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Updated: June 12, 2025
He was not the stalwart fellow he had been, but looked bowed down as if by a premature old age. I asked him why he had left his regiment. 'Hernia, sir; hernia and pulmonary consumption, I had promised this man a hiding thirteen years ago, and thirteen years ago I am persuaded he had richly merited it, and am quite sure it would have done him good.
Intestinal fistulæ are sometimes met with in the abdominal wall after strangulated hernia, operations for appendicitis, tuberculous peritonitis, and other conditions. In the perineum, fistulæ frequently complicate stricture of the urethra. The treatment of these various forms of fistula will be described in the sections dealing with the regions in which they occur.
An oval swelling forms in the upper part of the thigh, is soft and prominent when the muscle is relaxed, less prominent when it is passively extended, and disappears when the muscle is thrown into contraction. It is liable to be mistaken, according to its situation, for a tumour, a cyst, a pouched vein, or a femoral or obturator hernia.
The affection is frequently bilateral, and may be associated with lymph scrotum, with elephantiasis, and with chyluria. The diagnosis is to be made from such other swellings in the groin as hernia, lipoma, or cystic pouching of the great saphenous vein. It is confirmed by finding the recently dead or dying worms in the inflamed lymph glands. Treatment.
Next, the forehead closes and the hernia retreats, leaving visible only a kind of shapeless muzzle. In short, a frontal pouch, with deep pulsations momentarily renewed, becomes the instrument of deliverance, the pestle wherewith the newly hatched bluebottle bruises the sand and causes it to crumble. Gradually the legs push the rubbish back and the insect advances so much toward the surface.
On looking into the abdomen he perceived a black object, whereupon he introduced his hand and extracted piecemeal an entire fetal skeleton and some decomposed animal-matter. The abdomen was bound up, and in six weeks the woman was enabled to superintend her domestic affairs; excepting a ventral hernia she had no bad after-results.
We have here, then, in the position of the testes in Mammalia a condition which is not in the slightest degree 'adaptive' in the ordinary sense that is, fulfilling any special function or utility. The condition must be regarded as distinctly disadvantageous, since the organs are more exposed to injury, and the abdominal wall is weakened, as we know from the risk of scrotal hernia in man.
There were eighteen eye cases and nineteen ear cases, three nose, and eighteen of the throat. Of the circulatory system the total was sixty-eight of which twenty-two were heart trouble and thirty-one hemorrhoids brought on by exposure. There were eighty respiratory cases, ninety-three digestive cases, of which sixteen were appendicitis and thirty-two were hernia.
The other two, who were both young men, had still pain and strength sufficient for further venesection, and they neither of them had any appearance of hernia, both recovered by repeated bleeding, and a scruple of calomel given to one, and half a dram to the other, in very small pills: the usual means of clysters, and purges joined with opiates, had been in vain attempted.
In a limb this interferes with the functions of the muscle; in the abdominal wall the scar tissue may stretch, and so favour the development of a ventral hernia. Tendons may be cut across accidentally, especially in those wounds so commonly met with above the wrist as a result, for example, of the hand being thrust through a pane of glass.
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