the induration of the
spermatic cord extends to the upper portion, or that which is enclosed
in the inguinal canal, in such a manner as to interfere with locomotion,
the leg corresponding with the diseased side being carried in abduction,
with numerous fistulous tracks existing on the surface of the scrotum,
the intensity of the symptoms varying with the extent of the diseased
process, the condition of the cord will be easily discovered by an
examination of the parts, and the presence of an _intra-inguinal
champignon_ established. If, besides these symptoms, we discover by
rectal examination that there is in front of and above the pubes a tumor
more or less ovoid, or giving the sensation of a cylindrical mass, of
size varying to the touch--which is the diseased indurated cord--the
case is judged at once to be one of _intra-abdominal_ nature. At times
the inflammation may extend to the sub-lumbar region, when the hand
introduced into the rectum may discover in that locality an ovoid tumor
or abscess which may be of great size. This form of champignon is
incomparably the most serious of them all; an intense and persistent
reactive fever is always present, and this at length terminates together
the life and suffering of the animal. The abscess may sometimes open
externally, and in some cases it may accumulate within the thickness of
the cord and form large collections; or, again, it may find its way into
the abdominal cavity, where it may excite a fatal peritonitis.
This rapid examination of the various forms of deep champignon will
enable us easily to realize the difficulty of the progress in the case.
While the pedunculated form, exterior to the scrotum, is not,
comparatively, a very serious matter, it becomes, on the contrary, a
very grave occurrence when it assumes the characters of the
intra-abdominal variety, and must in a majority of cases be recognized
as an incurable disorder.
_Treatment._--While champignon is an affection in which surgical
interference cannot usually be dispensed with, it is still essential
that the surgeon should avoid being over hasty in determining in favor
of an operation, and he should give the case a very careful
consideration before deciding upon his course. At first emollient
applications, appropriate topical treatment, and a few points of
cauterization, may be followed by a process of resolution. But in the
event of their failure four modes of operation present themselves. These
are, in their order, the application of the clamps; the ligature; the
linear crushing or ecraseur; and cauterization. When the case is one of
the extra-scrotal variety, the application of a ligature around the base
of the peduncle, or removal by ecraseur, will be the simplest mode of
treatment, unless there should exist a tendency to infiltration of the
cord, in which case the manipulations to be followed become the same as
those which are adapted to that of the deep or intra-scrotal form.
[Illustration: FIG. 25.
CURVED CLAMPS.]
_By the clamps._--When the application of the clamps is resorted to,
they may be similar to those used in ordinary castration, or may be
curved in form (Fig. 25). The animal to be operated on is to be thrown
on either side according to which cord is affected, and an incision
made through the envelopes as nearly parallel with the median line of
the body as the case permits, when the tumor and the cord are carefully
dissected and separated from their adhesions. If the tumor is suspended
from the end of the cord there will be no difficulty in applying the
clamp above it and upon a healthy portion of the cord. But if the
diseased process extends within the inguinal canal, there will be need
of great caution in dissecting the cord up to the healthy structure. In
doing this the safer mode will be for the operator to treat the
adhesions with the fingers or the blunt end of the scissors, rather than
to employ the sharp edge of the bistoury with the accompanying danger of
causing hemorrhage. If, on the contrary, the cord is diseased to an
extent that renders it difficult to reach a healthy portion, other modes
of operation--as by the ligature--become the wiser and more practicable
indication. When the clamps are used it is necessary to leave them in
place for several days, and sometimes they are allowed to slough off,
while the growth is usually suffered to remain for a few days after the
operation.
[Illustration: FIG. 26.
LIGATURE-CARRIER.]
_Ligature._--When this mode of procedure is adopted, the tumor having
been dissected and the cord well freed from its adhesions with
surrounding parts, and the ligature being applied, the tumor may either
be amputated immediately or be left to slough off in its own time. The
ligature may be either of twine, silk, or elastic cord. We have
ourselves operated by this method in the successful removal of growths
of very considerable size. So long as the upper portion of the cord,
which retains its healthy structure, can be reached, the application of
the ligature is attended with no difficulty, the manipulations required
being similar to those which attend the removal of all growths by the
process of ligation. But if the diseased process extends so far that the
ligature cannot be applied at the proper point, as in the case of
intra-inguinal champignon, it will be necessary to have resort to the
ligature-carrier recommended by Serres (Fig. 26). In using this
instrument the loop of the ligature being passed over the tumor around
the cord, is carried into the inguinal canal as high up as possible,
pressure being made by holding the instrument against the cord, while
strong traction is made on the ends of the ligature, which is then
secured by a knot upon a small stick placed across the opening of the
instrument, with a view to the prevention of slipping. If an increase of
pressure is found to be necessary, it can easily be obtained by
tightening the ligature from day to day as required. If the size of the
cord should be such as to prevent a proper application of a single
ligature, it may become necessary to divide it in applying a double,
triple, or multiple ligatures, in accordance with the rules for such
ligating.
In whatsoever manner the ligature may be applied, even when it is of the
elastic kind, the process of sloughing of the tissues is always a slow
one. It is for this reason that we agree with Prof. Bouley in
considering the treatment of champignon by the linear crushing very much
to be preferred.
_Ecraseur._--The steps of the operation with this instrument are similar
to those required in the other methods already considered. The
champignon is isolated from its surrounding parts, the chain is placed
on the cord above the base of the tumor, and the amputation is completed
by a slow pressure upon the cord, which, crushing it by degrees, permits
its immediate removal. It must be done slowly, occupying from ten to
twenty minutes for the complete separation of the champignon, according
to the size of the tumor. The operation being finished, the parts are
left in the condition of a simple wound, where no cause exists to
interfere with its rapid cicatrization.
_Cauterization._--This is a mode of treatment which we have never had
occasion to submit to trial, having always given the preference to the
process we have just referred to. It is recommended, however, by
European authorities. Some of these advocate the “melting” process, or
the introduction of sharp points deeply into the thickest parts of the
enlargement, while others advise a removal of a portion of the growth
and deep cauterization afterwards. If cauterization can be
advantageously employed, the best method, in our judgment, would be the
process of amputation with Paccalin, or with the galvanic cautery. We
may here, while referring to the application of electricity in this
connection, appropriately refer to our own experience of a number of
years ago, in treating an animal suffering with intra-scrotal
champignon, by electrolysis, and succeeding after two applications, in
obtaining the complete removal of the tumor. This method, however,
consumes too much time to justify its employment in general practice.
