Anomalies and Curiosities of Medicine [417]
but various other organs, such as the spleen, liver, etc. In some monsters all the abdominal contents are contained in the hernia. Infantile umbilical hernia is common, and appears after the separation of the umbilical cord; it is caused by the yielding of the cicatrix in this situation. It never reaches a large size, and shows a tendency to spontaneous cure. Adult umbilical hernia rarely commences in infancy. It is most commonly seen in persons with pendulous bellies, and is sometimes of enormous size, in addition to the ordinary abdominal contents, containing even the stomach and uterus. A few years since there was a man in Philadelphia past middle age, the victim of adult umbilical hernia so pendulous that while walking he had to support it with his arms and hands. It was said that this hernia did not enlarge until after his service as a soldier in the late war.
Abbott recites the case of an Irish woman of thirty-five who applied to know if she was pregnant. No history of a hernia could be elicited. No pregnancy existed, but there was found a ventral hernia of the abdominal viscera through an opening which extended the entire length of the linea alba, and which was four inches wide in the middle of the abdomen.
Pim saw a colored woman of twenty-four who, on December 29, 1858, was delivered normally of her first child, and who died in bed at 3 A.M. on February 12, 1859. The postmortem showed a tumor from the ensiform cartilage to the symphysis pubis, which contained the omentum, liver (left lobe), small intestines, and colon. It rested upon the abdominal muscles of the right side. The pelvic viscera were normally placed and there was no inguinal nor femoral hernia.
Hulke reports a case remarkable for the immense size of the rupture which protruded from a spot weakened by a former abscess. There was a partial absence of the peritoneal sac, and the obstruction readily yielded to a clyster and laxative. The rupture had a transverse diameter of 14 1/2 inches, with a vertical diameter of 11 1/2 inches. The opening was in the abdominal walls outside of the internal inguinal ring. The writhings of the intestines were very conspicuous through the walls of the pouch.
Dade reports a case of prodigious umbilical hernia. The patient was a widow of fifty-eight, a native of Ireland. Her family history was good, and she had never borne any children. The present dimensions of the tumor, which for fifteen years had been accompanied with pain, and had progressively increased in size, are as follows: Circumference at the base, 19 1/2 inches; circumference at the extremity, 11 1/4 inches; distance of extremity from abdominal wall, 12 3/4 inches. Inspection showed a large lobulated tumor protruding from the abdominal wall at the umbilicus. The veins covering it were prominent and distended. The circulation of the skin was defective, giving it a blue appearance. Vermicular contractions of the small intestines could be seen at the distance of ten feet. The tumor was soft and velvety to the touch, and could only partially be reduced. Borborygmus could be easily heard. On percussion the note over the bulk was tympanitic, and dull at the base. The distal extremity 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
Abbott recites the case of an Irish woman of thirty-five who applied to know if she was pregnant. No history of a hernia could be elicited. No pregnancy existed, but there was found a ventral hernia of the abdominal viscera through an opening which extended the entire length of the linea alba, and which was four inches wide in the middle of the abdomen.
Pim saw a colored woman of twenty-four who, on December 29, 1858, was delivered normally of her first child, and who died in bed at 3 A.M. on February 12, 1859. The postmortem showed a tumor from the ensiform cartilage to the symphysis pubis, which contained the omentum, liver (left lobe), small intestines, and colon. It rested upon the abdominal muscles of the right side. The pelvic viscera were normally placed and there was no inguinal nor femoral hernia.
Hulke reports a case remarkable for the immense size of the rupture which protruded from a spot weakened by a former abscess. There was a partial absence of the peritoneal sac, and the obstruction readily yielded to a clyster and laxative. The rupture had a transverse diameter of 14 1/2 inches, with a vertical diameter of 11 1/2 inches. The opening was in the abdominal walls outside of the internal inguinal ring. The writhings of the intestines were very conspicuous through the walls of the pouch.
Dade reports a case of prodigious umbilical hernia. The patient was a widow of fifty-eight, a native of Ireland. Her family history was good, and she had never borne any children. The present dimensions of the tumor, which for fifteen years had been accompanied with pain, and had progressively increased in size, are as follows: Circumference at the base, 19 1/2 inches; circumference at the extremity, 11 1/4 inches; distance of extremity from abdominal wall, 12 3/4 inches. Inspection showed a large lobulated tumor protruding from the abdominal wall at the umbilicus. The veins covering it were prominent and distended. The circulation of the skin was defective, giving it a blue appearance. Vermicular contractions of the small intestines could be seen at the distance of ten feet. The tumor was soft and velvety to the touch, and could only partially be reduced. Borborygmus could be easily heard. On percussion the note over the bulk was tympanitic, and dull at the base. The distal extremity 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