. Hernia, strangulated and reducible. With cure by subcutaneous injections, together with sugcested [!] and improved methods for kelotomy. Also an appendix giving a short account of various new surgical instruments. r up the spermatic canal until we come to the inguinal ring,and by slightly raising the end of the middle finger as abovementioned, the same is felt by the forefinger, which also helps usto indicate the exact point, and guide to insert the point of theinstrument. Having ascertained that the ring is well open andfree from attachments or adhesions to the returned sac, we beginto inse
. Hernia, strangulated and reducible. With cure by subcutaneous injections, together with sugcested [!] and improved methods for kelotomy. Also an appendix giving a short account of various new surgical instruments. r up the spermatic canal until we come to the inguinal ring,and by slightly raising the end of the middle finger as abovementioned, the same is felt by the forefinger, which also helps usto indicate the exact point, and guide to insert the point of theinstrument. Having ascertained that the ring is well open andfree from attachments or adhesions to the returned sac, we beginto insert the needle at the lower portion of the ring, where wefeel its edges through the abdominal The needle should always enter this lower portion of the ring,as in passing obliquely upwards and backwards it is less likelyto wound either column of the internal ring. Great care should i All the sac that can be put back free from adhesions must be returnedIf it is firmly bound down the injecting fluids should be freely distributedaround it as thoroughly as possible. 1M HERNIA. be taken in inserting it through the integuments and superficialfascia, so as not to wound the external pillar, but to enter the. Fia. 36.—Thethree most common forms ot Hernia, in the order of their occurrence in the male,are (1) Oblique Inguinal; (2) Direct Inguinal; (3) canal at once. The needle then should never be passed ina perpendicular direction, as there is thus danger of wound- 1 The artist has drawn the instrument too nearly horizontal, so that itappears as if it were entering the left groin. The instrument should lieacross the thumb of the left hand between the first and second joints,making an angle of about forty degrees when the needle first passing the superficial integuments the instrument should be de-pressed so that the needle may pass freely into the rings along the superiorsurface of the spermatic cord, taking care not to wound the cord. AUTHORS OIEHATIUN
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