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

  • Charles Barrett Lockwood
Date:
1889
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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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    by the following quotation from his works:* An intestine cannot be removed from its natural situation but in so far as it is per- mitted by the unnatural elongation of that portion of mesentery to which the protruded intestine is attached. But it does not result from this, as a necessary consequence, that the relaxation of a portion of the mesentery must precede the formation of the hernia, rather than that it should be simultaneous with its appear- ance. He then proceeds to argue that under certain mechanical conditions the concentration of the compressing muscular forces will act simultaneously upon the intestine and upon the corre- sponding portion of mesentery, which portion of membrane will be similarly, and at the same time, relaxed and elongated in propor- tion as the intestine is protruded out of the abdomen to form a hernia. f As I proceed some additional evidence in support of the views of the pathological school will be forthcoming, but that which has been given is sufficient to show that the matter is in need of further investigation. Statistics of Radical Cure. The statistics which have been pubHshed to show the result of operations cast an uncertain light upon the pathology of hernia. The latest are those given by Mr. Mitchell Banks,t in November, 1888. His table, which is evidently drawn up with can- dour and impartiahty, tabulates the result of 116 operations upon strangulated and non-strangulated hernise, in which efforts were made to obtain a permanent cure. (i) Of the 100 cases of moderate-sized non-strangulated and strangulated herniae combined, it has been possible to trace for very con- siderable periods 77. Of these, 48 remain quite sound, 17 are partial successes, and 12 are complete failures. (2) Of the 16 cases of very large and enormous hernias, it has been possible to follow up 10. Of these, 5 remain practically sound (though all * A T.eatise on Hernia, by Antonio Scarpa, translated by Wishart, 1814, P- 43- t Loc. cit., p. 45. X Most of these cases were published in the British Medical lournal, Dec. 10, 1887, p. 1,260.
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