Scar pa's Triangle and Femoval Hetnia. 305 



and is filled with areolar tissue, which, according to Clo- 

 quet, is condensed to form a septum the septum crurale. 

 On the other hand, Joussel maintains that there is no fas- 

 cial septum here, that it is merely areolar tis- 

 sue, and that this areolar tissue, with a gland 

 Rosenmuller's protects the ring. The presence of 

 a canal or space alongside the femoral vein proves of 

 great importance in connection with the circulation of the 

 lower extremity, for, if the inner margin of the sheath, 

 formed by the iliac and transversalis fasciae, \v ere as close- 

 ly applied to the vein as the outer margin is to the artery, 

 there would be more or less interference with the venous 

 circulation, especially in the different movements of the 

 limb, on account of the sluggish nature of the current of 

 blood in the vein as compared with that in the artery. The 

 tip of the index finger can be readily inserted into this 

 ring in the dead subject, due, no doubt, to the fact that the 

 femoral vein is here collapsed, whereas, in the living sub- 

 ject, it is altogether likely that the distended state of the 

 vein would markedly lessen the size of the ring as found 

 in the dead subject. The presence of the areolar tissue, 

 mentioned above, strengthens what would otherwise be a 

 rather weak part, so that femoral hernia is very infrequent 

 as compared with inguinal hernia. But, when in the old, 

 or in patients after frequent pregnancy, Poupart's liga- 

 ment becomes more or less lax from repeated over-stretch- 

 ing, this potentially weak spot may, during efforts of 

 straining, become converted into an actual defect, and, 

 yielding to the pressure of the intestine, permit a femoral 

 hernia to occur. 



Coverings of Femoral Hernia. When the bowel 

 protrudes, it pushes in front of it, the peritoneum covering 

 the ring; next, the subserous areolar tissue; the septum 

 crurale, when it exists, and the areolar tissue of the canal ; 



