OTHER VARIETIES OF HERNIA. 79 



It occurs also in women who have borne many children ; though 

 in them the point of the protrusion is not through the navel, but near it. 



Strangulation does not often take place. 



The treatment in a child is simple and effective. A small hemi- 

 spherical pad, made of cork, or half of a nutmeg, covered with 

 buckskin, is properly fitted, and there secured by a broad strip of 

 adhesive plaster, which should surround the be.lly of the child. 



In the adult the tumour may become very large, and usually 

 contains a large quantity of omentum. Pain, indigestion, and con- 

 stipation are often its accompaniments. The trea.tment consists of a 

 large truss, adapted to the case. In case it should be strangulated, 

 the operation for relief of the stricture is performed by making an 

 incision through the skin and superficial fascia, which exposes the 

 sac ; this is to be opened in the usual manner. The incision for the 

 relief of the stricture is to be made in the linea alba. 



OTHER VARIETIES OF HERNIA. 



Scrotal hernia is a term applied to the protrusion when it has 

 descended from the groin into the scrotum. It occasionajly entirely 

 obscures the penis, and reaches almost to the knees. Its coverings 

 are those of inguinal hernia. 



Congenital Hernia. — This depends upon a want of obliteration 

 of the connexion between the peritoneum and tunica vaginalis of the 

 testicle. The intestine descends in the same manner as the testicle. 

 It has no sac or peritoneal covering other than that in which it and 

 the testicle are contained. 



This is most common in young male children, and is easily cured 

 by a truss ; there being a natural tendency to closure in this tubular 

 connexion between the peritoneum and tunica vaginalis. Care 

 should be taken in the application of the truss or compress, not to 

 injure the spermatic cord. 



In very young children a graduated compress and roller will 

 effect a cure if properly applied. 



Ventral Hernia^ is a protrusion at any part of the belly except 

 the navel and groin ; and it may be the result of a bruise, wounds, 

 and unnatural weakness of the muscles of the abdomen. 



Vaginal Hernia,^ is a protrusion into the vagina ; perineal^ 

 when the tumour is in the perineum, having descended between the 

 bladder and rectum ; phrenic or diaphragmatic, is a protrusion 

 through an opening of the diaphragm. 



The intestine is sometimes strangulated within the cavity of the 

 abdomen, through an opening in the mesentery, or meso-colon, or 

 some portion of peritoneum, or peritoneal band, resulting from in- 

 flammation. 



