. Surgery, its principles and practice . ernia should besubjected to operation, unless there bestrong contraindications, e. g., the coexist-ence of organic trouble of the kidney orheart, the advanced age of the patient, orthe great size of the hernia. In those casesin which operation seems unwise, ourefforts should be directed toward prevent-ing further increase in the size of thehernia and toward securing the greatestamount of comfort for the patient. Inmany cases all that we can do is to adjusta well-fitting scrotal bag, made of canvasor some other unyielding material, whichis held firmly ag
. Surgery, its principles and practice . ernia should besubjected to operation, unless there bestrong contraindications, e. g., the coexist-ence of organic trouble of the kidney orheart, the advanced age of the patient, orthe great size of the hernia. In those casesin which operation seems unwise, ourefforts should be directed toward prevent-ing further increase in the size of thehernia and toward securing the greatestamount of comfort for the patient. Inmany cases all that we can do is to adjusta well-fitting scrotal bag, made of canvasor some other unyielding material, whichis held firmly against the body by a strap ^^encircling the pelvis and supported byanother strap from the shoulders. In infants or young children a worstedor yarn truss has been highly recommendedby some writers. We have given it an ex-tensive trial at the Hospital for Ruptured and Crippled, and discarded itfor the reason that it is less efficient than the spring truss and much lesscleanly. There is no better truss than a well-tempered spring truss, and. Fig. is.—The French Truss forFemoral Hernia. TREATMENT OF HERNIA. 33 if such truss is properly fitted, it causes no more discomfort to the infant tlianthe worsted truss. The truss should be apphed as soon as possible after thediscovery of the rupture, no matter how young the infant. Although thereis a tendency at present toward extending operative treatment to an earlierand earUer period of hfe, some surgeons advocating operation upon theyoungest infants, I beheve such practice unwise. My reasons are:(1) That a large number of infants and young children under the age ofone to two years are permanently cured by mechanical treatment; hence,if all cases below tliis age were operated upon, many unnecessary opera-tions would be performed. (2) Operation in infants and very youngcMldren is attended with a higher mortahty, as the statistics of Stilesand others have shown. I beheve that operation is seldom indicatedunder the age of four years, althoug
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