THE VETERINARY JOURNAL

AND

Annals of Comparative Pathology.

MARCH, 1881.

CRYPTORCHIDISM, AND THE CASTRATION OF CRYPTORCHID HORSES.* BY GEORGE FLEMING, F.R.C.V.S., ARMY VETERINARY INSPECTOR. MAN has long sought to render certain of the animals he has domesticated more useful, by depriving them of their sexual powers of procreation. How long the emasculation of these animals has been practised, we know not: the origin of the custom is lost in the obscurity of countless centuries. It appears to have been well known to the most ancient peoples, and the operation was not confined to animals, for man himself, from various motives, was submitted to it. Defective as were the notions then entertained with regard to anatomy and physiology, they were sufficiently exact, it would seem—if we are to credit the earliest writers—to allow emasculation to be performed, not only with comparative safety, but at the age and time of year most suitable to produce the desired result. The Egyptians, Persians, Phoenicians, Greeks, and Romans possessed this know- ledge, and the Jews were evidently well acquainted with the operation as practised upon animals, as we find Moses alluding to itin Leviticus (chap. xxii. verse 24). Hesiod, an ancient Greek poet, the date of whose works is uncertain, some authorities placing them before, and others after Homer, but who was the first to write on agriculture, speaks of it ; and he, as well as Strabo and Xenophon, admits that castration was practised by the Scythians, Persians, Sarmatians, and other races long before

* Read before the Yorkshire Veterinary Medical Society on February 4th. VOL. XII. M

146 The Veterinary Fournal.

their time. Ammianus Marcellinus, who lived about the fourth century of our era, states that the Sarmatians and northern people generally had known it from the remotest antiquity.

Aristotle, who lived three centuries before the Christian era, and whose writings on natural history even now fill us with sur- prise and admiration, enters largely, in his history of animals, into the subject. He speaks of the castration of man, of quad- rupeds (male and female), and of birds, and gives an outline of the mode of operation, indicating the modifications it produces in the creatures operated upon.*

* “Animals not only change their forms and dispositions at particular ages and seasons, but also when castrated. All animals that have testicles may be castrated. In birds and oviparous animals with feet they are gene- rally external, though sometimes internal; in all they are situated at the extremity of the abdomen. Birds are castrated near the rump, at the part with which they touch the female in copulation ; and if they are burnt in that part two or three times with irons, after they are full-grown, the comb turns yellow, and they cease to crow, and no longer desire sexual intercourse. If they are not full-grown, these parts never reach perfection.

“The same is the case with the human subject ; for if a boy is castrated, the hair that should be produced after birth never appears, nor does his voice change, but continues sharp ; though if a full-grown man is castrated, all the hair produced after birth falls off except that on the pubes—this be- comes weak, but still remains. The hair produced at birth does not fall off, for the eunuch never becomes bald. The voice also of castrated animals ehanges to that of the female. Other animals, if not castrated when young, are destroyed by the operation ; though with the boar it makes no difference. All animals, if castrated when young, become larger and more graceful than those not castrated ; but if already grown, they never become any larger.

“If stags are castrated before they are old enough to have horns, these never ap’ ; but if castrated after they have horns, their size never varies, nor are they subject to their annual change. Calves are castrated at a year old ; if not, they become bad and inferior. The steer is castrated in this manner : they lay down the animal, and cut the scrotum, then press out the testicle as much as possible, and fill up the wound with hair, in order that the discharge may escape ; if it inflames, they cauterise and foment the scrotum. If adult bulls are castrated, they are still apparently capable of sexual intercourse.

The capria (ovary) of the sow is also cut out, so that the animal should not desire coition, but fatten rapidly. It is operated on after fasting for two days. They hang the sow up by the hind legs, and make an incision into the lower part of the belly, where the testicles of the male are generally found ; the capria is there formed upon the matrix, from which they cut off a portion, and sew up the wound again.

“The female camels are also cut when they are to be taken to war, that they may not become pregnant. Some of the people in the upper parts of Asia possess as many as three thousand. Such camels, when they run, are far more swift than the Niszean horses, from the length of their stretch. And, on the whole, castrated animals are longer-bodied than those not castrated.”—Ai7storia Animalia, lib. ix., cap. 37.

