This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. In two cases of strangulated hernia in which the patients were operated on recently, the contents of the sac were thought viable and were therefore replaced within the abdomen. Subsequent necropsies revealed gangrene of these intestinal loops with a plastic peritonitis. In order to determine the frequency of this untoward complication a statistical review of all cases of strangulated hernia for a period of ten years was made. There were 4,139 patients with abdominal hernias admitted to the surgical wards of the Mt. Sinai Hospital from Jan. 1, 1914, to Dec. 31, 1923. Of this number 3,208 of the cases were inguinal, 294 femoral, 377 ventral, 167 umbilical, 85 epigastric, and 8 comprised the rarer varieties. The classification is given in Table 1. Of the total number 278, or 6.7 per cent., were strangulated. These all had the characteristic of strangulation in that there was a direct interference with the