THE OPERATIVE TREATMENT OF HERNIA WITH REPORT OF CASES.*

BY W. W. BECKETT, M. D., LOS ANGELES, CAL.

Of the twenty-five operations here reported for the radical cure for hernia twelve were for inguinal, ten for femoral, two for umbilical and one for ventral hernia. Nine cases were strangulated and two irreducible. In two resection of the intestine was made and Murphy button used. The youngest case was eleven weeks and the oldest seventy-five years old. Eight were under twelve years. Twelve were male and thirteen female. One case relapsed two months after operation, but was not large, and was easily controlled by a well fitted truss. Chromicized catgut was used in six cases. In other cases plain catgut was used for buried sutures and silkworm gut for closing the wound. Primary union took place in fifteen cases, in ten cases superficial

suppuration occurred.
In no case
was there prolonged suppuration. Sup-
puration by producing weak scar tissue
in place of normal union, is a prolific
cause of failure in operations for the
cure of hernia. Since the instruments,
suture material and dressing can be
thoroughly sterilized, the skin of the
patient or the hands of the operator is
usually responsible for the infection.
The patient should be given a full
bath on the day preceding the operation.
The seat of operation should be care-
fully shaved and a thorough local scrub-
bing given with green soap, and a
green soap poultice applied for from
three to four hours. This is taken off
and a moist bi-chloride dressing (1:3000)
applied and allowed to remain until the
patient is etherized. A final scrubbing

Presented, to the Southern California Med'c al Society, Pasadena, Dec. 7, 1899.