Reports on hospital cases : strangulated inguinal hernia / by William Mac Cormac.

  • Maccormac, William, Sir, 1836-1901.
Date:
1866
Catalogue details

Licence: Public Domain Mark

Credit: Reports on hospital cases : strangulated inguinal hernia / by William Mac Cormac. 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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    another attempt to reduce the hernia while the patient Was uhdfet*! the influence of chloroform. This trial merely confirmed my pre*<^ibiiS Impression that a very tight stricture, which the taxis was' tiot liTrely to overcome, existed. Accordingly I determined at onbe to gerfdrhi’ herniotomy. An incision through the skin and superficial fascia' was first made commencing over the internal ring, and extbiidihg for three inches downwards towards the Scrotum iii the aiis of the inguinal canal. Three different layers of fascia were divided, flild a thickened sac, with some bands constricting it^'in the''te^bh^ of the external ring, was exposed. These bands were divided inAM hopes of returning the protrusion without opening the'^ac; but the stricture Avas evidently seated elsewhere, it if as necessity tU open the sac, which I did at the ioAvest part of the woundV'atid in doing 80, so tense Avas it, I experienced the greatest difficulty in pinching it up betAveen the blades of the forceps previous'to iiicisifi^ it. About an ounce and a half of reddish serum escaped, and a siuglfe knuckle of small intestine Avas found to be the only ptOtruded portion of the abdominal contents. The gut Avas greatly congested, and so sharply folded upon itself that one portion of its cdUc^vO border, about the size of a sixpenny piece, Avas chocolate-brown in colour, and seemingly in a state not flxr removed from becoUiing gangi’enous. On introducing the finger a very tight stricture Avit^ felt at the internal ring. I freed this to, Avhat I cons^idehedj’^? sufficient extent, AAdth the knife guarded, as' before, but coiild ’H8t return the protimsion. I, therefore, reintroduced the bi^oury, ^tld ' made a second incision in the stricture, being afraid of the’results’ which might follow any rough or protracted handling of the boAvel.^ Still, notAvithstanding the second incision, I fohnd myself unable't6* reduce the hernia, and it was not, strange to say, Till'I hdd a thM time cut through the tense fibres of the ring that I Avas abi^, avithOfifl' using violence, to replace the intestine Avithin the abdomen. 9 Foil? sutures were noAv .-introduced, and water dressings, aiid'a haMllgfe* Avere applied. The patient, wdio Avas in an extfemCly loAv State the combined effects of the disease and the operation, was cautiously*- removed to bed, and a glass of brandy and water, with thir1;y minimi of laudanum in it, was administered to him. h om On seeing the patient next morning, about nine hours after the ' operation, he told me he felt himself “ cpiite a ncAV man.^’ The pain and sickness, and other symptoms, had almost completely subsided.^ He was ordered nutritious diet, and a glass of whiskey daily. On the fourth day the report states that he had slept the entire of the'