Permanent cure of reducible hernia / by George Hayward ; presented to the American Medical Association, at its session of May, 1852.

  • Hayward, George, 1791-1863.
Date:
1852
Catalogue details

Licence: Public Domain Mark

Credit: Permanent cure of reducible hernia / by George Hayward ; presented to the American Medical Association, at its session of May, 1852. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    for how long a time the patients enjoyed this immunity, and it can- not therefore be known whether the cure was permanent. One of the Committee is able to state a case which came under his own observation, which, in his opinion, has an important bearing on this point. A healthy young man underwent an operation for irre- ducible omental hernia. All the omentum beyond the external ring was cut oif; the inguinal canal was plugged up by the omentum, which was closely adherent to it; and it was remarked at the time that the patient would never probably be troubled with hernia again. Within two years of that period, he was obliged to submit to an operation for strangulated enterocele on the same side. The very circumstance that was supposed to be sufficient to relieve him perma- nently was probably the cause why the hernia could not be returned by taxis. It has been attempted to close the external ring by forcing the testicle into it, and then bringing on such a degree of inflammation as would be likely to retain it there by the effusion of fibrin. Some- times this has been done without making an incision in the integu- ments, and at others the testicle has previously been laid bare. This operation is certainly not admissible. It is unsafe; it is not probable that the testicle could be kept either at the external ring or within the inguinal canal; if it could, it would, no doubt, be a source of great inconvenience and irritation, and in addition to all this, it would not in all probability prevent the return of the hernia, but would, on the contrary, rather facilitate it. It has been attempted also to close the external ring and inguinal canal by means of the hernial sac. This operation has been done by Petit and Garengeot. The sac is first exposed; a portion of it is then crowded into the inguinal canal, under the expectation that adhesions would be formed between them sufficiently strong to pre- vent any subsequent descent of the hernia. This method is, perhaps, less objectionable than the preceding one, on the score of danger to the patient, though by no means entirely free from it, but is not any more likely to effect a cure. There is no reason to believe that it is performed by any one at the present day. M. Gerdy has practised an operation, which consists in crowding the integuments into the inguinal canal, and removing the cuticle from them by means of caustic alkali. This is what has been called by the French invagination by the integuments. Some modifi- cations of this method have been suggested by M. Leroy and M.