Journal of the American Medical Association
hernias. After painstaking disinfection of the field of opera¬ tion and of the hands, he lifts up the hernial sac with the left hand. The contents slide back and the tip of the syringe needle is inserted in the sac with the right hand. About 3 or 4 c.c. of paraffin, heated to 65 C. ( 149 F. ), are injected, and the left hand releases the hernia so that it spreads out again to its original size. Ethyl chlorid is then sprayed for half a minute after withdrawal of the needle. The spot is then cov¬
... e spot is then cov¬ ered with a flat pad of medicated gauze fastened with adhesive plaster, and a strip of adhesive plaster around the abdomen completes the dressing. The injected paraffin thus spreads out over the hernia like a cap and hardens tinder the anes¬ thetic, forming a broad plate extending on all sides beyond the area of the hernia, holding 'back the intestines and by the irritation induced causing production of adhesions. The method is applicable only to hernia not larger than 1 cm. in diameter; if larger than this several sittings are required. If too much paraffin is injected the result is cumbersome and dis¬ figuring. The most important point in the technic is to use only hard paraffin, with a melting point at 54 C. (159 F.). He has thus treated a number of children under 12 during the last four years, and the prothesis has persisted unmodified ex¬ cept for the ingrowing of connective tissue into the paraffin. The procedure requires only a minute, and he has heard no complaints from any one except at the moment the needle is first introduced.