Four Common Surgical Operations in India

Surgeon of the Madras Hospital, best qualified to write such a book which will be welcome to many a man who is called upon to perforin responsible duties in civil hospitals in India for which he has not had the proper training. A perusal of this book will no doubt supply him with useful hints, although " Confidence and skill can only be obtained by experience " in the words of the author. Major Gabbett is quite outspoken when he says " Let your business principle be cast down." I am afraid he must liave been " had " on several occasions like myself, and I quite endorse his statements, although I find very difficult at times to carry them out in actual XJracticeAfter the work is satisfactorily completed, one lias to apply the long forceps to extract the cash. With regard to his hernia operations, I must say that I differ from him in one particular point. I consider the approximation of the conjoint tendon to Poupart's ligament a necessary adjunct to the radical cure. Whether the hernia is congenital or acquired, there is always a weak spot in the abdominal wall which requires strengthening if Nature's methods are to be followed. In all my hernia operations I have invariably practised this method without any recurrence so far as I know of. The cord is left in situ without any displacement as in Fergusson's modification of Bassini's operation. The operation Major Gabbett describes is evidently his own Simple ligaturing of the neck of the sac and excising the rest of it without fixing the conjoint tendon to Poupart's ligament is not enough for a radical operation. I'1 old. standing hernias