Treatise on hernia : comprising the surgical anatomy, operative surgery, and treatment of that important disease in all its forms. As also, a newly proposed operation for the relief of strangulated hernia / by Malcolm W. Hilles.

Date:
1838
Catalogue details

Licence: Public Domain Mark

Credit: Treatise on hernia : comprising the surgical anatomy, operative surgery, and treatment of that important disease in all its forms. As also, a newly proposed operation for the relief of strangulated hernia / by Malcolm W. Hilles. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    the effect of supporting the tumour, and opposing the protrusion of any more of the viscera. Where the hernia is composed of omentum only, moderate pressure may be tried, as it has been found to cause an absorption of the protruded omentum and the gradual return of the hernial sac into the abdomen. It is evident that great care will be required in the use of the pressure, as otherwise it might be api)lied where an intestine forms part of the tumour, or it may bring on an inflammation of the omentum, and thus induce general peritonitis. In some cases where the hernia is large and of long standing, the abdo- minal cavity has become contracted, or a deposit of fat has taken place in its interior, which will materially oppose the reduction of the hernial tumour. Here, if our patient be very anxious to get rid of the disease, the moderate use of opening medicines, blood- letting, and a strict regimen, may give rise to an absorption of the adipose matter, so as to produce a diminution in the size of the hernial tumour, and afford room in the abdomen for its return, which will contribute much to the facility of the reduction of the hernia. Mr. Hey has several times succeeded in this way. Sir A. Cooper recommends the repealed application of cold to the tumour, which he has found beneficial, by causing a diminu- tion in its bulk, thus conducing to its final reduction. Incarceratkd Hernia. In this form of the disease the hernial tumour is so constricted as to interfere, to a moderate extent, with the functions of the intestines. It rarely occurs, except in cases of old irreducible hernia, and is most frequently produced by a collection of feculent matter, or of air in the cavity of the intestines. It may be also caused by an increased deposit of fatty matter in the protruded omentum pressing on the intestines, or from an additional portion of intestine or omentum having been forced into the hernial sac. Incarceration is a condition of the hernial tumour which requires immediate attention, as if allowed to continue in this state for any length of time, more acute symptoms will at last supervene, and thus the patient will be oblitied to submit to an operation for its removal. Nor can we expect otherwise. The constriction of the intestine produces inflammation of the parts protruded ; they become swollen, and thus increase the constriction; the inflammation
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