314 On the Ulll'dy of Pullic Dispevsarks. 



Thirty-one have been home patients, and there have been 

 seven operations; viz. one for an abscess in thetonsal gland, 

 one for a dislocation of the infra maxilla (or lower jaw), 

 one for an abscess in the thigh, one for paracentesis (or tap- 

 ping for the dropsv), one for a tumour on the forehead, 

 and two for hernia (or rupture). 



Mrs. B., St. John's-street, Clerkenwell, had been sub- 

 ject to femoral hernia for several vears, which only came 

 Jdown occasionallv, was small, and never remained so long- 

 as to require surgical aid till the present attack; " though 

 the svmptoms, as stated bv herself, were violent pain in 

 the abdomen anr) in the part itself, nausea and vomiting, 

 the tumour receding during the debilitating effects ot ttie 

 sickness." 



On Sunday, November lOlb, during a violent fit of 

 coughing, the hernia came down, and could not be re- 

 turned : the part became very painful, from which she 

 suffered much during the night, as well as from the hiccup 

 and almost constant sickne.-^s which succeeded. On the 

 ilth, a medical practitioner was called in, whose attempts 

 to reduce the hernia were unsuccessful. He therefore or- 

 dered enemas, and gave some cathartic medicines combined 

 with opium. The enemas were immediately returned with- 

 out producing any eifecl ; and every thing was rejected by 

 the stomach. In the afternoon the syrnptoms had all in- 

 creased; the pain extended over the fore part of the ab- 

 tlomen, on which she could not bear the least pressure. 

 A tobacco enema was then given, which produced syncope 

 ■without any favourable change to the hernia. The opera- 

 tion was then proposed ; to which she would by no means 

 consent. 



On the 12th she obtained a letter for the Finsbury Dis- 

 pensary, which was brought to me about four o'clock in the 

 afternoon. On visiting her I made several fruitless attempts 

 to reduce the hernia, which was small but extremely pain- 

 ful. On considering every circumstance, therefore, I con- 

 cluded that the operation was the best mode of practice that 

 could be adopted. In this opinion I was joined by Dr. 

 Lidderdale, one of the physicians to the dispensary. But 

 she still refused her consent : and some pills were then or- 

 dered, in which opium formed a principal ingredient. These 

 could not be retained on the stomach ; and the faeculent 

 matter which was now vomited became so distressing, to- 

 gether with the pain, that she consented to have the opera- 

 tion performed ; which was done at ten o'clock at night. 

 The sac in which the hernia was situated was unusually- 

 thin. 



