_Inflammation of Hernial Sac._
The previous report of this case (Gazette, No. 51) conducted it to
Nov. 18th, the tenth day from the operation, and the third on which
fæces had been discharged from the wound; that discharge continued
on the 19th, but on the 20th pus only was seen.
Nov. 22.--Yesterday the dresser, Mr. King, observed a portion of
_solid_ fæces make its escape, and to-day a similar discharge, in
the fluid form, is manifest.
Nov. 26.--Since the 22d, nothing but healthy pus has been seen; the
wound is rapidly healing, and the patient's general condition as
good as can be desired.
Dec. 4.--He has begun to wear a truss, and is to-day allowed to
leave his bed.
Dec. 8.--As regards his original complaint, the man is perfectly
convalescent, but he now discloses a small abscess in the scrotum,
which has been gradually forming, and will detain him in the house
some time longer.
If it be a sound surgical maxim that, in strangulated hernia,
the patient's safety depends upon an early operation, it is also
a maxim no less sound, that where the evidence and symptoms of
strangulation are imperfect, or dubious, the benefit of the doubt
should be given to the operation, and it should be performed: for
it is better that buboes should be laid open, or inflamed sacs cut
into, twenty, aye, fifty times in succession, than that in one case
a man should be suffered to die with strangulation of the intestine
unrelieved.
These remarks apply strikingly to this case of Mr. Key's, in which,
although no hernia was found, they perfectly justify the operation.
No case of strangulation could be more distinctly marked, or
more clearly call for the knife, than did this; and had Mr. Key
refused to use it, he would have deserved the scoff which, by a
contemporary, has so preposterously been thrown on the "no hernia
case." But, more than this, the operation was not only justifiable,
but beyond a doubt _beneficial_--beneficial inasmuch as it at
once relieved the distress of the patient, secured him from more
extensive suppuration, from farther sloughing of intestine, and
probably from extravasation of fæces into the abdomen; rendering
also the process of reparation more easy and rapid.
_Hereditary Hare-Lip._
Dec. 4th, Mr. Key performed the operation for hare-lip on a child
a few months old, whose case was remarkable only as it afforded an
instance of _hereditary_ malformation. The father of the child had
congenital hare-lip, for which no operation had been performed, and
of his six children _two_ were born with the same malformation.
_Queries._--1. If the father's lip had, in his infancy, been
restored to the natural form, would the malformation in that case
have descended to his children?
2. Is the casualty in these cases to be traced _directly_ from
the father to the incipient embryo, or _indirectly_, through the
medium of the mother's imagination--It has been said that paternal
resemblances are produced in the latter mode.