On rupture, inguinal, crural, and numerical : the anatomy, pathology, diagnosis, cause and prevention; with new methods of effecting a radical and permanent cure; embodying The jacksonian prize essay of the Royal college of Surgeons, 1861.
- John Wood
- Date:
- 1863
Licence: Public Domain Mark
Credit: On rupture, inguinal, crural, and numerical : the anatomy, pathology, diagnosis, cause and prevention; with new methods of effecting a radical and permanent cure; embodying The jacksonian prize essay of the Royal college of Surgeons, 1861. Source: Wellcome Collection.
Provider: This material has been provided by the Gerstein Science Information Centre at the University of Toronto, through the Medical Heritage Library. The original may be consulted at the Gerstein Science Information Centre, University of Toronto.
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![operation (page 109) Jan llth, 1862. The bandage was kept on till the 14th; the patient having slept well each night; very few or no symptoms being present. On that day complained of more pain in the groin ; bandage removed. 15th.—Still complains of pain in the groin ; none in the belly ; no tympanitis; bowels not open; very little dis- charge ; pulse 79. To have castor-oil. 16th.—Much more discharge; less pain; pulse 80 ; bowels freely opened ; poultice applied. 23rd.— Has been doing very well; bowels open regularly; eats and sleeps well. A small superficial slough at the lower opening. 27th.—Slough removed; wounds look well; water dressing. 30th.—Much consolida- tion ; testis a little swollen. 31st.—Wires removed without difficulty ; canal filled by hard effusion. Feb. 10th.—The openings have now entirely healed ; no impulse or protrusion whatever on coughing ; the hernial opening seems to be quite closed. Discharged, wearing his old truss. ]\[ay 7th.—Applied to-day; has been working ever since his discharge as a Covent Garden porter, lifting very heavy loads on his back. Has had latterly, in addition, a very bad cough, which has given him some pain in the groin. The superficial ring is now more evident to the finger, but the cough impulse does not seem to affect it. June 20th.—To-day he again applied, complaining that on taking off his truss the other night, after a hard day's work, and a severe coughing fit, a small tumour appeared in the groin. On examina- tion the ring feels more patulous, but still the tumour does not at once appear on coughing. The sides of the ring are hard and resisting. Recommended to get a lighter employment, and to wear his truss night and clay while he has the cough. I have since seen this patient several times; on one occasion a tumour of the size of an egg was evident when he coughed very hard. The protrusion had evidently returned to some extent, but was not a tithe of the size that it was before the operation, and is now easily retained by the truss. Says it has appeared three or four times to some extent, but never unless the truss Avas removed. Can- not get a lighter employment. This case, in consequence of the poor fellow's necessity of doing very heavy work for the support of his family, and his violent cough so soon after the operation, has thus returned to some extent. The directness of the opening into the abdomen, and, per- haps, the adoption of the simpler operation for its cure, although so large, have no doubt rendered the adhesions less efficient in retaining the rup- ture. The powerful muscular development in the patient, especially of the recti abdomines, has also aided in reproducing the rupture to the limited extent which it now possesses. Another operation was proposed, affording, as I believe, a very good chance of ultimate complete success,](https://iiif.wellcomecollection.org/image/b20996962_0326.jp2/full/800%2C/0/default.jpg)
