1000000031

.65·1-

(he in!1.l nce in \\ hich

is mo!1: I¡kely

anfwer, ¡s,

w;,~n

l he

uplure is Q',vinr:; to any

Hraio,

fudden jerk.

<:¡!ld is .. l–

tend, d ",illl Iho(, di(ordclS IVhieh follow upon Ihe O""gu–

huian of a gut.

In t!lis cafc. h:wing tried alJ other

mean.

vain.

Ihe

operl tion is

~b rolutely

neceff.ary; which m_y be thus per–

{ormed : l\hkc

Ihe

¡nci lion

fom ewhólt

auove

the lum our,

the Icfl fide 01 the navcl. through lhe

m:lllbrana IldiPofni

and

lhen empt ying lhe rae of ils water, or monific:d omcntum. di·

'hte

I.lH

r,ng with lhe

f2me

crooked knife; condulted

your

finge"

as in lhe operation (OT lhe bubonocde; arter Ihis,

returo

lhe:

inldlincs and omentum ioto lhe: abdomen, and

drefs

lhe

wound

WilhoUl

mak:ng any Jjg. ture

bUI

of tbe

11<10

ooly.

O.r /h_

H ERNIA VENTRALIS .

TWE

l:~rníQ v~nlralj¡.

which

Cen~etimes

"fpCí\rs betwceo

the rctlí

m~fclcs,

is vcry hrge ¡

!lU[

that tumeur which re–

qui res the operation is fd dom biggcr than

w;tll)ut,

and

a diCeafe nel fo cornmon ;u to hive bten obfer ..ed by

many: bu t there are cafo eoou3h known,

l O

put

furg<>on

upon inquiry a(ter

il.

' Vhen [he palient is fuddc:nly

t¡¡k~n

\Vith all rhe Cymptoms of

rUpture, wi[huut any appe<HaDee

o( one in the navel, (crotum, or thigh, Ihe manner of

d¡la–

ting it will be the [aole ;,s that ahove direéled in the o1her

hernias : arter the oper¡tióo

this

and all

hernias wbere

the ¡nterlines have b<>en reduced . it

will

be conyenienl tO

weu a truCs, finee the eicatrix i.. not always lirm eoough

io aoy of Ihem 'o preveo, • relap(e.

E X PLANAT'ON

of Fig .

2 .

PI.te

CLVIf.

The round_edgc:d knife, or

eonvenieot lize for

al·

mon all opcrations where

knife is ufed ; the make of

" 'iI!

be be" er underfl ood by Ihe fi gure Ihan .ny other de·

feription ; only it ma)' he remarked, ·that che haodle is

m..

of a ligh' wood; as indeed ,he h.ndles of .11 ioOrumen.s

Olould be, ,h.. Ihe rer.n.nee ' o Ihe blade, may be be""

fdl by Ihe (urgeon.

pair

prohe_feilr..rs,

which re.quire

nothing very

plrlieular in thei r farOl, htH chac the

low~r

bladc: (hould be

m;¡de as (mall as poOi ole, fa that

is ftr ong, and has a good

edge¡ bccau fe, heing ehicBy ufed

finulas

«7:0,

the ¡Otro·

duflion of • thiek blade iOlo Ihe

r.ou

., whieh is fleoeralJy

narro\V. would be very painru! to the pltieoL

C. The erooked knife wilh the poin' bluolcd, . fed in Ihe

ope,"Iion of Ihe bubonoecle.

Oj' th,

HYDRO CE LE .

h,droa ¡_,

e.lled .Ifo

h"nia

aqu.fa

"dropl

f Cr9Ji,

aoJ

b),dropJ

rdliJ,

is a watery tumou r of the fero–

tum ; whieh, notwithfi anding

lhe

mull iplicity of

rlifiinttions

ufed by writers, is hu t

t\Vo

kinds j lhe one when the

wa–

ter is conuiDed in lhe

IUlIica vagina/h ,

and the orher

when

in (he

membrana ce/lularÍJ

foroli.

This

lall is

al –

mon

always

eomplicated

with ao

anaCarca ; which fpecics

drop(y is ,n

extr.va

(ation of water lodged in ,he eells of

thc

m:l"hrana

adipo!.J :

and

when thus cireumfhnced.

will

nOl

be diffi cult

dilli nguinled j befidc:s IhH it is fuffi.;i–

<n!lr eh. raélerif,d by Ihe Olining .nd (ofloe(, of Ihe Ocin.

whieh givcs

way

tO the

lean

imprdTion. ;¡nd

rc. mains

pi[ted

fur fome time. The pe::nis is like::wlfe fometi mes cnor01oufl y

~nl"g,d,

by ,he

ior.nu

¡tion of ,he fl uid. ioto Ihe

lIICJ:,úr a·

Jl 7

ccllulariJ:

aH whieh fymptoms :re ábfoIutt Jy war.lin;: in

lile:: dn)pry

of the

(ul!lca

t'ogina/iJ.

