Accidents and Operations. 308 
bladder was accounted for by its having been emptied 
before the operation ; otherwise it would have occupied the 
entire sac, 
Having fully reduced the hernia, I closed the peritoneal 
rent, which was a little less than two inches, with uninter- 
rupted catgut suture, and the external wound with 
interrupted silk sutures. A light wire muzzle was then 
put on the patient, to prevent her gnawing or licking the 
parts, and she was made as comfortable as possible. 
The diet for the first fortnight was sweetened milk and 
water, subsequently pure milk; and, finally, bread and 
milk, until the part was well. The case proceeded to a 
perfectly satisfactory conclusion. The last external suture 
came away on the twenty-third day, and within four weeks 
all was thoroughly healed, and no enlargement apparent, 
or anything to denote what had been amiss beyond a fine 
seam where the incision had been made, * 
Having allowed the patient a month to recover condition 
and establish the firmness of the part, I proceeded to 
prepare her for the second operation; viz. the reduction 
of the hernia on the opposite side. This took place on 
the 11th of August, in the presence of Messrs. Newnham 
and Manby, surgeons, and others. The operation was 
conducted under chloroform, in precisely the same manner 
as on the first occasion. I should observe that this 
rupture, which in the first instance was comparatively 
small, had increased considerably in size, and was now 
larger than the one already operated on. This I attributed 
to the pressure brought to bear on it from reducing the 
opposite large one, which must necessarily have had a 
tendency to force the smaller one further out. As may be 
imagined, I did not feel so sanguine about the result of 
the second operation as the first; for I had grave doubts 
whether, in reducing this zzcreased rupture, the opposite 
one would not break through again. However, I operated; 
the hernia was intestinal, the peritoneal rent was not so 