FISTULA OF THE SCROTUM.
Being already aware of several causes of this complication of the
operation of castration, we may readily appreciate the treatment they
require. It must be remembered that in a majority of cases, the cause of
this lesion is the presence of a foreign body in the wound, and that
until it is removed, it is in vain to look for a cure. Prof. Bouley has
reported a case in which the fistula was due to the presence of a pair
of clamps over which the skin had almost entirely cicatrized.
INGUINAL HERNIA; HERNIA OF CASTRATION.
By this is understood the protrusion of some portion of the contents of
the abdominal cavity through the inguinal ring, either a portion of the
omentum or of some part of the small intestines, creating either an
epiplocele or an enterocele. This complication may take place either
during the operation, or shortly afterwards, or at the period of the
removal of the clamps. It proceeds from the violent struggling of the
animal during the operation; to the colics which are so apt to
supervene; to his position when placed in a stall of which the floor is
too much inclined; or it may result from some of the various modes of
castration, as, for example, the uncovered operation.
At times the two forms of hernia may present themselves together,
constituting a case of entero-epiplocele. When the epiploan alone
protrudes, it need not give rise to any unnecessary anxiety, as it may
easily be either reduced and returned to its place, or ligated with the
clamps, or torn apart. If, on the contrary, it is a portion of the small
intestines which becomes involved, the first indication is to restore it
to its place by the proper taxis without delay, which may be readily
done, the animal being yet down and placed under an anesthetic, by the
rectal taxis combined with the necessary inguinal manipulations. When
this has been accomplished the intestine is kept in place by the
application of a clamp over the cord, upon which the fibrous coat of the
cremaster has been carefully drawn.
PERITONITIS.
This complication, considered as one of the most frequent following
castration, is also, beyond doubt, one of the most serious. It is
generally the result of exposure to cold, especially when its occurrence
accompanies the suppurative fever. But it also develops itself in
animals which have received the best hygienic care, its appearance being
attributed to an excessive dragging of the cord, or to the extension of
the local inflammation by continuity of tissues. It manifests itself
generally between the second and third day following the operation,
except when it becomes symptomatic, as of gangrene of the cord, when we
have seen it making its appearance towards the tenth day.
The symptoms of this traumatic peritonitis differ somewhat from those of
the acute inflammatory type. According to Gourdon, “the animal is dull
and refuses all food--the suppuration of the wound of the scrotum has
ceased, the bags and surrounding parts become the seat of a warm, hard
and painful swelling. The animal stands with his four legs brought close
together, the back is stiff and arched, the flanks are cordy, the
abdomen painful, the pulse hard, small and increased. As the disease
progresses, the symptoms are more marked, the enlargement of the
envelopes increases and is more diffuse, it extends down to the abdomen,
and even under the chest, passes along the thighs, is less warm, less
hard, less painful, and pits under pressure. There are slight colics,
the pulse gets smaller, intermittent, the respiration is increased, and
the animal dies towards the fifth or sixth day.”
The treatment to be recommended varies according to different authors.
While some prescribe depletive and sedative treatment, laxatives and
diuretics, many prefer tonics and stimulants. The Germans claim great
results from the use of tincture of arnica (in small doses) administered
internally. The external treatment consists in sinapisms, warm
fomentations, poultices, or fumigations under the abdomen.
TETANUS.
As with most cases of traumatic tetanus, this complication is generally
fatal, and it is, without doubt, the most dangerous of all and marked by
the greatest mortality. It is generally admitted that exposure to cold
and dampness is one of the most prolific causes, especially in animals
which, having but recently recovered, are too soon put to work. The
various modes of operation have also been considered to have some
influence upon its development, though there is probably no ground upon
which this theory can find a support. Whether the nature of the soil of
a district, or its atmospheric condition, may have any connection with
it, is also a question. We know that in some portions of Long Island,
cases of tetanus are commonly met with, at some seasons of the year,
after surgical operations of every kind. It may appear within a few days
following the castration, or it may defer its visitation for a period of
twenty days, or longer.
The treatment adopted for the tetanus of castration is that which is
applied to all cases of that traumatic affection.
AMAUROSIS.
This disease may also be included among those classed as the sequelæ of
castration, having been known to follow cases where hemorrhage of the
small testicular artery had occurred. Tonic treatment internally and
local stimulating applications may sometimes relieve this complication,
but it will generally be admitted to be incurable.
COMPARATIVE VIEW OF THE VARIOUS MODES OF CASTRATION.
The process by _simple excision_, by reason of the hemorrhage which
necessarily accompanies it, though not inevitably dangerous, must be
excluded from the domain of general practice.
That of _scraping the cord_ has not, so far as our knowledge extends,
been sufficiently tested, either in European or American practice, to
justify its recommendation.
The process of _torsion below the epididymis_ is too much subject to the
development of champignon, as well as that of _free torsion_ with the
hands, to be admitted by judicious operators, while the _limited
torsion_ is a method which has taken rank amongst safe operators,
notwithstanding the enormous swelling of the parts by which it is
commonly accompanied, and the necessity it involves of the introduction
of the fingers into the wound to prevent its premature closing.
The method by the _ecraseur_, though occupying a longer time in its
completion than some others, has secured very favorable results,
especially in the hands of American operators.
The operation by _cauterization_ is highly recommended by English
veterinarians. We believe, contrary to the statements of French authors,
that it is not widely in use on this Continent. The objections urged
against it are that the hemostatic effect upon the cord is less reliable
than in the method by the clamps or the ligature; that there is more or
less danger of cauterizing the surrounding parts by the effect of the
radiant heat from the cautery; and that the swelling which follows the
operation is always excessively great.
Castration by the _clamps_ is the best known and most extensively
practised. It is easy and quick in its performance; performs the most
certain hemostasis upon the artery, and notwithstanding some slight
objections, merits a preference over all others. The principal objection
alleged against it is that it is attended with great pain to the
suffering patient when the pressure of the instrument upon the soft
tissues is first felt. This is a doubtful question, and if this
excessive amount of pain really exists, it certainly cannot be of long
continuance, merely on account of the effect produced by the clamps
themselves.
