HERNIA. 
apt te flip down; mh fean people, it readily gets ap too 
high. The latter change is the worit, as the lower part of 
of the pad is too convex or conical, which is a very 
mon defeét, its prominent central part makes {trong 
fure, while, on the other hand, the fides lie hollow, fo tha 
in the om 
“or principally at the point of the conical inner furface 
of the | 
preflure is 
ad this cafe a 
the bowels are apt to protrude, efpecially when the pad flips 
cover and thut up the whole of the ring. The fize of the pad, 
indeed, fhould always, in fome meaiure, be resrilatele by: 
that of the hernia. A fmall pad is alfo fubjeé& to the defe 
of ealily flipping out of its proper place, whereby the danger 
of a protrution through the ring is produced. Let it not be 
inferred, however, that a trufs is always better, and that 
the hernia muft certainly be more fecurely ke i 
Whe 
the motions of which it is pufhed about, fo as not only to: 
create a rifk of the hernia defcending, but to fret and irritate: 
the part of the {kin which it rubs. 
trufs, according to Richtér, ought always to be applied! 
in fuch a manner, that, at leaft, the lower third of t 
fhould lie upon the os pubis, and clofe the neck of the hernial 
fac, while the upper part fhuts up the abdominal ring. 
The preffure, which is made againft the os pubis, is the molt 
material, as it operates againit a fixed point, and has the 
effect of rendering the neck of the hernial fac impervious. 
Since the foft parts yield and give way, Richter thinks all 
preflure upon them cannot be trufted. e cenfures fuch. 
practitioners as are in the habit of applying the trufs, foas 
to make its pad only prefs upon the abdominal ring, and 
merely touch the os pubis with its lower edge. He ttates,. 
that by the defcent of the vifcera, from the cavity of the 
abdomen, into the hernial fac, the lower angle of the abdo~ 
minal ring becomes drawn down, fo far as to be fituated 
clofe to the os pubis; and, confequently, he maintains, that — 
when the lower edge of the pad merely touches the upper 
margin of the os pubis, the abdominal ring is not fufficiently, 
nor fecurely covered, being apt to be left unguarded, when- 
ever the pad flips in the leait upwards. In fat fubjedts, the 
pad would not long remain in this fituation, as it would be 
forced downward by the projeétion of the parietes of the 
abdomen above it. 
this opening 
depreffion, and the .os pubis is fo Page 
ferviceable. : to ei roe ae 
n a patient is afflicted with a. hernia in each LAW 
it is cuitomary to direét him, either. to wear two didines 
