The practice of surgery . al to the parietes, at the loweraperture, and thence descends into the scrotum in the male, consti-tuting an oscheocele, or scrotal hernia ; into the labium of the female,constituting labial hernia. The investments of the tumor are as fol-lows : externally, the integument; then the superficial fascia of theabdomen ; then the proper fascia, or fascia propria of Camper, consist-ing of fibres from the tendon of the external oblique; then the fasciacremasterica, consisting of fibres from the cremaster muscle; then theinfundibuliform, or transversalis fascia, consisting of
The practice of surgery . al to the parietes, at the loweraperture, and thence descends into the scrotum in the male, consti-tuting an oscheocele, or scrotal hernia ; into the labium of the female,constituting labial hernia. The investments of the tumor are as fol-lows : externally, the integument; then the superficial fascia of theabdomen ; then the proper fascia, or fascia propria of Camper, consist-ing of fibres from the tendon of the external oblique; then the fasciacremasterica, consisting of fibres from the cremaster muscle; then theinfundibuliform, or transversalis fascia, consisting of a prolongation ofthe fascia transversalis abdominis ; lastly, the sac. As the tumor is about to descend, a painful fulness is found oppositethe upper abdominal aperture, increased by abdominal exertion, andsustaining an impulse upon coughing. Then is the time for applying atruss carefully, and avoiding exciting causes, with a view to preventionof the hernia. The pad of the truss should compress the superior ab- Fig. Plan of Inguinal Hernia; on the right side oblique, on the left direct, a. The hernial BBC. I. The epigartric artery. (After Tiedemann.) dominal aperture, not the lower; otherwise there is room enough forhernia, and strangulated hernia too, within the abdominal parietes. 404 OBLIQUE INGUINAL HERNIA, To reduce this form of tumor, the pressure of the taxis is appliedobliquely upwards and outwards, in the direction of the inguinal large tumors of old standing, however, it must be remembered thatthe canal becomes shortened as well as more direct, the two aperturescoming to be almost opposite to each other; and this is attended to inthe taxis. The patient is laid recumbent, with the trunk raised, andthe thighs flexed and approximated. In the operation for strangulation, a simple straight incision is madealong the neck of the tumor, beginning a little above the aperture ofprotrusion, and extending downwards on the tumor, as far as may bedeemed necessary. T
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