Scar pa s Triangle and Femoral Hernia. 307 



femoral canal is in a more dependent position than the 

 inguinal, and is directed vertically rather than obliquely 

 as the latter is, femoral hernia is not very common, prin- 

 cipally because of the small size of the femoral ring. Ac- 

 cording to Macready, out of one hundred cases of rupture, 

 there would be, in the male, 83.5% of inguinal and 2.1% 

 of femoral, and, in the female, 8.5% inguinal and 5.9% 

 femoral. The greater width of the pelvis in the female 

 and the effect of child-bearing on the length of Poupart's 

 ligament account for the larger number of cases of 

 femoral hernia in the female than in the male. When a 

 femoral hernia is strangulated, the seat of stricture may 

 be at the neck of the sac, at the femoral ring, or under the 

 overhanging upper margin of the saphenous opening, and 

 in the operation for its relief this seat of stricture may 

 have to be divided. Should the stricture be situ- 

 ated at the femoral ring, it should be divided by 

 nicking its inner border, i.e., Gimbernat's ligament. 

 The femoral vein forms the outer boundary and 

 could hardly escape being wounded if the knife were 

 directed outwards ; the vas deferens, in the male, and the 

 round ligament, in the female, lie above Poupart's liga- 

 ment, and, therefore, are in front of the ring ; the bone is 

 behind, while the free crescentic edge of Gimbernat's liga- 

 ment is situated internally. In one out of one hundred 

 cases the obturator artery is given off from the deep epi- 

 gastric to wind around the inner border of the ring, so 

 that, under these circumstances, this artery might be 

 wounded during the operation. In the radical cure, the 

 margins of the saphenous opening are approximated by 

 interrupted sutures after the sac has been ligated and ex- 



