HERNIA. 
the (pring, always makes more preflure than the other one; 
the {pring of the trufs fhould invariably be put on that fide, 
where the hernia, which it is moft difficult to keep up, is: 
fituated. Should one hernia be an enterocele, the other an 
domen, 
inftrument, which unites the two pads, ought to form an 
angle outwards. he two rami of the offa pubis do not 
make a ftraight line in the place of their junction, but an 
angle, and it is to this angle, that the one made in the trufs, 
between the two pads, ought to be adapted. Were this 
part of the apparatus ftraight, or not fufficiently hollow, 
the pad, fartheit from the f{pring, could not touch the 
parts underneath as it ought to do, nor, of courfe, make 
effectual preffure. 
The pad of a trufs ought to lie upon the furface, to which 
it is applied, in fuch a manner, that it will make an equal 
preffure upon every point of fuch furface. When the upper 
part of the pad makes more preflure than the lower, a pain is 
produced above, and the hernia protrudes below. Then. 
‘its lower edge prefles more forcibly than the upper part, 
the {permatic cord is injured below, and a protrufion of the: 
vifcera may occur above : fimilar evils may enfue, when one 
fide of the pad preflés much more than the other. nce, 
it i obje& of great importance to have a pad of a flat. 
contruction, fo that, when it is applied, and an attempt 1s 
made to pufh a finger under it, am equal refiftance is en- 
countered om every fide. Truffles are alfo fabricated with 
pads, which admit of being: turned in various directions 
o 
<< 
Though, by this: means, 
its lower part will not make more preflure than its upper. 
Richter: contends, that this is not enough, and that we 
move- 
hich 
able by means of fcrews, &c. He fancies, that his flexible = 
i i poli- 
r 
moved in the fimited 
: fince highly elaltic 
ngs have been accounted the beft, by all the mo/t emment 
pada, which ad 
feen pads in this country, fo 
ved, without fuch limita- 
| of imperfection. 
ground ‘ 
Before applying a trufs, | 5 
by 
truffes. made upon this principle, and, therefore, we do not 
hetitate to pronounce them t 
fiderable peril, and not to lofe, in an iftant, the chief ad- 
vantage refulting from the employment of the in{trument, 
The conitant preffure of the pad, upon the neck o 
hernial fac, fometimes excites adhefons init, or even a total 
obliteration. of its cavity, whereby a radical cure of the 
difeafe is accomplithed. Now, when a patient, after wear 
ing a trufs a certain-time, lays it alide, even for the fpace 
of a few moments, an opportunity is afforded for the ices 
to defcend again, and they may unfortunately do fo, fhort - 
as the omiffion of the trufs may have been. When this 
which perhaps has been the effect of his having worn 
trufs for feveral years before. But the greateft. misfortune 
is, that the hernia, in becomi rola rain, is- exceed- 
ingly apt to be ftcangulated, by reafon of the alterations. 
made in the hernial fac and its neck, fince a former. de 
of the vifcerainto them, If the patient is obliged, by fome 
urgent caufe, to take off his tru a time, let him be 
careful to do it in a recumbent pofition, and refrain from. . 
But as foon as he 
inftrument, he will not mind it much, and he 
vifed to wear it continually, at every time and in all places.. 
The habit of doing fo will become natural to him, and he 
will feel no material annoyance from it. For there is no 
certainty, that a protrufion of the vifcera would not occury, 
when the patient is lying in an horizontal pofition, particu 
larly from a fit of coughing, or fome other. occafional. 
caufe. 
morning in bed, 
The perfpiration penetrates the leather, rots it,. 
sit wet. ‘The patient’s {kin becomes reddened and. 
which he ought to change ever 
€ 
‘affeGied with veficles and excoriations, which compel him to 
leave off the apparatus for a time. Or elfe, the {pring 
sHfelf ruts, and is rendered unferviceable. To prevent 
fe unpleafant occurrences, Richter recommends purting 
a {mall linen comprefs under the pad, changing it every 
morning, fo as to preferve cleanlinefs. The back of 
the truis fometimes produces pain about the fpine, efpecially 
in lean perfons. To obviate this, a comprefs may alio be. 
placed under the back end of the trufs, or elfe a leather 
little cufhion.may be fattened. this of the appa- 3 
4 
Teeter 
the hernia is really reduced. | 
pore a while any portion of the hernial contents is 
jent is oo aged Caco ne of danger. 
preflure of the truls upc truded part 
makes the ‘not, alee or elfe it produces adhefions; : 
or, laitly, if a piece of inteitine is prolapfed, he eyabe 
ren : 
