Monro, Alexander: Observations On Crural Hernia: To Which Is Prefixed, A General Account Of The Other Varieties Of Hernia: Illustrated By Engravings (Edinburgh [u.a.], 1803)

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If it be certain that the bowels are mortified, the new
cessity of opening the sac is evident, that we may give our
patient a chance of life, though to be attended with moll
uncomfortable circumstances : But if there be the small-
est chance that the inssammation may terminate without
mortification, it is equally certain that nothing can be fo
pernicious as opening the sac, and that the bowels ought
to be returned without exposing them to the air.
To make this more evident, I shall suppose that the
bowe^ cannot be reduced by taxis, or that the operation
is necesiary in two hundred patients ; and that in one
fourth part os the number, the bowels are so much st ;an-
gulated and inssamed, that the termination in a mortifica-
tion could not by any means be prevented, but that in the
other three fourths there is a probable chance that the in-
flammation may be dispersed.
If the operation be done in all these cases by opening
the sac, it is probable that of the first fifty we may lave
one or two in all ; and of the other hundred and fifty,
thirty or forty at the utmost. Whereas, if we suppose
that in all these patients the skin and tendon only are di-
vided, and the bowels reduced without opening the sac,
we should indeed lole all those in whom the mortification
was complete : but I am well convinced we should not
lose above ten or twenty at most of the other hundred and
fifty ; and that upon the whole many more lives would
be saved.
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