1000000031

749 / 868

s u G
""ere pcoplc wha:He ful>jct1 to rupturcs al\V~ys''to wea( lhem,
Vl:"y few \\.'oul.l die of ,hls diHemper ~ fince It Orlen ,
tlpOIl illC}uil y. ",heo \Ve pedolOl lhe opaJtlun (ur lhe: bu–
b,\n:) , thítt lhe nc:cellity uf th-:: upa..uon is owing lO lhe
nf'~l, ~t of we<tn ng a truls.
l u Ihe ..ppltC<tlillll of .l trt1 rs tO Ihert kinds of rwell ings,
a gl l. dl dc: .•1 uf judgment 15 lomctitnes necef[\ry, and t'or
W ,t lll {lf -t·, we J ily fc.'e truf1'(s pUl even on b\.lbúc:s, inJura·
teJ cI~s. hydro des, te.
H Ih("re 1$ <1 ruplur~ of the intefline ooly, il is eafily.
wh .." relurnLd ¡lito (he ...bJomc:n, fuprorted by .lO ¡ntlru
me!!t . but Ir uf Ihe omcmum, nOl withnandlng it m,¡,y be
l dtl. n'"d, yet Ihe rerl utbon re:! 0111 bnngs rcltef, unlds thc:re
is onl)' a fmalJ qu.lntlty ot ji ; fo r lhe omenturn \ViII lie un·
v , y In a Iump at the oottom of the btlly. aud, upun re·
muv..1 of th~ lOíl rumcnr, d lop down 2g,un InlCdlAtel y , uuun
,vhl~h nCCOllnt, reeing Ihe hule! d ... nger and Ih<.'n: 15 In
tlllS kind of hernl~, noth lllg need be uf:d bUI ~ b g [rU IS,
to lul'pend Ihe rerolum. and preveO' poffibly hy thnl
the lncn:..fe of Ihe lumon r. Toe d,fLrc:nce 01' IIH:fc: 1UnH.iUIS
\Vd l be ddhngul0h:rl by lhe (ed; Ihou o( the: omt::n\~nl
feeJing {Li "cid and rumpled. the oliler mú:e eVt!n, f1.:il uJenl,
and fprlngy.
Sl)meli ~les , in í1 rurture o( both Ihe intenine afió omen
tumo Ihe gOl m.y be! u:duced, bUI lh:: wíll Itdl
rer.lítin in lile fcrotlllll; and when thus ellcuml. anced, a
Heli tru rs mun be u!~d.
'vV e ha\'e 11IIhel lO confidered the ruplure as m~lveable;
but it hdppens freCJuently, thdl the inl cfbne ¡¡fter n hns
p::tfrt;J lhe fings of Ihe murcies, is prelently :cf, whu:h
enl:lrging th~ IUnlOllr, prcvenls Ihe return of 11 Intu the db.
dOO1::!n, anu heconllng every mOffi(nt nHH(: and more Ilr"dng
l::d. 11 ruon técds lO " mOl tihc"tlon. unlc:ls we dalate the
(:S through v. hlch iI 1S (.lIc:n. Wilh fome Intlrumc:m,
to mnke room for iu ,n::lurn; WhlCh ddatéUlUn is lhe opera·
cion for th:: B~boooctle .
lt rnn:ly happens that patients fubmít to t!,is ¡ncífion be·
{Ore che gUt is monified, and 11 is 10.0 Lue tO do fc:rvlce i
not but (hAt there are in{l..¡nc"s of pt'opJ..: furv,ving {m.U
g~nglent!s, and ev~n perfc:étly recoverin~ ~ fler\\';¡rcts.
