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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    and inconvenience hardly amounting to that presented in a case of hydrocele treated by injection or in any simple operation. The following case, attended with success, will serve as an illustra- tion of the course generally pursued :— A male child, three years of age, with congenital inguinal hernia of the right side, was brought to the Massachusetts General Hospital to obtain relief, if it was possible, as no truss had been found to retain the protruded intestine in the abdomen, and the pain and in- convenience from the infirmity were great. On examination, a tumour, the size of a small orange, was found to occupy the scrotum. By a little manipulation, the contents were ascertained to be a por- tion of omentum, a loop of intestine, and the testicle—the whole of which, by care, could be easily returned into the abdomen. The question which first presented itself was, whether the testicle could be separated from the other parts, the adhesions being quite intimate between them, so as to admit the return of the intestine and omentum into the abdomen, leaving the testicle in the scrotum. This being determined, the operation was performed as follows: The intestine and omentum being returned into the abdomen, and the testicle prevented from following, the spermatic cord was held out of the way in the manner stated above. A subcutaneous incision was then made by a cataract knife, the point of which was carried into the sac, and the neck scarified in different directions. Through the aperture thus made, a small trocar and canula were introduced; the former being withdrawn, the syringe was adapted, and thirty drops of sulphuric ether were injected. The truss was now applied. The operation was performed on October 28, 1847, and there was every prospect of success, when, from a violent paroxysm of crying, the hernia was forced down on December 9. On the 12th, the in- jection was repeated, and resulted, on the following day, in a swell- ing of the scrotum, such as is observed after the injection for hydro- cele. On December 22, the report was made that the hernia came slightly down, and was returned with difficulty, the aperture being apparently quite small. By the end of the month, it was stated that the hernia was perfectly retained. I have been informed by an individual who saw this patient a year afterwards, that the cure was permanent. During the treatment of this case, a slight superficial suppuration took place under the pad of the truss, which, the patient bein^ some- what fractious, was necessarily applied pretty firmly to prevent the recurrence of the hernia after the operation. In a large proportion of the other cases operated on, the patient experienced much relief, though still obliged to wear a truss. In one case, where the hernia was quite large, no relief was experienced. A female, with a double femoral hernia, on whom the scarification and injection were once or twice repeated, expressed herself much bene- fited by the operation, the hernia being retained, and the sutferino- previously experienced much relieved. Another patient, a labouring man, was seen by me six months after the operation ; the rupture