Case TIL?Fnkeer Chand, a Hindoo trader, aged 70 a very infirm old man, whs admitted on 11th November, 1871, with symptoms of strangulated, oblique inguino-serotal hernia on the left side. It was only of three months' duration be said, and was not very large. It had never before been obstructed ; the symptoms of strangulation, vomiting and constipation with pain in the tumour and abdomen, had set in twenty hours before admission. The ordinary measures?taxis under chloroform,enemata, ice applied to the tumour?having faded, the operation was performed. The stricture was found at the external ring, and was divided without opening the sac. He was immediately relieved of symptoms of strangulation, but sank on the 17th November, with symptoms of gangrene of the scrotum, and chronic dysentery. On examination it was found that the lungs were congested. There wns a fibrinous clot in the right auricle, extending into the ramifications of the pulmonary artery. The lower portion of the ileum was partially gangrenous, but not perforated. The scrotum was gangrenous. The kidneys were extensively diseased. He was a very infirm old man, and had no of reof the scrotum was probably caused, The grangrene covery. in his debilitated condition,' by the attempts at reduction by taxis before operation.

powkr

IY.?Nilmoney Paul, aged 45, a stout aged looking by occupation a clerk, had suffered from inguino-serotal hernia of the right side for five months; the tumour was verv large, and the hernia had previously been reducible. When the symptom* of strangulation set in, the hernia had been incarcerated for two days ; ir had come down when travelling Cast.

man,

the railway, and he could not reduce it. When I saw on 5th November, 1871, the symp'otns of strangulation urgent, and general peritonitis was setting in. I operated without delay, and had to divide thick layers of adipose tissue, before the strictu e which wns at the external ring, and in tlie canal at the margin of internal oblique and transversalis, was reached ; it was divided without oppning the The symptoms of strangulation were immediately relieved, sac. and the bowels acted freely, but he never rallied, and sank five hours after the operation. He was evidently of an unhealthy constitution, and had probably bad kidneys. No post-mortem was permitted. on

him

were

A MXREOR OF HOSPITAL PRACTICE. MEDICAL COLLEGE HOSPITAL. CASES

OF

STRANGULATED

Under the

care

HERNIA.

of J. Father, M.P., C.S.I.

Case T.?Modun Mohun, a Hindoo sircar, aged 45, was admitted on the 15th Mny. 1871, with symptoms of strangulated ohliqne, inguino-scrotal hernia on the right side. The hernia was of four years' duration, but hnd hitherto been reducible, and the present symptoms, pain in the tumour, which was very large, and in the umbilical region, constipation and constant vomiting, had set in about two hours before admission. His pulse The usual measures, chloroform and was weak and depressed. taxis, &c., having failed, the operation for strangulated hernia The stricture was found was performed without, further delay. to be at the external ring : it was divided, without opening the The wound was antiseptically sac, and the hernia reduced. dressed, healed rapidly, and he was discharged, cured, on 29th

June, 1871,

Case II.?Mohesh Clmnder Bose, a Bengalli, aged 55, a was admitted on the 13th September, 1871, with symptoms of strangulated oblique, ingnino-serotal hernia on the The hern:a was of fifteen years' duration, bad once right side. been strangulated before, but was reduced by taxis. The sympand toms, vomiting constipation, had been present for some time. All the ordinary measures for reduction having failed, the operation was performed. The stricture was found to be at the external ring, and was divided without opening the sac. The wound healed, and he is now well, and waiting to.hare the operation for the radical cure performed.

broker,