288 



CHAPTER XII. 



Hernia (Rujotures). ' 



GENERAL REMARKS ^ACUTE INGUINAL HERNIA CHRONIC INGUINAL 



HERNIA ^HERNIA AT THE NAVEL VENTRAL HERNIA OTHER FORMS 



OF HERNIA. 



General Remarks. 



The most of this chapter has been compiled from the writings of 

 H. Bouley, Signolj Peuch and Toussaint, and Moller. 



DEFINITION AND NATURE.— A hernia is a tumour formed by 

 the escape of an internal structure out of the cavity which usually 

 holds it. I propose to limit my remarks in this chapter to hernise 

 which take place out of the abdomen. These so-called ruptures 

 are usually contained in a sac formed of peritoneum (p. 284) which 

 gets pushed through the opening out of the abdomen. The tumour 

 is said to have a neck, when the opening through which it escaped, 

 is smaller than the transverse diameter of the tumour. If a 

 hernia occurred throug-h an accidental wound which had involved 

 the peritoneum as well as the wall of the abdomen, the contents of 

 the hernia, instead of being enclosed in a sac of peritoneum, Avould 

 probably become exposed to view, as might happen if a horse was 

 staked. Although, for convenience sake, the term " rupture " is 

 applied to all kinds of hernise ; strictly speaking it is incorrect to 

 do so, except when referring to those which have escaped through 

 an accidental opening. 



The hernise which we are at present considering, generally con- 

 sist of a portion of the small intestine, of its connecting membrane 

 (p. 284), or of both. Constriction round the neck of a hernia, if 

 unrelieved, may cause death from mortification brought on by 

 stoppage of the circulation. Even if it be but slight, it Avill, if 

 prolonged, give rise to thickening of the part, and to the forma- 

 tion of adhesions. In any case, the contents of a hernia being 



