=RUPTURE.=--Hernia or rupture consists in a protrusion of a portion of
the contents of the abdomen (a part of the bowel or its covering, or
both) through the belly wall. The common seats of rupture are at the
navel and in the groin. Rupture at the navel is called umbilical
hernia; that in the groin either inguinal or femoral, according to
slight differences in site. Umbilical hernia is common in babies and
occurs as a whole in only five per cent of all ruptures, whereas
rupture in the groin is seen to the extent of ninety-four per cent of
all ruptures. There is still another variety of hernia happening in
the scars of wounds of the belly after injuries or surgical
operations, and this may arise at almost any point.
=Causes.=--Rupture is sometimes present at birth. In other cases it is
acquired as a result of various causes, of which natural weakness of
the part is the chief. Twenty-five per cent of persons with rupture
give a history of the same trouble in their parents. Rupture is three
times more frequent in men than in women, and is favored by severe
muscular work, fatness, chronic coughing, constipation, diarrhea,
sudden strain, or blows on the abdomen.
=Symptoms.=--Rupture first appears as a fullness or swelling, more
noticeable on standing, lifting, coughing, or straining. It may
disappear entirely on lying down or on pressure with the fingers. In
the beginning there may be discomfort after standing or walking for
any length of time, and later there is often a dragging pain or
uneasiness complained of, or a sensation of weakness or griping at the
seat of the rupture. In case the rupture cannot be returned, it is
called irreducible and is a more serious form. The great danger of
hernias is the likelihood of their being strangulated, as the term is;
that is, so nipped in the divided abdominal wall that the blood
current is shut off and often the bowels are completely obstructed. If
this condition is not speedily relieved death will ensue in from two
to eight days. Such a result is occasioned, in persons having rupture,
by heavy lifting, severe coughing or straining, or by a blow or fall.
The symptoms of strangulated hernia are sudden and complete
constipation, persistent vomiting, and severe pain at the seat of the
rupture or often about the navel. The vomiting consists first of the
contents of the stomach, then of yellowish-stained fluid, and finally
of dark material having the odor of excrement. Great weakness,
distention of the belly, retching, hiccough, thirst, profound
exhaustion, and death follow if the condition is not remedied. In
some cases, where the obstruction is not complete, the symptoms are
comparatively milder, as occasional vomiting and slight pain and
partial constipation.
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