VOL. XL.j PHILOSOPHICAL TRANSACTIONS. 237 



had a return of a tumour in the groin, with unusual pains, which was soon fol- 

 lowed with an excruciating pain in the belly, and such colics, retchings, and 

 excreinentitious vomitings, as usually attend the strangulation of the gut in the 

 miserere mei. This came upon her unawares, and the distress she was in, made 

 her forget that for '25 years before she had had a swelling in the groin, as large 

 as a hasel nut, which seldom had given her any uneasiness, and which she never 

 suspected to be a rupture. Latterly the patient had been more subject to colics 

 than usual, but this was imputed to bad digestion ; and that day she had used 

 no motion capable of producing a rupture ; so that it was by chance that Mr. 

 Despaignol, who was sent for the next day, discovered the cause of the com- 

 plaint. She was blooded, clystered, fomented, &c. ; but the complaints sub- 

 sisting with a continual singultus, Mr. A. was called in the 1 1th. 



The tumour was then oblong, about the size of a hen's egg, somewhat in- 

 flamed, yet not tense, nor so painful as to make him take much notice of it. 



On the repeated use of the abovementioned means, and of lenient purges 

 and opiates, the vomitings and hiccough were at times stopped, and the patient 

 made so much easier, as to give hopes of success ; but as during 6 days the 

 patient had no passage, and the tumour could not be reduced, it was thought 

 unsafe to delay the operation any longer. 



The tumour felt unequal, though it appeared even, and pappy, as the 

 tumours of the omentum generally are ; and therefore of that kind which is 

 always most difficult to reduce, the omentum not having that elastic springiness 

 which favours the replacing of the guts. 



On dissection, it was found embodied in the hernial bag, and that upon the 

 external surface of the slits in the abdominal muscles, the folds of it had formed 

 a round protuberance, not unlike the os tincae in the vagina, or like a bourlet 

 which, by compressing the gut, prevented its return into the belly, and by ob- 

 structing the opening, as the gut pressed upon it, had strangulated about an 

 inch of the gut encompassed by it in the hernia. 



This being the 6th day from the beginning of this disorder, the gut in that 

 place was found of a very swarthy colour, but yet springy ; so that it was not 

 quite mortified. It lay inclosed in a net, formed by the omentum (like a fish 

 in a fishing-net) strangulating the gut under its pressure without the abdominal 

 muscles. 



It was with some difficulty the omentum was torn off and separated from the 

 bag it was attached to ; and as this lay in the way of the reduction of the gut, 

 and almost sphacelated, so it was cut ofF without any previous ligature, though 

 its vessels were turgid and large, as it was impossible to pull it out so as to make 

 the ligature upon the sound part of it ; after which the reduction of the gut 



