Accidents and Operations. 3 



bladder was accounted for by its having been empti 

 before the operation ; otherwise it would have occupied t 

 entire sac. 



Having fully reduced the hernia, I closed the peritoni 

 rent, which was a little less than two inches, with unint^ 

 rupted catgut suture, and the external wound w 

 interrupted silk sutures. A light wire muzzle was th 

 put on the patient, to prevent her gnawing or licking 1 

 parts, and she was made as comfortable as possible. 



The diet for the first fortnight was sweetened milk a 

 water, subsequently pure milk ; and, finally, bread a 

 milk, until the part was well. The case proceeded tc 

 perfectly satisfactory conclusion. The last external suti 

 came away on the twenty-third day, and within four wet 

 all was thoroughly healed, and no enlargement appare 

 or anything to denote what had been amiss beyond a f 

 seam where the incision had been made. 



Having allowed the patient a month to recover conditi 

 and establish the firmness of the part, I proceeded 

 prepare her for the second operation ; viz., the reduct 

 of the hernia on the opposite side. This took place 

 the nth of August, in the presence of Messrs. Newnh 

 and Manby, surgeons, and others. The operation ^ 

 conducted under chloroform, in precisely the same man 

 as on the first occasion. I should observe that f 

 rupture, which in the first instance was comparativ 

 small, had increased considerably in size, and was n 

 larger than the one already operated on. This I attribu 

 to the pressure brought to bear on it from reducing 

 opposite large one, which must necessarily have hac 

 tendency to force the smaller one further out. As may 

 imagined, I did not feel so sanguine about the resuli 

 the second operation as the first ; for I had grave dou 

 whether, in reducing this increased rupture, the oppo; 

 one would not break through again. However, I operat. 

 the hernia was intestinal, the peritoneal rent was not 



