The cure of the more difficult as well as the simpler inguinal ruptures.

  • Halsted, William, 1852-1922.
Date:
1903
Catalogue details

Licence: Public Domain Mark

Credit: The cure of the more difficult as well as the simpler inguinal ruptures. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    [308] zeal and a particular honesty of purpose; and for the recogni- tion and interpretation of the nicer facts, keen perception and fine tactile sense are indispensable. A few drops or even a dram of fluid in the tunica vaginalis might readily escape de- tection, and to determine slight swelling or induration here and there in the epididymis and the relative size of the two testicles may be difficult. A novice can usually discover a dis- tinct recurrence and so can the patient, but I have known an eminent surgeon to overlook a weakness in a scar of his own making sufficient to constitute, without doubt, a recurrence. The surgeon is fortunate and likely to be true to himself whose observations are controlled by mature assistants with large experience in the operative treatment of hernia and who are as eager as he to ascertain and state the exact truth. If our operation for the radical cure of inguinal hernia has improved, it is due in no small measure to the arduous labors of Dr. Bloodgood, whose valuable contribution' should be better known. He established several facts of prime import- ance from his study of our first 300 cases of inguinal hernia. The majority of inguinal ruptures are now easily and quite well cured by a variety of procedures and by the average oper- ator, hence it is difficult for the student and young practi- tioner to comprehend that it is hardly more than a decade since this variety of hernia completely baffled the efforts of the best surgeons to cure it. That so simple an operation as Kocher's can cure perhaps many of the milder ruptures, provided the neck of the sac is not too wide, leads to the inquiry whether the features, of these operations, upon which most stress has been laid may not be relatively unimportant, since operations of the magnitude of Bassini's and the author's are not in all cases indispensable. If the transplantation of tlie neck of the sac can cure so many cases, is it not possible that the trans- plantation of the cord, which at first was deemed so essential by Bassini and the author, may have owed its success in part to the fact that it made possible this very high closure of the sac's neck? Although for several years our operation, so far as transplantation of the cord and high closure of the sac is «Johns Hopkins Hospital Reports, vol. vii.