upture cannot be returned, it is
called irreducible and is a more serious form. The great danger of
hernias is the likelihood of their being strangulated, as the term is;
that is, so nipped in the divided abdominal wall that the blood
current is shut off and often the bowels are completely obstructed. If
this condition is not speedily relieved death will ensue in from two
to eight days. Such a result is occasioned, in persons having rupture,
by heavy lifting, severe coughing or straining, or by a blow or fall.
The symptoms of strangulated hernia are sudden and complete
constipation, persistent vomiting, and severe pain at the seat of the
rupture or often about the navel. The vomiting consists first of the
contents of the stomach, then of yellowish-stained fluid, and finally
of dark material having the odor of excrement. Great weakness,
distention of the belly, retching, hiccough, thirst, profound
exhaustion, and death follow if the condition is not remedied. In
some cases, where the obstruction is not complete, the symptoms are
comparatively milder, as occasional vomiting and slight pain and
partial constipation.

If the patient cannot return the protrusion speedily, a surgeon should
be secured at all costs--the patient meanwhile lying in bed with an
ice bag or cold cloths over the rupture. The surgeon will reduce the
protrusion under ether, or operate. Strangulation of any rupture may
occur, but of course it is less likely to happen in those who wear a
well-fitting truss; still it is always a dangerous possibility, and
this fact and the liability of the rupture's increasing in size make a
surgical operation for complete cure advisable in proper subjects.

=Treatment.=--Two means of treatment are open to the ruptured: the use
of the truss and surgical operation. By the wearing of a truss,
fifty-eight per cent of ruptures recover completely in children under
one year. In children from one to five years, with rupture, ten per
cent get well with the truss. Statistics show that in rupture which
has been acquired after birth but five per cent recover with a truss
after the age of fifteen, and but one per cent after thirty. The truss
must be worn two years after cure of the rupture in children, and in
adults practically during the rest of their lives. A truss consists of
a steel spring which encircles the body, holding in place a pad which
fits over the seat of hernia. The Knight truss is one of the best. The
truss is most