The Abdomen 293 



on the left side than on the right. In this connection it is worth 

 remembering that normal descent of the testes in the male is said 

 to be naturally later and more liable to deflection on the right side 

 than on the left, suggesting that the mechanism of descent is more 

 ample on the left. It is sometimes congenital in origin, and it may 

 not be detected until, the uterine cornua forming the contents and 

 becoming gravid, it commences to enlarge with the growth of the 

 contained fetuses. It may often be observed to occur in animals 

 after giving birth to litters sired by males very much their superiors 

 in size. In these cases the ring seems to dilate in sympathy with 

 the enormous distension of the abdominal cavity, its caliber being 

 increased with the stretching of the wall. As soon as delivery is 

 accomplished, a part of the collapsed uterus falls through, Carrying 

 the peritoneum before it. 



It is most common to find the round ligament together with the 

 peritoneal fold by which it is connected with the broad ligament, 

 and this is often the seat of deposit of a mass of fat. Some writers 

 in describing inguinal hernia refer to this ligamentous tissue as 

 omentum, evidently owing to the similarity between the two struc- 

 tures, but my investigations have shown me that it is a rare ex- 

 perience to discover omentum forming part of an inguinal hernia. 



A condition of hypertrophy of the round ligament has been 

 designated pseudo-hernia. It is easily differentiated from the true 

 form. 



Next in frequency we find one or both uterine cornua, in part 

 or whole, together with the broad and round ligaments, forming 

 the contents of the sac. As already remarked, should pregnancy 

 occur, a rapidly growing enlargement soon becomes apparent. The 

 increase in size may be first detected about one week after impreg- 

 nation has taken place. Delivery of the fetus per vias naturales is, 

 as a rule, impossible, the inguinal ring forming an impassable con- 

 striction. Unless removed by operation of hysterotomy it dies and 

 either macerates or decomposes and induces infective inflammation 

 and gangrene of the maternal parts. Instances have been recorded, 

 however, in which the young have been brought forth in a natural 

 manner. Prange described a case of hernia of a portion of the 

 uterus which contained three fetuses, all of which were delivered 

 naturally a few hours after birth of six others. Roell had a similar 

 experience. In one instance which I relieved by operative measures 



