The surgical treatment of the diseases of infancy and childhood / by T. Holmes.
- Timothy Holmes
- Date:
- 1868
Licence: Public Domain Mark
Credit: The surgical treatment of the diseases of infancy and childhood / by T. Holmes. Source: Wellcome Collection.
Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.
645/682
![CONGENITAL HYDROCELE. G1 5 ately from the ring into tlie' scrotum, and resuming its ori- ginal volume, as the hernia does, the hydrocele gradually commences to collect at the bottom of the scrotum, and fills somethino; like an india-rubber bottle when released from compression. By the combination of all these diagnostic signs, it is generally easy to tell in any given case whether there is any gut in the sac or not at the time of examination; but if the ring is at all freely o])en, the surgeon must be aware that a hernia may descend at any time. The treatment of congenital liydi'ocele is tisually satisfactory. In many cases, when the ring is but small, the disease will disappear spon- taneously, its disappearance being assisted, as it seems, by some of the many evaporating or irritating lotions that we are in the habit of prescribing, such as strong spirit lotion, the acetate of ammonia ten grains to an oujtcc of Avater, or tincture of iodine. The tincture of iodine has tlie advantage of not requiring renewal; the others must be constantly re- placed as the lotion-rag dries. On the other hand, I do not think that the action of iodine is so effectual as that of the acetate of ammonia. Guersant uses the tincture of digitalis mixed with equal parts of water. If such means as these produce no immediate effect, a cure must be sought by compression applied to the open ring by means of a truss, the fluid in the hydrocele having been evacuated before the truss is applied. This is usually done by acupuncture; a plan which occasionally succeeds without the truss, if the ring is small. I prefer, on the whole, a small trocar, removing the fluid entirely and altogether. The ob- ject of acupuncture appears to be to allow the fluid to collect in the subcutaneous cellular tissue, and thus to make some pressure on the collapsed tunica vaginalis, opposing its re- distension ; but such an effect seems to me imaginary. These means usually succeed in curing congenital hydro- cele ; at any rate, if the truss prevented the descent of in- testine, I would not advise further measures. If the ring was so large that this object was only imperfectly secured, the case becomes one of congenital hernia, and must be treated as such by some measure for its radical cure, if any operative procedure seems indicated (see Hernia). The French surgeons speak of injecting congenital hydro-](https://iiif.wellcomecollection.org/image/b21511469_0645.jp2/full/800%2C/0/default.jpg)
