.36 Treatment of the Strangulated Hernia. 



Dear Sir, 



I have attentively considered the case of Scrotal Her- 

 nia, which lately fell under our joint care. 1 find it 

 most accurately stated throughout, except where you say 

 the hernial or peritoneal sac was returned, \\'ith its con- 

 tents, on tlie enlargement of the ring : it is true, the vis- 

 ceral contents of the sac immediately and easily receded; 

 but it appeared to me, that an adhesion had taken place 

 on the posterior part of the sac, and the ring near the 

 pubes : for I observed, on every attempt to return, it 

 never yielded in that part. However, it is a very consoling 

 reflection, that the whole of the protruded peritoneum 

 may remain in the scrotum without any material injury, 

 or gangrene, following. I have, since the closing of the 

 wound, examined the boy, and find the parts perfectiy 

 sound, and in a natural state, except a small enlargement 

 on tlie groin, feeling like a cord, about the siae of a small 

 finger, and which I suppose to be the contracted perito- 

 neal sac filling up the ring. This circumstance may 

 probably be attended with considerable effect in pre\'ent- 

 ing future descents through the rilig, enlarged by the 

 operation. 



Yours, respectfully, 



J. WORRALL. 



Dr. Lyons. 



