old by other physicians, Jealous at your success,
not to go to your place, but I am now more than pleased that I
disregarded their advice.

E.A. BROWN,
Corfu, N.Y.

* * * * *

RUPTURE. (BREACH OR HERNIA.)

By the term _Hernia_, we mean a tumor, which is formed by the
displacement of the intestines, the omentum (covering of the bowels), or
both, and which protrudes from the abdominal cavity. The most common
varieties are _umbilical, inguinal_ and _femoral_ hernia. Children are
most subject to umbilical, males to inguinal, and females to femoral,
hernia.

[Illustration: Fig. 1.
Indirect Inguinal Hernia.

Sketched from a case subsequently
cured by our improved method
of treatment. ]

CAUSES. These are either _predisposing_ or _exciting_. Any thing which
occasions general or local muscular debility, as dropsy, pregnancy,
abscesses, wounds, obstructions to natural evacuations, etc., is a
predisposing cause of hernia. The exciting cause is pressure applied to
the contents of the abdomen, as straining in evacuating the bowels and
bladder, lifting heavy weights, or violent physical exertion.

SYMPTOMS. The only characteristic symptom of hernia is the presentation
of an elastic, or doughy tumor of variable size, which either gradually
or suddenly makes its appearance. There is flatulence, uneasiness, and
sometimes pain in the abdomen.

Sharp and dull pains frequently recurring and confined to the locations
where ruptures appear should receive attention. Examination will not
infrequently reveal a small enlargement. If a hernia, this will usually
disappear after a night's rest and may not be again noticed until the
next day, or for several days. On coughing, with the finger applied to
the enlargement, a sensation of an impulse (succussion), or slight
additional protrusion will be felt

The trouble appears at any time of life, an analysis of seventy thousand
cases indicating that it is most common in debilitated persons, and that
there is a constant decrease in the frequency of the affection from the
first to the thirteenth year, after which rupture is more and more
frequently met with as age advances.

[Illustration: Fig. 2.

This figure illustrates a case of Femoral
Hernia which was radically cured by our
improved method. This tumor is a little
lower on the thigh than in cases of inguinal
hernia. Femoral Hernia is most common
to females, and inguinal in males.]