The anatomy and surgical treatment of abdominal hernia / From the 2d London ed. by C. Aston Key.

  • Cooper, Astley, Sir, 1768-1841.
Date:
1844
Catalogue details

Licence: Public Domain Mark

Credit: The anatomy and surgical treatment of abdominal hernia / From the 2d London ed. by C. Aston Key. Source: Wellcome Collection.

Provider: This material has been provided by the University of Massachusetts Medical School, Lamar Soutter Library, through the Medical Heritage Library. The original may be consulted at the Lamar Soutter Library at the University of Massachusetts Medical School.

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    nial sacs at each groin, with another in an incipient state on the left side; and the subject of one. of the plates in this part of the work, represents two hernice on one side and one on the other. When this is the case, they seldom are all at the same time in a state of protrusion, and the second sac is often formed after the cure of the first, two examples of which will be hereafter related. A hernial sac is sometimes burst by a blow. When this happens, its contents escape out of the sac, and become placed under the contiguous skin, so that the viscera require to be returned into the sac before they can pass into ihe abdomen. I attended a case of inguinal hernia under these circumstances, with Mr. Brickenden, a surgeon in Southwark: the viscera had escaped under the skin of the scrotum, through a hole in the fore part of the sac, and were obliged to be returned into the sac before the reduction of the hernia could be effected. The protruded parts are not always, however, contained in a sac; for when hernia arises from a mal-formation of the muscles, attended with unnatural apertures in them, these holes are not always covered by perito- neum. This was the case in a hernia protruding through the diaphragm which I met with some years ago; the colon, the viscus that had escaped into the chest, was lying upon the lung without any peritoneal sac. This exception, however, does not universally hold in the diaphragmatic her- niae, for I have known one instance in which the viscera were included in a process of peritoneum. The hernia congenita has not a peritoneal covering distinct from the tunica vaginalis testis, except in a very uncom- mon variety of the disease. The hernia cystica is described as being equally destitute of this membranous coat; but this is only true in the commencement of the disease. Dr. Marshall has a preparation of umbilical hernia in which no sac appears, but the protruded parts lie in direct contact with the skin. This variety is very rare; but the possibility of such an occurrence should be known, as in performing the operation for hernia extreme care should on this account be taken, to avoid wounding any of the protruded viscera.