Hunterian lectures on the morbid anatomy, pathology, and treatment of hernia / by Charles Barrett Lockwood.

  • Charles Barrett Lockwood
Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: Hunterian lectures on the morbid anatomy, pathology, and treatment of hernia / by Charles Barrett Lockwood. Source: Wellcome Collection.

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    will not permit a protrusion of the intestines until it has undergone elongation. It might have been imagined that the assumption that the mesentery is elongated in hernia could easily have been proved or disproved by a simple series of measure- ments, but as far as can be ascertained it has been allowed to^ rest upon such arguments as the following, used by Mr. Kmgdon: * « If the intestines were always in a condition ready for protrusion as soon as a fault in the parieties allowed it, it must of necessity follow that whenever the tunica vaginalis remains sufficiently patulent hernia must invariably occur. But it is well known that this is not invariably the case. In the autumn of 1859 Mr. Stanley removed a cancerous testicle from a patient in St. Bartholomew's Hospital. During the operation it was found that the tunica vaginalis and the peritoneum formed together one continuous cavity. The communication was free enough to admit the finger easily within the serous cavity of the abdomen. Yet there had never been any hernia before the opera- tion, ^ nor, when the man left the hospital with a sound cicatrix, was there any unusual impulse to be felt at the ring. Further, Among females, too, the diverticula of Nuck are acknowledged, even by Malgaigne, to be as often open as the tunica vaginalis, yet hernia is less frequent. Without endeavouring at present to discuss the value of such evidence as the foregoing, I would observe that the author from whose writings the quotation is made gives no actual measurements of mesenteries—either long or short—nor does he give any references to any which may have been made by others. On the other hand, the primary assumption, that unless it has become elongated the mesentery prevents protrusion of the intestines, is weakened by Malgaigne's f assertion that the contrary is the case; but this, again, is little more than a state- ment of opinion, and has rightly been taken exception to.t * Kingdon, p. 301 ei s. t LeQons Cliniques sur les Hernies, Paris, 1841, p. 10. X Kingdon, p. 296.
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