erally a success.

[124 MOTHERS' REMEDIES]

Strangulation Hernia or Rupture.--This means the rupture is so tightly
constricted that it cannot be returned into the abdominal cavity, and its
circulation is interfered with; then there is not only obstruction to the
passage of the feces, but also an arrest of circulation in the protruded
portion of bowel which, if not relieved, results in gangrene and death.
This occurs more often in old than in recent ruptures and more often in
congenital than in acquired rupture.

Symptoms.--Sudden and complete constipation with persistent vomiting. The
lump may be tense, hard and irreducible. Then there is faintness,
collapse; severe abdominal pain, complete constipation, with no gas
passing, then vomiting, at first of food, then of the bile-stained fluid
and finally of fluid with a bowel odor. All these symptoms increase and
the patient gradually sinks from exhaustion in eight or nine days, though
in very acute cases the patient may die within forty-eight hours.

MOTHERS' REMEDIES.--Strangulated Hernia, Hop Poultice for.--"A large warm
poultice of hops over the abdomen will be found one of the best known
means of relieving strangulated hernia."

PHYSICIANS' TREATMENT.--It must be reduced or an operation must be
performed and soon.

To reduce.--The patient is put under an anesthetic and placed on his back
with the hips (pelvis) raised and the thigh of the affected side flexed,
bent up and rotated inward if the rupture be inguinal or femoral. This
motion relaxes the parts. The neck of the sac is then seized with the
thumb and fingers of one hand, and thus fixed, while with the other hand,
the operator endeavors to return the strangulated gut by gentle pressure
in the proper direction. In femoral rupture, this is at first downward, to
bring the gut opposite the opening then backward and then upward. In groin
(inguinal) rupture it is usually slightly upward and outward. It must be
coaxed, kneaded and squeezed carefully. Care must be taken. If it cannot
be returned in from five to ten minutes no further time should be wasted,
but an operation should be performed immediately. This consists in cutting
down to the constriction and through it, thus allowing the rupture to be
reduced.

The patient should be kept in bed and treated the same way as for other
abdominal operations.

Caution.--Persons with rupture must be very careful not to lift or fall.
If a support is worn it must fit perf