Page:The American Cyclopædia (1879) Volume VIII.djvu/704

 686 HERNIA HEROD forming a tumor on the inner and upper part of the thigh ; umbilical, in which the protrusion takes place at the navel or foetal opening of the umbilical cord ; ventral, at the openings in the linea alba or linece semilunares ; diaphragmatic, in which the abdominal organs pass into the cavity of the chest through some natural or abnormal opening in the diaphragm. All the abdominal viscera, except the duodenum, pan- creas, and kidneys, may form part of the con- tents of a hernial tumor ; but the floating por- tions of the small intestines (jejunum and ileum), the omentum, and the arch of the colon, are their most frequent constituents. Hernia rarely protrudes on the posterior and lateral portions of the abdomen, which are protected by thick muscles and firm unperforated aponeu- roses, and where the organs are large and but little movable ; the anterior abdominal wall, on the contrary, is thin, extensible, having weak points in the inguinal rings and canals, and freely floating organs always pressing upon its yielding tissues. A hernia is said to be re- ducible when the protruding organ may be re- turned into the abdomen ; irreducible when it is not thus returnable ; and strangulated when, owing to its unusually close constriction, the circulation of blood in its vessels, or the natu- ral passage of the intestinal contents, is ar- rested. The sac of a hernia is a pouch of the reflected or parietal layer of the peritoneum, which is pushed forward in proportion to the escape of the viscera ; external to this are the layers of fasciae, muscles, and cellular tissue, varying in thickness according to the situation of the tumor. When we consider the yielding nature of the abdominal walls, their liability to pressure from muscular action, and the weak points inviting protrusion of the viscera, it is not surprising that hernia is so common ; it has been estimated that in the male sex at least one in five is affected by it. The exciting causes are such as suddenly or violently com- press the organs by action of the abdominal muscles, such as great bodily exertion, the lift- ing of heavy weights, violent vomiting, cough- ing, and sneezing; long continued efforts in parturition, defecation, or micturition ; habit- ual compression by corsets, belts, bandages, and heavy hip-supported clothing ; falls, im- proper gymnastic exercises and feats of strength, severe blows and contusions. A simple hernia, easily reducible and kept so by a proper truss, is rather an annoying infirmity than a positive disease, and is often susceptible of a radical cure. The treatment of reducible hernia is to return it to the abdomen by a process called the taxis, and to retain it in place by a proper- ly constructed and well fitting truss. Great care is necessary in the preparation of the truss; it should fit exactly, the springs should have the right bearings and pressure, and the pads the proper shape and consistency. Her- nia may be rendered irreducible by adhesions of the sac to its contents, and of the latter to each other, or by enlargement of the contained omentum from fatty deposition ; the treatment is merely palliative, except in rare and favora- ble cases. Strangulated hernia may be pro- duced by a sudden protrusion through a nar- row aperture after violent exertion, by swelling or spasmodic action about the neck of the sac, distention of the intestine by flatus or faeces, and swelling and congestion of the omentum and mesentery ; the stricture is generally at the neck of the sac. The indications of treat- ment are to reduce the hernial contents by the taxis, if possible, with the assistance of relax- ation of the muscles by position, by bleeding, hot baths, narcotics, tobacco enemata, cold ap- plications, and antimonial prostration, or, in modern times, by the inhalation of sulphuric ether and chloroform ; if these fail, the sac must be cautiously opened, the stricture di- vided by the knife, and the hernia returned. Strangulated hernia is always a dangerous af- fection, and frequently fatal either in itself or from the effects of inflammation. Umbilical hernia, most common in new-born children, is treated on similar principles, by the reduc- tion of the contents, and their retention by a special bandage. Diaphragmatic hernia, whether from congenital deficiency or acciden- tal rupture of this partition, when strangu- lated, is difficult of diagnosis, and beyond the reach of operative surgery. HERNICI, an ancient people of central Italy, often mentioned in the early history of Rome. They were of the Sabine race, and inhabited the Apennines of Latium between Lacus Fu- cinus (now Lake Oelano) and the Trerus (Sac- co), a tributary of the Liris (Garigliano). Their name is supposed to have signified " mountain- eers." Their nearest neighbors were the Mar- si, .^Equi, and Volsci, whom they equalled in bravery, and like whom they obstinately re- sisted the growing power of Rome. In 486 B. 0., however, they became the allies of the Romans, and 180 years later they were finally subdued by them. Anagnia (Anagni) was the chief town in their territory. Ill KOSAD. See WESTEE NOBBLAND. HERO. See HERON. HERO, in Greek mythology, a priestess of Venus at Sestos, beloved by Leander, a native of Abydos. Leander used to swim across the Hellespont nightly to visit his mistress; but one tempestuous night he was drowned, and in the morning the billows cast his body on the shore. When Hero beheld it she threw herself into the sea. HEROD, surnamed the Great, king of the Jews, son of Antipater, a noble Idumsean, bora in Ascalon, Judea, about 72 B. 0., died in 4. When in 47 Julius Caesar appointed his father procurator of Judea, the young Herod obtained the government of Galilee, and quickly van- quished the hordes of robbers which then in- fested the province. Alarming the ruling men> at Jerusalem by his popularity, he was sum- moned before the sanhedrim on complaints of having put Jewish citizens to death without