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Article
January 11, 1896

SOME MECHANICAL PROBLEMS IN THE OPERATIVE CURE OF INGUINAL HERNIA.

Author Affiliations

SURGEON TO IMMANUEL HOSPITAL. OMAHA, NEB.

JAMA. 1896;XXVI(2):63-66. doi:10.1001/jama.1896.02430540015002d

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Abstract

It is customary to think of the abdominal viscera as making unrestrained pressure in every direction in their efforts to escape from the cavity in which they are enclosed. If this were literally true, hernia to the extent of total disability would be the rule. In the normal condition the relationship is such that when the omentum, the small intestine or the large intestine has pressed about so far in any given direction, it can go no farther, not because of the resistance met in front, but because of the restraint offered by the mesentery, the mesocolon, or other attachments. This restraining force does not manifest itself by a sudden pull like the jerk when the end of an elastic cord is reached, but by the gentle traction of an elastic tether, which causes the organ to glide away from the danger point over the slippery peritoneal surface.

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