In l11oru!iCnliuns uf Ihe bu <vd s, wht:n f.illen UUt of the
abJomt n ¡rito tile navel, iI is nOI vely unCammun for lhe
wholc ~angrened inl<:llllle to fepuate " om the roun.~ one,
fo thdt Ihe: ~xclC:m':"nt m,.!i nt'edr... nly ever a(ter be dlf·
ch.;r~cd at lhdl orifice: lhoe are Itkewlfe ii (cw innances,
\l htlt lhe ru plure of the fcrol um hdS moru lied, and become
the ~ nus, Ihe p~tient JOlOg \Vel! io cver'j other nfpc{t
Beíore the pellO lmM'Ict: of the oper;¡uon for the bubono·
cele. \1. hieh is 001 '1 10 be done in the extremil'j of d.tngtr,
the m:Jucr medlOJ~ ;U ~ tO be trit:cl j theCe are, fuch as \Viii
cor.<.!Ul:e tú re",Cothe lhe inlll mmation,
Pub rs e'Cct.'p( Ih~ rl:u li"y. no difoluer is more im·
me:Jiatdy rdíc\'t!J by pllnti lul hlc.dlng .han this. Clyrtt."rs
rcpcaled. One itfter .nolllt'r. thrce or (o~ r times, if lh~ 61H
or ICtond art cithcf rl'ljjincd too lung, Or iml1l~di3lel y re·
urm:d. pro\':! vt:rt cni 'l':IOU1¡ : lh:le.are fr.:rvlccable, n. t
(J11h i4S lbt!y ('lOpty lht: ~'e,l t in:dlw.l'S of lheír excrt:n1t:nts
• nd {)llulr:ndcs. \\l llch "dI al(' \!{ ry rl,lngl·fGu<;. bUI Ihey
t,ke.. ,ft: plo..,e a comfllnahlt' ft>tnr nlJllt'll. lty p..nin~ duo'
loe ec,loo ;,1/ around Ihe ..bd mrn. Th.:: fero'ltO) noJ gro;n
nluH. dnlin~ lhe H"y rI Ihe: e/}f1er. be.' h... thc:J \\11th w.lfm
ni t1j'lS wlu rg 1'\11{ u( ,. ~o~u"I'~l lon : .lnd ;\(t(' r lhe p:(n has
ne<.o wdl lolllclIleJ, ) ou lUull altempl ~o r:: ~\:,=e (he rup·
E n Y.
ture: for thi, pur~ofe, let yoor p?ticnt be ¡.id on bis back,
fo lh.t.t I11S buttoek' OlnY b~ r. 'rdidy dbuvc: 11IS he;¡d ;
the bowcls wdl dlcn fCllle tuW".llIS lht: dllph ragm"anc..l give
W.1Y tu thott: wlllch lart: tu be pUlh td In. 1,. alter en Jea .
YOllring 1\110 or tlH"e mInUt eS, you do nOI fiad Jur.:cefs,
)'OU lid' lt the trI a!.
If. Ihlt u.'lI blt"ndlog fllde m~ans. rhe patieor continue:s ia
l'er'j gredt tul ture, IlIough not Ju bdd ..s 10 thrt:Aten an Im–
m ~IAle moni lic..uon , Wé mu : ...pply fume: lome Cort o( poul.
tlce tO ,he C...:rutum ~ lueh as equ.,1 p:HIS of 011 aod vlnegar
I11Ade lOto .. prop. r C ' Wilh oat ,mea l : afta fome
fl!w hours, t flt.' IUnl.:n¡ÓlUOn is 10 be repeated, and lhe other
dlf<."éhon.s pUl In pr..c'hcc: .
Aacr í!.II , IhouJ.l tbe p.. io and tenreners of l he pan coo..
antl Il1C~01l6hs and vonmings of ,he excrl me:nls fue..
t e d , the '.pa.1H1n mUlt Inke pl~ct:; for tf you wait until
a langl:,d pulft:, eold IWC21S, IUDridlOg of the tumour, and
emphykmalOus f~el Corn:: on, it will be moH Ilkdy too late,
as tht y are: pretty ture lymplOnls of a mor' die.&tlon
T u conCt:1\ e rli~h Iy 01 lhe occurrcnct:s In this opnalion.
il mull be rememucre 1, IhtH in every rpt:CleS 01' fUpture, a
portlon or lhe prritolltCulJJ generdlly (ails down u"lth what.
