Strangulated Hernia Operation, and Subsequent Operation for the Radical Cure

Nazir, Mahomedan, aged 35 years, was admitted on the 20th April -with symptoms of strangulation of an inguinal hernia of the right side. It was of seven years' duration, and had been always reducible. He had never worn a truss, and on one occasion he seems to have been in peril from a temporary incarceration of the hernia. On the 19th of April it protruded when ho was talking, and he was unable to rcducc it as before. The pain increased, and he vomited frequently. The symptoms of strangulation rapidly set in, and he was brought to the hospital on the morning of the 20th. The tumour was then about the size of an orange, and had not descended into the scrotum. It was evidently, from the feeling and tympanitic condition, an enterocele. The Usual measures for reduction were tried without effect. Enomata and taxis under chloroform failed. The symptoms being urgent, the hernia small, and the process of strangulation rapid, with no prospect of reduction, the operation was performed at once, delay in such cases being attended with great danger. The stricture lay at the external ring, and the inter-columnar fascia was tightly stretched over the protrusion. The vas deferens lay across the neck of the sac. The stricture was divided ?n a director, and the hernia, with a little manipulation, was easily reduced. The lips of the wound having been brought together with a few sutures, a pad and bandage were applied. 21si.?He is doing well; no fever ; bowels have acted freely several times; no pain; no sickness. The wound is evidently siting; temperature in axilla 100? ; pulse 82. 22nd.?Slight pain in the wound. Temperature 102?. 23rd.?He is doing well; no fever; no pain; wound nearly healed. 24th.?A little suppuration from between the ligatures, evidently from the sac. Pulse quiet; no fever; no tenderness, excepting about the wound. 2Ith.?Removed all the sutures ; wound healthy. He is doing ^"ell; discharge diminishing. 28th.?"Wound nearly healed. May 5th.?"Wound healed. \0th.?To-day I operated for the radical cure of the recently strangulated hernia. I used the plug and ligatures as usual. . UfA.?He is doing well; no fever; not much pain; there ls tenderness all round the plug. \Zth.?Free suppuration round the plug and ligatures ; removed the plug. The invaginated scrotum firmly fixed in the canal; 110 fever. In all respects he is doing well; pad and spica bandage applied. 17th.?Wound healing; he is doing well. 1\th.?He has quite recovered ; the canal seems perfectlyclosed ; no muscular effort or .straining causes the hernia to protrude. He has been put to the usual test of lifting weights and running. 28M.?lie was discharged) to all appearance perfectly cured. The above case is interesting, as the patient underwent the operations of strangulated hernia, and for the radical cure of it, in so short a period. He was admitted with strangulated hernia