Hunterian lectures on the morbid anatomy, pathology, and treatment of hernia / by Charles Barrett Lockwood.

Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: Hunterian lectures on the morbid anatomy, pathology, and treatment of hernia / by Charles Barrett Lockwood. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    rest of the peritoneum, is approached by the bulging, so that it is more or less funnel-shaped {vide fig. 14). These bulgings of the abdominal wall are, I think, a morbid change antecedent to hernia. In the hundred cases without hernia (fig. 12, p. 37) eight had bulgings of the abdominal, but all of them were over fifty years of age (Nos. 66, 70, 71, 72, 87, 90, 94, and 96). When the cases of acquired hernia are detailed it will be seen that that affection occurs when there is neither elongation nor prolapse of the mesentery, and similarly in these eight cases of bulging, although there was no elongation, Fig. 14. Diagram of Hypogastric Fossae in Congenital and Acquired Hernia. C, Congenital Sac. Ac, Acquired Sac. U, Urachus and its Fold. H, Hypogastric Artery and its Fold. E, Epigastric Artery. they usually had a low attachment of the mesentery; never- theless, the latter was far from being an invariable accom- paniment. For instance, in them the height of the flexura duodeno-jejunalis was as follows : In one case it was on a level with the base line; in another, two inches above the base line; in another, two and a half inches above the base line ; in two cases, two and three-quarter inches above the base line; in two cases it was three inches above the base line : and lastly, in one case the flexura was four inches above the base line. There are two factors which would be likely to diminish the likelihood of a low attach- ment of the mesentery being always associated with bulging of the hypogastric fossae, namely, the variability of the length of
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