376 . SURGICAL OPERATIOXS. 



dered to be kept constantly wet with cold Wcater, and to be sup- 

 ported with a wide bandage. She was placed on a restricted 

 and mash diet. On the next day, being honoured by a visit 

 by Messrs. Morton, Spooner, and Youatt, I had the pleasure 

 and advantage of sul)mitting the case to their examination, and 

 obtaining their opinion. They urged me to attempt to return 

 the protruding viscera and secure them by a surgical operation ; 

 and ]Mr. Spooner kindly offered to be present, and to give me 

 his valuable assistance. 



" On the 24th, we therefore gave her two ounces and a half of 

 the tincture of opium shortly before she was led from the box 

 to the operating house. Her pulse was 31, owing, probably, to 

 the administration of the opiate : her i-espiration and other vital 

 functions seemed not to be interfered with. 



" She was cast on her right side, and the hobbles being secured, 

 we had her elevated so as to place a large quantity of straw 

 under her quarters, which being done, she was turned nearly on 

 her back, and kept in that situation by more trusses of straw. 

 Her head was made fast to a ring in the front, by means of a 

 long rope ; while the left hind leg, being disengaged from the 

 hobbles, was fixed to another ring behind, by which means she 

 was well secured, and so confined that she scarcely moved from 

 the spot ; but this was probably produced more by the opiate 

 than by our arrangements. After a careful examination, exter- 

 nally as well as per rectum, in order to ascertain the situation 

 and probable size of the laceration of the muscles, an incision 

 was carefully made througii the integument into the sac, in a 

 line with the inferior border of the cartilages of the false ribs; 

 which incision was about seven inches in length. This, as we 

 had hoped, proved to be directly upon the aperture in the mus- 

 cular parietes of the abdomen. The intestines were exposed, 

 and after having sufficiently dilated the opening to permit the 

 introduction of the hands, they were quickly returned, portion 

 after portion, into their proper cavity, together with a part of 

 the omentum, which we found somewhat annoying, it being fre- 

 quently forced back again through the laceration. 



" At times, it required the exertion of our united strength to 

 prevent tlie escape of the intestines, and which Avas only efi'ected 

 by placing our hands side by side, covering and pressing upon the 

 opening. By these means we succeeded in keeping in the 

 viscera, until we were satisfied that we had placed them all 

 Avithin their proper cavity. At about the central part of the 

 aperture, we decidedly found the greatest pressure of the intes- 

 tines to effect an escape. A strong metallic suture of flexible 

 wire was then passed through the edges of the laceration, taking 

 in the peritoneum and portions of the transversalis, rectus, and 

 internal abdominal nniscles, and other sutures, embracing the 