The Castration of Cryptorchid Horses. 147

Pliny mentions castration of male and female camels.* Varro goes somewhat into detail with regard to castration ; he gives the ages at which it is best to emasculate animals, and refers to the operation as performed on the horse, dog, and fowl.

Magon, a Carthaginian writer who lived in the second century before our era, likewise alludes to the operation, and speaks of plates of wood, and wooden clams to fix above the testicles, in order to arrest hemorrhage. Apsyrtus describes castration by cau- tery, and Hierocles that by ligature ; while Vegetius says Tetanus is sometimes due to the operation, when the animals get chilled.

Such is a brief summary of our knowledge of castration in the very early days of veterinary surgery ; and it is to be regretted that during what are called the “dark” and “middle ages” we have no evidence to show whether any improvements had been introduced, and to what extent emasculation was resorted to. The operation was probably performed, when deemed necessary, by very unskilful men and rude methods. That it was practised in this country, and that it was attended with risk, is manifest from a passage in the Gwentian Code, the laws of Wales previous to the Norman invasion, which ordains, “If a person sell an entire animal, let the seller insure it under gelding until the end of the ninth day, to wit, by paying half its worth to the buyer if it dies.”

Little mention is made of castration until the end of the six- teenth century, when Carlo Ruini barely alludes to it; and Solleysel speaks of it as a barbarous operation—the heavy under-bred stallions of that day requiring castration as little as many of the horses of his country do at the present time. At the commencement of the fifteenth century, however, Laurentius Rusius speaks of the method by bistournage ; and in the seven- teenth century Bartholin alludes to the castration of ewes, sows, cows, and mares by the Danes, who operated by opening the left flank. In the same century, the practice of castrating mares had become so common in France that in 1717 an ordinance was

* Asserting that camels are liable to frenzy, supposed to be at the time of rutting, he says, ‘‘ There is a peculiar mode of castrating them, and the females, even, when required for the purposes of war, that has been dis- : it renders them more courageous, by the destruction of all sexual

ings.

148 The Veterinary Fournal.

issued to restrain it, on account of its dangerous consequences, and the little need there was for it.

It is scarcely necessary for me to touch upon the different ways of operating. That by the wooden clams appears to have been a very ancient procedure, as was also crushing and direct excision of the testicle, as well as destroying by the actual cau- tery. Torsion, of one kind or another, was known in the last century, and crushing of the testicular vessels by means of the éraseur had been anticipated by those ancient people, who destroyed them by means of scraping or breaking with the finger. In Lapland, at the present time, the male reindeer are castrated by the old women, who gnaw through the vessels and attachments of the testicle with their teeth.

I mention these facts here to show that we have learned but little of the operation of castration since the remotest times— ancient peoples removing the testicles from male animals, and the ovaries from female animals, when fashion or circumstances demanded. However destitute they may have been of general anatomical knowledge, it must be confessed that in surgery they were at least as bold, if not bolder, than veterinary surgeons in this country are at the present day. There are few of our number who would venture to remove the ovaries from a mare, or even a cow, with much hope of success ; and though there are none, perhaps, who would decline to castrate a colt, though some might entertain fears as to their being favoured by fortune if they attempted an adult stallion, yet the large majority, I fancy, would altogether refuse to operate upon a colt or stallion whose testicles were not readily accessible to the hand.

It is indeed strange that the possibility of removing the testi- cles from a horse when these were not within immediate reach— visible, in fact—never seems to have been dreamt of in this country. Nowhere is it mentioned, and I have never heard of its being attempted or spoken of. Not that there was absence of opportunity, for horses whose testicles have not descended into the scrotum are not remarkably rare ; and however vicious and useless or dangerous they may have been, their vice could not be removed, nor their value increased ten or a hundredfold, because they could not be emasculated.

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The Castration of Cryptorchid Horses. 149

The reason for this we need not dwell upon. Suffice it to say that it may have been due to the extremely slight and superficial manner in which anatomy and some portions of surgery were taught at the veterinary schools; that we had no text-books on these subjects worthy of the name; and that we were unac- quainted with the labours of our Continental colleagues.

About two years ago an American farmer, Mr. Miles, visited this country, and his presence startled many practitioners, as he had the temerity to come among us to show us how to remove the non-apparent testicles from horses. Received with doubt, jealousy, and incredulity, he nevertheless was able to teach British veterinary surgeons what they did not know, and show them what they had never seen—possibly never heard of.

