A CASE OF ABDOMINAL HERNIA, i<LC. 135 
feet of small intestine protruding through the external wound, with 
a considerable quantity of mesentery. The wound was a longitu¬ 
dinal one, measuring about five by four inches. There was frac¬ 
ture of the fifteenth rib, with much contusion and laceration of the 
contiguous parts. The protruded intestine was considerably dis¬ 
tended with flatus, as was also the whole alimentary canal. Small 
quantities of soft fseces were frequently voided, and she also made 
repeated attempts to expel a quantity of gas, both by anus and 
mouth. The pulse was but little affected, as but a few minutes 
had elapsed since the accident. 
As Mr. Daws was gone some distance into the country on pro¬ 
fessional business, I immediately proceeded to reduce the hernia. 
1 found no difficulty in returning the gut until I got to the last fold, 
which was with difficulty placed, on account of its distention by 
gas. 
The lips of the wound were brought into apposition by the in¬ 
terrupted thread suture, inserted through the peritoneum, muscles, 
and integument. A compress was retained on the part by a band¬ 
age, and a ball administered containing opii 5 i. 
Two hours afterwards the pulse was scarcely perceptible. The 
buccal, conjunctival, and Schneiderian membranes were blanched. 
A great deal of intestinal irritation supervened, and the poor animal 
evidently appeared in a sinking state from the severe shock which 
the system had received. I placed bandages around her legs, and 
gave her a ball containing aloes 3 iv, and also tinct. opii et sp. aether, 
nit. a a 3 xij, and administered enemata of tepid water. The pulse 
was now between 70 and 80, and very feeble. Four hours after¬ 
wards Mr. Daws removed the sutures, and substituted those of the 
flexible metallic wire, embracing the muscles and peritoneum 
with four and the integument with three stitches. The ends of the 
former were left about two inches, the latter about one inch in 
length. The lacerated edges of the muscles were also removed. 
In the evening the pulse rose, became round, full, and strong, 
and, fearing that enteritis might supervene, she was bled to the 
amount of six quarts, when the character of the pulse was altered, 
and she began to be very faint. No food was allowed, but plenty 
of tepid water placed within her reach. 
J)ec. ^oth, six o clock, A.M. —The pulse 85, and feeble ; the mu¬ 
cous membranes pale, and she shewed great soreness of chest, aris¬ 
ing from pleurisy on the injured side. Tlie fmces were soft. A 
bran mash was given to her, the wound was occasionally bathed 
with warm water, and a solution of nitrate of potash (^i to ibiss) 
was employed to correct the foctor tliat was beginning to arise from 
tlie wound. Enemata were occasionallv administered, and tinct. 
opii 3x, e.\t. belladon. 3 iv, in mixture. 
