ANATOMY OF INGUINAL HERNIA. 169 



will probably be found that one of these layers has been 

 removed with the skin. Directly beneath this is the ten- 

 don of the external oblique, between the fibres of which 

 emerges the spermatic cord. This point of emergence is 

 called the external abdominal ring, and consists merely of 

 a separation of the tendon, the upper border of which is 

 called the superior pillar, and the lower, the inferior pillar 

 of the ring. The further separation of these pillars is 

 prevented by transverse fibres, called inter-columnar. The 

 spermatic cord consists of the excretor}^ duct of the testi- 

 cle, called the vas deferens, the spermatic artery and vein, 

 a nerve, some lymphatics, and cellular tissue. These con- 

 stitute a bundle of considerable size, reinforced by the 

 cremaster muscle, which is not properly a part of the cord, 

 the whole of which lies behind a thin fascia, extending 

 across the pillars of the external ring, and continued down 

 upon the cord, called the spermatic fascia. 



Upon reflecting the lower part of the external oblique, 

 toward the groin, the spermatic cord will be observed lying 

 for a short distance behind it ; the internal oblique and 

 transversalis curve over it, and Poupart's ligament is 

 directly beneath it. The cremaster muscle, being fibres of 

 the internal oblique and transversalis muscles, lies upon 

 the cord itself, and its connection with those muscles may 

 possibly be traced. The space traversed by the cord, be- 

 hind the external oblique, is called the inguinal canal. 



If the internal oblique and transversalis are separated, 

 upon turning down the lower part of the former muscle, 

 it will be seen that the transversalis leaves a space between 

 itself and Poupart's ligament ; in this space will be seen 

 the transversalis fascia, and upon reflecting the transver- 

 salis muscle, it will be seen lying behind it, upon the peri- 

 toneum. This, like the superficial fascia, were it not for 

 its relations to hernia, would be considered merely as the 

 sheath of the transversalis muscle ; it is of very variable 

 thickness, sometimes amounting to nothing but a little 

 cellular tissue; it is attached to Poupart's ligament below, 

 and internally to the conjoined tendon and sheath of the 

 rectus muscle. By pulling the spermatic cord, it will be 

 seen that this fascia is reflected from the peritoneum on to 

 the surface of the cord, and the cone which is thus formed 

 and made apparent, by this traction, is called the infundi- 

 buliform fascia. The orifice forming the base of this cone, 

 and across which the peritoneum is stretched, is the inter- 

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