Those who had the opportunity of seeing him operate will, I am sure, willingly testify to the skill and dexterity with which he performed an operation requiring, perhaps, the best qualities of the surgeon. Possessed of some of the weaknesses of our American cousins, he nevertheless proved that he was endowed with more than one of their excellencies. The one grand draw- back to his visit was that he made his method of operating a secret, only to be made known to those who were willing to fur- nish a fair instalment of the “almighty dollar,” and vowed in ad- dition not to divulge the details of the operation. This certainly was not professional, and savoured strongly of the charlatan ; and we fear it was this which rendered Mr. Miles’ visit less auspicious and genial than it might have been. Medical men have no secrets to be sold, and all improvements in medicine or surgery are made public immediately ; indeed there is almost a rash eagerness exhibited to publish new systems of treating disease, or new methods of performing operations. If the visit of Mr. Miles startled many into the belief that the operation for which he was in a manner celebrated in his own country was a novelty, that belief must be shaken by the knowledge that it has been known, and most successfully practised, since at least the com- mencement of this century. It may have been practised in the

centuries before our era, for anything we know to the contrary ;

for the operators of these distant days, who had the courage to temove the ovaries, after seeking for them in the abdominal

150 The Veterinary Fournal.

cavity, would probably not hesitate to search for and remove the testicles when these did not occupy their ordinary situation. Certain it is, however, that the emasculation of cryptorchid horses is not mentioned by Continental veterinary writers until the commencement of this century, though some of these admit that non-professional men had regularly resorted to it long before. In a very interesting article* by one of the most distinguished and accomplished veterinary operators in Europe—Professor Degive, of the Brussels Veterinary School—we learn that Hurtrel d’Arboval appears to have been the first to allude to the operation, but in a very succinct and incomplete manner.t M. Marrel, veterinary surgeon in Vaucluse, relates that in 1838 he successfully castrated a cryptorchid horse.f{ In 1840 M. Serres reports that, having refused to operate on a horse affected with single cryptorchidism, an ordinary castrator successfully operated by making an incision at the upper and posterior part of the left flank.§ Van Seymortier, of Audenaerde, Belgium, in 1845 gives a very full description of the operation for this anomaly, by removal of the testicle through the inguinal canal.|| In the same year Brogniez, then Professor at the Brussels Veterinary School, communicated to the Veterinary Society of Belgium the results of some experiments tending to demonstrate two points which are nowadays amply confirmed : the ease and facility with which the inguinal canal may be dilated, and the harmlessness of this dilatation when performed in a certain manner.

Van Haelst, a Belgian military veterinary surgeon, in 1846 published a good paper on the anatomy of this condition, and a description of the operation for inguinal cryptorchidism, the only form of the anomaly which he considered as likely to be successfully treated.**

In 1847 Marrel gives two more cases upon which he had

* Annales de Médecine Vétérinaire, 1875.

+ Dictionnaire de Méd. Vétérinaire, second edition, 1838, vol. i., p. 152. Mémoire de la Société Vétérinaire de Vaucluse, 1846. Guide Hygienique et Chirurgical de la Castration. Paris, 1860.

|| Brogniez. Traité de Chirurgie Vétérinaire, 1845, vol. iii., p. 380. Journal Vétérinaire et Agricole de Belgique, 1845, p. 545.

** Recueil de Méd. Vétérinaire, 1846, p. 799.

The Castratwn of Cryptorchid Horses. 151

successfully operated—a horse and an ass.* In 1856, in the Proceedings of a Danish Veterinary Congress, a somewhat detailed account is given of the operation for cryptorchidism, which appears to have been long known in that country ; and the three methods practised are alluded to: penetration of the abdomen by manual dilatation of the inguinal canal, by incision of the flank, and by incision of the abdominal wall, in front of the inguinal ring.t In 1858 Stockfleth, Director of the Copenhagen Vete- rinary School, published a small work on the subject ;{ and in 1860 Serres§ and Gourdon|| likewise published similar treatises ; while a very excellent memoir on the subject, from an anatomo- physiological point of view, was produced in 1856 by Goubaux, then Professor of Anatomy at, and now Director of the Alfort Veterinary School, and Follin, Professor at the Paris Faculty of Medicine ;{ and a similar service was rendered by Franck, of the Munich Veterinary School, in his work on anatomy.** In 1864 Diericx, of Aeltre, Belgium, published a most practical paper on the operation and its results, in his experience, and in which he showed that it could be performed almost without danger.tft Subsequently, articles have appeared now and again on the subject in various of the Continental journals, and it has received notice in some of the foreign works on veterinary operative surgery ; but it is really to that brilliant operator and capable writer on veterinary surgery, Professor Degive, that our science is indebted for popularising the operation in recent days, and rescuing it from the hands of the ordinary castrator, who per- formed it in a routine manner, and could rarely successfully con- tend against unexpected results, through lack of surgical and pathological knowledge. Degive generally acknowledges that it was to Diericx he owed his first instructions in the operation, that practitioner having disinterestedly offered to demonstrate his method and give all necessary information to his colleagues. * Ibid., 1847, p. 1002.

