Protrusion of the navel takes place when the peritoneum there is ruptured and prolapsed; or from the omentum, intestine, and sometimes an inert fluid falling down upon the navel, sometimes from hypertrophy of the flesh, and sometimes from a collection of blood there, proceeding from the rupture of a vein or artery, as in aneurisms; and sometimes the collection consists not of blood, but of spirits only. If, then, the omentum be protruded, there appears a swelling at the navel, which is free from discoloration, soft to the touch, without pain, and uneven; but if it is intestine in addition to the afore-mentioned symptoms, there is greater inequality,—the tumour, when pressed by the fingers, disappears, sometimes with borborygmi; and it is increased by baths and straining. If its contents be a fluid, the tumour is equally soft, not yielding to pressure, and is neither diminished nor increased by it. If it consist of blood, in addition to the afore-mentioned symptoms, the swelling is more livid; but if it arise from hypertrophy of flesh, the tumour will be harder, elastic, and will continue of the same size. Those occasioned by flatulence are attended with softness, a certain sound when tapped, and disappearance upon pressure. We must operate then in this manner. Having placed the man in an erect posture, we order him to press down at the same time that he retains his breath; then, having marked the whole prominence of the navel with black ink, we are to lay him on his back, and dissect around the tumour with a scalpel, agreeably to the marking; then, stretching the middle with a hook, we must apply a thread or string around the part which is dissected, for thus it will be prevented from falling down, when secured with a knot. Then, at the top, having opened the constricted tumour, we must introduce the index-finger, and search carefully lest any fold of the intestine, or part of the omentum, be included in the ligature; and if intestine be included, we must loosen the fold of the thread, and push it inwards, but if it is omentum we may draw it out, and cut off what is redundant of it, securing, as is proper, with a thread, any vessel that may come in the way; and then taking two needles, containing a plain thread, we pass them through the scarified part in the form of the Greek letter Χ, and cutting the doubles of the threads, as we mentioned for aneurism, we make constriction with the four heads. After the bodies secured by the ligatures have become putrid and dropped off, we complete the cure by dressing the part with pledgets, and strive to make the cicatrix particularly hollow. Such is the operation when the part concerned is the intestine or omentum. But if flesh, or fluid, or blood occasions the complaint, having divided the middle of the tumour circularly, and then removed whatever lies external to the peritoneum at the navel, we perform the cure by incarnative applications.