VOL. XLI.] PHILOSOPHICAL TRANSACTIONS. 475 



thrust out with great force; tliey were both prodigiously distended with wind, 

 highly inflamed, and in several places very livid. That part of the guts com- 

 monly called caecum, was blown up into a kind of globular figure, as large as a 

 child's head. It was remarkable, whether it was in the original conformation, 

 or by the vast distention, that there was no manner of appearance of the appen- 

 dix vermiformis to be found, though diligently sought for. And further, that 

 the caecum was vastly thicker set with glands, and these much larger than he 

 had ever seen before in any subject. The convolutions of the ilium and colon 

 were so immensely distended with wind, that the valvular corrugations in both 

 almost totally disappeared. Yet exactly at the valvula Tulpii, alias Bauhini, 

 there was a very great constriction of the intestinal canal, as if tied strongly 

 with a cord ; and though we opened the colon about a hand's breadth beyond 

 the valve, and let out the flatus, we could not possibly press any wind from 

 the ilium into the colon through the valve. Dr. H. suspected indurated ex- 

 crement, as an obstacle ; but on a careful inquiry, he only found the whole 

 valvular production, and the end of the ilium, at its insertion into the colon, 

 highly inflamed, and quite shutting up the passage. On dilating the rings of 

 the oblique and transverse muscles, the wind rumbled up out of the ilium into 

 the cavity of the belly very readily. They found pretty much bloody sanies in 

 the guts, on slitting them open, but little or no indurated faeces : a manifest 

 proof, that the exceeding hardness of the tumour was owing only to the exces- 

 sive flatulence, and great inflammation ; and shows how much we may be de- 

 ceived in our conjecture on like occasions. The tumour of the scrotum was 28 

 inches round. There was no adhesion of the intestines to the containing parts, 

 though he had so long laboured under the hernia. 



This unhappy case gave Dr. H. a severe reflection, and he thought the 

 malady was much increased by the repeated application of the hot fomentations; 

 as it rarefied the air greatly, and, by relaxing the parts, gave further room to 

 the vast expansion, — At that time he had never seen Belloste's second part to 

 his Hospital-Surgeon, where he advises, in such cases, the most cold astringent 

 fomentations. In this and the like, they might have been very proper ; espe- 

 cially if a portion of spirit of wine camphorated had been added to prevent 

 mortification. 



It sometimes happens, that though the annular perforations of the abdominal 

 muscles are dilated by the operation, yet the hernia cannot be reduced, — Dr, H. 

 believes, as the guts were distended to so enormous a bulk in this man, it 

 would have been impracticable. In such cases may it not be proper to prick 

 them with a needle, to let out the flatus, as is commonly practised in small 

 wounds of the abdomen, where the intestine thrusts out, and becomes so turgid 



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