+ “Tidschrift for Veterinairer,” 1856. t Operation an Spitzhengsten, Copenhagen, 1858. cit.

YD. cit.

; “Traité de la Castration des Animaux Domestiques.” Paris, 1860. I “Recueil de Médecine Vétérinaire,” 1856, pp. 508, 599, 819.

** “Handbuck der Anatomie der Hausthiere.” Munich, 1871.

tt “Annales de Méd. Vétérinaire,” 1864, p. 169.

152 The Veterinary Fournal.

For ten years previous to issuing his monograph (which was first published in the Bulletin of the Academie Royale de Médecine, of Belgium, for July, 1875), Degive had operated on thirty-seven animals. Thirty-four of the cases were perfectly successful, and only three died ; notwithstanding that the majority were cases of abdominal cryptorchidism, and only four were single and inguinal.*

Such was the knowledge possessed by our Continental con- Jreres before the arrival of Mr. Miles in this country ; and it is not a subject for congratulation that the operation was unknown here before that time. It must be confessed that we British vete- rinary surgeons have not particularly distinguished ourselves in operative surgery. Perhaps the only important operation we have introduced has been that of plantar neurotomy ; and even that, I fear, we cannot altogether lay claim to, as I have elsewhere shown that it was probably described nearly two centuries ago.

Surgery is nothing if it is not bold, while circumspect; but the good anatomist has most confidence. It was possibly due to a deficient knowledge of anatomy, and a dread of fatal results, which made our practitioners afraid to undertake the operation, or it was more probably considered impracticable. However it may be explained, the fact remains that the operation was never mentioned in our schools, and never, to my knowledge, performed in the country; and so it was that one of the finest operations perhaps in the whole range of surgery, human or veterinary, was lost to us until the arrival of an American farmer on our shores.

I have not been initiated into Mr. Miles’ secret method of operating, though I have seen him operate ; and therefore I can- not describe it. But amongst professional men, as I have already said, there are not, or rather should not be, any pro- fessional secrets; and our foreign colleagues have made no mystery of their method. While in Brussels last July, attending the Veterinary Congress, Professor Degive gave a demonstration of his method on several horses collected for the purpose, before a number of the visitors, and he fairly astonished them by his extraordinary manipulative dexterity and coolness. All con-

* Annales de Méd. Vétérinaire, 1875, p. 635.

The Castration of Cryptorchid Horses. 153

fessed that anything more brilliant they had never witnessed. So that it is no infraction of promises, or violation of secrecy, if I describe what he and others have already so fully done, and venture to add my own remarks.

The anomaly is most frequently met with in solipeds, and the porcine and ovine species; but I believe it is rare in the bovine and canine species. To what extent it may prevail among horses in this country, there are means of judging ; but from experience I am inclined to the opinion that it is not at all un- common. Mr. Miles assured me that there were far more rig” horses here than we imagined; and so numerous were they in the United States, that he was fully occupied, when at home, in travelling about to operate upon them. In France they are often metvith, but they appear to be most frequent in Belgium and Denmark.

There is strong evidence in favour of the anomaly being hereditary, the progeny of certain “rig” stallions being affected with it. Degive states that of thirty-seven horses he operated upon, the sires of five, at least, were cryptorchids. But in these stallions the anomaly only existed on one side—at least it could not be abdominal on both sides, as such animals are sterile. The same fact has been observed when one normally situated testicle has been removed, and the other is concealed—unilateral cryptorchidism.

