284 SURGICAL APPLIED ANATOMY. [Chap. xvi. 



enveloped in the hernia. In the second and third 

 forms, as well as in the acquired form, it is to be felt 

 quite distinct from the rupture, being actually behind 

 and below it. 



A congenital hernia may form in cases where the 

 testicle has not descended at all. In such instances 

 the vaginal process may occupy the would-be canal, 

 and along this process a hernia may descend. It is 

 well known that the testicle may make its first appear- 

 ance in the scrotum, months and even years after birth. 

 In such cases the vaginal process may be normally 

 developed at birth (i.e., may occupy the scrotum), or 

 it may be abortive. 



In the foetus the inguinal canal is relatively 

 much shorter than it is in the adult. As the pelvis 

 develops, however, the relations of the canal approach 

 more to the normal. In the congenital hernia the 

 relations of the canal are not disturbed as they are 

 in the acquired form. Thus, it happens that such 

 ruptures have long and narrow necks, and the difficulty 

 in steadying this neck constitutes one of the special 

 obstacles in the effectual reduction of the hernia. 



There is another possible congenital defect that 

 may predispose to hernia, viz., an abnormally long 

 mesentery. If, in the dead subject, the inguinal canal 

 be opened up, and an attempt made to draw a piece of 

 gut down from the abdomen into the scrotum, it will 

 be found that it cannot be done, owing to the shortness 

 of the mesentery. In any case of scrotal hernia, there- 

 fore, the mesentery must become lengthened, and it is 

 a question whether or not an abnormally long mesen- 

 tery may exist as a congenital defect, and so predispose 

 the patient to rupture. More information is required 

 upon the subject. 



The ingiiiaial canal in the female is much 

 smaller and narrower, although a trifle longer, than it 

 is in the male. It is occupied by the round ligament, 