Of the various methods by _ligature_, that of the ligation of the cord
with its envelopes is applicable to small animals only. That upon the
cord alone is liable to be followed by hemorrhage, or by the excessive
retraction of the cord into the abdominal cavity, drawing the ligature
with it. That of the efferent canal, and of the cord by the subcutaneous
mode are not admitted in general practice, while that of the artery
alone has not been extensively performed on large animals, so far as we
are informed, except by certain Massachusetts veterinarians.
The castration by _double subcutaneous twisting_, when extensively
applied to solipeds, will probably prove to be the safest mode of all,
and least likely to be followed by complications. We are not informed as
to the extent to which it has been practised in this country, even
amongst ruminants.
CHAPTER VI.
CASTRATION OF FEMALES -- HISTORY -- INDICATIONS -- EFFECTS UPON THE
ORGANISM AND SPECIAL FUNCTIONS -- ADVANTAGES IN COWS -- CONDITIONS
FAVORABLE TO THE OPERATION -- ANATOMY -- MODUS OPERANDI -- BY THE
FLANKS -- CHARLIER’S PROCESS -- INSTRUMENTS -- VARIOUS STEPS --
DIVISION OF THE VAGINA -- SEIZING THE OVARY -- TWISTING IT OFF --
COMPLICATIONS -- HEMORRHAGE -- PERITONITIS -- ABSCESS OF THE PELVIC
CAVITY -- CONSTIPATION -- SUBCUTANEOUS EMPHYSEMA -- CASTRATION OF THE
SMALL ANIMALS -- OF SWINE -- OF SLUTS -- OF FOWLS.
As I have stated before, the revival of the operation of castration upon
large females is due to a Louisiana farmer, Thomas Winn, who, in the
year 1831, castrated several of his cows.
Without entering upon the history which includes a record of the
failures and successes attendant upon the introduction of the operation,
it may suffice to say that until the improvements made by Charlier in
the manipulations involved in the operation, it encountered considerable
opposition, and it is within a comparatively recent period that it has
become established in the domains of veterinary surgery.
The indications by which this operation commend itself to
agriculturists, and others who find profit or pleasure in the use or
ownership of these domestic animals, are several. Among them are the
influence which it exercises upon the secretion of milk in cows, and
upon the power of accumulating fat, and its effects upon the character
and temper of all the large females, in which relation it obviously acts
as a therapeutic agent, in overcoming certain peculiar conditions by
which they are distinguished. In respect to the effect of the operation
of spaying the cow upon the milk secretion, it is a fact well
established that it not only increases the amount and duration of the
flow, but also improves the quality of that valuable fluid, the spayed
cow not only continuing the production from eighteen to twenty-four
months, but giving a product far richer in the elements of nutrition.
This is shown by the enhanced proportions of the cream, the caseine and
the sugar, which determine its richness and value, both economically and
commercially, after alteration.
But even this argument in favor of spaying the cow is rendered more
weighty by the fact that besides its influence on the milky secretion,
there is also that which is furnished by the consideration of its effect
in augmenting the deposit of fat throughout the frame, for it is through
this tendency that the flesh of the animal becomes so greatly improved
in its nutritive quality as compared with that of the same species when
in the entire condition, becoming so noticeably more tender, juicy and
palatable, retaining more of the oily element, digesting more easily,
and so, of course, acquiring a pecuniary value in the market not before
possessed. These remarks apply to the dry equally with the milch cow,
and leaving out the reference to the milk secretion, to the ox as well.
With respect to the effect of the operation upon the character and
disposition of the cow, these are easily illustrated in the movements of
the nymphomaniac animal, which may be said to be constantly in a state
of hysterical excitement. They seem to be in continual conditions of
heat, running after and mounting other animals with which they may be in
company, while never producing and giving no milk. They are always in a
lean condition, and must remain a pecuniary loss to the dairyman. This
manifestation of nymphomania is also met with in the mare, which,
continually exhibiting signs of heat, becomes more or less dangerous on
that account. In these cases the advantage of the operation of spaying
cannot be overlooked. We have personal knowledge of several cases of
this character, in which worthless and troublesome mares have been
transformed into docile and valuable animals.
CONDITIONS FAVORABLE TO THE OPERATION.
Charlier expresses the opinion that the best time for the performance of
the operation upon cows is from the sixth to the eighth year, or after
they have had their second or third calf. If performed at an earlier
period the great objection originally urged against castration, that its
performance would tend to the diminution of the stock in numbers or
“population,” might find more or less confirmation. But by an observance
of this condition all danger of the annihilation of stock would be
obviated. The cow to be operated on ought to be in fair condition, not
in heat or pregnant, and the time selected should be from forty to sixty
days after calving.
ANATOMY.
The _vagina_ is situated within the pelvic cavity, between the rectum
and the bladder. Its internal face presents numerous longitudinal folds,
the purpose of which is to permit the free dilatation of the parts. At
the bottom of the passage is situated the _neck of the uterus_, giving
to the finger the sensation of a projection, hard towards the cavity of
the vagina, and in the centre of which is felt a closed opening, from
which radiate the folds of the mucous membrane. The _uterus_ (Figs. 27
and 28), continued forward to the neck, is situated in the abdominal
cavity, occupying the sub-lumbar region, with its posterior extremity
resting at the end of the pelvic cavity. It is somewhat pyriform in
shape, and larger at its base, where it divides into two lateral halves,
continued by the _horns_. The concave curvature of these horns look
downward in the cow, but face upwards in the mare. In both they give
attachment to the _broad ligaments_. These are folds of the peritoneum,
more developed forward than behind, rising from the sub-lumbar region,
and descending towards the uterus, to fix themselves upon the sides of
the superior face of the body of this organ, and, as before stated, upon
the curvature of the horns. Their anterior border is free, and gives
support to the oviducts and the ovaries. Between the serous layers are
found the utero-ovarian artery and veins, largely developed. The
_ovaries_ are situated on the internal face of the broad ligament,
forming a small ovoid mass, which receives a special serous lamella, a
sort of ligament, having between its layers a few grayish muscular
fibres, which may be strong enough to offer serious resistance when the
extirpation of the organ is attempted.
MODUS OPERANDI.
There are two modes of operation. The original method was that of
removal through the flanks, which, however, has fallen into disuse since
the introduction of the process of Charlier, of removal through the
vagina. This process is altogether to be preferred, as being safer, more
consistent with scientific surgery, and in a word is the only one which
it is proper to perform, so long as the capacity of the vagina permits
the necessary manipulations to be performed.
