INGUINAL HERNIA. 



77 



Fig. 60. 



Now, the next structure with which the testicle comes in contact, 

 is the fascia transversalis ; let us follow this in its descent with the 

 testicle, and observe the changes which it undergoes. It is not per- 

 forated as most pictures represent, but pushed before the testicle, 

 covering it and the cord. The point where this protrusion takes 

 place, is midway between the anterior superior spinous process of 

 the ilium and the pubes, and about an inch and a half above Pou- 

 part's ligament, and is called the internal abdominal ring; but 

 there is no hole or opening unless mad6 with a scalpel. The fascia 

 is continuous from the abdomen upon the cord, although that portion 

 covering the abdomen is tougher and thicker than that of the cord. 

 If the cord is stretched, this portion of the fascia will resemble a 

 funnel, and hence some call it the infundibiliform fascia. That 

 portion which covers the testicle, assists in forming its cellular coat, 

 which is termed by some tunica vaginalis communis testis, by 

 others, fascia pro2:)ria. Terms are 

 matters of minor importance; the truth 

 to be taught is, that the testicle, cord, 

 and abdomen are invested by the same 

 fascia, having different names and dif- 

 ferent thicknesses in different parts. 



The next layer of the abdominal wall 

 with which the testicle comes in con- 

 tact is the transversalis muscle. At 

 the lower part of the abdomen, the in- 

 ternal oblique is so much blended with 

 the transversalis, that the two may be 

 considered as having the same relation 

 to the testicle in its descent, and also 

 to hernia. At the internal abdominal 

 ring, the testicle, already covered by 

 the peritoneum and fascia transver- 

 salis, comes in contact with these 

 muscles; it does not perforate them, 

 but pushes their conjoined lower edge 

 before it, obtains for itself and cord a 



muscular covering, which is the cremaster muscle ; and this accounts 

 for that looped appearance which the fibres of this muscle have upon 

 the testicle ; also, for the muscle being thicker upon the anterior part 

 of the cord. These muscular fibres are very pale, and very scattered 

 upon the lower part of the testicle, and form an imperfect covering for 

 the testicle. When the cremaster is cut away from the transversalis 

 and internal oblique, their inferior edge presents an arched appear- 

 ance. 



The tendon of the external oblique is the next structure opposing 

 its descent, and since this is very tough, it is not pushed before the 



7* 



