The surgical anatomy of the groin, the femoral, and popliteal regions / by Thomas Morton ... illustrated with lithographic plates and wood engravings.

  • Morton, Thomas, 1813-1849.
Date:
1839
Catalogue details

Licence: Public Domain Mark

Credit: The surgical anatomy of the groin, the femoral, and popliteal regions / by Thomas Morton ... illustrated with lithographic plates and wood engravings. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

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    aponeurosis of the external oblique, draws it downwards into the centre of the upper part of the thigh, in order to obliterate the angle which is formed between the fundus and neck of the swell- ing. When this has been done, lie steadies the parts about the neck of the sac with the fingers of the left hand, while he makes a gentle but gradually increasing pressure upon the whole of the contents of the hernia with his right hand. The direction of this pressure upon the tumour should be (when the angular re- flection of it described has been effaced) upwards, with a slight inclination outwards, so as to avoid compressing the contents of the sac against the spine of the pubis and Gimbernat’s liga- ment. If there be any gurgling sensation perceived in the tumour during the employment of the taxis, it is an encourage- ment to continue in our efforts to reduce the intestine, as it probably arises from the passage of some of the fluid and gase- ous contents of the gut from the strangulated into the un- affected part of the alimentary canal. It is much better to main- tain the pressure gently for a considerable time, than to act with more haste and to employ a greater degree of force, in a shorter period. Moving the neck of the tumour a little from one side to the other, and endeavouring to draw it outwards, as it were, sometimes prove very useful in altering the exact relations of the strictured part of the bowel to the neck of the sac, and in this manner facilitate the return of a portion of its contents, after which the whole will in general quickly follow. I have known the taxis to succeed almost immediately in a great number of cases sent into the hospital for the express purpose of being submitted to the operation with the knife, and in which the first attendants had tried the taxis most indefatigably for an unusual length of time, but without success, simply because the patient had not been placed in that position which is most favourable to effect the relaxation of the structures attached to and composing the crural arch. It is extremely injurious to persevere very long in the employment of the taxis, as it it can be readily ascertained by any one who is qualified to estimate the resistance, whether there is any likelihood of the hernia being reduced without a previous division of the stricture; indeed, it is the deli- berate opinion of many of the best writers in surgery, that the taxis has been productive of much more harm than good, in consequence of the long-continued and persevering efforts to re-