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)

Upon the whole, I have no doubt that many lives rtiay
be saved by adopting the sollowing rules in the operation
for hernia,
Is the surgeon is not called till the bowels are evidently
in a Hate os mortisication, the method recommended by
authors is to be sollowed.
But is he is called in proper time, after trying in vain
the ordinary method os reducing the bowels, he ought to
operate more early than is commonly done, or besore the
inflammation can have produced aclhciion ; in which case
the operation, aster dividing the ikin, shouid confift mere-
ly in the taking oss the striclure by cutting the tendon.
In this case, aster the Ikin oppofite to the ring is cut, the
st riclure is to be taken oss by dividing the tendon ; aster
which the bowels may, by gentle prefiure, be returned
into the abdomen, without any danger os their sussering
by being twisted ; and the inslammation which sollows
the diviiion of the tendon, especially is the sides os the in-
cifion in the skin be joined by ftitches, will scarcely be
greater than where the skin alone is divided.
By the by, I would here observe, that the diviiion os
the tendon in the crural hernia is not attended with that
decree os dano-er which some os the lateft and moil emi-
nent writers have supposed *, providing the edge os the
knife be turned towards the umbilicus ; in which direc-
tion, both the epigaftric artery and spermatic cord are at
thu
* Pott, p. 308-