THIS Rupture is owing to a Protrusion of the Intestine, or Omentum, or both of them, at the Navel, and rarely happens to be the Subject of an Operation; for though the Case is common, yet most of them are gradually formed from very small Beginnings, and if they do not return into the Abdomen upon lying down, in all Probability they adhere without any great Inconvenience to the Patient, 'till some time or other an Inflammation falls upon the Intestines, which soon brings on a Mortification, and Death; unless by great Chance, the mortified Part separates from the sound one, leaving its Extremity to perform the Office of an Anus: in this Emergency, however, I think it adviseable to attempt the Reduction, if called in at the Beginning, tho' the universal Adhesion of the Sac and its Contents, are a great Obstacle to the Success: the Instance in which it is most likely to answer, is, when the Rupture is owing to any Strain, or sudden jerk, and is attended with those Disorders which follow upon the Strangulation of a Gut.

In this Case, having tried all other Means, in vain, the Operation is absolutely necessary; which may be thus performed: make the Incision somewhat above the Tumour, on the left Side of the Navel, through the Membrana Adiposa; and then emptying the Sac of its Water, or mortified Omentum, dilate the Ring with the same crooked Knife, conducted on your Finger, as in the Operation for the Bubonocele; after this, return the Intestines and Omentum into the Abdomen, and dress the Wound without making any Ligature, but of the Skin only.

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