Report of the City and Finslury Dispensaries. 315 



'Nov. 30, I6O7. — Sy^.c complained of a tightntss across the 

 uni'nlical reirion. gre.Ht jiain over ihc abdomen, with hiccup 

 and vonming. These symptoms having frequently viekled to 

 purgative reinciiics, they were had recourse to, but without 

 effect . 



Dec. 1. — She h'ld passed a verv restless ni^ht, and wa* 

 much worse in every respect. This dav, for the tirst time, 

 she montioned the swelling in the grom. Some dr;iughts, 

 each contammg 25 drops of" tincture of opium, were given, 

 l>ut not retained on tiie stomach ; an enema composed of an 

 infusion of nicotiana was injected, and attempts were made 

 to reduce the hernia, hut without effect. 



I first saw her at 9 o'clock in the evening, when she ap- 

 peared very low, but the hiccup returned only when she at- 

 tempted to swallow ; the pain on the abdomen was not so 

 great as on the preceding day ; the pulse was regular, 

 moderately fiill, and did not exceed 90 : the hernia was 

 small, and seated under Poupart's ligament, on the inside of 

 the femoral vessels : on coiuinued pressure it receded under 

 the ligament between the lower edgt of the external oblique 

 and transversalis muscles. This circumstance has occasion- 

 ally misled inexperienced practitioners, one fatal instance of 

 which is recorded in the Surgical Report for December 1806, 

 vol. xxvi. page 255. 



She had had this complaint for several years, but could 

 not state when it had been reduced, as it did not appear to 

 her to have been of the least consequence, and she never 

 noticed it with much attention ; neither could we make her 

 believe that her present complaint arose from that small 

 swelling: however, she consented with considerable reluc- 

 tance to have the operation performed early in the morning, 

 provided the symptoms continued. 



2d. Four A. M. — She appeared much the same as on the 

 preceding evening ; but her countenance, and in some in- 

 ftances incoherent answers, argued an unfavourable termi- 

 nation. 



On dividing the integuments, cellular and adipose sub- 

 Itaiice with the fascia, a small tumour of a rough unequal 



surface 



