f= inflammation, and Tfeoleerstion of the integuments. 
HER NAA 
difpofition to the complaint. In’ fuch perfons, a very flight 
occalional caufe, fuch as the act of coughing or fneezing, 
- will bring on a rupture. The complaint indeed appears fome- 
times fpontane -know, fays Richter, a favant, 
who leads a fedentary life, and in. whom an inguinal hernia 
appeared fuddenly fome time ago. I applied a bandage, 
and, in a few weeks, a fimilar hernia came on the oppofite 
— ; a bandage wasapplied to thisalfo ; and in a very fhort 
time a crural hernia — its appearance. I have feen feveral 
fimilar cafes, and have wn four, or even five herniz come 
in the fame tush Sahai the leaft occafional caufe. 
Traité des Her neceflity of admitting 
fome original aihaes of bradintes crouse to the oc- 
~ currence of ruptures, is apparent from this confideration, v 
that the psy exift in all fubjeéts, and the mitts Dot 
caufes are applie =< all individuals ; bat the effect is only 
partial.’ Lawrence on Ruptures, p. 21. ed. 2 
Of Reducible Hovwid wit ues this aa are Sompbented 
fuch as are in a quiet ftate, and admit of being put back into 
the cavity of the abdomen without difficulty, or,  inileeds often 
return of: themfelves into that — when the patient is in 
a recumbent pofture. The. pro 
up at night upon a patient ‘sehen down and come 
- down again in the morni "g ape, his getting = and refuming 
an erect pofition. 
an w oft Ps serie cinta and 
to, confift * a gradual aains « of the containing parts. . The 
— is ones ubjeét toa a fize, being fmaller 
e patient s down on r when he 
‘ditnisiilion ite Sionk ows large a 
— and tention often increafe. after 
shen the patient is flatulent. is free from pain, 
Its 
‘contents, if omentum, betray a foft doughy feel ; if —~ 
the fenfation communicated to the fingers o an ner 
is frequently fomewhat tenfe and elaftic. It-is Mo a cir- 
eupinaell highly meriting notice, that patients, with large 
reducible herniz, are apt to be troubled with colic, conftipa- 
tion, and vomiting, in confequence of the unnatural fituation 
of the bowels. Ve: ebten, however, the —— mi 
vifcera _ to fuffer little or no. sirigace ae 
inftances, the reduction is 
prolaple parts, 
withou it ipcedy sm judicious -afliit- 
ey F the cafe be an enteroceley, and the . portion of inteftine 
cone) id ie 
j let the prolapfed 
tumour of what- 
: 
ruded parts,commonly go. 
ever fize, yet the tenfion will be little, and no pain will atterd 
the handling of it ; upon the patient's coughing, it will feel 
as if it were blown into ; and, in general, it will be found d very 
Rego returnable, a guggling noile being often audible, whea 
wel is 
afcendin 
_ If the sotake be an epiplocele, or one of - the ‘omental 
kind, the tumour has a more flab and a more unequal 
feel; itis in are perfectly sidolents is mere c 
fible, and, if in 
patient adult, it is, in fome meafure, diftinguith sable by its 
— ps cee piece of omentum in aha pa afles up 
very. flowly, and never makes a guggling n 
lf mam cafe be an entero-epiplocele, that ae one contiting 
of both inteftine and omentum, the characteriftic. marks 
will be lefs clear than in either of the fimple cafes ; but the 
ee may eafily be diflinguifhed from every one, by any 
ne in the habit of making the examination, ~See Pott oa 
recedin 
It matt: be acknowledged, hessiene i ‘Sat it is often difh- 
cult, and even impoffible, to afcertain what are the contents 
of the hernia, by merely handling the {welling. This is 
more efpecially the cafe when the hernia is old, large, and 
tenfe. In fuch inftances the protruded vifcera undergo furprif 
ing changes in their figure and ftruéture, while the thicknels 
of the hernial fac tends aterially to impede the acquirement 
any accurate information, as to the nature of its con- 
tents, by the fingers of an examiner. It is often equally 
difficult to form a —_— opinion in pene to what i is'con- 
— ina {mall 
of omer 
ly, an guggling noife leaving fome th 
aeons is Stele walt of relaibaae it is reafonable to 
that the difeafe is, in all probability, an entero-epiploce’ 
See Lawrence on Ruptures, edit. 2. p. 2 
Nothing is more common, than to fee perfons with ind 
deni — a Peace atu and following t c 
tier 1¢ tumours down , expoled 
Since 20 
prefent —< nor ek iseeatiats: confiderable inconveniences 
3,1 
inftances, a juft fenfe of the manner, in which fuch eet 
= e continually Face to peril, have the | 
due attention to the pepe a 
ne them to revise de as quiet, temperate, and regu 
o — as their circumftances in life might peri 
part of the vi oA 
aes ok the abdomen renders a perfon spaveizulesly espolet 
to the danger — an diascicisal quantity of the vilcera ae oid 
co ncaa alfo protruded, and probably Atsingulstee Foon 
important truth, ‘which cannot be too tg i aes ee pope 
oy ee 
bowel i is fuffered to remain fo, an soe. ‘mt 
BE Ways open, » toe receive a) 
protrufion. th bs Paccgpamnege fag 3 with: - + 
ducible hernia, ought to have sie ‘danger of fuifering * 
continue” down Seasatoe i to" him 
oe 
d. neceflity @ 
+ 
