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disease, or the immediate necessity of an operation; but he withheld his consent until he could see his wife, which caused some delay. At 7, p. m. I was enabled to proceed.
From the inflammatory action going on, the Profusedbleedin
an very
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bleeding was most copious, “ neither do I remember any case in which there were so many layers to be divided.” There was, however, a considerable quantity of fluid, turbid and offensive. There was only one knuckle of intestine down, notwithstanding the great size of the tumour; the remainder was constituted by the fluid, and the thickened state of the parts, chiefly by the latter. There were many strong adhesion's, particularly about the neck of the sac. A portion of the intestine, on the outside, was in a state of sphacelus. I divided the stricture and adhesion's, and returned the intestine. Immediate relief followed the operation, and he had free passage of the bowels. On the 22nd, four days after the operation, faeces appeared at the wound; he recovered, however, and the faeces resumed their natural course.f Case hi. — On the 27th Jan. 1827, I was desired to see, in consultation, Mrs. G. who had a femoral hernia, of old standing. Her health was delicate; her age about 37.
Extract from case book.
1' In cases where a small portion of intestine is in a state of gangrene, but not ready to give way, it probably is not a bad plan to return it. Adhesions are very soon formed in the neighbourhood of the divided strictures, which prevent the faaces from making their way into the abdomen; and the parts are likely to go through the processes of restoration better, in their own natural cavity, than under circumstances of exposure, or super added injury.
