On some points in the surgery of hernia, with illustrative cases : (read before the London Hospital Collegiate Society, and re-printed from the Lancet) / by Nathaniel Ward.

  • Ward, Nathaniel, 1820-1866
Date:
1856
Catalogue details

Licence: Public Domain Mark

Credit: On some points in the surgery of hernia, with illustrative cases : (read before the London Hospital Collegiate Society, and re-printed from the Lancet) / by Nathaniel Ward. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    ceeding, whereas it will fail over and over again, and may be the cause of considerable mischief, when applied by one either ignorant of or indifferent to it. I think it may be serviceable to append the following description of the profes- sional way of applying the taxis ; for to attempt to define or put in practice the frequently successful method adopted by patients themselves would be almost impossible, inasmuch as the proceeding they have recourse to appears peculiar, and at times complicated and ridiculous, and is followed by most serious consequences. My friend, Mr. Hovell, gave me an opportunity, a short time ago, of seeing an elderly woman, who had had a right femoral hernia for many years, and on being seized, as she frequently had been on former occasions, with symptoms of strangulated bowel, applied the taxis herself during the night. It was successful as far as referred to the reduction of the gut, but so much force had been used, that when I visited the patient, she had great prostration with marked mitigation of the symptoms of strangulation. Con- cluding that she would probably sink during an operation, and that the bowel had been ruptured, we decided on not inter- fering. In a few hours, an after-death inspection confirmed the qualified diagnosis that we had made. The following is the plan to be recommended in the use of the taxis :—Draw the body of the tumour gently down with one hand, and with the thumb and two or three fingers of the other steadily compress the neck of the hernia, with the view of causing the contained fluid to pass into the intestine above the swelling. When gurgling is heard, or when, from the sensible diminu- tion in the size and tension of the hernia, there is reason to infer that the passage of fluid has commenced, then, at the same time, keep up gentle pressure on the body of the tumour without pressing it upwards, and the possibility is that the contents of, and then the hernia itself will be reduced. Ii the body of the tumour is not drawn somewhat downwards and kept so, the part of the gut (and the neck around it) just below the lower orifice of protrusion will be forced up, and doubled a little on itself against the borders of the opening, and iniury to the intestine and a failure in reduction be the probable consequence. If this plan be found not to succeed
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