When the testicles are retained in the abdomen, they are generally smaller and softer than when in the scrotum, though very exceptionally there is little difference. The testicles are merely atrophied, or their more important constituents have undergone fatty degeneration to a greater or lesser degree. Their secreting power has also undergone serious modification, as the semen no longer contains spermatozoa. When in the inguinal canal the testicle is smaller, as a rule, than when in the scrotum; and though in early adult life it may perform its function, yet it generally undergoes atrophy and degeneration at a later period.

The term “cryptorchid” being applied to an animal whose testicles have not appeared in their natural situation at a certain period of life, the question arises as to when a horse should be

154 The Veterinary Fournal.

so designated. It is generally understood among veterinary anatomists, that the testicles are in the scrotum when the foal is about six months old—though instances are recorded in which they have not descended until two and even three years of age. But it may be accepted as an established fact, that when the testicles are not in the scrotum at eighteen months or two years, the animal is a cryptorchid.

The signs which denote this condition are known to the majority of men familiar with the habits of horses. Such animals, at an adult age especially, appear and act pretty much as if they were entire males ; indeed they are frequently more unsteady, more difficult to manage, more excitable, sexually, when among other horses, and particularly mares, and are often more vicious, than stallions. Their viciousness only too frequently renders them dangerous, not only to their own, but also to the human species.

These characteristics serve to indicate, in the larger number of cases, the existence of the anomaly ; but it may nevertheless hap- pen that doubts will arise in some instances, not only as to whether the animal is the subject of double or single cryptor- chidism, or whether it is inguinal or abdominal, but whether it is really a cryptorchid. In such cases, the veterinary surgeon who may be called upon to decide the question, and perhaps to operate, will not of course be satisfied with the general appear- ance and behaviour of the horse, as both might be deceptive, and must have recourse to a careful examination.

A close examination of the scrotum will reveal the existence of cicatrices, if the animal has been castrated ; though their presence must not always be received as certain evidence of this, for they may have been fraudulently produced, or may only show that an unsuccessful attempt has previously been made to emasculate the animal. On the side at which the testicle has not descended, the scrotum is not salient or slightly pendulous as after castration ; but it has been asserted that there is often at the part where the testicle should be a slight round swelling, which increases in size when the twitch is somewhat severely applied to the nose. The fingers, pushed up in the direction of the inguinal canal, find it either empty, in the case of abdominal cryptorchidism, or occu-

The Castration of Cryptorchid Horses. 155

pied by the missing testicle at a more or less accessible altitude. Internal taxis, or examination fer rectum, when doubt still exists, is an excellent means of arriving at a just conclusion, especially when combined with external taxis. When the wall of the in- testine is relaxed, the practised hand (the hand accustomed to explore the abdominal cavity and its contents fer rectum) can ascertain the state of the vaginal or inguinal ring, and with the hand outside also whether the testicle is in the canal, or even in the abdomen, especially if it should be moderately developed. When the inguinal opening is found to be extremely small, or the hand cannot feel it through the wall of the intestine, then it may be concluded that the testicle is in the abdomen, and, as has just been said, careful manipulation may discover it suspended in that cavity

This examination also enables the explorer to decide whether the cryptorchidism is bilateral or double, or unilateral or single, . and right or left.

Before attempting to operate, it is well to discover everything possible with regard to the existence and nature of the anomaly. But expert operators, such as Degive, confess that they have often commenced to operate without being quite confident as to whether they had a case of abdominal or inguinal cryptorchid- ism, and that they were not assured of this until after they had penetrated the inguinal canal. Not until the hand has been passed into that cavity have they been positive whether the or- gan they were in search of was there or in the abdomen.

With regard to the immediate causes of cryptorchidism, we need not examine them in detail. The descent of the testicle from the abdominal cavity, as is well known, is due to the action of the gubernaculum testis, one extremity of which is attached to the epididymis, while the other passes into or forms part of the dartos muscle lining the scrotum. By the gradual retraction and atrophy of this band, the testicle is slowly drawn into the in- guinal canal, which itself appears to be formed by this retraction and atrophy of the gubernaculum, When, therefore, this retractile band is too feeble to exert its action, from imperfect development or loss of power, the testicle either continues its primary location in the abdomen, floating at the end of a serous fold or folds, analo-

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156 The Veterinary Fournal.

gous to the suspensory ligament of the ovary in the female, but containing at one margin or border the vas deferens, at another the spermatic blood-vessels, and at a third the gubernaculum ; or it is adherent to the abdominal wall or adjacent organs. The epididymis is greatly elongated, and so detached from the testicle that it forms a globus, according to Degive, which the hand in- troduced into the abdominal cavity can easily distinguish, while its tail reaches nearly to the inguinal ring.

