Case 1.
Case 1 A. G.--Italian child, age twenty-eight months, female. (Ass.
Civ. Char. Disp.) Umbilical hernia protruding about one-half inch and
with an opening which may be filled by tip of index finger.
Parts thoroughly sterilized, hernia reduced and contents held in
abdominal cavity by pressure of index finger of assistant. The margins
of ring and the skin covering hernial opening injected with paraffin
of melting point 108. In effort to avoid puncturing of hernial sac and
throwing paraffin into the peritoneal cavity the skin of sac injected
with the paraffin. About half dram amount used. Operation Jan. 17,
1905. Jan. 18, 1905. Temp. normal. Parts sensitive. Cries and
struggles when parts touched. May 13, 1905. Last examination. Skin
somewhat red. Paraffin mass easily palpable. Skin red but not
sensitive.
Case 2.
Case 2 A. C. C.--Disp. W. P. Swedish boy, age 2 years and 9 months.
Injected Feb. 3, 1905. Hernia as large as walnut. Reduced. Finger of
assistant holding in contents. Injection made into tissue surrounding
the hernial opening with view of crowding margins together. Half dram
injected. Child crying forced contents into sac. Reduced and injection
under skin of sac and around margins of opening to plug. Nearly dram
paraffin used, melting point 108.
Parts moderately sensitive at end of week. No redness though paraffin
mass palpable close under skin and intimately connected with it. April
11, 1905. Last examination. No redness, no tenderness, no recurrence.
Case 3.
Case 3 T. F.--Teamster. Irish parentage. Age 20. A. C. C. Disp.
Bubonocele, left side. First noted four weeks previously. Operation
May 14, 1905. Area sterilized. Small area of skin infiltrated with a
one percent solution of cocain. Paraffin melting point 108, injected
over area of prominence of bubonocele and into upper portion of canal.
Two punctures made a dram and a half of paraffin injected. Parts
sensitive for three days so that patient walked without bending thigh
at hip joint. No temperature. Local applications. Codeine given in
quarter grain doses every two hours. Fourth day parts much less
sensitive, can bend leg freely in sitting or walking. Area prominent
from swelling but no impulse. Examination June 25, 1905. No pain, no
tenderness, no impulse, prominence in region of internal ring slightly
greater than on opposite side.
Case 4.
Case 4 A. P.--Sicilian. Worker in shoe factory. Age 24. Hernia four
months duration. Never retained by truss. Sac extends half way to
bottom of scrotum. Pubes shaved, skin sterilized. Operation Aug. 26,
1905. Skin infiltrated to allow passage of large needle without pain.
Injection at internal ring of forty minims. Injections into canal of
about thirty minims. In attempting to inject paraffin in cold state
screw piston syringe broken. All metal syringe used for infiltrating,
warmed and filled with melted paraffin. In using syringe to inject the
canal near the external ring the needle plugged. Using all force
possible the plug forced from needle and over a dram of melted
paraffin thrown between the pillars of the external ring. Patient
complained of considerable pain. Codeine used one-fourth grain every
hour. On the third day after injection skin over the external ring
infiltrated and with sharp spoon about a half dram of paraffin
removed. Operation painless. Formaldehyde solutions one to five
thousand used as moist dressings. Codeine continued for two days
longer. Patient lost one week from work. Sept. 24, 1905. No
recurrence, no pain or tenderness. Area at former site of hernia
slightly more prominent than opposite side, no redness of skin.
Case 5.
Case 5 F. C.--American born, age 18. Private patient. Hernia about
size of average marble midway between ensiform cartilage and
umbilicus. Spontaneous origin. Injected at office with half dram of
paraffin, melting point 115. Operation Dec. 2, 1905. About half dram
total quantity used. No reaction when adhesive strip removed on fourth
day. Slightly tender on pressure. Examination Feb. 7, 1906. No
recurrence, no redness, no pain.
Case 6.
Case 6 J. C.--Italian barber. A. C. C. Disp. Inguinal hernia on right
side. Noted three weeks before. Sac protruding through external ring.
Injection after infiltration. Forty minims injected about internal
ring. Twenty minims in canal. Twelve or fifteen minims thrown between
the pillars of external ring. Codeine prescribed but not taken. Parts
quite sensitive on third day. No fever. Sleeps well with two pillows
under thigh of affected side. Fifth day, no pain, tenderness very much
less, able to bend leg almost as freely as ever. Twelfth day impulse
at internal ring? (Questionable.) Injection of twenty minims at
internal ring, ten into canal and ten between pillars, melting point
104. March 4, 1906. Last examination. No recurrence, no pain or
tenderness.
Case 7.
Case 7 A. Y.--Femoral hernia. Female, age 35, A. C. C. Disp. Worker in
tailor shop. History of case indefinite as to length of time present.
Never been treated in any way. Operation March 21, 1906. Injection of
forty minims of paraffin through saphenous opening and about ten
minims through Poupart's ligament. Codeine discontinued at end of
fourth night. Tenderness slight. No recurrence at end of twenty days.
Patient not seen subsequently.
Case 8.
Case 8 E. H.--Marshalltown, Iowa. Private patient. American born.
Varicocele on left side and oblique inguinal hernia. Operation April
16, 1906. Infiltration and removal of dilated veins in scrotum. Wound
closed and inguinal canal followed by large needle. No blood aspirated
and cold paraffin mixture with melting point 115 injected along canal.
About forty minims thrown along canal and then puncture made at site
of internal ring and half dram diffused at this point.
Personal communication one year later making final payment for
operation. Patient cured and grateful.
Case 9.
Case 9--Italian section worker wearing spring truss for holding of
inguinal hernia. Strong pressure of truss making marked depression at
site of internal ring. Patient injected with dram and half of paraffin
of melting point 115. May 20, 1906. Agent deposited along canal and at
internal ring. One week later no pain, no tenderness to moderate
pressure. Cord somewhat larger than normal and epididimus thickened
but not tender. Shreds in urine. Through interpreter information
gleaned that epididimus had been somewhat tender following operation.
History of acute epididimitis some months before.
Case 10.
Case 10 A. J.--Patient first consulted at Harvey dispensary. Treated
for urethral stricture by internal urethrotomy. Subsequently
referred to A. C. C. Disp. for treatment. Developed acute appendicitis
and operation for removal after development of abscess. Abscess
drained and healing of abdominal incision imperfect leaving hernial
protrusion internally and near superior angle of scar. Injected with
seventy minims of paraffin, 115 melting point, on Aug. 2, 1906. No
pain following injection, no discoloration, and no recurrence over a
year and a half after operation.