= 
as we have alfo inferted the fentiments of fome of t 
one ¢ pillow aes 
’ Both the thighs fhhould ae be elevated to a Bow a with 
the patient’s body, and the knees — 
_ aperture which the firft 
and which is ultimately coanefied wit with gee * fafcia. 
tent 
HERNIA. 
-' When the protruded parts are free from ftrangulation, “ 
yet are rendered irreducible by any of the caufes 
have noticed above, all that can be prudently done is 2 
wear a fu ory bandage, to check the increafe of th 
{wellin we have already ahiod the kind of spneaete -in 
which S onicaes is irreducible herniz continually live, and 
the belt c 
exercifes and exertions, we fhall not expatiate upon thefe 
topics again 
A ftrangulated hernia is one of the moft urgent cafes in 
re ; if not foon relieved it is almoft always fatal. What 
as ier been oo defcribed. 
The cafe of a ftrangulated hernia, therefore, demands a 
davidersble fhare of decifion and Pere n e judgment on 
the part of the furgeon. He fhould be familiarly acquainted 
aie the belt methods to ve tried before the operation, 
m in. practice without the 
have been often effectual induce him to defer the operation 
to too late a period. Mr. Hey has performed the operation 
po times, and ftates, that he has often had occafion to lament 
performed it too late, but never that he had done 
hee foon. ‘There are fome cafes fo urgent that it is not 
advifable to lofe any time in the trial of means to produce 
a reduction. The delay of a few hours may cut off all hope 
of fuccefs, when a {peedy operation would fave the life of 
the i atient. cin s Praétical Obfervations in pee 
. 
ght fo clofe 
ee nae as only to admit the fi s arm between them. 
reprefents this | oe a moft effential point, 
eee eas Oe acne 
B thighs and Sepoledneany the 
through w the abdomen 
= milf by te pte . = i fur ne 
then places himfe patient t braci 
. the tumour —— his ngh ng a it ais ie sae 
7 ring, fo as to. co keep mee from receding. Then, appl 
the a he et hand ponte ck of he 
, : parti erent enters the he gently 
‘fize of that part, which he 
parts. 
been ftrangulated, the m: 
Cooper on Tage? Hernia, ae. pi:2 
During the taxis the patient is casefilly to abftain from 
coughing, or making any effort. 
The prudence of employ: ing genie preffure cannot be too 
mind. V iolence, as Mr. 
ine rence remarks, cannot = is onei ficial as it li kely y to 
Cooper, Mr 
W ae unfcientific roughnefs produced ehh fuppuration of 
the omentum, or a gangrene or rupture of the inteftine. 
Every impartial man mutta with Mr. Lawrence, that 
the danger of the fubfequent eaentiis will be greatly in- 
ed by all rough manual attempts, fuppofing that they 
prove ineffeétual in seen es sae ceduction: Petit had 
much confidence in plan o ing a general at 
upon the whole furface of he Gerlling with both hands. 
Mr. Lawrence informs us, that in a bubonocele the fol- 
ree method will fometimes fucceed, when more. ordi- 
ary plans fail; efpecially when the ftrangulation feems to 
Posts been canfe y an accumulation of fecal matter... “ Let 
he furgeon embrace the neck of the fwelling, clofe to the 
tendon, with the finger and thumb of one hand, and carry 
them downwards with a moderate preffure, fo as to remove the 
contents from. the partion next the ring: this will reduce the 
may then attempt to pafs into the 
rin "g with the other hand.”’ ” Freuaig: 9 on siete edit. ile 
115. 
ie) 
1 
ot 
ominal mufe 
ward to the furgeon. 
the plan; but having found it were me he has, for many 
he’ pat, laid it aide. Mr. Afil 
he has never found it anfwer when the common metho™ 
ia failed, after being fairly and fully perform med. Eee 
In attempting the taxis, in cafes of femoral hernia, the 
dire€tion in which the parts defcend fhould be well ess 
bered. They pafs firft downwards, and then forwards, and © 
courfe the preffure fhould be dircéted firft backw ards, 
then upwards, Pages 
fpeakin , a piece of inteftine may 
reduced than a saris Of omentum. The former got 
fuddenly ; the latter returns flowly, excepting the are 
bit, which does indeed flip up rapidly, but without any ™ 
“When the Hagley bane the {welling clearly es | 
