gi PHILOSOPHICAL TRANSACTIONS. [anNO 1/36. 



charge, was attended with very little pain, or much less than generally attends 

 suppuration. Which shows that the extravasation of the excrements from the 

 gut into the hernial bag, and the bursting of this bag, were the cause of the 

 fistulous discharge, and of the continuance of it outwardly. 



As to the pin found in the rupture at the time of the operation, it is observ- 

 able, that two-thirds of it, incrusted with a chalky matter, were confined and 

 concealed within the gut ; the other third, next the point, had made its way 

 through it, the point of which was so lodged in the omentum, where it was 

 fixed, as to leave a free passage for the excrement from the perforated gut out- 

 wardly, whenever the perforation in the gut, on shifting the position of the 

 inclosed pin, could open, and afford a passage for the discharge of the faeces 

 this way, which was as often as this conical or pyramidal pin altered its place, 

 or did not exactly obturate the aperture in the appendix ccEci, it exactly fitted. 

 The aperture made in the gut by the pin lay concealed, the point being lodged 

 in the omentum, lying parallel with the gut, which was here duplicated, where 

 it was so secured, that it seemed almost impossible it could ever make its way 

 out of this place, and its other confinement in the gut, as the aperture was 

 callous, and so resisting that it was with some violence it was forced out of its 

 confinement, through an aperture fitted for the point only, and so straight, 

 that the report on its coming out, was like that of a cork out of a bottle; for 

 though it appeared that the opening had occasionally been enlarged, as the in- 

 crusted part of the pin was pressed forward into it, yet it is plain that nature's 

 attempts to get rid of it had been fruitless, and might possibly have been so 

 during all the patient's life. 



Sir Hans Sloane has furnished the curious with instances of bodies incrusted 

 in the guts with stone, and of some making their way out, when there was 

 little probability of it. Daily experience shows how far nature will struggle to 

 free herself; so that it is always most eligible to trust them lo her care : this 

 may appear from the difficulties that have attended the cure of this case, which 

 at last did not prove so successful as it was first hoped for; for the patient having 

 been remiss in the wearing of his truss, on some effort the guts found a way 

 into the inguen again, 6 months after the healing of the wound. This case 

 also shows, that the best operation, or the utmost care, is no security against 

 the relapse of a rupture. This is the third or fourth instance Mr, A. had met 

 with, of the insufficiency of this operation to effectuate a cure of ruptures; 

 and yet it is plain that this is far more likely to prove effectual than the caustic, 

 or any other method cried up for the cure of this evil. In a growing age, a 

 good spring truss is an eflfectual remedy ; and in an adult, this should be the 

 ultimate one, though it is no more than a palliative cure. 



