. Surgical differentials. bsorbable sutures andthe second is imbrication. This latter is the most recent ad-vance which has been made in the treatment of hernia and iswell exemplified in Mayos technic for the treatment of ven-tral hernia and in Andrews modification of the Bassini. An-drews accomplishes what Halsted endeavored to do, Hal-steds operation, by which the cord and its appendages wereplaced on the outer surface of the external oblique, did notwork well because the skin gave insufficient protection to thecord. It is obvious that a stronger abdominal wall may bemade by uniting the thre
. Surgical differentials. bsorbable sutures andthe second is imbrication. This latter is the most recent ad-vance which has been made in the treatment of hernia and iswell exemplified in Mayos technic for the treatment of ven-tral hernia and in Andrews modification of the Bassini. An-drews accomplishes what Halsted endeavored to do, Hal-steds operation, by which the cord and its appendages wereplaced on the outer surface of the external oblique, did notwork well because the skin gave insufficient protection to thecord. It is obvious that a stronger abdominal wall may bemade by uniting the three muscles rather than by having themsplit by the cord. Andrews accomplishes this tighter union,and, in addition, successfully protects the cord. He transplantsit to the outer surface of the wound just as in the Halstedtechnic and then imbricates or folds fibres of the externaloblique over it. In a large direct hernia, Blake sews the rectus to Pou-parts and closes the internal oblique over it. \7to*e ^^-ra cLcfrun^^. S&n. (7} Fig. 48. The fanciful resemblance of the Inguinal Canal to a drum helpsone to remember the coverings. INDICATIONS FOR BROPHYS TECHNIC. 185. MALFORMATIONS. It is interesting to notice that most malformations occuralong the central line of the body. We should, in other words^.suffer from very few malformations were it not that Naturetries to make us bilaterally symmetrical. She sometimes fails. Starting in the mid-line of the face, one of the most fre-quent malformations met with is hare lip. This is rarely in the-exact median line, being just to the right or left side of it. Itmay be single or double. It is rarely uncomplicated by a moreextensive lesion, but it may exist alone. If this happily be thecase, it is a relatively easy matter to freshen the surfaces andsew it up. Failure of the hard part to unite, however, usuallyaccompanies it. Cleft Palate. The teaching on the treatment of this im-portant subject is destined soon to undergo very importantm
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