FEMORAL HERNIA. 289 



wall of the sheath. The superior opening of this space is named the 

 femoral ring ; it is bounded in front by Poupart's ligament, behind 

 by the os pubis, internally by Gimbernat's ligament, and externally 

 by the femoral vein. The interval itself serves for the passage of the 

 superficial lymphatic vessels from the saphenous opening to a lymphatic 

 gland, which generally occupies the femoral ring ; and from thence 

 they proceed into the current of the deep lymphatics. The femoral 

 ring is closed merely by a thin layer of subserous areolar tissue,* 

 which retains the lymphatic gland in its position and is named 

 septum crurale ; and by the peritoneum. It follows from this descrip- 

 tion, that the femoral ring must be a weak point in the parietes of 

 the abdomen, particularly in the female, where the femoral arch, or 

 space included between Poupart's ligament and the border of the 

 pelvis, is larger than in the male, while the structures which pass 

 through it are smaller. It happens consequently, that, if violent or 

 continued pressure be made upon the abdominal viscera, a portion of 

 intestine may be forced through the femoral ring into the infundibuli- 

 form space in the sheath of the femoral vessels, carrying before it the 

 peritoneum and the septum crurale, this constitutes femoral hernia. 

 If the causes which give rise to the formation of this hernia continue, 

 the intestine, unable to extend further down the sheath, from the close 

 connection of the latter with the vessels, will in the next place be 

 forced forwards through the saphenous opening in the fascia lata, car- 

 rying before it two additional coverings, the sheath of the vessels, or 

 fascia propria, and the cribriform fascia; and then curving upwards 

 over Poupart's ligament, the hernia will become placed beneath the 

 superficial fascia and integument. 



The direction which femoral hernia takes in its descent is at first 

 downwards, then forwards, and then upwards ; and in endeavouring 

 to reduce it, the application of the taxis must have reference to this 

 course, and be directed in precisely the reverse order. The coverings 

 of femoral hernia are the 



Integument, 

 Superficial fascia, 

 Cribriform fascia, 

 Fascia propria, 

 Septum crurale, 

 Peritoneal sac. 



The FASCIA OF THE LEG is strong in the anterior tibial region, and 

 gives origin by its inner surface to the upper part of the tibialis anti- 

 cus, and extensor longus digitorum muscles. 



It is firmly attached to the tibia and fibula at each side, and 

 becomes thickened inferiorly into a narrow band, the anterior annular 



* This areolar tissue is sometimes very considerably thickened by a deposit 

 of fat within its areolse, and forms a thick stratum over the hernial sac. 



