5 ^ 
ALL THE 
Se^. IX. 
A Description of 
‘‘ the Pitching, befide lefTening the danger, will contribute very much to a 
“ fpeedy recovery. 
I am, &c. 
Dalkeith, Nov. 8. 1782. ,, 
, - ■ • ■ R. C A L D E R W O O D. 
N 
This patient, and, fo far as I know, all the others, are ftill alive and well. 
i 
We are told, in the lall place, that the fac ought to be laid open, in order 
that the furgeon may feparate any adhelions the bowels may have contra died. 
For my own part, I am much inclined to believe, that, in the cafe of adhe- 
fion, the fafeft and bell general rule will be, to take off the ftridure by cutting 
the tendon, without expofing the patient to the imminent danger of opening 
the fac, to be heightened by the time which' muft be necelTary for the fepara- 
• • 
tion of the adhelions. 
But if, inftead of this, the reader fliall, upon the authority of Mr Pott, 
judge it advifable in all cafes to attempt the feparation of adhering parts (e), 
it will furely be time enough to open the fac after we have taken off the ftric- 
ture by cutting the tendon, ' and found that the bowels cannot be reduced by 
prelTure becaufe they adhere,to the inner fide of the fac. 
t, r . . 'f 
The rule of opening the fac after dividing the Ikin, feems to have been 
introduced becaufe furgeons fuppofed the mere incilion of the tendinous 
parts conftituted a principal part of the danger of the operation 5 and that 
they were by no means aware that the danger proceeded chiefly and al- 
moft entirely from the expofure of the bowels to the air : And this pradice 
has 
(<?) Mr Pott, p.,291. fays, “ I have feen the inteftines very firmly adherent to each other, to the 
4 
“ fac, to the omentum, and to the tefticle ; but never in fuch a Hate of adhefion as to be inca- 
“ pable of being returned.” 