[Illustration: FIG. 27.
RIGHT OVARY OF THE COW WITH ITS ATTACHMENTS.
U.--Right horn of the uterus. L.--Broad ligament. L′--Its anterior
border. O.--Ovary. R.--Peritoneal fold where it is suspended.
S.--Superior ovarian ligament. T.--Inferior ovarian ligament.
A.--Ovarian artery. V.--Ovarian vein. I.--Oviduct. P.--Its pavilion.
X.--Its superior or fimbriated opening. Z.--Its inferior opening.]
[Illustration: FIG. 28.
LONGITUDINAL SECTION OF THE PELVIS OF THE MARE SHOWING THE POSITION AND
CONNECTION OF THE GENITAL ORGANS.
1--Uterus. 2--Horn of the uterus. 3--Vagina. 4--Bladder. 5--Rectum. 7
8--Vulva. 9--Ovary. 10--Oviduct. 11--Kidney. 12--Broad ligament.]
METHOD BY THE FLANKS.
Four steps are necessary to be followed in this method. The first
is securing the animal. The cow is usually kept on her feet, pressed
firmly against a wall, the legs secured with hobbles, and her head
controlled, as much as possible, by a strong assistant. The second step
is the incision of the flank. This is made on the left side, with a
sharp, convex bistoury, in the middle of the superior portion of that
region, dividing the skin and muscles vertically, care being taken that
the incision is not carried too low down, in order to avoid the division
of the circumflex artery, which passes along in that vicinity. An
opening is then made in the peritoneum, either with the knife or with
the fingers, sufficiently large to permit the introduction of the
fingers. In the third step of the operation, which comprehends the
removal of the ovary, the surgeon introduces his hand into the abdomen,
and turning it towards the pelvis, feels for the horns of the uterus.
Upon finding these the ovaries are easily discovered. He carefully draws
them outwards, and their removal is effected either with the ecraseur or
the forceps of Charlier. The operation is concluded by the application
of a quill suture.
[Illustration: FIG. 29.--CHARLIER’S VAGINAL SPECULUM.
(Closed.) (Open.)]
[Illustration: FIG. 30.
MODIFIED VAGINAL SPECULUM.]
[Illustration: FIG. 31.
BISTOURY CACHÉ.]
[Illustration: FIG. 32.
COLIN’S BISTOURY CACHÉ.]
CHARLIER’S METHOD--INSTRUMENTS.
For this operation special instruments are required. These consist of,
first, a vaginal dilator (Fig. 29), or speculum, of peculiar and
somewhat complicated construction, to be modified subsequently by
another (Fig 30), of superior form and easier of application, and now in
general use; second, a bistoury caché (Fig. 31), sliding on its handles,
which is a true embryotomy knife, modified by Colin (Fig. 32); third, a
pair of long, sharp scissors (Fig. 33), with guarded blades, curved on
its flat surface; fourth, a torsion forceps (Fig. 34), closed by a
peculiar thread arrangement, moved by the handle; and fifth, a steel
thimble (Fig. 35), which has been modified by the instrument shown in
Fig. 36, and which is used in applying the limited torsion on the
broad ligaments.
[Illustration: FIG. 33.
SCISSORS TO DIVIDE THE BROAD LIGAMENT.]
[Illustration: FIG. 34.
FORCEPS FOR CASTRATION OF COWS.]
[Illustration: FIG. 35.--THIMBLE FOR CASTRATION.]
[Illustration: FIG. 36.--COLIN’S NIPPERS, to take the place of the
thimble.]
_Preparation of the animal._--No general preparation is required, except
one, which may be regarded as of local effect, but is not to be
overlooked. This consists in the evacuation of the bowels by means of a
rectal injection, in order that the arms of the surgeon may not become
unnecessarily soiled during the operation. The animal is secured on her
feet by being placed in a narrow stall to prevent her from moving from
side to side, the floor of the stall having an inclination forwards, in
order to prevent the pressure by gravitation of the intestinal mass
towards the posterior parts of the abdomen.
The operation is completed in two steps, of which the first is the
incision of the vagina, and the second the extirpation of the ovaries.
THE INCISION IN THE VAGINA.
This is made in the following manner. The operator introduces the
speculum with his right hand, through the vulva, into the vaginal
cavity, and carefully passing in his left hand, well oiled, directs and
introduces the little prolongation A of the speculum into the centre of
the neck of the uterus, gently pressing upon it in order to keep it in
place. In using the original dilator, the opening of the branches must
be so regulated as to put the walls of the vagina upon the stretch. Or,
if he uses the modified speculum, he pushes the instrument downwards and
forwards, and by this motion distends the upper wall of the cavity,
keeping the instrument in that position by a hold of the left hand,
which has been withdrawn from the vagina. He then arms himself with the
bistoury caché, which he holds closed in his full hand and introduces
with the right hand into the vagina. Carefully feeling the condition of
the upper wall of this cavity, and assuring himself of its being well
stretched, he rests his hand, still holding the bistoury, upon the
opening or “window” at the end of the speculum (Figs. 37 and 38), and by
firmly pushing the blade (the sharp edge being turned backwards) out of
its handle, pierces with it the vaginal walls, about two inches above
the neck of the uterus, and with a motion from below upwards and from
before backwards, makes an incision on the median line, from three to
three and a half inches in length. The introduction of the instrument
must be made in such a manner that it will pass at once through the
walls of the vagina proper, as well as through the peritoneal cap which
it presents at its anterior portion.
The incision being completed, the speculum is carefully withdrawn; and
if a slight hemorrhage should occur, the blood should be removed before
the surgeon proceeds to the second step of the operation.
[Illustration: FIG. 37.
CASTRATION OF COWS. (Charlier’s process).
Incision of the vagina.]
[Illustration: FIG. 38.
CASTRATION OF COWS. (Charlier’s process).
1st step. Incision of the vagina.]
[Illustration: FIG. 39.
SCISSORS DIVIDING THE BROAD LIGAMENTS.]
REMOVAL OF THE OVARIES.
