64 PHILOSOPHICAL TRANSACTIONS. ' [aNNO ITjG. 



lapsed intestines, and renewed occasionally, to jjrevent them from getting too 

 dry, as well as to preserve as much as possible their natural heat. The reduction 

 of the displaced bowels was begun with laying the patient's legs over an assistant's 

 shoulders, who was desired to kneel on the bed for that purpose, with his back 

 towards him, and then the legs were brought forward as far as to the hams. By 

 this means the lower parts of the body were elevated, and in consequence the 

 weight of the bowels falling back towards the chest, counteracted their further 

 protrusion. While the patient continued in this position, Mr. N. endeavoured, 

 v/ith his hands, to force the guts back into their proper place; but soon found, 

 from the quantity of them protruded, with their great inflation, that a larger or 

 more extended pressure than his own hands could afford him was necessary; and 

 not thinking it prudent to employ any of the by-standcrs in so hazardous a task, 

 lest by their inexjjerience they might handle the bowels too roughly, he sent for 

 2 of his fellow-labourers in the care of the Radcliffe Infirmary, to his assistance. 

 As soon as they came, the reduction was again attem})ted; one of them directing 

 that portion of the bowel which was last protruded, while the 2 others made a 

 gentle, regular, and circumscribed pressure from all sides towards the opening. 

 But this endeavour not succeeding, convinced them, that it would be much safer 

 to enlarge the wound, to facilitate the return of the prolapsed parts, than hazard 

 the necessity of handling them too much, or exposing them too long to the ex- 

 ternal air, either of wliich would, in all probability, have proved fatal. This 

 being done accordingly, by continuing the wound in the same direction upwards 

 about 2 inches, the exposed bowels were easily and soon returned into the abdo- 

 men. They then brought the edges of the wound together, and kept them by 

 the suture called gastroraphia, leaving a proper opening in the most depending 

 part of it for the discharge of the blood or matter which might be collected in 

 the cavity; and afterwards it was dressed in the usual way, lightly and almost 

 superficially, with an anodyne poultice over all. The regimen enjoined him, 

 with respect to diet, was only gruel, panado, and sage-tea, with barley water or 

 thin gruel to drink; with an oily laxative draught and emollient anodyne clyster. 

 27th. Visiting him early the next morning, Mr. N. found the night had been 

 spent in great restlessness and inquietude, notwithstanding the clyster had been 

 thrown up according to the direction. He was exceedingly low; his skin felt still 

 cold and clammy; his pulse weak and fluttering; he complained of frequent 

 chills, and an oppressive tightness of his belly, though the wound had discharged 

 considerably a thin, serous humour, which had wetted the bandage quite through. 

 Nor was the tension of the abdomen, at this time, sufiicient to account for this 

 oppressive pain he complained of; from which Mr. N. concluded it to be spas- 

 modic. The dressings were removed; and Mr. N. desired his a|)prentice to fo- 

 ment the part with an infusion of the emollient flowers for a full hour, and to 



