Edmund Owen

“ Sometimes there is complete absence of pain and tenderness in the hernia itself, and in an aged person all the symptoms may be very slight. Sooner or later, from eight hours to eight days, if the strangulation is unrelieved, the tumour becomes livid, crackling with gas, mortification of the bowel at the neck of the sac takes place, followed by extravasation of the intestinal contents into the abdominal cavity ”

“ Such a tumour is a constant source of danger: its contents are liable, from their exposed situation, to injury from external violence; it has a constant risk of increase; it may at any time become strangulated, or the contents may inflame, and strangulation may occur secondarily to the inflammation. ”

“ A person who is the subject of a reducible hernia should take great care to obtain an accurately fitting truss, and should remember that whenever symptoms resembling in any degree those of strangulation occur, delay in treatment may prove fatal. ”

“ The exciting cause of hernia is generally some over-exertion, as in lifting a heavy weight, jumping off a high wall, straining (as in difficult micturition) , constipation or excessive coughing. The pressure of the diaphragm above and the abdominal wall in front acting on the abdominal viscera causes a protrusion at the weakest point.
Rupture is either congenital or acquired. A child may be born with a hernia in the inguinal or umbilical region, the result of an arrest of development in these parts ”

“ Men suffer more frequently than women, because of their physical labours, because they are more liable to accidents, and because of the passage for the spermatic cord out of the abdomen being more spacious than that for the round ligament of the womb. ”

“ Matted or diseased omentum must be tied off and removed. Should peritonitis supervene after the operation on account of bacillary infection, the bowels should be quickly made to act by repeated doses of Epsom salts in hot water. ”