(58) IIlSrORT of the SOCIETT. 



Acwim of bonocele had, from inaccurate obfervation, been often defcribed 



Vi'. H.isiiiltun. 



for femoral hernia. From the time I began to have thefe fuf- 

 picions, I have miiTed no opportimity of determining my point ; 

 and I have been hicky enough to have the difledlion of two wo- 

 men, with the appai'ent femoral hernia; which turned out bubo- 

 nocele. I have likewife had five or fix living patients with her- 

 nia, where I had an opportunity of a careful examination, and 

 have again operated in a fimilar cafe. As the refult of thefe 

 ten or twelve cafes is againfl the common opinion, I ftiall ftate 

 my obfervations at full length. 



" The idea that a btibonocele in women was to take the fame 

 road with a fimilar hernia in men, has, I fancy, mifled ; for we 

 find, that this is the account commonly given of the difeafe, that 

 the gut paflTes down into the labium. Now, if we compare the 

 two cafes, we will find there is no fimilarity. In men, the gut 

 and fack are furrounded by the cremafler, and are therefore 

 conduded towards the teflicle. The cellular membrane of the 

 Icrotum is free of fat, and therefore yields more eafily to the 

 prefiTure of the gut than that of the parts around ; and thus the 

 hernia pafles more eafily in this direcftion than in any other. 

 In vsromen, when the hernia has pad the ring, it has no crema- 

 fter to condud it to the labium, it may therefore pufh in any 

 other direftion ; but as the cellular membrane of the labium, 

 and from it to the ring, is very much loaded with fat in moft 

 women, it will find more obflirudion in this dire(5lion, and will 

 therefore be pvifhed where the parts yield more readily. The 

 parts on the groin are lefs loaded with fat, the gut therefore will 

 be prefled here. This I found corroborated by all the three 

 cafes, where I either operated or was affiftant ; and in the two 

 difl'edtions the hernia was pufhed outwards from the ring, and 

 in one it had gone up along the belly above the ring. This on- 

 ly takes place when the hernia is fmall. If the ring is much 

 opened, and a great quantity of gut forced out, the motion of 



the 