Then, again introducing his hand into the vagina, and passing his finger
through the opening made by the incision, he feels for the ovaries,
which he finds floating at the extremity of their ligaments, towards the
entrance of the pelvis, below, on each side, and at a short
distance from the incision, between the base of the uterine horns, near
and inside of the free border of the ligaments, and a little above the
anterior border of the pubis. Then, grasping the ovarian body, he draws
it carefully into the vagina, through the incision, and introduces the
long scissors, with the guarded blade of which he divides the thick
border of the broad ligament (Fig. 39), replacing the ovaries into the
abdomen without releasing his hold. The torsion forceps is then passed
into the vagina and through the incision, and is made to take hold with
its open jaws of the broad ligament (Fig. 40), above the ovary, and is
firmly closed by the movement of the spiral crank of the handle (D).
Both hands being now outside of the vaginal cavity, and the forceps
being secured on the broad ligament, held by the right hand, the left
thumb is protected by the thimble (E), and the hand once more inserted,
to grasp the broad ligament above the point where the jaws of the
torsion forceps are placed. In this position the torsion is made with
the forceps, the twisting of the ligament being limited by the firm
pressure made by the thimble on the thumb with the index finger, or by a
pair of crushing pincers. After several turns of the instrument, the
ovary is separated from its attachment, and may be brought out of the
cavity, still held securely between the oval jaws of the torsion
forceps. The same method is applicable to the ovaries of both sides.
These rules are subject to more or less modification by indications
which may occasionally present themselves, arising from the age of
the animal or the structure or other conditions of the ovaries.
[Illustration: FIG. 40.--TORSION OF THE OVARY.
A B--Forceps closed. B C--Forceps open. E--Thimble.]
This method of castration has been modified in many ways, both as to the
forms of the instruments used, and the mode of using them, a majority of
operators, at the present time even, discarding the dilator, and making
the incision simply by stretching the walls of the vagina and pushing
against the neck of the uterus with the hand. The manner in which the
removal of the ovaries is effected has also been subjected to many
changes. For more than twenty years, during which we have been
performing the operation, we have been accustomed to use the ecraseur in
the last step, and with excellent and satisfactory results.
The subsequent attention required by the spayed cow is usually a very
simple matter, and involves little beyond careful dieting, the patient
recovering from the general effects upon the system usually in a few
days.
COMPLICATIONS.
It may properly be said that there are no complications likely to follow
the process in the castration of cows, which may be denominated serious.
In the statistics which record the mortality attending it, the fatal
cases are represented at the very trifling rate of two per cent. A light
colic may sometimes follow it, but it usually subsides without medical
treatment. Still, however, spaying may at times be accompanied by
accidents of a serious character, though these have considerably
diminished in frequency since the introduction of the method of
Charlier. One of these is
HEMORRHAGE,
which may occur when the torsion or the crushing of the artery has not
been sufficiently complete. But though it is likely to give rise to
peritonitis, it is not necessarily a fatal complication. We have
ourselves known of cases of its occurrence in mares which had survived
it a number of days, and when destroyed exhibited none of the lesions of
that affection.
PERITONITIS.
We have several times met with this sequel to the operation, especially
in mares. But in these cases, as revealed by _post mortem_
investigation, the disease seemed generally to have remained localized.
Less common than prior to the practice of castration per vagina, it
still is followed by fatal consequences when the entire peritoneum
becomes diseased. Its appearance usually occurs from the third to the
sixth day. There is suspension of the milky secretion, general dullness,
chills, anorexia, suspension of rumination, rapid, small and thready
pulse, sometimes painful respiration, rapid loss of flesh, and
speedily--death. The indications of treatment are similar to those which
are applicable to peritonitis in the solipeds, but the prognosis is
always serious.
ABSCESS IN THE PELVIC CAVITY.
This is a complication we have quite often encountered. Besides the
general symptoms, there are those of a local character, which are
detected by rectal examination, by which discovery is made of the
presence of a tumor on one side or the other of the vagina, varying in
size, fluctuating, and easily identified. This abscess may be opened in
the cavity of the vagina, and should be attended to as soon as discovery
is made of the fluctuating character of the growth, without waiting for
the process of natural resolution.
SUBCUTANEOUS EMPHYSEMA.
Emphysema of the subcutaneous connective tissue is said to be a common
sequel to the flank operation. Its appearance need not excite any
special uneasiness, as its termination is usually by spontaneous
disappearance. It is an accident we have never encountered in our
practice.
CONSTIPATION.
This complication, which is often met with in mares, is to be carefully
looked for, and must be relieved by laxative food and rectal injections.
It is due to the pain which accompanies defecation while the wound of
the vagina is healing, and which the animal tries to avoid by keeping
the rectum full.
CASTRATION OF THE SMALL ANIMALS.
SMALL RUMINANTS.
For these subjects, two modes of operation are to be principally
recommended. The first is the double subcutaneous torsion; the other the
ligature _en masse_ of the cord and its envelopes. Having already
considered these operations, a passing reference will suffice here.
FOR SWINE.
In _males_, the varying modes employed are the ligature, limited
torsion, and the clamps.
[Illustration: FIG. 41.
GENITAL ORGANS OF A YOUNG SOW.
(Median and antero-posterior section). 1--Ovary. 2--Horn of the uterus.
3--Body of the uterus. 4--Rectum. 5--Vagina. 6--Bladder. 7--Kidney.
9--Intestines. 10--Stump of one of the horns of the uterus.]
[Illustration: FIG. 42.
BISTOURY FOR THE CASTRATION OF SOW.
(Division of the flank).]
In _females_, it must be remembered that the horns of the uterus are
very long and flexuous (Fig. 41), and that the very small ovaries are
situated on the inside of the broad ligaments, which are very large, and
allow the horns to float freely amongst the circumvolutions of the
intestines. The animal must be prepared by being secured upon the right
side in order to expose the left flank. The incision is made with a
knife of peculiar form (Fig. 42), the coarse bristles having been
previously closely clipped off. Care should be taken to carry the left
leg in extension backwards, in such a manner that the edges of the
various tissues divided shall not meet each other when the operation is
completed. The incision may be made either vertically, horizontally, or
obliquely. When vertical it should be immediately below the lumbar
vertebra next to the last rib; if horizontal it should be parallel with
the vertebral column. The vertical incision should be preferred, because
it brings the ovaries within easy reach of the fingers. It should be
from two to three inches in length, and should be made by a single
stroke of the knife, and without dividing the peritoneum, which should,
afterwards, be either torn with the finger or carefully cut while raised
with the forceps. To find the ovaries the operator introduces the index
finger of the right hand between the vertebral column and the
intestines, and explores the lumbar region. Upon finding the ovarian
sac, he presses it against the abdominal wall and causes it to slide by
pushing towards the opening through which it is extruded and grasped.
