GEORGE ARMSTRONG ON THE TREATMENT OF INGUINAL HERNIAS IN MALE INFANTS (1783)

George Armstrong (1719-1789), the founder, in 1769, of the first children's dispensary in Europe and author of one of the best pediatric works of the period, treated inguinal hernias in male infants as follows:

Hernia scroti ... in very young children, for the most part readily yields to the following treatment. If the child is of a costive habit, an emollient glyster[enema] is requisite, consisting of three or four ounces of thin water-gruel, a tablespoonful or two of salad-oil, and the same quantity of brown sugar, which must be repeated occasionally. At the same time, a gentle laxative should be given from day to day, just sufficient to open the body moderately, and thereby preventing the straining during the time of going to stool, which, from the child being costive, pushed down the intestine. On the other hand, if the child is of a lax habit of body, and especially if it is purged, the indication of cure is to remove the stimulus attending, or sometimes occasioning the looseness, and thereby prevent the straining in this case also ... I direct the groins and scrotum to be well dabbled with cold pump-water, or lime-water when it can conveniently be had night and morning, the rupture being first reduced, if it was down. By this simple method I have cured a great number of infants (many of whom were born with ruptures) in a few months, and some in a few weeks. But if the disease is stubborn, and the child a little grown up, for example a year or two old, or upwards, I recommend the elastic steel truss to be used, which if skilfully made, answers the purpose very well, without hurting, and should be worn until the cure is perfectly completed, and the part has gathered sufficient strength.¹