A system of surgery : theoretical and practical . of course, in one casemore distinctly than in another. If thewhole of the tumour lies below the liga-ment, and its neck can be traced continuouswith the crural aperture, its contents haveescaped beneath Pouparts ligament, and it is a crural rupture; but if the contrary,it is an inguinal, especially too if the neck be traceable to the internal inguinal is distinguishable from inguino-labial hernia by placing the finger on the spineof the pubes, or upon the attachment of the tendon of the adductor longus into thatpoint of bone ; for e
A system of surgery : theoretical and practical . of course, in one casemore distinctly than in another. If thewhole of the tumour lies below the liga-ment, and its neck can be traced continuouswith the crural aperture, its contents haveescaped beneath Pouparts ligament, and it is a crural rupture; but if the contrary,it is an inguinal, especially too if the neck be traceable to the internal inguinal is distinguishable from inguino-labial hernia by placing the finger on the spineof the pubes, or upon the attachment of the tendon of the adductor longus into thatpoint of bone ; for even in very fat persons the pubic spine can be always felt. If thetumour be to its outer side, the protrusion has escaped below Pouparts ligament, inwhich case it is crural rupture ; if, on the contrary, it has passed through the externalinguinal ring, it must be an inguinal. The same point of bone will aid in dis-tinguishing between a pudendal hernia and a crural. A crur-al hernia is much more superficially seated than an obturator, and in 3g 2. in bad health previously, was extremely emaciated,and sank from exhaustion. Large and hard massesof scybalse were found in the ileum as shown in thepart of ttie bowel cut open. The small piece of bowelwhich had been in the sac, and was but little diseased,is indicated by the dotted line. The contracted andopened bowel below this contained mucus only. Thefigure in the centre represents the sac. Through itsmouth a piece of glass rod is insei-ted ; and althoughthe sac is very small, it was remarkable for the layer offat, b, between the peritonceum, c, whicli is not cut,and the fascia propria, «. (Museum Gujs Hospital,No. 477=.) 820 HERNIA. consequence the tumour which the latter produces is neither so prominent nor sowell defined as the former. The latter escapes from the pelvis behind the horizontalramus of the pubes, and therefore Gimbernats ligament and the crural aperture canbe felt. The elevation of the integuments produced by an ob
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