LE RE TA: 
wife women whofe abdominal parietes have often been dif2  « In fome the entrance of the fac is large, and the parts 
tended by pregnancy ; but it is feldom met with in male eafily reducible ; in others they are difficult, and in fome 
’ 8 abfolutely irreducible, Of the laft kind many have been 
fufpended for years ina proper bag, 
t e. They who are affliéted with this diforder, who 
p- 250.) But Mr, Aitley Cooper is of Opinion, that the are advanced in life, i i 
' protrufion ufually happens through that opening itfelf. fubje& to colics, 
(OnCrural and Umbilical Hernia, P- 35-)* Ina late excel- at all obftruéted, 
lent work on fur ery, it is remarked, that the umbilicus is a 
continuous, and that it only gradually acquires the degree of ther to eat or drink any thing likely to make any difturbance 
firmnefs which it has in the adult fubjea. As it is fora in that part.” See Pott’s Chirurgical Works, vol. ii, 
long while weaker than the relt of the abdominal parietes, ili i 
it only makes an inferior degree of refiftance to the vifcera ; i 
but this refiftance increafes with age 
Firit ; that infancy is more fubje& than any other age to the 
umbilical hernia, ftriétly fo called, in which the parts are neglected, it attains an enormous fize, defcending to the 
4 ‘ Hi 
of life are more fubject than infancy to falfe umbilical herniz, 
mbilicus. inteftinal complaints. When the patient is f,; 
om, ii 
+ 315. cauling any external fwellng. Lawrence on Rup 
The obfervations, which Mr. Pott has left us on the ex-. p, 9- ce 
omphalos, are, ar as they go, exceedingly accurate. It has been afferted by many eminent furgeons, that the 
e takes notice, that this f{pecies of hernia, like others, exomphalos is deftitute of a hernial fac. Dionis, De la Faye, 
“has for its general contents, a portion of inteftine, or Garengeot, and J. L. Petit, maintain fuch an opinion. The 
omentum, or both. In old. umbilical ruptures, the quan- truth is, that the umbilical hernia, like moft other ruptures, 
tity of omentum is fometimes very great. i i 
al : 
“ Mr. Ranby fays, that he found two ells and a half of exceedingly thin, and intimately adherent to the mufcles. 
intefline in one of thefe, with about a third part of the W. 
i her 
| Mr. Gay and Mr. Nourfe found the liver in the fac fally adopted 
ef an umbilical hernia; and Bohnius fays that he did alfo. peritonéal inveftment. 
ee 
The 
| Bat wh: the contents, they are originally which contributed to the miftake, that the umbilical hernia 
- contained in the fac, formed by the protrufion of the peri- . had no hernial fac. Firft. it; 
toneum ili 
; « ‘ t 
« In recent and fimall ruptures, this fac is very vifible; thereby rendered im 
but in old, and large ones, it is broken th : 
i he rea Y particular examples, the fac is in fome places abforbed, or 
it has by fome been doubted whether this kind of rupture lacerated, fo as to allow of a protrufion of its contents, and 
threaten, from this caufe, a double ftri@ure. Two fuch. 
“« Infants are very fubje@ to this difeafe, in a fmall de- examples have been feen by Mr. A ftley Cooper ; but they 
» from the feparation of the funiculus 3 but in general | 
os ftrength, or are eafily ficient. Even where th P 
cure wi _ pre pe bandage. It is of ftill more {welling, in confequence of the abforption occafioned by 
confequence to get this diforder cured in females, even than the preflure of the vifcera, the deficiency only exifts ata 
in males, that its return, when are become adult, and diftance from the navel, in the vicinity of which opening, 
regnant, may be prevented as much as poffible ; for at this veltiges of the exiftence of a hernial fac may in general be 
ns. i : 
5 ee 
the firetc ¢ Bese ar is On parts are upon Although the advice, delivered to us by many writers, 
re re peeG elt ? it iS oiten very troublefome, to procéed with great caution in the divifion of the contain- 
oan agape A ing parts of an umbilical hernia, j 
fion, they will often return, and may be kept in their place < fsth ae i 
by a proper bandage. 
y 
€rroneous opinion of there being no hernial fac, yet, fince the 
rop dage. : oe coverings of this rupture are frequently very thin, ect 
if fuch bandage was always put on in time, an worn fel is not to be difregarded. Ty in fome inftances, the 
conftantly, the difeafe might in general be kept within mo- integuments and hernial fac are infeparably confounded to- 
derate bounds, ar fome of the very terrible confequences gether on the forepart of the {welling. Tite vifcera have 
which often ‘attend it might be prevented. The woman likewife been repeat y feen adhering to thei . 
‘who has the fmallett degree of it, and who from | been deftroyed by abs 
and fituation has reafon to expe&t chil it 
ytion, See es | on Hernia, P- 323+ Mem. zi 
PAcad. de Chie. tom.ti p. 590, Monro’ on Crural Her 
