emity contained a portion of the small intestine instead
of the colon, which Wood considered the most frequent occupant. The
umbilicus was completely obliterated. Dade believed that this hernia
was caused by the weakening of the abdominal walls from a blow, and
considered that the protrusion came from an aperture near the umbilicus
and not through it, in this manner differing from congenital umbilical
hernia.

A peculiar form of hernia is spontaneous rupture of the abdominal
walls, which, however, is very rare. There is an account of such a case
in a woman of seventy-two living in Pittsburg, who, after a spasmodic
cough, had a spontaneous rupture of the parietes. The rent was four
inches in length and extended along the linea alba, and through it
protruded a mass of omentum about the size of a child's head. It was
successfully treated and the woman recovered. Wallace reports a case of
spontaneous rupture of the abdominal wall, following a fit of coughing.
The skin was torn and a large coil of ileum protruded, uncovered by
peritoneum. After protracted exposure of the bowel it was replaced,
the rent was closed, and the patient recovered.

CHAPTER XIII.

SURGICAL ANOMALIES OF THE GENITO-URINARY SYSTEM.

Wounds of the kidney may be very severe without causing death, and even
one entire kidney may be lost without interfering with the functions of
life. Marvand, the Surgeon-Major of an Algerian regiment, reports the
case of a young Arab woman who had been severely injured in the right
lumbar region by a weapon called a "yataghan," an instrument which has
only one cutting edge. On withdrawing this instrument the right kidney
was extruded, became strangulated between the lips of the wound, and
caused considerable hemorrhage. A ligature was put around the base of
the organ, and after some weeks the mass separated. The patient
continued in good health the whole time, and her urinary secretion was
normal. She was discharged in two months completely recovered. Price
mentions the case of a groom who was kicked over the kidney by a horse,
and eighteen months later died of dropsy. Postmortem examination
showed traces of a line of rupture through the substance of the gland;
the preparation was deposited in St. George's Hospital Museum in
London. The case is singular in that this man, with granular
degeneration of the kidney, recovered from so extensive a lesion, and,
moreover, that he remained in perfect health for over a ye