APPENDIX. isi) 



It when proper, though we may not be certain of -the nature of 

 the fluid contained. In moft cafes we may afcertain this before 

 from the fymptomsj but, at all events, the pun<5ture in the pleura 

 will put it beyond a doubt." 



Mr Hamijlton had an opportunity of feeing feveral herniai 

 in women, upon fome of whom he operated fuccefsfully j and^ 

 from confidering all the cafes he had feen, he was led to make 

 the following remarks, fome of which he thought new. 



" When I began the pra6lice of furgery, as I had never met 

 with a cafe of hernia in women, I believed implicitly in the doc- 

 trines we find in every writer on the fubjecfl, viz. that women 

 have feldom bubonocele, but are more fubje(5l to femoral hernia. 

 Soon after I had begun to pradlife, I was called to a confultation 

 about a woman with a hernia, which had been flrangulated for 

 two days. As it was placed in the groin, I at firft fight thought 

 it a femoral hernia ; but, upon examining it attentively, I found 

 it was a bubonocele that had gone towards the thigh, in place 

 of towards the labium. The operation which was performed put 

 the matter beyond a doubt, and fliowed that it came through 

 the ring of the mufcle. In a few months I w^as called to another 

 patient in the fame fituation, and I found, to my furprife, the 

 fame appearances which in the firft I took to be a lufus naturae ; 

 the hernia in the groin, at the top of the thigh, and yet evident- 

 ly coming through the ring ; having all the appearances at 

 firft fight of femoral hernia, but in reality a bubonocele. The 

 operation here, likewife, which I performed, made me certain 

 of the fadl. In a third, under ftrangulation, I found the fame 

 appearances, and operated, 



" Finding the hernia bubonocele in thefe three cafes, yet 

 with all the appearance of , that fpecies where the gut is pufhed 

 out under Pa up art's ligament, I began to fufped that the 

 common account given by authors was erroneous, and that bu- 



VoL. IV, (H) bonocele 



Account of 