While it is held there the left horn is carefully drawn out after it,
until arriving at the bifurcation of the horns at the uterus, the right
horn also is brought out and the ovary on that side secured. Both glands
being now outside, they are torn or scraped off from their attachment,
and the horns are returned to the abdomen.
While this process is readily applicable to young sows, and requires a
certain amount of practice to be performed expertly and with success, it
is slightly modified when applied to older animals. In that case the two
horns must not be exposed outside together, but each must be returned
when the removal of the ovary connected with it has been effected.
The simple tearing of the ovaries is not always sufficient, and may be
sometimes followed by serious hemorrhage. The scraping and the torsion
are safer, and in some instances the ligature has been applied. The
incision is closed with the interrupted or, which is preferable, the
continued suture. No special after-treatment is required beyond low diet
for a few days, with a little extra attention to cleanliness.
The operation may at times be rendered difficult by exceptional and
accidental conditions, as, for example, the shortness of the fingers of
the operator. This difficulty, however, can be overcome by placing a
bundle of straw or other substance under the right flank, which, by
raising the body displaces the intestines upwards and crowds the ovary
towards the left flank.
It may also happen, as sometimes with old sows, that the ovary has
become the seat of large cysts, or that its size is increased in
consequence of pathological changes in its structure. In the first case,
the cyst may be punctured and emptied with a trochar before attempting
the obliteration of the organ. In the second, the opening into the
abdomen must be enlarged sufficiently to permit the exit of the extra
bulk.
If through inadvertence the operation has been begun while the animal is
in a state of pregnancy, the proceeding must be discontinued, the
patient kept quiet and the matter indefinitely postponed.
[Illustration: FIG. 43.
GENITAL ORGANS OF THE BITCH.
1--Ovary. 2--Fold of the broad ligament, displaced to expose the ovary.
3--Internal fold of the same. 4--Broad ligaments. 5--Horn of the uterus.
6--Its body. 7--Rectum. 8--Vagina. 9--Kidney. 10--Bladder.
11--Descending colon.]
DOGS.
The _male_ is altered by either the process of excision, torsion, or
ligature, according to the age and size of the animal.
In the _female_, when, as is sometimes supposed, it becomes a preventive
measure in respect to hydrophobia--though if it be so, it can only be
from the fact that a castrated bitch will usually remain at home while
others are running abroad in heat, and thus being more exposed to
contagion--the operation is only justifiable in the case of house dogs,
domestic pets, in order to obviate the annoyance caused to their owners
by their demonstrations while in heat. In the bitch the broad ligaments
are very long (Fig. 43), extending as far as the hypochondriac region,
where they divide into an external layer, which reaches to the last rib,
while the other extends to the sub-lumbar region behind the diaphragm.
The broad ligaments diminish in height as they run forward in such a way
that the anterior border of the external layer where the ovary is found,
shorter in its median part, gives a certain amount of fixity to the
anterior extremity of the horns which it keeps elevated in each
hypochondriac region; on that account both horns cannot be at one time
brought through the incision, and it becomes generally necessary in the
bitch to operate on each side.
The manipulations are similar to those followed in spaying sows, with
the exception that the incision is made lower, more forward and nearer
to the last rib.
CASTRATION OF FOWLS.
The effect of this operation upon the quality of the flesh and the
power of accumulating fat, in the domestic fowl is a fact too familiar
to those who have learned to appreciate the exquisite juicy quality of
the meat of the capon to need any comment at our hands. The operation
upon these animals is one of considerable difficulty and requires skill
and experience to perform with nicety and success.
In birds the testicles are situated in the abdominal cavity, immediately
behind the lungs, under the vertebral column and in front of the kidneys
(Fig. 44). They correspond exactly to the articulation of the last three
ribs with the spinal column, where they lie close together and in
contact with the blood vessels which separate them from the kidneys.
They are held in position by the peritoneum spread above them, and by
minute blood vessels, branches of the aorta or of the vena cava.
[Illustration: FIG. 44.
GENITAL ORGAN OF THE ROOSTER.
1.--Testicle. 2a, 2d.--Deferent canals. 3.--Ureters. 4.--Cloacum.
5.--Posterior aorta. 7.--Posterior vena cava. 8, 9, 10.--Three last
ribs. 11.--Pelvic bones.]
In the operation the fowl is placed on his side, the tail being towards
the operator, with the hind leg carried backwards, in order to expose
the flank of the side selected for the incision. The first step of the
operation consists in plucking the feathers from a sufficient extent of
surface, and making an incision a little behind the lateral internal
processes of the sternum, from within outwards, and from before
backwards, and slightly oblique, through the skin and the thin muscles
of the abdomen, and when reaching the peritoneum carefully opening it
with a puncture, having it raised with a pair of forceps. The second
step, or that which involves the extirpation of the gland, is performed
by the introduction of the index finger of the right hand into the
abdomen, passing it above the intestinal mass and turning towards the
dorsal region near the articulation of the last two ribs, where the
testicles are felt, prominent at the sub-lumbar region. Then, with the
fingers half flexed, the adhesions of the organ are broken off, and the
organ, held in the bend of the finger, is brought outside. The second
testicle is removed by the same process. If the testicles should slip
from the grasp of the finger, the accident is of little account, as they
will graft themselves upon the walls of the abdomen, and in time
disappear by resolution. The operation is concluded by the closing of
the wound by stitches of interrupted suture, and the healing usually
takes place by first intention.
The operation is performed in the hen in the same manner as with the
male bird, the ovaries being found in the lumbar region, from which they
are removed by the same manipulations that are employed in caponing.
Young fowls about in their third month, are usually selected as the
victims of this epicurean barbarity.
CONTENTS.
