366 Case of Hernia successfully treated. 



9 P.M. The pills remained on the stomach; the hic- 

 cough and sickness were less. An enema was directed to be 

 given. 



20. 5 A.M. Much the same as on the preceding even- 

 ing. Another box oK pills was ordered to be taken as be- 

 fore ; the same as the former, excepting [^the omission of 

 the opium. The tobacco enema was directed to be given, 

 which liad the ctrect of producing a stool, after which she 

 seemed a little relieved ; but the hernia remained in the same 

 state. 



4 P.M. Restless, skin dry, tongue furred, the hiccough 

 and sickness worse. 



9 P. M. The unfavourable symptoms had all increased 

 considerably. On pro'posing' the operation it was agreed to 

 immediately, and perfouned soon after 10 P. M. The peri- 

 toneal sac was very thin, and contained only a few drops 

 of serLim ; the contents of the sac was an adipose tumour *, 

 having exactly the appearance of condensed omentum. This 

 tumour grew from the coat of the intestine, by a small neck. 

 No part of the canal of the intestine was included in ths 

 stricture. 



The stricture was dilated in the usual way inwards and 

 downward-, towards the symphysis pubis. Immediately on 

 the pari bcinc; returned she experienced relief, and said she 

 fell much more comfortalile. The wound was dressi'd with 

 lint and adhesive plaster, secured by a bandage; but no medi- 

 cine was given. 



21. 5 A. M. Has had some sleep; the sickness, hic- 

 cough, and pain have subsided. There remains only a 

 sense of soreness in the abdominal viscera ; the skin is a 

 lutle dry. 



Vy. Syrup, papav. ^ i. 

 Liquor amnion, acet. 

 Mist, camph. aa J iii. M. 

 3 P.M. Wis not had any evacuation by the bowels: gave 

 Ihree of the pills which were ordered yesterday, with three 

 table spoonfuls of tne following niixlure : 

 J^ Magn. sulph. J ii. , 

 Inf. sennas ^ v. 

 Tinct. gentian, comp. 5'' ^^ ^^• 



22. Has had two stools; rested well during the night, 

 'and appears quite well. 



* This is the second caso of rh's kind I have seen: the first occurred in 

 May last, in a palient of the riusbuiy Dispensary, aged 70, who diu not ap- 

 ply to tlie charity till a very late period of the disease, and died iu JO hours 

 after the operation. The diseased pnrn are preserved in my anatomical mu- 



KUJJl. 



25. Has 