eVer nukes lhe h·rnía ; WhlCh, rrom lhe: clfcumH.nce of eOIl ..
tnlOlng im1llt' ly the COntents of the tumour, 15 c..lled lhe
foc of lhe ht rnia. Now, the portlon of Ihe PUit0I14U11/.
wh lch ufuAlly yrelds to lhe impullion of {he delcenrilD;! vif–
Cera, is th.u which currc1ponds wl1h tne lomoH openlOg of
the ;¡l>domlOí!.1 mu rcIes, jull whe,e ,he melhbrarUl cellu/arÍJ
p:ritOl!ici b::fins lO forOl lhe lumc,' vagina/u of the: fperma.
lic cord j fu thal the fat wuh lhe v1ctra inlinudre t hem..
Cek ts into Ihe Itwica f'llgifl.llil of lhe Ipermui: cord. and
lie upon ,he 11InicQ vag ;na/ÍJ or (he rdile/e : neverthelcofs,
upoo eXamlOAtlOn, the contents of lhe hernia are romelimes
in contnél .....ith the udlicle ¡trelr; IhA( is to (ay. within lhe
lu nica v.'lginaliJ of Ihe {dbe/e. For fome months Junn:
gelt.trion, Ihe teflel of the: f'Z/UJ remain Ir, Ihe ahd! lIul! ;
aod wnen they Jelcend io to lhe luniea vagina/h. thne IS ln
immeotatc communication brtwlxf the U \'1t y o( the :J"d~ ..
1II(n, and the ~avlt y of Ihe /unicQ v~gif1.,'¡iJ . whtr.:h, in
proe::fs or time, b<:.:omes oblueratt:d by (he coalilion ú' lhe
I{Ulit~ wit h ,he cord; but ir il happen. bt'fore lhe cOdll..
tion be c:ffd'ted, Ihat rhe Intdline or lhe 0lllrlllu1II f;,¡lllnto
the(croIU1J/, thc:y will aecdfHily remOlín 10 cont.,,') u'ilh the
' ,jln
Frflm Ihis defcription of the defeent of the t'¡'ara, it is
evidenr thal the hrrn;'lr)' ["o: is contained withln Ih~ 1'ln!ca
v.'gll/alll, :,¡nd ought 10 &Ive thl! Idca o( one ba:4 incloling
another: bU l in lhe operatlOO, this dilbntboo of C,jJIS dves
nOI :tlways Appea r . for the hUlJiar) [tU 100lelimes ar\h('rei
CO ·fi'Oll y 10 lhe IUllieJ v,,~inflliJ, rh lt t.>g('lhef lhe} m ,.kc
one thick eOOit: IhlS adhdion m. y p~drlt-tly rt'fult írolll Ihe
prefent infldmOlittion of Ihe pans, v.IHch has rendcrcd Ihe
'opc:ration ntCllTJry.
Th~ bdl WJy of I.ying yoor p>tient ",iJl b, on , ,. bl. a·
bmH fl lrce tet!t ruur io. h!s hi ~h, leltlng hlC" le~~ h ,o~ duwn;
th n propcrl y fecunA~ hun, you begln your Inc:,liun .lbl'9":
lh:- rio;.:s uf Ihe mu re/~s, bcyond (he l '(tr ...ml.y of tht tU·
mou r, and bnng it oown about halC he I~n.~' h 01 tlu!'·ro•
f ilm through lhe m.·IJI~rllll.1 n.JiJ"'o(tI, wllleh wilJ tequlrr I:"ry
liu lc Irou le 10 CCP\f1IC frum che" I wJ· J t. /1..'" ,J!:J ;¡nd
conf' qurntly wíll c:xpoft" the rUl'lolc rOf tI·(' t .. "h<.·r pro..
ccfli. s orthl' 0rcr.lt1nn. IC" 1, 1: ' \:II~'I ,~ ,,;,!(,\C' l h, 1I1<: IQ·
c¡j¡un) it JIlult be! [ak~n up o"lorc ) OU proc.:cd Junlw r
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