(4.) _Smell._--The peculiar gangrenous odour on opening the sac is very characteristic. In cases where ulceration and perforation have occurred, the odour is fæcal. 1. If, then, the bowel is tolerably healthy-looking, though discoloured, it should be returned gradually, not _en masse_, into the abdomen, the wound sewed up, and a pad of lint put on, with a bandage. 2. If there are adhesions of bowel to sac or to a neighbouring coil, or of omentum to sac, the stricture should be freely divided, the protruding coils of intestine should be emptied of their contents, but no rash attempt made to force their return. Especially is this rule to be observed with protruded, swollen, or adherent omentum, for considerable risks attend any attempt at excision of the protruded portion--risks of hæmorrhage, peritonitis, and ulceration of the contiguous bowel. If the bowel be returned, or even the continuity of the canal restored by the cutting of the stricture, though the bowel be not returned, no great risks accrue from the retention of a piece of omentum in the sac, in a position which it may possibly have already occupied for years. 3. If the bowel is absolutely gangrenous, even in a very small portion of its length, no reduction should be attempted, but the gangrenous portion should be kept outside, with the hope that adhesive inflammation may be set up, so as to glue the bowel to the abdominal wall, prevent fæcal extravasation, and form a temporary artificial anus. If the gangrenous portion be very full of fæces or flatus, incisions may be made into it. This should be avoided in cases where the patient is already much prostrated, as I have seen cases in which the opening of the bowel seemed to inflict a fatal shock. Enterectomy or excision of the gangrenous portion has recently been recommended and performed by some surgeons. The very high authority of the late Professor Spence is against such procedure.[143] Cases of gangrene of even large portions of bowel are by no means necessarily fatal. They may recover with an artificial anus, the remedy of which by surgical means we must notice in its proper place. OPERATION FOR STRANGULATED FEMORAL HERNIA.--While the general principles guiding treatment and ruling the conduct of the operation are the same as in inguinal, there are some differences in points of detail which render a brief separate description necessary.