HERNIA. 
the altered bowel is really mortified or not, we are directed 
to prefs forward the blood in its veins, and if they become 
filled again, it is inferred that the part is {till poffefled of vita- 
ity. On the contrary, when the blood is coa ulated, and 
cannot be urged forward, it is concluded that the difcoloured 
portion is actually in a ftate of gangrene. mortified 
piece of bowel is black, flabby, and gives way under the 
finger, while in cafes where it is cealy difcoloured, it re- 
i degree of firmnefs, and prefents a dark brown or 
_ Sometimes, on laying open the hernial fac, the omentum 
contained in it is found fo difeafed, thickened, and altered, 
that its reduction is either impra¢ticable or improper. 
The treatment of fuch cafes, as well as of others, where 
the inteftine in the fac is affeGted with mortification, will be 
prefently confidered. 63 
tirmeit and 
‘tween the omentum and hernial fac : the bowels are not often 
a, conneéted together. 
LJ . 
the cafe is an entero-epiplocele, 
duce the inteftine before the omentum. In all cafes, where the 
latter membrane prefents itfelf, the operator mult be exceed- 
ae 
ingly careful not to practie any 
‘When the fides of the hernial fac feem fo difeafed and 
thickened, as to be likely to retard the union of the wound, 
fourth day after the operation, uilefs 
Should require an earlier removal of them. The wound o : at 
Its edges {wel its circ’ becomes red, —— 
deal of inflammatory fever, the futures 
of 10 €2 F) ‘ihe wait 
with of adhefive 
Plafters and lint. 
lated 
Aha 
Pati 
hernia, fhould be permitted to get out oF bed 4 
it is proper to re- 
tient, who has been operated npon for a ftrangu- < 
patient's mode o 
fearcely prefume to advife the omiffion of the trufs, at any 
period after the operation, however great the hope might be, 
that a radical cure had been accomplifhed. 
After the operation, the practitioner is not to believe that 
he has done the whole of his duty towards the patient. 
fhould now promote evacuation from the bowels, by means 
of clyiters, and {mall dof 
diffolved in mint water. 
w the operation fpontaneoufly. 
light and {paring, until he is 
eeches ap- 
fect 
load 
* 
4 
a 
ia] 
oe 
: 
oO 
g) 
a 
B 
09 
i 
ed 
Q 
S 
3 
g- 
oO 
= 
ty us 6% oe 
rethod ating on large Hernit.—The foregoing plap 
ae ae oat = means proper for large, old, and ad- 
i by the above incom- 
ernatural con- 
fed by laying open the whole of a m3 
hernial tumour, danger to 
tient, W ; 
iat shieredoee Aele liable to withftand an extentive im. 
‘tion and fuppuration.”’ 
occafional imipoflibility, a: riggs Ha 
sany years in a hernial fac. He calls the attention of his 
. cade ta'the dilated ftate of the ring, a circumitance, which 
‘mult remove all ex 
hout opening the tumour. 
the part forming the 
< to be guided alon 
When this 
sings 
* 
say 
