Cases of hernia : with remarks / by James Spence.

  • Spence, James, 1812-1882.
Date:
[1845]
Catalogue details

Licence: Public Domain Mark

Credit: Cases of hernia : with remarks / by James Spence. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    CASES OF HERNIA: WITH REMARKS. By JAMES SPENCE, Esq., LECTURER ON OPERATIVE SURGERY. Extracted from the Monthly Journal of Medical Science, August 1845. As there are few surgical diseases in which every practitioner is so frequently called upon to act for himself, as in Hernia, and, therefore, few in which he is so immediately interested, I offer the following cases, as illustrating some of the difficulties which occur from time to time, in the treatment of this disease. Case 1. P. B., aged 40, the subject of the present case, had been affected with hernia for a great many years. At an early period of the complaint he had worn a truss, but for some time back had discontinued its use. Since then, the swelling had rapidly increased in bulk, but he had always been able to reduce it himself, when it became troublesome. On the 25th of August 1840, he was attacked with vomiting and twisting pains in the belly, which, as he had been living rather freely for a few days previously, he attributed to an “ attack of bile,” and did not apply for medical assistance until the morning of the 27th, when the hernial swelling became painful, and on trying to re- duce it as usual, he found he could not do so. He then sent for Mr Lawrie, who tried to reduce it by taxis, but without success. I saw him for the first time, at 9 p.m. of the 27th August, along with Mr Lawrie, when his state, as recorded in my notes, was as follows:— There is a large scrotal hernia on the right side, which is tense, and painful to the touch ; but the contents of which can be returned into the abdomen, with the exception of a hard rounded mass, which feels exactly like an enlarged testicle, and which cannot be reduced. The cord can be felt behind the hernia, and the testicle, of natural size, in its usual position, at the lower part of the scro- tum. He has frequent vomiting and hiccup ; the belly is tense, tympanitic, and tender to the touch, and he complains of severe twisting pains from the hernia towards the navel. Except a scanty stool when the vomiting first began, he has had no motion in his bowels since the commencement of the attack, although enemata and laxative medicines have been given. The expression of his countenance is anxious; skin rather warm, and covered with per- spiration; pulse 108. He says that he never felt the “ hard lump” in the rupture on any previous occasion. At half-past 11 a.m., I saw him, along with Drs J. A. Robertson, J. Reid, and Duncan. The symptoms had become more urgent, and EDINBURGH: SUTHERLAND & KNOX, 58 Princes Street.