The accompanying drawings of the position of the testicle in the foal will afford an idea of the nature of cryptorchidism. In Fig. 1 the testicle is shown as floating in the abdomen, A being the peritoneal fold or suspensory ligament which attaches it to the lumbar region, B the testicle, C the gubernaculum testis, and D the inguinal opening or ring.

FIG. 1.

In Fig. 2 the testicle, B, has been drawn towards the ring, D, by the gubernaculum, C’ being the internal portion of that band, and C its external portion which has passed into the inguinal canal.

The Castration of Cryptorchid Horses.

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FIG. 2.

And Fig. 3 represents the testicle, B, in the inguinal canal, D, C, the gubernaculum having disappeared, or rather now forms part of the walls of the canal itself.

The Veterinary Fournal.

It must be remarked here that many authorities attribute abdominal cryptorchidism, not to the absence of the vaginal or inguinal canal, or defect in the gubernaculum testis, but rather to a disproportion between the testicle itself and this opening, which it should passinto ; while others, again, think that the way in which the testicle presents itself at the upper orifice of the canal may ope- rate in leading to its permanent retention in the abdominal cavity.

Incomplete abdominal cryptorchidism differs only from the abdominal form by a more or less rudimentary inguinal canal which, according to a distinguished veterinary anatomist— Franck, of Munich—is very early developed, and long before the descent of the testicles into the scrotum, and to which he has given the name of Arocessus vaginalis. ‘This he describes as a very narrow and short canal, which is scarcely more than the internal inguinal ring, the walls of which are composed, as in the adult stallion, of an external, but atrophied cremaster; an internal serous layer, in continuity with the peritoneum ; and a middle layer, formed of white fibrous tissue, In this kind of cryptorchidism the canal contains, in certain cases, according to Degive, a more or less considerable portion of the gubernaculum, vas deferens, and tail of the epidymis; while in rarer cases it only contains a portion of the gubernaculum.

In cases of inguinal cryptorchidism, this sheath is, of course, more extensive, occupying a larger portion of the inguinal space, and containing a testicle which is smaller than that found in the scrotum, or it may be atrophied ; but otherwise it is the same in disposition.

These slight details will prepare the way for the consideration of the removal of the concealed testicle by operation.

Apart from the danger attending the operation—danger which varies more or less with the situation of the testicle—there is in nearly every case of cryptorchidism an advantage, often very great, in removing the organ. When we consider the trouble- someness, oftentimes real viciousness, of such animals, which usually renders them of comparatively little value, and the beneficial alteration which castration brings about, there are very few cases indeed in which the operation may not be counselled, if the animal is worth the expense,

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The Castration of Cryptorchid Florses. 159

With regard to age, the operation is most successful as the horse is young ; though under two or three years the inguinal canal is generally so narrow that the hand cannot be easily introduced into it. The season of the year does not appear to have much influence ; though of course the operator will do well, if he has any choice, to select mild weather. During the prevalence of jany epizootic equine malady, perhaps it would be advisable to defer the operation.

The only preparation necessary is that until for ordinary castration. Degive speaks highly of tincture of arnica, which he administers during eight days before the operation, thirty grammes being given in the morning in a half-pint of cold water. To the employment of this drug he ascribes the frequent and complete absence of febrile reaction, notwithstanding the very extensive and profound lesions produced in the course of the necessary surgical manceuvres. For two days before operating no oats are given, and on the day of operation no food at all.

As for the operation itself, this varies with respect to the form of cryptorchidism we have to deal with; that for the inguinal form differing considerably from the one to be adopted for the abdominal form.

Operation for Inguinal Cryptorchidism.

The operation for this form differs but little from that ot ordinary castration. The horse is cast and secured in the same way, the hind legs being drawn well downwards and outwards by means of the back-strap. Mr. Miles’ method of casting and binding the horse is good, but to me it appeared to be very complicated and tedious ; that operator, with all his experience, occupying quite ten minutes in securing the animal. As in castration, it is well to clean out of the sheath.

