oS. Vou XVI! 
HERNIA. 
e ball ‘infuperable by purgative medicines, as where the. 
whole width of a bowel is included. 
aoe m a note in Mr. rpms 8 ‘excelleat treatil on rup- 
tures, it appears that Morgagni mentions a cafe h 
part only of the diameter ie rinlitias where the ftools were 
not pe: yet it ended fatally. (De Cantfis et cad 
Morb. art. 15.) Mr. Lawrence refers’ to man 
Fifiatices in which the conftipation was complete, saad 
inthe Mémoires de ]’Acad. de Chirurgie, tom. iti. 
London, Med. Obf. and Rit? vol iv. p. 178 and 955. 
Philofophical’ Magazine, vol. x et feq. is ae 
Ratio Medendi, p. 2. c. Mo org, Ae is alfo ftated 
had a patient who died on . the fixth day, after sontligee 
continuing the whole time. The entire diameter of the in- 
teitine was unobitructed, the protruded part being merely a 
diverticnlum. (Ep. 3 34-art. 18.) A fimilar cafe is faid to be 
y Benevoli, in Due Relazioni Chir. art. 19. See 
Lawrence on Ra tures, edit. 2. p. 33. 
Befides the vomiting, ha tag &e. the pulfe is mek a 
and at firft hard. ual relief be not obtained, the 
ola becomes red and more painful, and when ha ndled, 
mark of each finger is left in a white hollow impreffion, 
like what occurs on prefling a dropfical limbs The abdo- 
men now becomes flightly tenfe — jody upon preflu 
The vomiting is very frequent, and t ole body covered 
with fweat. ‘The ph saat te remains 5 obithaates and inftead 
of “ph ae hiccough comes on, W the Cope na BCE 
;S) 
J 
exacer- 
more violent, a cold fweat breaks out over 
and the pulfe, though now fuller and fofter 
| rye of Ske eat and drink Se ccolle fot a minute or 
fo, and then 
Tei isa i daidans fact, that fometimes that remarkable 
fymptom, the conttipation, will attend a firangulated hernia, 
although the omentum is the only part in the fac, and of 
courfe the only part which can fuffer i “8 
we examine the hernial tumour after death, a quan- 
o of clear ferum is found under the fkin, while the fac it- 
aoe The Bune 
ae may b tein 7 
a i y be ( 
of no great ftren exift between the bowel and sae 
Where the rites asl ie inte ati is either. 
of may be 
- 
lives alfo i fometimes as 
pond 
found in the cellular membrane, when the inflammation has 
een very extenlive. 
- Within the abdomen, the peritoneum ard bowels are 
found inflamed. The inteftines are freaked with red 
Imes, and glued together. The tenfion of the belly depends, 
not upon any general effufion, but upon the quantity of 
air in the bowels. Cooper on Inguinal Hernia, Ks. 
ta 
v 
An omental rupture is not fo fubjedt to ftrangulation as an 
inteftinal one, and, when ftrangulated, the fymptoms which 
are brought on are lefs violent than in cafes of enterocele, 
and their progrefs is not fo rapid. ‘I'he vomiting is not fo 
frequent, the pain in the tumour lefs, the tenfton over the 
abdomen not fo great, and the conttipation by no means fo 
complete ; for itools can in general be procured t 
many as fourteen days. 
The fkin-of the tumour occafionally inflames; but it does 
not do this fo foughis tly as in cafes of enterocele ; and when 
ile an aggravation 
fee ~ us Wi effeét 0 extendin oie 
nthe parts are examined, in cafes of death from a ftran- 
Saeed Weed the omentum is found but little changed © 
ep rom its natural — being only trivially ee than ufual. 
There is not muc th ough the abdomen is 
inflamed, and the Licolihies flightly adherent together, they 
never appear to have fuffered fo much as in cafes of flrangu- 
lated enteroceles 
Qn examining ‘the feat of the Revuiclanceo in inguinal her- 
niz, it will fometimes be found, (fays Mr. A file y Cooper,) 
at the abdominal ring, which, from its iadidsiee nature, 
has operated like a tight cord upon the protruded omentum, | 
or inteftine. This is the principal point of tlrangulation ia 
i : 
ai > 
The rey pref- 
made by the cog lh pt mufcle and its tendon, 
which pafs over the hernial fac emi-cireul: 
and by the fafcia ben. from Scant’ 3 ligament, 
ri ero paffes under the fac. Hence 
aoe fora sigs will pay altention to 
a Ree e fea t of the ftrangulation, he will find, that ex- 
cept in large hernie, biog : rough the pe is inbuflicient to 
releafe the protruded. parts, and he muit proceed with his 
knife further up towards the {pinous proceis ar eae ilium, 
bef can return the {welling 
many to futpeet the frangulation tu be 
effeé iia: of the neck of the fac; but Mr, 
the of . eens pop seamen that inch a-cale is 
= iene like 
awrence ap a 
Seiovipd ig a te hernia, may be affected 
fine, 
= and thus rip rife to "ey iy and ane 
ealily miltaken : 
ee ALS 
