= 
HERNIA. 
But, to return to the fubje& of reducible hernix, it be- 
hoves every furgeon to underftand, that though thefe cafes 
immenfe fize. 
increafes with the fize of the tumour. e portion of intef- 
tine, or omentum, which has quitted the abdomen, produces 
(as Mr. Lawrence defcribes) various complaints ‘from its 
From this fource of irri- 
arge ruptures are almoft invariably 
i The, patient 
more immediate danger, by forcing down freth parts, fo as 
as well as for the formation of fuch adhefions of the parts 
toeach other, and.to the hernial fac ; circumftances changing 
the cafe from a reducible to an irreducible fwelling. As the 
opening is rendered larger by the protrufion of the parts, 
and the preffure on the vifcera, which caufes the defcent, is 
into the cavity of the fac, generally obferved in old ruptures, 
frequently renewed, additions to the tumour are eafily made. 
In fituations where pofition is favourable, and the furround- 
ing parts offer no obitacle, as in the fcrotum, the only limit 
_ to the poffible bulk of a rupture arifes from the connec- 
__ continue to grow larger 
* frighten him into a differeat line of condu 
things may le 
. Mies oes! «a3 
fuppoting the patient to. 
tions of the parts within. Inftances are not uncommon 
where all the moveable vifcera have been contained in fucha 
{welling 5 and even thofe which are more fixed may be gra- 4 
dually difplaced by the conftant dragging of organs con- 
ne&ted with them. See Lawrence on Ruptures, p. 31, 32. 
edit. 2. 
Of gga EES have endeavoured to reprefent the impru- 
rT ich fe 
) 
to defcend into the fac, perhaps witho ' 
convenience ; but the perils and difagreeable circumttances 
which may be thé confequence of fuch temerity, ought to 
: utet 
charmlefs {tate of the protruded vifcera is not at all to be 
‘depended upon, being of very uncertain continuance. Man 
‘thin ad to a change, in which the patient’s life will 
t into the moft imminent danger. Any exertion 
“which occalions an additional protrufion ; i 
‘the tumour ; any intemperance in di y fu 
vert afimple, reducible, in hernia, into a cafe attended 
with. all the alarming, and fatal fymptoms, which pro- 
ceed from t sulation otruded parts. But, 
oft 
{cape thefe evils for a great length 
of time, other unpieafant things will be the refult of his rath 
negleét, The hernia, as we have already defcribed, will 
i r and larger, until its magnitude is 
ch, as interferes with the exercife of any ative kind of 
juftly regarded 
life, is accompanied with a protrufion of all the moveable 
vifcera of the abdomen, and brings on afflicting diforders of 
the fun@tions of the various parts. Even the pylorus of the 
ftomach has been found dragged into the mouth of a hernial 
a 
The ,effe&t of every eligible trufs, or bandage for rup- 
tures, is to produce an adequate, unremitting, equal degree 
of preffure upon the part where the hernia opens into the 
abdomen, fo as to fhut up the paffage through which the 
parts efcape from the cavity in which they are naturally 
contained. No reafonable expe€tation can be indulged, that 
any contrivance will operate im this manner, unlefs the pref 
fure which it makes is uninterrupted, and of fufficient power, 
being alfo fuch as will not induce any complaints which might 
oblige the patient, for a certain’ time, to defift from wearing 
the apparatus. ; 
All bandages for ruptures are either elaftic, or inelaftic. 
The laft are ufually made of dimity or leather. - They are 
. 
iving. he ine ; 
the patient himfelf, who endeavours to make its operation 
more availing by tightening it. But this is not only apt to 
ing on pain and foviin of the tetticles, (fuppoling the 
cafe to be an inguinal hernia,) but t efame affeétion of the 
external parts, to which the bandage is applied. — Thefe 
circumftances compel the patient to difcontinue 1ts em 
ployment, till the complaints which it has occafioned have 
had time to fubfide. Now, nothing is more dangerous 
than even leaving off any kind of contrivance eS: 
i the a 
o 
a] 
and hydroceles, arife from their employment. ~ - 
fentiments, with 
Suc e as much calculated for them 4s . 
adults, and the opinion to the contrary is totally deftitute 
foundation. 
All inelaftic banda of hi 
as only affording a falfe fecurity, 
gerous even than a total omiffion of this: kind. of 
fince they encourage the patient to take violent 
Py 5 “ L Fe of th prob pk j = g neces, 
VaVsl Vis 
wes for the fupport of herniz are 10W 
more Gali- 
fupports 
exercifey 
Coopers 
ies 
part ip. 14. : Ree oes 
‘The only way in which any apparatus of this kind may 
be ufeful in cafes of ruptures, is as a ‘ufpenfory bandagt 
i sduced in cone- 
in fupporting the parts, and preventin ua 3 
iri it an angerous magnitude. _Elattic bat ‘ay 
hey are commonly called) truffe : 7 
in every attitude of the body. -V 
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