are no fleshy fibres. In thefe cafes, any compreffion almoft of the abdomen, will give rise to a rupture in this paffage.

SYMPTOMS.

The fymptoms of both

thefe ruptures are much the fame as in the preceeding cafe. A fmall tumour gradually augmenting, appears in the groin, annuli or fcrotum; a dull pain in the abdomen from the diftraction of its contents, and in the paffage from its preternatural dilatation. All thefe may happen with or without any frangulation of the inteftins. If the volume of the inteftins or epiploon be great, or the paffage very narrow, they will be pinched, or the faces will be intercepted, and a gangrene may enfue.

DIAGNOSTICs. The rupture either at the annuli, or crural arch, is immediately discovered by the fight or touch; the other diagnostics are the fame as in the preceding fpecies of rupture.

PROGNOSTICs. This diforder is rarely dangerous, if the inteftins be not pinched; but in this cafe, the illiac paffion, gangrène, and death may fupervene.

CURE. In adults, the operation is requifite; but feldom or never in children, through

through the weak and yeilding texture of their folids. Therefore the rupture is to be reduced in both the prefent cafes, in the manner mentioned in the biernia umbilicalis. But if this cannot be done without difficulty, let the tumour be fomented as in the above cafe; nay, if the refiftance be still great, the phyfician may order venefcetion, and an anodyne cataplafm to prevent inflammation. The parts being reduced, they are to be retained by a proper bandage. That commonly intended for children is the Spica. But as it should be frequently renewed, being very fubject to become dirty, fo fome prefer the ordinary bandage of adults, which is furnished with a kind of ball or button, to compress and ftrengthen the paffage but this is fit only for children who walk, and are pretty old. Befides thefe precautions, the child should keep his bed for forty days, nor should he cry, leap, &c. To the rupture may be alfo applied the plaifter against the rupture, or the above-mentioned cataplafm of comfrey. The patient should also take some aftringent strengthening remedies internally, as a glass of the decoction of rupture wort, or folomon's feal, or two ounces of

:

their juices, to which add a little fugar or fyrup. Six ounces of their decoction may be exhibited.

The powders of these aftringents may be also exhibited, or the powder of tormentill root, all which are gentle aftringents. These are given in the patient's foup, broth, pap,

c. But a remedy which is much more efficacious than all these, and which has done miracles in this cafe, is, dulcified fpirit of falt, given in the patient's ptifan, till it is gratefully acid, or to five drops only to younger children. Another celebrated specific in this disorder, and which is met with in the works of moft modern French physicians, is the remedy of the prior of Cabriaire, with which he is faid to have cured vaft numbers .of

ruptures; but these great effects are, I believe chymerical, and the fame of his remedy is rather owing to the ignorance of those who used. it, than to its real efficacy; for in the provinces of France where this is mostly in esteem, every patient strives to conceal this imperfection, under the colour of an effectual cure; for fear of miffing a good wife or husband.

CHAP.

CHA P. XXI.

Of the RUPTURE by congeftion, or of the

TH

HYDROCELE.

HIS is a watery tumour most commonly feated in the fcrotum, or betwixt this and the tefticles, but is no genuine rupture. The only tumour of this kind, which merits the name of an hernia, is a collection of water in the tunica vaginalis of the testicles. In order to explain this tumour, it will be neceffary to give a fhort description of these parts. The tunica vaginalis then is naturally very smooth on its internal furface, nor does it adhere to the testicles but on its pofterior part, or on the epididymides or paraftatæ; but it gently touches on the surface of the testicles in all

its other parts; fo that it may be compared to the pleura with regard to the lungs. Betwixt this and the tefticles, or their proper coat, is fecerned a fmall quantity of serum, which is intended to lubricate them, and facilitate their motion; but this ferum in the

natural

natural ftate is abforbed in the fame proportion in which it is fecerned. In this cafe, on the contrary, it is more abundantly fecerned than abforbed; as alfo in the pneumatocele. Hence this ferum is collected by degrees, till it forms a fenfible tumour; fo that the causes of the diforder are all fuch circumstances as hinder the abforption of this ferum, and these are various; as, 1. A bandage which compreffes the fpermatic veffels, fo that the return of the lymph of the testicles is impeded. 2. Obftructions in the glands of the groin, or in those which are placed about the fpermatic veffels; whereby these are compreffed, or the paffage of the lymph through thefe glands obftructed. 3. The varices of the veins in the corpus pampiniforme, which is compofed of many complications of the fpermatic veins. Thefe varices happen through the weakness of these veffels, and hanging down of the tefticles by the relax ation, or inactivity of the mufculus cremaster, or by the constant cries of the infant, whereby the abdomen is continually compressed.

SYMPTOMS. No fymptom is more remarkable or worth our notice in this diforder, than the tumour of the scrotum, which