34 Treatment of the Strangulated Hernia, 



1st. Whether we are not too often deterred from per- 

 forming the operation for the Strangulated Hernia, from 

 the supposed difficulty and danger of it ? 



2d. Whether it is not the safest way of operating, to 

 return the prolapsed sac without opening it, unless there 

 are appearances which indicate gangrene, or some other 

 circumstance should exist, to make it necessary ? 



I am satisfied, that many die from this complaint, who 

 might be saved by a timely operation, which, most com- 

 monly, is owing to the objections which surgeons have 

 to perform it ; and I believe, both Dr. Worrall and Dr. 

 M'Lane agree in opinion with me, that the life of the 

 patient \vas in imminent danger, in this case, from the 

 delay. I know that Mr. Bell, and many other eminent 

 surgeons, have endeavoured very strongly to dissuade 

 from returning the sac without opening ; but, as I con- 

 sider successful experience as tiie best guide, I have 

 ventured to difler from them. 



In confirmation of what I have proposed in the first 

 query, I subjoin an extract from a publication by Mr. 

 WiUiam Hey, of Leeds, in England, a surgeon of high 

 repute, and much experience. Mr. Hey says, " When 

 I first entered upon the profession of surgery, in the 

 year 1759, the operation for the strangulated hernia had 

 not been performed by any of the surgeons in Leeds. 

 My seniors in the profession were very kind in affording 

 me their assistance, or calling me into consultation when 

 such cases occurred ; but we considered the operation 

 as the last resource, and as improper until the danger 



