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found him pale, faint, and nearly pulseless ; the abdomen tense ; the hernial swelling presenting a doughy feel, and the integument covering the lower part of dark livid colour. Without touching the swelling, he at once recognised the importance of the case; and, foreseeing the possible condition of the intestine after five days' tight strangulation, he at once sent for Mr. Coote, who happened to be in the hospital. The operation was performed without delay. A long incision was made from abovedoi:10.1016/s0140-6736(02)77635-6 fatcat:d7hujlmu6bdbth47zcmdmoivye