The two chief divisions of the operation are exposing the testicle and removing it. The operator places himself as in ordinary castration. The testicle is exposed by incising its envelopes, which are, as already stated, the skin or scrotum, dartos, and the sac or vaginal sheath containing that organ. The skin and dartos are divided as in ordinary castration, and in about the same place. The incision should be from four to

The Veterinary Fournal.

six inches in length from before to behind; and it is perhaps as well to have it more forward than backward, in order to allow discharges to escape more readily. I have made the incision with an ordinary scalpel or bistoury, the skin being made tense on the abdomen. But this requires a light hand and great care, in order to guard against accidents. Degive raises a large transverse fold of skin over the part, and with the aid of an assistant, cuts through it to the necessary depth. Mr. Miles’ plan is better. With a small, hook-pointed knife, the inner margin of the hook alone being sharp, and the hook itself being very short, he cuts through the tense skin from before to behind, towards himself, to the requisite length, with neatness and speed. The hook is sufficiently long to cut through the integument and subcutaneous tissues, and no more cutting is necessary, as a rule, until the testicle is reached. When the scalpel or bistoury is employed, it is necessary to raise the outer margin of the wound, and by two or three cuts divide the yellow fibrous layer and dartos immediately beneath, and which extends over this region. By selecting the outer instead of the inner margin, we avoid wounding the somewhat large pudic veins lying in the prepubic region, beneath this layer.

The external inguinal ring is reached by lacerating the loose connective tissue which intervenes between it and the wound, the tearing being effected by two fingers of each hand—the index and the median—introduced into the wound, and moved about, the fingers being slightly bent. Sometimes, though rarely, the knife may be required to divide some strong fibres which the fingers cannot tear. This finger dissection is continued until the hand can feel the external inguinal ring, or rather the internal or prepubic commissure, the most distinct part of the ring.

One hand alone is now passed into the inguinal canal, the fingers being gathered into a cone-shaped mass, and pressed gently inwards in a semi-rotatory manner, care being taken not to injure the walls of the canal, especially on the inner side, where perforation is easy.

In this way, dissection is continued until the fingers reach the bottom or cu/-de-sac of the vagino-testicular sheath containing the testicle, the extent of dissection depending upon the depth

The Castration of Cryptorchid Horses. 161

at which this is found, and this again varying with the degree of descent of the testicle.

When it is reached, the fingers are moved around it, so as to isolate or enucleate it as much as possible. When the testicle is not very high in the canal the sac is easily made tense over it, and divided longitudinally at the bottom; sufficient to allow the organ to pass through. When the testicle is high in the canal, however, it is difficult to make the incision, and care is necessary in seizing and dividing the sac. I am inclined to think that Mr. Miles, by means of a rather long and sharp finger-nail, was enabled to dispense with a knife at this stage of the operation. I may also remark that the finger-dissection was greatly facilitated in his operation by the use of olive oil, which he poured freely over the wound, beneath the skin, when the latter was incised. By this means his hand—he only employed one— was well lubricated, and he could pass it freely towards and into the inguinal canal. I find that Diericx, in 1864, used water or oil for his hand and arm. It may also be noted that a long, thin arm, hand, and fingers possess a great advantage.

The testicle being liberated and seized, may be removed either by direct or indirect'division. Direct division may be accomplished by cauterisation, torsion, scraping, or by means of the &raseur ; while indirect removal can be effected by /igature or clams. In direct division, the écraseur is certainly to be pre- ferred ; but if it is not resorted to, the scraping, torsion, or the actual cautery will answer. Indirect removal is not desirable, except in very exceptional cases, as when there is inguinal hernia, or danger of that condition. When this is present, if the spermatic cord and vessels are sufficiently long, then the clam may be applied over them, outside the vaginal coverings.

The wound is to be treated according to surgical principles, being immediately after the operation cleansed and dried. As a rule, it requires little subsequent attention.

It has occupied more time to describe this operation than is usually required to accomplish it. If the testicle is near the external inguinal ring, very few minutes are necessary ; but the time, of course, increases as the organ is deeper in the canal.

VOL. XII. N

162 The Veterinary Fournal.

Operation for Abdominal Cryptorchidism.