Abdominal Cryptorchidy 77
Abscesses in Scrotal region 89
Abscesses in Pelvic cavity 130
Advantages of Castration in cows 108
Age at which Castration ought to be performed 8
Amaurosis 103
Anatomy of the male parts 15
Anatomy of the female parts 109
Bistournage 58
Bistoury Caché 117
Castration of Cryptorchids 67
Castration of Dogs 136
Castration of Fashion and convenience 5
Castration of Females 106
Castration of Fowls 139
Castration of Necessity 4
Castration of Small ruminants 131
Castration of Swine 132
Champignon 90
Champignon, Superficial 92
Champignon, Deep 93
Charlier’s Instruments 115, 116
Charlier’s Method 115
Charlier’s Scissors 118
Clamps 41, 42
Clamps, House 35
Classification of Methods 19
Colics 85
Combined Forceps of M. Beaufils 30
Comparative View of the Various Modes 103
Complications and their Treatment 84, 129
Conditions favorable to the operation 108
Constipation 131
Covered Operation 44
Crushing of the Testicular Cord 57
Curved Clamps 95
Dangers of Operation Standing Up 12
Definition of Castration 3
Dogs 136
Double Subcutaneous Torsion 58
Ecraseurs 33
Effects of Castration 5, 78, 108
Emphysema, subcutaneous 131
Excision 20
Farmer Miles 68
Firing 35
Firing, Forceps for Castration by 69
Fistula of the Scrotum 99
Forceps for Holding the Ovary 118
Fowls 139
Free Torsion 24
Gangrene 88
Hemorrhage 86, 130
Hernia of Castration 99
History of Castration 4
Hygiene and subsequent attention 82
Incision in the Vagina 119
Inguinal Cryptorchidy 75
Inguinal Hernia 99
Ligature 51
Ligature Carrier 97
Ligature of the Cord and its envelopes 52
Ligature of the Cord only 52
Ligature of the Efferent Canal 55
Ligature of the Spermatic Artery 54
Limited Torsion 26
Linear Crushing 32
Method by the Clamps 39
Method by the Ecraseur 34
Method by the Flanks 110
Methods, Classification of 19
Modes of Cicatrization 81
Modus operandi of Bistournage 59
Modus operandi of Bistournage, 1st Step of 60, 61
Modus operandi of Bistournage, 2d Step of 62, 63
Modus operandi of Bistournage, 3d Step of 64, 65
Modus operandi of Bistournage, 4th Step of 66
Modus operandi of Castration of Females 110
Modus operandi of Covered Operation 44
Modus operandi of Limited Torsion 28
Modus operandi of Uncovered Operation 47
Peritonitis 100, 130
Preparations of the Patient 9
Purposes of Castration 4
Removal of the Ovaries 120
Restraint, Modes of 10
Season most favorable 8
Scraping 21
Second Method of Castration 39
Securing the Animal Down 10
Softening of the Bags 60, 61
Standing Up Operation 10
Standing Up Operation, Dangers of 12
Subcutaneous Twisting 58
Swelling of the Scrotal Region 87
Swine 132
Tearing and Torsion 22
Tearing of the Clamps 85
Tetanus 102
Thimble for Castration 118
Third Method of Castration 56
Torsion 23
Torsion above the Epididimis 24
Torsion below the Epididimis 25
Torsion Forceps 26, 27
Torsion, Free 24
Torsion, Limited 26
Uncovered Operation 47
Vaginal Speculum 116, 117
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=Law.= The Lung Plague of Cattle; Contagious Pleuro-Pneumonia.
Illustrated. By James Law, Professor of Veterinary Medicine in
Cornell University. Paper, 100 pp. 30
=Law.= Farmers’ Veterinary Adviser. A Guide to the Prevention
and Treatment of Disease in Domestic Animals. By James Law,
Professor of Veterinary Medicine in Cornell University.
Illustrated. 8vo, cloth. 3 00
=Lehndorff.= Horsebreeding Recollections. By G. Lehndorff. 8vo,
cloth. 4 20
=Martin.= Cattle. Their Various Breeds, Management, and
Diseases. By W. C. L. Martin. Revised by W. Raynbird. 16mo,
boards. 50
=McAlpine.= Biological Atlas. Containing 24 plates of 423
colored illustrations. Oblong quarto cloth. By D. McAlpine,
F.C.S. 3 00
=McBride.= Anatomical Outlines of the Horse. Revised and
Enlarged by T. M. Mayer, M.R.C.V.S. With colored illustrations.
12mo, cloth. 3 40
=McClure.= Diseases of American Horses, Cattle, and Sheep. Their
Treatment; with full description of the Medicines employed. By
R. McClure, M.D., V.S. 12mo, cl., illus. 2 00
=McClure.= American Gentlemen’s Stable Guide; with the most
Approved Methods of Feeding, Grooming, and Managing the Horse.
By Robert McClure, M.D., V.S. 12mo, cloth. 1 00
=Meyrick.= Stable Management and the Prevention of Diseases
among Horses in India. By J. J. Meyrick, F.R.C.V.S. 12mo, cloth. 1 00
=Miles.= Remarks on Horses’ Teeth. Addressed to Purchasers. By
W. Miles. 60
=Moreton.= “On Horsebreaking.” By Robert Moreton. 12mo, cloth. 50
=Moreton’s Manual of Pharmacy for the Veterinary Student.= By
J. W. Morton. 12mo, cloth. 4 00
=Navin.= “The Explanatory Stock Doctor,” for the use of the
Farmer, Breeder, and Owner of the Horse. With numerous
illustrations. By John Nicholson Navin, V.S. 8vo, sheep. 4 75
=Percival.= Hyppo-pathology. A Systematic Treatise on the
Disorders and Lameness of the Horse. By W. Percival. With many
illustrations. 6 vols., boards. 34 20
=Percival.= Lectures on Horses; Their Form and Action. By W.
