Part 3

Case 9--Italian section worker wearing spring truss for holding of inguinal hernia. Strong pressure of truss making marked depression at site of internal ring. Patient injected with dram and half of paraffin of melting point 115. May 20, 1906. Agent deposited along canal and at internal ring. One week later no pain, no tenderness to moderate pressure. Cord somewhat larger than normal and epididimus thickened but not tender. Shreds in urine. Through interpreter information gleaned that epididimus had been somewhat tender following operation. History of acute epididimitis some months before.

Case 10.

Case 10 A. J.--Patient first consulted at Harvey dispensary. Treated for urethral stricture by internal urethrotomy. Subsequently referred to A. C. C. Disp. for treatment. Developed acute appendicitis and operation for removal after development of abscess. Abscess drained and healing of abdominal incision imperfect leaving hernial protrusion internally and near superior angle of scar. Injected with seventy minims of paraffin, 115 melting point, on Aug. 2, 1906. No pain following injection, no discoloration, and no recurrence over a year and a half after operation.

CONCLUSION.

These cases represent the ten first which were seen subsequent to injection. Cases which were injected and which did not return subsequent to injection have not been included as they would be of no value in estimating as to the usefulness of this method. In no instance has an ill consequence been suffered which would cause the patient to seek surgical aid elsewhere, or at least no case has come to the knowledge of the author directly or indirectly.

Large hernia which have gone unreduced for years have not been treated by injection and discretion demands that for some time, or until injection treatments have been practiced upon many patients, that large ruptures which have been outside the abdomen for long periods be left to the surgeon or be injected only by practitioners capable of doing the cutting operation in the advent of the failure of the injection treatment.

The author for his own part has felt no hesitancy in injecting cases which promised a fair degree of success, realizing full well that untoward symptoms of a local character may be overcome by free dissection, removal of the paraffin and restoration of the inguinal canal by the usual surgical means.

CONTENTS

PAGE Foreword 3 Preparation of the skin 10 Preparation of the hands of the operator 12 Preparation of the syringe 15 Preparation of the paraffin 18 Posture of patient for injection 23 Skin infiltration to permit of insertion of long needle without undue pain 25 The effect of paraffin compounds upon the tissues 27 The immediate after effects of the paraffin injections 30 The precaution used to prevent throwing of paraffin into the circulation 32 Factors to be considered in dealing with inguinal hernia 35 Where the injection should be placed 39 The amount of paraffin to be introduced in a given case 42 Technic to be used in injecting inguinal hernia 44 The injection of femoral hernia 51 Injection of umbilical hernia 53 Case reports 69

Cosmetic Surgery

The Correction of Featural Imperfections

BY

CHARLES C. MILLER, M. D.

Very excellent and practical. _Southern Practitioner._

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The book is certainly a valuable contribution to the subject. _Ophthalmology._

Has gone far beyond the limits of surgery as understood and practiced in this country. _British Medical Journal._

The author has done the profession a service in offering his work upon the subject. _Yale Medical Journal._

The book furnishes in an extremely convenient and accessible form much information concerning a branch of surgery which is daily growing in importance and interest. _Military Surgeon._

Dr. Miller has made out a good case as to why the regular surgeon should give this question some considerable attention rather than leave such things to the charlatan and quack. _Canadian Journal of Medicine and Surgery._

160 Pages. 98 Illustrations. Price $1.50.

Transcriber's Notes:

Words and phrases in italics are surrounded by underscores, _like this_.

Spelling changes:

acqainted to acquainted, ... thoroughly acquainted with ... patrolatum to petrolatum, ... white petrolatum is a few cents ... PRACAUTION to PRECAUTION, ... THE PRECAUTION USED TO PREVENT ... pertoneal to peritoneal, ... into the peritoneal cavity ... urtehrotomy to urethrotomy, ... by internal urethrotomy ... protrusian to protrusion, ... leaving hernial protrusion,... Opthalmology to Ophthalmology, advertisement at end of book

Added missing period at end of chapter, ... reaction is well marked.