INGUINAL OPERATION ON CRYPTORCHIDS. 245 



present great differences in this respect ; in some perforation is easy, 

 in others it requires considerable force. 



4. Finding the testicle or spermatic cord is always the most 

 difficult part of the operation for the unpractised ; nevertheless it 

 can generally be effected with the first two fingers, and without in- 

 troducing the entire hand. As soon as the abdominal wall is perforated, 

 search is made on all sides for the testicle, epididymis, or spermatic 



Fig. 254. — Transverse section of the posterior abdominal region in a vertical 

 plane. This figure shgws the insertion and arrangement of the obliquus 

 abdominis internus and the cremaster. The peritoneum and transverse 

 abdominal muscle have been removed. 



o..\ I. Obliquus abdominis internus. p.m Posterior margin of same. c. 

 Upper portion of the cremaster muscle (dividedj. R..\. Rectus abdominis 

 muscle. L..\.R. The dotted line shows the position of the lower abdominal 

 ring. L'.A.R. The dotted line indicates the upper abdominal ring. L. The 

 dotted line shows the point at which the hand pierces the peritoneum in the 

 operation for abdominal cryptorchidism, p. Pelvis. R. Rectum, bl. Bladder. 



cord. The testicle may easily be mistaken for an empty loop of bowel, 

 but is distinguished by its sharper outline and greater firmness ; 

 pressure on it causes struggling. The end of the epididymis is 

 recognised as a soft mass, containing harder, firmer cords. The 

 spermatic duct can be felt as a hard cord, and is very useful for 

 discovering and drawing forward the testicle, for its slight size and 



