HERNIA. 
4mode in which a cafe of this kind ends, is, when the intefti- 
nal matter gradually refumes its natural courfe, after being 
either partly, or entirely difcharged from the wound. 
But, fometimes, an artificial anus continues for life. 
The repeated obfervations of modern furgeons have now 
decided, that no ligature, pafled through the mefentery to 
keep the gangrenous part of the bowel near the wound, is at 
all neceflary he parts in the neighbourhood of the ring 
have all Bicee adherent together, in confequence of inflam- 
m tion, at the fame time that the parts in the hernial fac mor- 
ify 3 and, of courfe, the partially gangrenous bowel, when 
reduced, is mesnnnealy hindered, oY thefe a helions, from 
flipping far from the woun ault and 
both confirm the fact, that the saa Raine never cade bee 
r. Lawrence, in his — very ite es on rup- 
tures, has clearly thewn the impropriety of fewing the ends 
of the pasate canal together, introducirg one within the | 
“other, {upporte d by a cylinder of ifinglafs, &c. put in their 
cavity, in thofe cafes in which the whole circle of the intef- 
tine has mortified and been cut away, as is advifed by the 
majority of furgical writers. By drawing the inteftine 
Out of the cavity, in order to remove the dead part, the 
-adhefion behind the ring, on which the profpeét of a cure 
— depends, mutt be entirely deftroyed ; and new irrita- 
tien and inflammation muft be see es ies tf 
Jhandling and fewing an inflamed part 
Inftead of fuch practice 
anc 
continuity of the inteftinal canal becoming eftablifhed 
a 
ain < 
eoacrer in recent wounds of the abdomen, Saath 
with a protrufion of a portion of intefline, wt completely 
-acto's, the bowel is as yet neither inflamed nor adherent to 
with filk or thread, and a {mall fewing-needle ; 
fine the wounded part of abe netiiney pay aarcé Seas in es 
Elona angs Tm. 
. A, Cooper has aM ee oo of proceed- 
ing, in cafes of hernia attended with mortification of the 
whole diameter of — os but, for reafons already | °.. 
' lated, and many facts wi in Mr. Lawrence’s work, 
“it is to be ws a4 a plan of fewing the inteftines, in 
‘Didi of hernia with gangrene, will be for ever abandoned. 
ionary of Praslical Surgery. 
econ without -an After his 
death the parts were examined, pa as ze caput coli os 
appendicula epee were nah found wanting. 
mity of the colon adhered to the Frcs i 
ring, and afforded no obf{truction to the ee of the 
feces. Praétical Obfervations in Surgery . edit, 2. 
We ftated above, that when the HE omg in the 
hernial fac is found in a completely gangrenous fate, the 
duty of the furgeon confifls in dividing the ftndure, and 
leaving the fubfequent progrefs of the cure tonature. Itis 
to be underftood, however, that contiderable benefit may 
frequently be derived by giving vent to the Pre iy of the 
inteftine. We may ‘ttate, phercire, with Mr. Aftley Cooper, 
that. th r treatment of a mortified inteltine in 
ftrangulated hernia confiils in the two fellowing cireum- 
ces: 
a is paar — cintipsuon, cee ugh, 
continue; but if the inteftine is opened, the patient, ina 
few hours, becomes relie % from. fuch fymptoms. See a 
fe communicated to ey, by Mr. A. Cooper, and 
publithed i in the: fecond citon of the former gentleman's 
o 
~ 
ue the 
or the greater part of his life, i in peat to avoid the ri 
fuffering the vifcera to remain protruded, the examples as a 
radical cure Mee d by truffes being not very nume- 
rous. e of fo defirable an event from the employ- 
ment of a erate, almoft confined to cafes of recent fi 
erniz in young fubjeéts. But even here, all chance of the 
benefit will be yaRy loft, grit the rupture be for feveral 
years inceflantly kept up made trufs; for the 0¢- 
one defcent of “the parts all oe acheoy all tendency of 
e mouth and neck of the ne to contract, and become 
effc Gually clofed. Nor does a radical cure, m nea ine 
ftances, fol'ow the ordinary sone for a ftrangulate 
aoe hernia, the nece ity of wearing a trufs continuing 28 
he e eoting 
te Uni roveg, 
econ deviled 
for the radical cure of the bubonocele, it mult be uiniverlally 
eet that the objeét is one of a OY eee r 
mankind, and that the difcovery of a nd fu nel 
method ak attaining it would be litte ition. in point 
confequence, to any of the moft boalted imp rovements in 
-furgery, Let it pet be imagined, however, fat we with “i 
encourag riments, or to revive any 0 ae thofe eros 
praktces which were  eamel adopted by a 
quacks, by whom many “ toes 
- eek mutilated, and deftroye 
In the time of Heifter, ere ee a bafe and eon 
f prastice of cattrati ting the EE after Pune 2 zoe 
