. An analytical compendium of the various branches of medical science, for the use and examination of students. Anatomy; Physiology; Surgery; Obstetrics; Medicine; Materia Medica. INGUINAL HERNIA. •79 Hence, in the operation for hernia, the following layers are cut through :— Skin, superficial fascia, cremaster mvscle, transversalis fascia^ and the hernial sac. In the dissection of a hernial sac, we will find alterations in thick- ness and colour, the consideration of which properly belongs to the surgical part of this work. Direct or ventro-ingui7ial hernia consists of a protrusion directly a
. An analytical compendium of the various branches of medical science, for the use and examination of students. Anatomy; Physiology; Surgery; Obstetrics; Medicine; Materia Medica. INGUINAL HERNIA. •79 Hence, in the operation for hernia, the following layers are cut through :— Skin, superficial fascia, cremaster mvscle, transversalis fascia^ and the hernial sac. In the dissection of a hernial sac, we will find alterations in thick- ness and colour, the consideration of which properly belongs to the surgical part of this work. Direct or ventro-ingui7ial hernia consists of a protrusion directly at the external abdominal ring, and of course does not pass through the canal. The coverings are the skin, superficial fascia, the com- mon tendon of the internal oblique and transversalis muscles, trans- versalis fascia, and hernial sac. This variety is not of so frequent occurrence, on account of the insertion of the tendon of the internal oblique and transversalis into the pubes immediately behind the external abdominal ring, which protects this opening, and therefore it must be ruptured or expanded when a protrusion takes place at this ring ; when it is ruptured, of course this covering of the sac does not exist. Diaphragma.—This muscle forms the septum between the thorax and abdomen ; it consists of two parts, a greater and lesser muscle. The greai^er*^^ muscle arises from the ensi- Fig. 61. form cartilage, and from six inferior ribs ; the fibres converge to the cordiform tendon, which is in the cen- tre. The lesser^ ^° muscle consists of two bellies, which are called crura, the right of which is the larger. Origin, from the second, third, and fourth lumbar verte- brae. Insertion, into the cordiform tendon. There are three openings in the dia- phragm ; one in the tendinous centre,^^ called foramen quadratum, which transmits the ascending vena cava; another, an elliptical muscular opening,*- called foramen ceso- phageum, through which passes the oesophagus and the par
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