INGUINAL HERNIA. 75 



Poupart's ligament ; it also arises from the cartilages of the six in- 

 ferior ribs. Insertion^ into the ensiform cartilage, linea alba, and 

 pubes, in common with the internal oblique tendon behind the exter- 

 nal abdominal ring. 



Rectus abdominis. ^^ — Origin, from the symphysis and body of 

 the pubes, gradually increasing in breadth. Insertion, into the ensi- 

 form cartilage, and into the cartilages of the fifth, sixth and seventh 

 ribs. This muscle has several tendinous intersections called linea 

 transverscB, which are three or four in number. 



Pyramidalis}'^ — Is in front of the lower part of the rectus, about 

 three inches in length, not always present. Origin, from the body 

 of the pubes. Insertion, into the linea alba. 



Oremaster. — This muscle forms a muscular sheath for the cord 

 and upper part of the testicle ; before the descent of the testicle, it 

 constitutes the inferior edge of the internal oblique and transversalis 

 muscles, which are much blended at this part; hence its origin may 

 be said to be the muscular portion of the lower edge of these muscles, 

 and that its insertion is into the conjoined tendon of these muscles. 



Fascia transversalis. — This fascia covers the abdomen, and lies 

 under the muscles and in front of the peritoneum ; it is continuous 

 with the iliac fascia, which surrounds the posterior part of the 

 peritoneum, and the pelvic, fascia, which surrounds that portion of 

 peritoneum in the cavity of the pelvis. It is thin and tough, and 

 near the groin possesses greater density. 



This fascia is an object of study, particularly on account of the 

 interiial abdominal ring being situated in it. This point is usually 

 much misunderstood, partly from the use of the term ring, which 

 gives rise to the idea that it is a hole or opening like the external 

 ring, and partly from the variety and confusion of terms employed in 

 its description. It may be said to be that portion of the fascia tran- 

 versalis where it ceases to cover the abdomen and commences to 

 cover the cord ; here it is very thin, and an artificial or false dis- 

 section readily can form a ring or hole with a well-defined edge. 

 But such does not exist in nature, for the fascia is continued from the 

 abdomen upon the cord. 



INGUINAL HERNIA. 



Inguinal hernia is of two kinds; oblique or indirect, and direct or 

 ventro-inguinal hernia. Oblique is by far the most common ; and in 

 order to understand the anatomy of it, it will be necessary to bear 

 in mind the arrangement of the parts previous to the descent of the 

 testicle, the subsequent and natural condition, and also the state of 

 things as altered by the affection. 