This form of cryptorchidism is certainly the most difficult for the operator, and the most serious for the animal. Veterinary surgeons, particularly in this country, have always looked upon operations in the abdominal cavity of the horse with feelings akin to fear as to the result. But the facts now accumulated tend to prove that the fear has been greatly exaggerated, and that with skill and care very serious injury may be inflicted without death resulting.

The testicle may be removed from the cavity of the abdomen by three principal ways, the zmguinal canal, the flank, and the floor of the abdomen.

The operation through the inguinal canal is that preferred, I have reason to believe, by Degive, and already practised, according to Van Seymortier, by the Flemish castrators in 1832. It appears that about this period horses were so numerous in Flanders, and the expense of keeping them so high, that their value became exceedingly low, and consequently hundreds fell into the hands of the knackers, who bought them for their skin and other debris. This diminished value gave the castrators an opportunity for practising the best method of emasculating horses affected with one or other form of this anomaly. This operation is also that adopted generally, if not altogether, I believe, by Mr. Miles. Van Seymortier estimated the mortality from it as one in eight; while Parret, a Belgian castrator, who asserted that he operated on an average of forty such horses every year, put down his loss at ten per cent. Diericx and Degive, however, have been more fortunate even than this.

The procedure is, up to a certain stage, the same as that for the other form. The prepuce is to be well cleaned out the previous evening, and the other precautions already mentioned adopted. The horse is thrown and placed on his back, the two legs on each side being fastened together, and drawn down to the level of the elbow, by means of a back-strap, so as to leave the inguinal space free, and prevent the hand or arm being severely compressed in the inguinal ring during the struggles of the animal. Diericx and Degive have often operated or the horse when lying on the side—the position usually chosen for

The Castration of Cryptorchid Florses. 163

castration or the Continent—opposite to that from which the testicle had to be removed, the limb being flexed as much as possible. When the testicle had been seized, and was brought outside the body, the trunk of the animal was then turned almost on the back, and maintained there sod a bundle of straw placed on the under-side.

The external inguinal ring is reached in the manner already described, and the precautions adopted for preventing the formation of needless or too extensive lacerations, particularly anteriorly, by working towards the internal or prepubic com- missure. When this ring has been arrived at, the operator has to form an artificial canal or direct communication between it and the abdominal cavity. For this purpose, the external ring has to be dilated, and a passage to the abdomen effected. On the manner in which this passage is made, and the direction it takes, must largely, if not altogether, depend the success of the operation. The external opening is, of course, constituted by the inguinal ring, but the internal or abdominal must not correspond to the internal ring; as if it does, Degive assures us, hernia of the intestine is almost certain to follow. The superior or internal opening should therefore be made through the peritoneum, at one side, and: in the vicinity of the sub-lumbar region, in front of the external iliac artery, and on the surface and near the posterior extremity of the small psoas muscle. In this situation. hernia is almost impossible.

The object is, therefore, to.make an artificial canal, the inferior opening of which shall be constituted by the dilated external inguinal ring, the superior opening by a peritoneal laceration necessarily of variable form and extent, situated laterally, and near the sub-lumbar region; with two walls—an anterior, formed by the small oblique muscle of the abdomen and peritoneum, and a posterior, constituted by the crural aponcurosis lying on the muscles of the anterior crural region, with two commissures, each resulting from the union of this aponeurosis with the small oblique muscle and peritoneum. The advantage of this pro- cedure consists chiefly in the fact, that as soon as the hand is withdrawn from the inguinal canal, the small oblique muscle, submitting to the natural pressure of the intestines, immediately

164 The Veterinary Fournal,

assumes its normal position, and almost completely closes the opening or openings the hand has made. Degive, to whom I have so often referred, and who has almost identified this opera- tion with his name, prefers it to any other, and well describes it.

As usual, the operator is placed behind the animal, with one hand and arm (right or left, according to the side to be operated upon) smeared with olive oil, or moistened with arnicated water. The fingers, gathered into a cone shape, are introduced into the external inguinal ring, and pushed slowly and steadily, in a rotary manner, in the direction of the canal or external angle of the hip, pressing lightly on the crural arch. In this way a passage is at first made through the internal inguinal ring, then through the space succeeding it, and finally reaches the peri- toneum, through which the fingers can feel the intestines. The peritoneum is perforated by the pressure of one of the fingers, and the</