42 
A Description of all THfe 
Sed. IX. 
Clark and Mr Adie furgeon, about twenty years ago, the arch of the colon 
had been eroded after a tedious dyfentery (x). In the fecond cafe, two holes 
were formed in the jejunum by two pins, with their points turned different 
ways, and tied together with a thread, which had been accidentally fwallow- 
ed (j?). In the third cafe, of a perfon in a typhus, the colon feemed to have 
burft during the operation of an emetic. 
In the flrft of thefe cafes, in which the belly was enormoufly diftended, I 
prevailed with Mr Adie furgeon to let off the air with a trocar, which relie- 
ved the patient much ; but as the hole in the colon was large, the abdomen 
foon filled again with air, and the patient died in a few days thereafter. 
(F.) If a large opening has by accident been made into a cavity, or is un- 
avoidable from the nature of an operation, fuch as the Csefarean fe^ion of the 
uterus, I ufed to remark the neceflity of excluding, as much as pollible, the ac* 
cefs of the air during the chirurgical operation, and afterwards by Hitching 
the wound far more accurately than has been pradifed by furgeons (%). 
t 
(G.) There llkewife feems to me to be flrong reafon for fuppofing that 
the danger, not only in the high but in the lateral operation of lithotomy, 
may be lefifened by the furgeon ufing every means to exclude the air from the 
wound and bladder during thefe operations, and by Hitching the teguments 
after the high operation. 
The late celebrated Mr Smith furgeon in Perth loft, as appears by a copy 
of his manufeript in my pofteflion, eight of eighteen patients on whom he per- 
formed the high operation : and I have obferved, that thofe patients generally 
died, or were in great danger, where the prefence of a number of fmall ftones ren- 
I 
' dered 
(*) See Tab. X. fig. i. 
(j) See Tab. X. fig. 2. 3. 4. 5. 
(sr) See an extradl from ray lectures on this fubjedt, publiftied by Dr Alexander Hamilton pro- 
feilbi-of midwifery, in his Outlines of Midwifery, from p. 345 to p. 352. 
