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                        The Cure of Rupture

                                 BY

                        Paraffin Injections

                                 BY

                      CHARLES C. MILLER, M. D.

     _Comprising a description of a method of treatment destined
          to occupy an important place as a cure for rupture
            owing to the extreme simplicity of the technic
                and its advantages from an economic
                            standpoint_




                              CHICAGO
                  Oak Printing Co., 9 Wendell St.
                                1908




                           Copyright 1908
                        By Charles C. Miller




                             FOREWORD.


In taking up the description of the injection of paraffin for the cure
of hernia a number of remarks of a prefatory nature are called for, as
it is necessary to justify a treatment which has come in for a
considerable censure from surgeons who have had no experience with the
method and who have judged solely from a few mishaps which came to
their attention and which in no way permit of an accurate estimate of
the treatment.

Paraffin injections have been in use only a few years. When first
introduced their value for the closing of hernial openings was
mentioned. At the time the factors which made injections valuable for
such treatment were not appreciated. Paraffin was merely looked upon
as an agent which might be used to plug a hernial opening and such
plugging of a hernial opening is impracticable without histologic
changes in the tissues to cause permanent closure of the hernial
passage.


            The need which Paraffin fulfills in Hernia.

Paraffin has a tendency to promote the formation of connective tissue
and in hernial cases there is invariably a state of the parts which
will be benefitted by the throwing out of connective tissue in the
neighborhood of the deficiency which gives passage to the hernial
contents. Besides this production of connective tissue, the occlusion
of the hernial sac and glueing together of the walls of the hernial
canal, the plugging and supportive action of a material like paraffin
is likely to be in a measure useful as the paraffin does not lie in
the tissues as a single mass, but it is traversed by trabeculae of
connective tissue.




          OPERATION WITHOUT ANESTHESIA A GREAT ADVANTAGE.


Injections of paraffin are accomplished with such ease without
anesthesia that the mere fact that a hernia is curable without the
taking of an anesthetic is an advantage on the part of the paraffin
method which will be highly appreciated by a very large percentage of
patients suffering from rupture.

It is safe to say that for every patient suffering from rupture who is
willing to submit to the cutting operation four or five patients will
be met who are afraid to submit to such operation because a general
anesthetic is to be taken.


               Applicable in the Physician's Office.

Paraffin injections may be made in the physician's office and there is
no condition produced which renders it difficult for the patient after
injection to go to his home, if he must not travel more than a
moderate distance. The reaction may be such as to make it advisable for
the patient to remain quiet for a week or even two weeks, though this
is exceptional, yet such avoidance of exertion is not looked upon in
the same light by patients as two weeks strict confinement to bed.

The probability of escaping confinement is a great incentive to a
patient to submit to an injection, when he would refuse operation.

Injections are not necessarily unphysiologic as the sufferer from a
hernia has a physiologic deficiency which the paraffin accurately
fills with normal connective tissue.

The dangers of injection can be eliminated. The technic is not
difficult even when all precautions are taken.

There is less likelihood of suppuration following the injection
treatment than following the cutting operation.

The consequences of suppuration are less. If suppuration occur after
the open operation failure is likely, not to mention the danger of
peritonitis. Such is not the case following injection, and while
consequences are less serious suppuration is avoided much more readily
than following the open operation.

Only the operator thoroughly acquainted with the manner of disposition
of paraffin should attempt the injection of hernia.


                            Simplicity.

To the skilled operator the injection treatment is exceedingly simple
and the injection method must always be far more simple than the open
operation can ever become.

A hernia can be injected without haste in from two to four minutes.

An assistant is of no use.

The open operation cannot be performed without the aid of several
trained assistants, and without elaborate and expensive preparations,
it is not feasable as anything but a hospital operation.

Hospital surgeons may be expected to condemn the injection treatment
of hernia, as it will open to thousands of the profession a field
which has hitherto been monopolized by the surgeons with hospital
facilities.


         Experimental injections before human injections.

Before injecting a