48 SPRING-TIME SURGERY 



cavity by this route is as follows: An incision, 

 five or six inches long, is made through the 

 scrotum parallel with and one or two inches 

 from the median raphe. This incision is carried 

 through the skin and dartos into the scrotal sac. 

 When this is done the scalpel is laid aside and the 

 remainder of the process is carried out entirely 

 by blunt dissection with the fingers. The scro- 

 tum is found to contain considerable areolar 

 fascia and a mass of blood and lymph vessels. 

 No attention is paid to these ; they are pulled this 

 way or that, until an opening is made through 

 them down to the external ring of the inguinal 

 canal, which is but an oval slit through the apon- 

 eurosis of the external oblique muscle, large 

 enough to freely to admit the operator's hand. 

 This muscle is located just in front of the pubis 

 and at the side of the prepubian tendon, land- 

 marks that are easily determined. The exposure 

 of this ring and the introduction of the hand into 

 it is a matter of no difficulty. The fingers of 

 both hands are used in the dissection up to this 

 point. Now but one hand is required to finish 

 the opening. 



