. The principles and practice of surgery. he tunicavaginalis propria testis. At the same time, per-haps—for the date of these events variessomewhat in different cases—the upper canalbegins to close from the internal ring down-wards ; or it may become especially constrictednear its middle, and the closure proceed inopposite directions, so that by the twentieth or Consenital In&^f Hernia in thethirtieth day after birth, according to Paletta, the entire canal is generally occluded. With some persons, however, thecanal remains patulous during life, or it closes imperfectly in its entirelength, or
. The principles and practice of surgery. he tunicavaginalis propria testis. At the same time, per-haps—for the date of these events variessomewhat in different cases—the upper canalbegins to close from the internal ring down-wards ; or it may become especially constrictednear its middle, and the closure proceed inopposite directions, so that by the twentieth or Consenital In&^f Hernia in thethirtieth day after birth, according to Paletta, the entire canal is generally occluded. With some persons, however, thecanal remains patulous during life, or it closes imperfectly in its entirelength, or only at certain points below, leaving the upper portions open,favoring, therefore, the occurrence of hernia so long as this conditionremains. Whenever the testicle does not descend until some time afterbirth, or this event is delayed until late in life, a funicular hernia is veryliable to occur. Symptoms.—Congenital hernise are most frequent in early infancy;they occur in most cases suddenly, but their descent may be completely. 726 CONGENITAL INGUINAL HEKNIA. arrested at any point of the peritoneal process, constituting, in someeases, only funicular hernise, and in others, scrotal; while acquiredhernise usually descend very slowly, but steadily and progressively. Theyare generally composed of intestine alone, and when occurring in adultlife the symptoms of strangulation are usually more intense than insimilar examples of acquired hernia, because of the more unyieldingnature of the stricture ; in other respects they do not differ essentiallyfrom other inguinal hernise. Congenital hydrocele is often associatedwith a patulous condition of the peritoneal process, and may be accom-panied with a hernia. It will be difficult to determine the presence of thiscomplication, but fortunately an error in this regard is practically of noconsequence, since the treatment must be directed only to the have often, however, met with cases of congenital hydrocele uncompli-cated with
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