CALCULI m THE 30WELS. 365 



strangulated hernia, which should be reduced either bj the pres- 

 sure of the hands, or by the aid of an operation with the knife — 

 which will be described under the chapter which treats of the seve- 

 ral operations. Whenever inflammation of the bowels is attended 

 with obstinate constipation, the walls of the abdomen should be 

 carefully examined, and especially the inguinal canal, scrotum, and 

 navel, at which points in most cases the hernia makes its appear- 

 ance. A swelling at any other part may, however, contain a 

 knuckle of intestine, which has found its way through the abdo- 

 minal parietes in consequence of a natural opening existing there, 

 or of one having been made by some accidental puncture with a 

 spike of wood or iron. The swelling is generally round, or nearly 

 so, and gives a drum-like sound on being tapped with the fingers. 

 It feels hard to the touch in consequence of the contents being 

 constricted, but it gives no sensation of solidity, and may be gene- 

 rally detected by these signs. None but an educated hand can, 

 however, be relied on to distinguish a ventral hernia from any 

 other tumor. When it occurs at the scrotum or navel the case i« 

 clear enough. 



CALCULI IN THE BOWELS. 



A STOPPAGE IN THE BOWELS Sometimes obstinately persists, in 

 spite of all kinds of remedies, and, death taking place, it is found 

 on examination that a large calculus has blocked up the area of 

 the canal. Sometimes one of these calculi is found in the stomach, 

 but this is extremely rare. On making a section they are found 

 to consist of concentric layers of bran, chaff, and other hard par- 

 ticles of the food, mixed generally with some small proportion of 

 earthy matter, and arranged around some foreign body, such as a 

 piece of stone from the corn, or the head of a nail. Treatment is 

 out of the question, as it is impossible to discover the calculus 

 during life, and even if it could be ascertained to exist, no remedy 

 is known for it. Those who are curious about the composition of 

 these calculi, will be pleased with the following letter by Mr. Buck- 

 land, surgeon to the 1st Life Guards, in reply to an inquiry made 

 in The Fidel as to the composition of a calculus found in a horse 

 belonging to a correspondent : — 



" Mr. C. Pemberton Carter having, in his interesting letter, re- 

 quested me to throw some light upon this subject, I have great 

 pleasure in giving what little information I am able to afford, with 

 apologies for delay, as Aldershot camp is by no means a favorable 

 spot for scientific investigations or literary pursuits. As regards 

 the actual composition of calculi such as he has sent, we learn 

 from the catalogue of the museum of the Royal College of Sur- 

 geons that they are composed for the most part of the phosphate 

 of magnesia and ammonia, wi^h small quantities of phosphate of 

 31* 



