HERNIA. 
be large ; and when the rent oms ims after being ap- 
peated by, this. medicine, Mr. thinks, that .the per- 
formance of the eperation Ast to. en no longer deferred. 
P. 121. edit. 2. 
Mr. Aftley Cooper coincides with Mr. Hey, i in regard to 
the efficacy of opium, in allaying the violence of the gan 
and in afliting the attempts es rey after a copiou 
eding. On Inguinal Hernia, p..2: 
Tobacco Clyfter— AU weitere learcee feem univerfally. to 
agrees that, next to the operation, the tobacco clytter, 
ifted by cold applications to the tumour, is the mott effec- 
tual means of relief... Mr. Aftley Cooper confeffes, that if 
this method were to fail, he fhould be little inclined to await 
the trial of any other remedy. Tobacco has been employed 
in cafes of ftrangulated hernia, both in the form of {moke, 
and as a liquid elylter. To ufe the {moke with any effet 
ted — edalas 
. Hey fays, that he has iets injected t 
: ‘The ae a way of makings the tobacco chef 
ter, is to infufe a dram of tobacco, for ten minutes, in twelve 
ounces of boiling water, and then ftrain the fluid for ufe. 
As dangerous and even fatal effeéts, however, may arife 
from. this powerful plant, the molt prudent method is to 
inject poly half of the preceding quantity at firft, and the 
remainder half an hour afterwards, if the previous portion 
has not sean fufficient. The tobacco clyfter appears 
fometimes to operate with dangerous violence, which-may be 
Owing either to the fort of tobacco ufed, or to fome parti- 
Mes in pee patient’s conftitution. 
— 
formed, 
On In 8h Hern 
Cold A, Applicat 
cold water Ste we tient, 
fucceede 
Y lhe ee igs a the throwing of 
d to have fometimes 
judiciou us ct 
Co oper moft properly condemns the rafhnefs 
According to this gentleman, the effect of this plan is ae 
immediately to —— ke the {ki 
tumour contraét, an 
truded parts -b = pre 
unabated violence, and the tumour relifts every attempt at 
reduction, no gees trial of the ice fhould be made. 
the ice, the degree of cold may be in- 
even beyond what can fafely | be employed. : 
j cenfures the cuftom of applying the i ice, 
in up t betwee folds of cloth, fince the melted portion 
keeps the patient’s bed wet and cateianfortables befides the 
sig i apt to render the parts froft bitten, and apt 
gy ice cannot always be procured, it is fometimes ne- 
“eolary to apply a fubititute. The mott convenient is'a 
mixture of fal ammon 
her in 
blended together in eq opor 
mixed falt is to be put into a be ig into which has been 
The bladder adder is then to 
be tied u ; 
produced eh this mixture, is lower, in the hotteft w 
than the freezing point of water, and if the water be pré- 
vioufly cooled, the cold will be greater. 
Nitrated ammonia and water, ‘in ee parts, produce a 
ftill greater intenlity of cold; but this falt cannot com- _ 
nly be h re cold ph ae by vinegar and fal’ 
v0 flight 
ammoniac, and 3. vinegar and {pirits of wine, 1s too 
to be depended up Cooper on Inguinal Hernia, p. 25. 
Tesceadban ga and  Poultces-OF all A a e means of promoting 
the reduétion of a ftrangulated hernia, saan a a 
the moft. infign ere they wu any other le 
-urgent difeate, the thing would not be ‘of fo much con+ 
fequence. But, in. the prefent.initance, the lofs of a very 
little time o a fatal difference in the fate of the 
patient. For this soufod, though poultices and fomenta- 
tions do no harm of themfelves, they a a — of time, 
hinder the trial of more effe become in- 
direétly highly detrimental. We thall gad errs that hate 
efficacy is almo{t univerfally doubted, if not denied, by fuch 
— as have had much experience. we fee, that 
ie medns for removing the vifcera from their ftrangu- 
ined ete are, with the exception of the ion, exceed- 
; unce be a principle aah ite the 
ther, fo as to! case 
Paint te clnce ‘of ne “a ae fae wee combined 
wiforill rte ik a Sadlanst to rie 
ted up, wiped cey> and laid upon 
er the inflamed ard 
ard fw "= Aili 
which cat | upon for a.cure. Mr. 
Hey has twice feen this e fatal in bout.twenty= 
evident ly little. tint Son ely Apfargecn, who is compe+ ; 
: form ant fi 
ie eioriewe point of bing mostihed.y: or is ace 
tually in a ftate of morti fication, The ee —— 
But w. fallet 
he is then caft, is tea 
