281 



CHAPTER XII. 



Hbrki^ (Ruptures). 



GBNBRAIi REMARKS ACUTE INGUINAL HERNIA CHRONIC INGUINAL 



HERNIA HERNIA AT THE NAVEL VENTRAL HERNIA OTHER FORMS 



OF HERNIA. 



General Remarks. 



Most of this chapter has been compiled from the writings of H. 

 Bouley, Signol, 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 

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

 ruptures are usually contained in a sac formed of peritoneum (p. 

 282) 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 through 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, would 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 herniae under consideration, generally consist of a portion 

 of the small intestine, of its connecting membrane (p. 282) or 

 of both. Constriction round the neck of a hernia, if unrdieved, 

 may cause death from mortification brought on by stoppage 

 of the circulation. Even if it be but -slight, it will, if pro- 

 longed, give rise to thickening of the part, and to the formation 

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



