The practice of surgery : embracing minor surgery and the application of dressings, etc., etc., etc. . in the number of tunics covering the hernial sac; this varietybeing deficient in the coating of the cremaster muscle. But anynumerical arrangement of tunics in these operations, mustalways lead to disappointment and perplexity, if they be expectedand looked for. In old hernia for instance, the fasciae are allthickened and increased, so that no certain number of coveringscan be found shutting in a hernial tumour; therefore the only goodrule for operation in this disease is to proceed carefully
The practice of surgery : embracing minor surgery and the application of dressings, etc., etc., etc. . in the number of tunics covering the hernial sac; this varietybeing deficient in the coating of the cremaster muscle. But anynumerical arrangement of tunics in these operations, mustalways lead to disappointment and perplexity, if they be expectedand looked for. In old hernia for instance, the fasciae are allthickened and increased, so that no certain number of coveringscan be found shutting in a hernial tumour; therefore the only goodrule for operation in this disease is to proceed carefully, dividingeverything that intervenes between the operator and the hernialsac (which can always be recognised from the superincumbenttissues) ; this gained, all uncertainty is at an end. In femoral hernia, Sir Astley Cooper operates by making anincision in the form of an inverted JL. Mr. Liston makes an in-cision parallel to and directly over Pouparts ligament; from thecentre of this an incision is carried down over the tumour, thelength and manner of incision being the same as in the former Other surgeons employ, with equal propriety, a perpendicularincision directly over the tumour, beginning at Pouparts ligament:this makes a smaller external wound, and as the only object is toapproach the strictured point, the smaller the opening necessary toaccomplish this object, the better. The integuments being divided by either of these incisions, the FISTULA IN A NO. 95 superficial fascia must then be raised and divided as alreadydescribed ; we next come to the fascia propria, which must be raisedin like manner, and the hernial sac is brought into view. This,as well as its contents, must be treated in the mode directed foringuinal hernia. The point of stricture in femoral hernia may either be theneck of the sack, the cribriform fascia, the falciform process of thefascia femoris, the femoral ring, or Hefs or Gimbernafs liga-ment. The almost universal point of stricture, is Gimbern
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Keywords: ., bookcentury1800, bookdecade1850, bookpublisherphiladelphialindsa
