VOL. XLVII.] PHILOSOPHICAL TRANSACTIONS. 221 



LI. On Hernias with Sacks. By Mons. le Cat, F. R.S. Jrom the French, by 

 Tho. Stack, M. D., F. R. S., p. 324. 



A Hernia by Rupture, having nevertheless a Sack. — In giving a private course 

 of operations to his English pupils, on the body of a lad of 18 years old, M. le 

 Cat discovered this hernia. The aponeurosis of the musculus obliquus extemus 

 ran over the whole tumor, and entirely covered it. At the anterior and lateral 

 internal part of this tumor was the ring lengthened into the shape of a perpen- 

 dicular button-hole ; which had nothing to close it but a cellular lamina, which 

 covered all this bag, being a continuation of the cellular membrana adiposa. 

 Through this button-hole appeared the cellular coat, with which the peritonaeum 

 furnishes the spermatic vessels. The intestine occupied the rest of this bag ; and 

 at the bottom was contained the testicle, which consequently had never taken 

 the way of the ring to come out of the belly, as it usually does ; but having 

 passed on one side, it had gradually pushed out the aponeurosis of the musculus 

 obliquus extemus ; and the intestine having followed it, and broke the true la- 

 mina of the peritonaeum, they had in concert formed this elongation. At least 

 this is the most natural explanation he could give of this singularity. That the 

 testicles are originally in the belly, is a fact sufficiently known. He had dis- 

 sected foetuses, in which he found them there, near the bladder. It is pretty 

 common to feel them in the rings in children ; and he had found them there 

 even in lads of upwards of 20 years old. 



A Hernia having Tico Sacks. — Continuing the above-mentioned course, he 

 lOund in the body of a bachelor of 48 years of age, a rupture with a double 

 herniary sack, the first of which was formed by the expansion of the aponeurosis 

 of the obliquus extemus, as in the preceding observation, excepting that this 

 expansion was only on the outer side, that the ring was in its usual place, that 

 the bottom of the bag formed by this expansion had some empty spaces, where 

 the expansion was wanting. In short, the bag was neither so complete, nor so 

 thick as that of the foregoing observation ; but on the other hand, there was a 

 2d bag, formed as usual by the true lamella of the peritonaeum. 



Another Sort of Duplicity of the Herniary Sack. — A coachman about 65 years 

 of age, had a rupture of long standing, of the strangulation of which he had al- 

 ready cured him in 1 748. Having taken off his truss, in order to get it mended, 

 he was seized with strangulation the IQth of Feb. 1750. After applying all the 

 remedies prescribed in such cases without success, he was obliged to perform the 

 operation on the 21st at 8 in the evening. Having laid the bag open in the 

 usual manner, which contained a little watery humour, he was much surprized at 

 discovering within this bag a second bag, or pocket, which could be nothing 

 else, but either a second hemiary bag, or an incomplete hernia ; that is, a por- 

 tion only of one side of an intestine elongated, and come down through the ring. 

 The number of considerable blood-vessels on this pocket, its thickness and fibrous 



