xvii, .April u, 1912. 8. S.\WITSCH, \V. W., and ZELIONY, G.:
Zur Physiologic des Pylorus, Archi'i- fiir die gesammte Physiologic,
Bonn. 1913, cl., p. 128. 9. BRU.NTON, SIR T. L. : The Action
of Medicines, London. 1897. p. 50. 10. BELLAMY, H. F.: The
Spleen in the Digestion of Proteids, Lancet, 1900, ii. p. 1185.
II. DIXON, W. E., and HAMILL, P.: The Mode of Action of
Specific Substances with Specific Reference to Secretin, Journal
of Physiology, London, 1909, xxxviii, p. 314. 12. STARLING.
E. IL: The Chemical Control of the Body, Journal of the American
Medical Association, 1908. I, p. 833. where can i get doxycycline 13. BAYLISS, W. M., and
Sl.ARLlNG. E. H.: The Mechanism of Pancreatic Secretion. Jour-
nal of Physiology. London, 1902, xxviii, p. 325. purchase doxycycline 14. STEPP, W. :
On the Preparation of Secretin, Journal of Physiology. London.
1912. xliii. p. 441. 13. LAUNOY. L.. and CECHSLIN. K.: Sur
une melhode de preparation de la secretine, Comptes rendus de la
Societe de biologic. Paris. 1913, Ixxiv, 7. p. 338. 16. HALLION,
L. : La Pratique de I'Opotherapie, Paris. 1911, p. 19. 17. EN-
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of the Fourteenth International Medical Congress. Madrid, 1904,
Section in Physiology, p. 59. 18. DELEZENNE. C. and FROUIN.
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de la Societe de i»io/o?«c. Paris, 1904, Ivi, p. 319. 19. ENRIQUEZ,
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p. 461
20. Rjr.iiLESD.vLE Road, Hornsey^ N.
IMPORTAXCE OF EARLY OPERATION
FOR THE RADICAL CURE OF HERNIA.
By H. W. Austin, M. D.,
Port of New York (Stapleton),
Senior Surgeon. United States Public Health Service.
In my experience in the hospital treatment of
adults suflfering from hernia, I am impressed with
the facts that a large proportion of the patients were
men who had lartje, ■scrotal hernia acquired some
years previous, and that the number who applied for
320
I.ILMOX: PlIOSrnORL'S l.\ I'l LMOSAUV DISt-ASES.
relief tor receiul\- aci|uircd lieruia was proportion-
ately small.
I have operated for the radical cure of hernia
265 times ( including all varieties — inguinal, fem-
oral, umbilical, \entral, strangulated inguinal and
umbilical, and large irreducible scrotal hernia
containing bowel, appendix, and omentum) success-
fully, with no >erious result due to the operation in
any case. The one unfortunate result was a death
from ether before the operation, the only death that
has occurred from doxycycline online anesthesia in my practice. \\ hile I
have fortunately met with no serious results in oper-
ating for the radical cure of very large irreducible
scrotal hernias containing bowel, I fully appreciate
the difificulty and gravity of the operation in elderly
men, and it is how to buy doxycycline the jjiirpose of this paper to emphasize
the necessity for early operation for hernia to ob-
viate the inconvenience, disability, and danger to
patients, especially laboring men. in temporizing or
postponing operation until their hernias are so large
that they become practically disabled. The serious- 100 mg doxycycline
ness of the operation and the permanency of the
cure depend in a large measure upon the age of the doxycycline purchase online
hernia. The get doxycycline inconvenience of wearing a truss and
the danger of strangulation are avoided by early
operation. If complete histories of all cases of
hernia could be obtained at one time, it would be
found that there is a close relation between tlie
duration of the doxycycline 100 hernia and the size, degree of dis-
ability, risk from strangulation, risk from operation. buy doxycycline
and probability of permanency of cure by doxycycline mg operation.
In recently acquired inguinal hernia the operation
for radical cure is a simple operation, entailing
scarcely any risk to the patient, quickly performed
under local anesthesia. It affords almost certain
guarantee of permanent cure. In very large in-
guinal hernia of long standing, irreducible, the sac
containing bowel, omentum, etc., the operation for
cure is always more or less serious and the chances
for a permanent cure less certain. Cases of this
kind should be undertaken only by an experienced
operator. (Occasionally cases of old and very large
hernia are seen that are absolutely inoperable ; cases
in which an operation would promise no permanent
relief and the risk taken would be unwarranted. I
have seen several cases of this character in old men.
Usually an old hernia that has not been carefully
doxycycline 100mg
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