. Abdominal hernia : its diagnosis and treatment. e median am quite partial to this method, but in some cases it cannotbe used on account of the extent to which the abdominal cavityis thereby diminished. I had previous to 1899 operated upon 6 cases by thismethod, my first having been on March 9, 1896, at the NewYork Post-Graduate Hospital. This statement is madedefinitely because of the fact that American writers haverecently been accused (P. T. Diaknow, , Annals of Sur-gery, July, 1906) of not giving credit to Russian authorswhose first writings were according to Dr. Diaknow, by hi
. Abdominal hernia : its diagnosis and treatment. e median am quite partial to this method, but in some cases it cannotbe used on account of the extent to which the abdominal cavityis thereby diminished. I had previous to 1899 operated upon 6 cases by thismethod, my first having been on March 9, 1896, at the NewYork Post-Graduate Hospital. This statement is madedefinitely because of the fact that American writers haverecently been accused (P. T. Diaknow, , Annals of Sur-gery, July, 1906) of not giving credit to Russian authorswhose first writings were according to Dr. Diaknow, by him-self in 1898, and Dr. Sapiejhko (Annals of Russian Surgery) 376 ABDOMINAL HERNL\. in 1900. The truth is that every operator of good surgicalcommon sense would be very likely sooner or later to see hisopportunity of making a closure of tliis type, and without feel-ing that he had made any great discovery. Dr. Joseph of Xew York was perhaps tlie first to demonstrate tliemethnd properly by drawings showing its teclmique {Medical Fig. Vertical overlapping oi abdominal \^all in umbilical and ventral hernia. (Size ofincision exaggerated.) Record, }.Iay 25, 1901). His claims for it were as follows:(i) The doubling of the abdominal wall at the hernial site.(2) The breaking of the lines of suture. (3) The broad sur-faces for union. (4) The obliteration of the separation of therecti, and tlie reduction in the size of the abdomen. .\fter several years experience with this operation I feelthat the claims made for it are fully justified. The method is SURGICAL CURE: UMBILICAL. 377 executed as follows: After the removal of the sac, the lineaalba, with the peritoneum, is divided for one and a half or twoinches above and below the umbilical ring. The peritoneum isseparated from the abdominal wall on both sides to whateverdistance the overlapping can be done, and it is then closed inthe median line by a running suture of catgut. The denudedaponeurosis of the right side is slippe
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