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OF RUPTURES

treating, is the bubonocele, or inguinal hernia, which may be defined,a soft swelling, somewhat elastic and tense, beginning in the groin, anddescending into the scrotum of men, and into the labia pudenda ofwomen. The tumor is most commonly formed by a part of the intestinalcanal, or of the omentum, commonly called the caul; or of both.

When the intestine or gut of an adult has been forced down with greatviolence, or happens from any cause to be inflamed, there is often greatdifficulty in returning it, and sometimes the attempt is impracticableivitliout an operation, a description of which is foreign to our purpose.We shall briefly mention the method which it is generally proper to\jursue.

After the patient has been bled, he must be laid upon his back, withhis head very low, and his breech laid high with pillows. In this situa-tion flannel-cloths wrung out of a decoction of mallows and camomile-flowers, or, if these are not at hand, of warm water, must be applied fora considerable time. A clyster made of this decoction, with a largespoonful of butter and an ounce or two of salt, may be afterwards thrownup. If these should not prove successful, recourse must be had topressure. If the tumor be very hard, considerable force will be neces-sary ; but it is not force alone which succeeds here. The operator, atthe same time that he makes a pressure with the palms of his hand, mustwith his fingers artfully conduct the gut in by the same aperture throughwhich it came out. The manner of doing this can be much easier con-ceived than described. Should these endeavours prove ineffectual,clysters of the smoke of tobacco may be tried. These have been oftenknown to succeed where every other method failed.

There is reason to believe that, by persisting in the use of these, andsuch other means as the circumstances of the case may suggest, mosthernias might be reduced without an operation. Cutting for the herniais a nice and difficult matter: I would therefore advise surgeons to tryevery method of returning the gut before they have recourse to theknife. 1 have once and again succeeded by persevering in my endea-vours, after eminent surgeons had declared the reduction of the gut im-practicable without an operation.

An adult, after the gut has been returned, must wear a steel truss, orsuitable bandage. Such bandages or supports are generally uneasy tothe wearer for some time, but by custom they become quite easy. Noperson who has had a rupture after he has attained the years of man-hood, should ever be without a proper bandage.

If the following simple method is made use of on the first perceptionof a protuberance or rupture in the groin, it will prevent the bad con.sequences that often result from inattention and neglect; but if the pa-tient frequently lifts a great weight, or if he carry heavy burthens, iythat case it will be best for him to wear a circular steel spring truss.

Procure a piece of strong broad tape (such as is now used in making(he braces or supporters of gentlemen's small-clothes), about two feetnine inches in length ; and at one end fix a large iron hook, and ;:t theother end sew five or six iron eyes (such as were formerly used univer-sally by women for their petticoats): let these eyes be placed about halan inch distant from each other, as represented in the Figure (see No.1.), so that the tape or belt may be made tight around the body or lower