The surgical anatomy of inguinal herniæ, the testis and its coverings / by Thomas Morton.

  • Morton, Thomas, 1813-1849.
Date:
1841
Catalogue details

Licence: Public Domain Mark

Credit: The surgical anatomy of inguinal herniæ, the testis and its coverings / by Thomas Morton. Source: Wellcome Collection.

    88/134 (page 290)
    INCOMPLETE INTERNAL liad protruded between it and the inferior pillar of the ring, in such a manner that the cord formed a sort of arch, embracing the neck of the sac for nearly two-thirds of its circumference, close to the external abdominal ring.-|- It has been very generally stated by surgical writers, that, inasmuch as the sac of a direct or internal inguinal hernia does not follow, in its descent through the inguinal canal, the same course as the sjiermatic cord, it is not covered by any of the fibres of the cremaster muscle. This statement, however, is not invariably correct, for in several examples of this species of ru]i- ture, whieh have been met with in the dissecting rooms of University College during the last four winters, it was noticed that the hernial sac derived a partial investment from the cre- master muscle. 1 hat direct or internal inguinal hernise arc of much less frequent occurrence than the oblique or external form of rup- ture, has been remarked by all those who have attentively examined the subject; and, if we adopt the opinion of M. .Tides Cloquet, their comparative frequency may be estimated as I to 5. There is no doubt, also, that direct inguinal hernia is much less frequently met with among women than men ; indeed. Sir Astley Cooper mentions that he has never ivitnessed any example of it in a female.^ I^rofessor Cooper, however, once attended a patient, a female, who was the subject of a hernia of this de- scription, the contents of which had been strangulated for three or four days previously: under these circumstances he performed the operation at once, without trying any other means but the taxis, and, in a very short time, the woman perfectly recovered. [| This rarity of the occurrence of direct or internal inguinal hernia amongst females is, in a great measure, attributable to the small size of the external abdominal ring, and to the very limited t Vide Observations on Hernia, by Charles II. Todd, in the Dublin Hos- pital Reports and Communications, vol. i. p. 231. J Similar cases have been observed by M. Jules Cloquet (Recherches Ana- tomiques sur les Hernies de I’Abdomen, p. 83, Proposition xxxviii.), and by Mr.Todd (Dublin Hospital Reports, vol. i. pp. 230-31). § ITV/e Sir Astley Cooper on Hernia, 2d edit. Part I. p. 73. II Vide The First Lines of the Theory and Practice of Surgery, by Samuel Cooper, 7th edit. p. 5G0. '