_ When, however, an operation for a scrotal hernia recomes nEeces- 
sary— (and I would here remark, that 1 have mever yet founda, case, _ 
in which I was obliged to resort to it; having always succe ded, 
even in very severe cases of strangulation in quelling the 1 na= 
tion, and of course reducing the ruptyre,: particularly by means of 
the ‘‘anodyne wash’’ applied with cloths, or a celd poultice of sal 
amoniae, vinegar, and yeast)—the patient should be placed on a.table. 
of convenient height, and in a proper light, with his buttocks some- 
what raised, as also the thighs, so as to relax the abdominal muscles ; 
and the legs separated, that the operator may stand between them. 
Previous to the operation the patient should empty his bladder, and 
the parts be shaved. The operator should then grasp the LaOT OR: 
the under side with his left, han e the fore part te 
and steady, while with the scalpel in, ] 
from one end of the tumor to the other. A Free 
The sac being laid bare, an opening must. be made into it so as to 
bring its contents to view ; this may. be,done as near to the under. 
point as possible, as there is less danger of wounding the gut. In 
making this perforation of the sac, consists the greatest nicety.in the. 
operation, the utmost caution being necessary, io avoid injuring. the. 
parts... Good eyes.and a steady hand are in no operation more requi- 
site than in this, as well asa correct knowledge of the anatomy of the 
The operator must proceed slowly with the scalpel, dividing one —~ 
fibre of the sac after another, till a | Opening is.made through, which 
may be discovered with a.probe. A director should then be intro- 
duced to eut upon, and the cut enlarged so as: to = 
of the operator. The fore finger should now be introduced and used 
as a director for entering a narrow probe-poited knife, with which 
the sac must be divided along its whole length upto the opening. in: 
the beily, Sean aie : 
On laying the sac open at the bottom, a quantity of colored Guid. 
commonly rushes out, and the protruded parts come fully in-view. 
They should be examined with the nicest attention, in order to dis- 
cover whether they are sound or not; and if they appear to be so, 
that is, not gangrenous, eyen though they seem inflamed, they should 
be immediately returned into the abdomen. -- 
-4ifwe cannot now, by the use of proper means, 
ded parts, when the incision is thus fas. made, we sed to. 
enlarge the opening by which they passed frora the abd n,..in 
doing this the probe-pointed knife should be used, with the finger for _ 
a director; and the incision should be made obliquely upwards, in 
the direction ‘of thesfibres.of the. muscles. «In general, a small en- 
largement is sufficient. If any adhesions of the gut are found, they 
Should be separated, ied et tPasiebersebe of = 
if, on examination, we find any part of the eaul or omentum 
