Rupture Hernia
Rupture may be produced by severe exercise on horseback or on foot, by lifting heavy weights, playing on wind instruments, vomiting, costiveness, whooping-cough, crying, tight clothing, jumping, etc.
In many cases it can be cured by internal remedies, when it has not been neglected too long. Trusses have been greatly improved in this country, but bad articles are still common. It is of great importance to get a good truss, for a bad one may do great injury; if it does not fit exactly, or if it slips, it may make the rupture incurable. A good truss must not be troublesome, although in the beginning it may feel rather uncomfortable; it must not be applied until the hernia has been entirely reduced, when the truss ought to keep it in its position. If the patient perceives, after the instrument has been applied, that something protrudes, let him take it off, lie down upon his back, reduce the hernia again, and replace the truss. When the hernia protrudes frequently, the truss is good for nothing. A person afflicted with hernia, who does not wear a truss, or who wears a bad one — who exerts himself afterwards too much, or is otherwise imprudent — exposes himself to the danger of having incarcerated or strangulated hernia, and mortification following. It is also of great importance to know how a hernia should be reduced.
In order to accomplish this properly, the patient should lie down on his back, and place a pillow under the hips, so that the ruptured part may be higher than the rest of the abdomen — he should then incline a little to the side on which the rupture appears, to relax the abdominal muscles as much as possible, remain perfectly quiet, and avoid all motion. If the proper medicines are taken the hernia will generally return of itself during sleep without external aid. If it does not become thus reduced, it can be better done by another person, though many are able to reduce it for themselves; it is best done by pressing the left hand gently against the part which protrudes, as if for the purpose of grasping it; after this, press the fingers of the right hand on the top, and then rub it lightly, by passing the fingers over it; place the flat of the hand from time to time on it, and gradually increase the pressure; continue these efforts patiently for half an hour, or longer, if the hernia is considerable. Most kinds of strangulated hernia can generally be reduced with facility, after the proper remedies have been taken, particularly Aconitum or Nux vomica. When the hernia will not bear pressure, medicine must first be taken to remove the irritability — after which it frequently returns of itself. In some case, placing a cloth dipped in warm water upon the tumor will effect the reduction. Some persons apply cold water or ice in a calf’s bladder, but this should not be kept on long and should not be used at all when the parts are hot and red.
