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Show 1111111 1&2 or Hrnnoane, 1.111) THE CURE BY INJECTION. point a little upward in'the direction of the outline B, so at the membranes, which will be excited to inflammation by a much slighter irritation. The injection is returned much changed in colour and very turbid. The most serious accident which can hapocn from the operation, is the injection of the stimulating; 11'111'1‘111 into the cellular substance. This is an accident which I have seen wry frequently happen, even in the hands of dcxterous 5111'; 1 to avoid the surface of the testicle A, and pass into the upper space of the hydrocelc. Further, if, as sometimes happens, the head of the stiletto (a) is larger than the canula, it is apt to pierce with a jerk deeper than the surgeon intended, because it may take some force to pierce the vaginal coat in its thickened state. To avoid this, the instrument may be held as is represented in the first plan, where it is made to rest against the fore-finger, in introducing it ; and is mov 111 by the hall of the thumb along the tine-linger, at the same time that it pierces the scrotum. If the hydroccle is small, and it does not appear that the instrument can be far within the sac (perhaps the canula has just pierced it), then, instead of withdrawing the stiletto with a motion of the thumb, the canula is pushed forward further into the sac, whilst the stilctte is at the same time withdrawn. Having withdrawn the stilctte, and allowed the water to flow, we have to knead the sac softly, and raise the lower part of it, so as to evacuate the whole. Here the operation terminates as a palliative remedy. 30W But if it be intended to inject the hydrocele, we need not be particular in evacuating the last drop. \Ve should rather, in that case, be careful to feel that the extremity of the ca: nula is within the sac, and that it remains there, while we ex. amine the state of the testicle. Though it be somewhat onlargcd, this is common to the disease ; but if large, hard, irregular, and painful, we may withdraw the canula, for the operation should not be performed in these circumstances. The assistant ought to bring the injection bag, and support it, so that the surgeon have only 113 turn the nosle of it into the canula, without moving his left hand. 1.11;, 1 think that I have ascertained in two inst 1.1; a, 111.1; 1:1is proceeded from the defective form of the int ‘uinenh ln pressing out the fluid, the end of the canula na1 ~11 3d upon the 5mface of the testicle,in consequence oi 11111111 th. siit 11nd small hole in the canula which had not passed into the =1 of the sac, giving a passage to the injection, it filled the cell 11lar membrane. On this account, and from the case with which it enters, and the firmness with which it remains in the vaginal coat, when the stiletto has been withdrawn, I have little heitation in preferring the old circular £01111 of the canu~ la, with the triangular pointed stilette, to any of the more recent inventions. When the fluid has got into the cellular membrane, I have seen very high inflammation of the scrotum, v ith fever, and violent pain in the course of the cord, and in the Joins, followed by suppuration and bursting of the scrotum, and a drip- piner discharge of serum, with curdy tlakes This accident may happen in a slight digice to the most exp!11 01101111111. But heis much to biame if he be not awai1, of the danger, and it he do not see what is about. to happen, and desist in time. Besides, he should puncture the part, and endeavour by gentle pressure to relieve it, and take precautions against the ric ing inflammation. He now slowly compresses the bag; fills the sac till it rises nearly to its former size, and turns the stop-cock. The injection should remain from two minutes and a half to five minutes; unless we are warned by the sensations of the patient to abridgee the operation. Severe pain in the cord and 10ins, 11 1th faintness, betrays a degree of sensibility in " One day while I was accompzmying.a celehr :1th surge on to the house Ofapatient on whom he was about to perifo'111 this O})Ul‘ltl01l,l wokenn~ 31011 to r'emaik to him this danger 111' slid that he could not conceit13 how it should happen. and Hut 111. had pertormed the opor1t1on tl :irt)‘ times "ithout such .111 acculent 111\111goccu1".1ed But 111 pa ioinnnr tln 0p 6% tion th at 01v the very thinghuppencd: a 11111c proporit on of 1111 fluidnot into the coil 111'11' men1h1a1ie.lhz1d not thereipxe to com 1ncc him that it J215 possible, but how it happened |