Percival. With eight outline plates. 8vo, cloth. 4 00
=Percival’s Anatomy of the Horse.= By W. Percival. 8vo, cloth. 8 00
=Peck.= “Classifications of the Muscles of the Horse.” This is
a large chart, printed on heavy paper, 24x38 inches, showing at
a glance the Classifications of the Muscles of the Horse, with
Origin, Insertion, Nervous Supply, and the Function of each. 50
=Reynolds.= “Breeding and Management of Draught Horses.” By
Richard S. Reynolds, M.R.C.V.S. Crown 8vo, cl. 1 40
=Riley.= The Mule. A Treatise on the Breeding, Training, and
Uses to which he may be put. 12mo, cloth, illus. 1 50
=Robertson.= The Practice of Equine Medicine. By W. Robertson. 6 00
=Steel.= A Treatise on the Diseases of the Ox. Being a Manual of
Bovine Pathology, especially adapted to Veterinary Practitioners
and Students. By John Henry Steel, M.R.C.V.S., F.Z.S. 8vo, with
118 illus., cl. 6 00
=Steel.= “Outlines of Equine Anatomy.” A Manual for the use of
Veterinary Students in the Dissecting Room. By John H. Steel,
M.R.C.V.S. 12mo, cloth. 3 00
=Strangeway.= “Veterinary Anatomy.” New edition, revised and
edited by I. Vaughn, F.L.S., M.R.C.V.S., with several hundred
illustrations. 8vo, cloth. 8 00
=Stornmouth’s Manual of Scientific Terms.= Especially referring
to those in Botany, Natural History, Medical and Veterinary
Science. By Rev. Jas. Stornmouth. 3 00
=Tellor.= “Diseases of Live Stock,” and their most Efficient
Remedies. By Lloyd V. Tellor. 8vo, cloth, illustrated, $2.50;
sheep. 3 00
=Tuson.= Pharmacopœia, including Outlines of Materia Medica and
Therapeutics in Veterinary Medicine. By R. V. Tuson. 12mo,
cloth. 2 50
=Veterinary Diagrams.= Five Charts, each 22x28 inches in size,
on stout paper, as follows, sold separately:
No. 1, with eight colored illustrations. External Form and
Elementary Anatomy of the Horse. 1 50
No. 2. Unsoundness and Defects of the Horse, with 50 woodcuts. 75
No. 3. The Age of the Domestic Animals, with 42 woodcuts. 75
No. 4. The Shoeing of the Horse, Mule, and Ox, with 59 woodcuts. 75
No. 5. The Elementary Anatomy, Points, and Butcher’s Joints of
the Ox, with 17 colored illustrations. With explanatory text. 1 50
Price per set of five. 5 00
=Walley.= “Four Bovine Scourges.” (Pleuro-Pneumonia, Foot and
Mouth Disease, Cattle Plague, and Tubercle.) With an Appendix on
the Inspection of Live Animals and Meat. By Thos. Walley,
M.R.C.V.S. With 49 colored illus. and numerous woodcuts. 4to,
cl. 6 40
=Webb.= “On the Dog.” Its Points, Peculiarities, Instincts, and
Whims. Illustrated with photographs. 3 00
=Williams.= Principles and Practice of Veterinary Medicine. New
edition, entirely revised, and illustrated with numerous plain
and colored plates. By W. Williams, M.R.C.V.S. 8vo, cloth. 5 00
=Williams.= Principles and Practice of Veterinary Surgery. New
edition, entirely revised, and illustrated with numerous plain
and colored plates. By W. Williams, M.R.C.V.S. 8vo, cloth. 7 50
=Williams.= Chart of the Contagious, Infectious, and Specific
Fevers of the Domesticated Animals. 1 00
=Zundel.= “On the Horse’s Foot.” Translated by A. Liautard,
M.D., D.V.S. 1 50
VETERINARY BOOKS IN FRENCH.
=Benion.= Traité de l’Élevage et des Maladies des Animaux et des
Oiseaux de Basse-Cour. $2 80
=Benion.= Traité de l’Élevage et des Maladies du Mouton. 3 60
=Benion.= Traité de l’Élevage et des Maladies du Porc. 2 60
=Beugnot.= Dictionnaire usuel de Chirurgie et de Médecine
Vétérinaire. 2 forts volumes in-8, avec planches. 7 20
=Bouley.= La Rage, moyen d’en éviter les Dangers et de prévenir
sa Propagation. 40
=Bouley-Reynal.= Nouveau Dictionnaire Pratique de Médecine, de
Chirurgie et Hygiène Vétérinaire (to be completed in 18
volumes), chaque volume. 3 00
=Colin.= Traité de Physiologie Comparée des Animaux; Par G.
Colin, Professeur à l’école Vétérinaire d’Alfort; avec Figures
intercalées dans le texte. 2 vols. in-8. 10 40
=Cruzel.= Des Maladies de l’Espèce Bovine. Par J. Cruzel. 5 60
=Dictionnaire.= Lexicographique et Descriptif des Sciences
Médicales et Vétérinaires. Un très-fort vol. de plus de 1500
pages. 8 00
=Gourdon.= Traité de la Castration des Animaux Domestiques. 3 60
=Hertwig.= Les Maladies des Chiens et leur Traitement. 1 40
=Lecoq.= Traité de l’Extérieur du Cheval et des Principaux
Animaux Domestiques. 3 60
=Leyh.= Anatomie des Animaux Domestiques. 3 60
=Magne.= Races Chevalines et leur Amélioration, Entretien,
Multiplication, Élevage et Éducation du Cheval, de l’Ane et du
Mulet. Par J. H. Magne. 3 20
=Magne.= Races Bovines et leur Amélioration, Entretien,
Multiplication, Élevage et Engraissement du Bœuf. Par J. H.
Magne. 2 00
=Magne.= Races Porcines et leur Amélioration, Entretien,
Multiplication, Élevage et Engraissement du Porc. Par J. H.
Magne. 80
=Magne.= Nourriture des Chevaux de Travail--brochure. 40
=Magne.= Choix du Cheval. 80
=Magne.= Choix et Nourriture du Cheval. Par J. H. Magne. Avec
Vignettes. 1 40
=Mourod.= Matière Médicale; ou la Pharmacologie Vétérinaire. 2 40
=Saint-Cyr.= Traité d’Obstétrique Vétérinaire. Avec cent
vignettes. 5 60
=Signol.= Aide Mémoire du Vétérinaire, Médecine, Chirurgie et
Obstétrique; Par Jules Signol; avec 395 Figures. 2 40
=Tabourin.= Nouveau Traité de Matière Médicale Thérapeutique et
de Pharmacie Vétérinaires, 2 fort volumes, in-8, avec plus de
100 figures. 8 00
Transcriber’s Notes
Some minor typographical errors have been corrected silently; spelling
inconsistencies have been retained (écraseur / ecraseur, cryptorchids/
criptorchids, etc.).
Illustrations have been moved outside text paragraphs.
Ditto characters („) in the table of contents have been replaced with
the dittoed text.
Advertisement page 8: Lecocq has been replaced with Lecoq.
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