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SOME OBSERVATIONS
ON THE VALUE OF THE DIFFERENT SIGNS WHICH DISTINGUISH THE
SAC IN STRANGULATED HERNIA;
WITH SOME
PRACTICAL REMARKS ON THE OPERATION,
AND
CASES IN ILLUSTRATION.
BY J, H. JAMES,
Surgeon to the Devon and Exeter Hospital.
So extensive and various have been the writings on the subject of hernia, that it is scarcely credible that any point belonging to it could still demand illustration; nor should I have believed it to be so, if I had not found that, in more respects than one, our information is not so complete and precise as it ought to be: and thinking it possible that others, as well as myself, may have felt the inconvenience of the deficiency, 1 shall endeavour to remedy it in some measure.
The point to which I now particularly allude, is the mode of ascertaining, during the operation of hernia, whether it be sac, or whether it be intestine which presents; the enquiry, however, will involve some other matters.
It is well known that the dangers incident to this operation, occur chiefly at two periods, one in open-