I n

Ihe

drop!y of the

lIN1IJIJ/:lfla ctllularh

! cr(¡li,

,he

pu nél ure with the tlocar is .recolilmendcd by fome, ..nd

lit

tle

orifiees

lnadc hC!1 e ...

nd tbere wuh ¡he poiat of a Jan·

ce' by olhers : or . fOlall níaoe of

r.lk

p.O·<d by . n'Ldle

through tht:

Ik .n,

and out "gain

;it

rhe cllHance úf (\\loor

tblee: ioehes, ta be

k~rt

th~

mar¡nc::r of a feton , till ,he

wclters are ql1ite dr..inc:d:

bU l

lhe:: twv {jrlt mc:thods avail

very l¡tde,

.15

they opt n but few eells; and the - l..

Cl nnoc

be fo effi..:a:.. ious in tb"t refpc:ét- as incifiogs, Olnd wilJ be mucu

more apt tO

b<>C'H\l~ croubl~fum~,

and e'len

gangrent' .

I nd~ed

¡s

n(lt oJren ['roper to pe-Iform

311y

opeJation at

311

l1?L>O

this poan, fin Le ,he

1IJ~lIJbranQ

u l/uluriJ

f.·n li,

be,n~

contintli4tion of the

tn~mbrtlllQ

adip,,¡a,

Larifications

m:tci~

through lhe

fkiD

in the

{mall

e f the legs will

dT.:c·

tUA.lIy emply ¡he fClolum: aod this rl:.ce ought rath!r tO be:

pltchC'd upon

(han

the otha , as bc:int; more hkcly

anfwer

che

pur~ofc

by reafua of

its

dependcney: however,

fc.m:·

times happc:ra, th fl t die Wilters

(aH

in fo great qllanlitic, io–

to the rcrotum, as, hy di,t-cnd:ng tt,

occa{jon great p;ain,

;,r.d

threltcn .. ruortificí\tioo: lhe prepuce of the penis alto

bt-come, very o(ten exceffivtly dil"led. anu fo twi(led, th"t

the p;:ttient canoot void

JlIS

urine. In theCe [wo inHanees,

an int:iúon of thre.· inches long fhould be made on each lide

of the IcrotulTI. quite throDgh lhe

Ocio

'ioto the celis eOD–

tainins lhe watt:r, aod tWOor lhree of half an ineh long, in any

p'Ut of

the

penis. wi th a Lmcet or koife,

all

which may be

De wilh

gre-:a (al elY. and {ometimes with the fuccefs of

.c.rrying

t.ff

,he dileaf. of Ihe whok body.

The dropfy of the

lunica vaginaliJ

is owing to a pre –

,tero:tlund d,feharge of th:ilt whleh is eontinually fepu.a ting

. in

fm.1! quantity. on the internal furfaee of the cunick,

for lhe nitlllt<!ning or lubrieiltin, the tenicle, aod whid l

colletl,ng

100

{,tll:

.lecumulates and for;ns in time a

íwel–

ling

üf

great magnitude;

Ihis

is what we uke to he th..:

o·

Iher fpeei" of h)'droeele, aod Ihe only one ber.des.

TJ¡e hydrocele of the

lunica vlIginllliJ

i, very eafily ro

be odlingu,Oled from che hydrocele of the

IntTl/brana

((l·

lulariJ,

by Ihe preeed:ng deferip,ion of ,ha< (pecies ofdropfy:

W e. 0, ,411

no\v t xplain how it dlffers from the other tumourl

of the fero·,um.

vir.

the

bubanou/~. tp;p/~ct!e.

and enl2rged

,eOicle. 10 ,he 6r11

pl.ee,

it i. (ddom or never .",nded

with pain

the oeginnlng. and is very rarely to be impuced

to ao y ace¡Jen!. as [he hernia', of tI!e omentum and ¡ntelline

are.

F rom

lhe time it firn makes

its

"ppearaccc, il very fel.

dom is

kno\~n

tOappear or dimiDiOl bUl gcnerJlly conrinuel

to incredre, d:ough io fome much fa{ter tbaD in others; in

one perfon growlng to a vt.:ry painful diHeofion iD l

few

monlllS, whdH

;¡nolht:r

/hall not be troublefome

many years; nay. (hal l ceafe to

{wl,:1I

3t ;,

eeru in p<>riod,

and ever ; f,c: r eontinue in thac Hate without ar.y oot,¡ule

dif.dv.ntoge; Ihougn lhis I. rl ,,(e very r.rely b.ppen,. l.

p(op~iun

it ellla rges , it beeomes more tenre, and theD

f~d-'to

he tranf[';ucnc :

ir~teed

the tr,¡fpar<>ney is molde the:

chid criterion o(

t~e

diflemper, it b,ing conJl ..

ntly

aJ rífc:J

to hold a

candl~

on cae fid e of lhe fcrol um. wllich it is l.1I iJ

will (hine through the lhe olher. if tllere be \V,Her.

BUl

this

experimC'nt dues rOl al\\'a)'s aof

·.a ,

bec.,Jufe (c.)01e·imes the

runlc.

\'J~in.¡Jls

very much

[hi~

blt.Cd

ar:J

fome~i,"!s

Ihe

water itfdiis not trafj'3rent: fo

lIu t

to judg<>

po:i:i\cl r

tbere

bt::

fhllJ,

w.:

Illult

hc'g\';d>:d by

f~e1ing

fl..i~!,J.tUln :

and