APPENDIX. (si) 



it when proper, though we may not be certain of -the nature of ^"k"!*;^"*, 

 the fluid contained. In mofl cafes we may afcertain this before 

 from the fymptoms } but, at all events, the pun<5lure in the pleura 

 will put it beyond a doubt." 



Ma Hamilton had an opportunity of feeing feveral hernia; 

 in women, upon fome of whom he operated fuccefsfuUy ; and, 

 from conGdering all the cafes he had feen, he was led to make 

 the following remarks, fome of which he thought new. 



" When I began the praeftice of furgery, as I had never met 

 with a cafe of hernia in women, I believed implicitly in the doc- 

 trines we find in every writer on the fubjedl, viz. that women 

 have feldom bubonocele, but are more fubjecSl to femoral hernia. 

 Soon after I had begun to pradlife, I was called to a confultation 

 about a woman with a hernia, which had been flrangulated for 

 two days. As it was placed in the groin, I at firft fight thought 

 it a femoral hernia ; but, vipon examining it attentively, I found 

 it was a bubonocele that had gone towards tlie thigh, in place 

 of towards the labium. The operation which was performed put 

 the matter beyond a doubt, and fliowed that it came through 

 the ring of the mufcle. In a few months I was called to another 

 patient in the fame fituation, and I found, to my furprife, the 

 fame appearances which in the firft I took to be a hifus naturce ; 

 the hernia in the groin, at the top of the thigh, and yet evident- 

 ly coming through the ring ; having all the appearances at 

 firft fight of femoral hernia, but in reality a bubonocele. The 

 operation here, likewife, which I performed, made me certain 

 of the fad. In a third, under ftrangulation, I found the fame 

 appearances, and operated. 



Finding the hernia bubonocele in thefe three cafes, yet 

 with all the appearance of .that fpecies where the gut is puflied 

 out under Pa up art's hgament, I began to fufpedl that the 

 common account given by authors was erroneous, and that bu- 



VOL. IV. (H) bonocele 



