HERNIA 
but when they reach down into the {erotum, it is comunonly 
nanied an spent. or eich ome rupture. 
‘The hern nia to n are moft gin? is the crural 
One leis eres fort of pvt Joe in which 
the protruded vifcera puth before them a production of the 
peritoneum into the tunica vaginalis, will be hereafter - 
defcribed. 
The inguinal, crural, umbilical, ventral, and congenital 
hernize, particularly the three former, are thofe moflly m 
with in practice. There are, haceavey, fome. lefs frequent 
— of hernia, “which muft not be omitted in the prefent i 
wor 
a 
cr 
Sometimes the vifcera are protruded at the ti ovale 
of pe pelvis, when the difeafe is called a hernia of the fara- 
men ov. 
On other eccahonn the vifcera.. are Pieeed between the 
on: and reétum in men, an the uterus an 
um in women, fo.as to be perineum. 
rotruded in: : 
he pe cafe is diftinguithed by the appellation of a hernia of 
produced in the vagina by, the dif 
may 
ped bo bowels, ce is nehe cafe is named, a vaginal hernia 
a mes occurs at.the iehiatic 
fs font by the- fide of the 
Hernize of the diaphragm, however, generally bape 
through unnatural openings in the mufcle. 
Mr. Aftley Cooper has feen a hernia protruding into che : 
labium pudendi, under the ramus of the sagen and | ex- fl 
fending up into ao meet by the fide of the v: 
_ The os nent furgeon has in his 
tions, exhi iz pele cdbt een 
. presi in which herniz were _ Ww 
the. sg rs of he mefocolon and mefentery. | Inguinal 
- Belides thefe man different fpecies | of hernizx, Sind 
imes become : y various kinds of adhe- 
fons, by Dipping throug unnatural holes in 
“the ames of hea emo er a na- hav 
when the hernia a contains 
aorta. 
the smefenterys' frm 
rocele, or inteflinal hernia. But when. the contents confitt 
ai and inteftine, it is often denominated an 
entero- -cpiplocele 
When the bladder i is protruded, the hernia receives the 
name of le el. Alfo, the terms ileatcele, gafrocele, hyfle- 
rocele, &c. are occafionally employed, when the fpleen, 
omach, or uterus is contained in the hernia. 
When the prolapfed vifcera admit of being returned into 
the abdomen, without any difficulty, or when they are ac- 
cuftomed to afcend and defeend {pontaneoufly, according as 
the patient is in a Se or erect poilure, the cafe is 
denominated a reducible her 
When the return of ne gi Tay of the tumour, however, 
is prevented either by adhetions to each other, or to the 
hernial fac, or by the increafed bulk which they have ac- 
quired i in their unnatural fituation, the hernia is termed irre- 
ucible. 
Laltly, sa Fe the reduction is rendered impracticable by 
the conttri@tion, which the vifcera fufler in. the opening 
through which they have pafied, the cafe is named a 
ee mg we or incarcerated hernia. 
This latter ftate of the difeafe proves a frequent se 
of death, and always demands prompt furgical affiftance. 
e parts, whic h moft commonly form the contents of 
herniz, are the omentum and inteftines. The ilium, in con- 
-fequence of its nearnefs to the ring, is moit Feequeily rO~ 
truded. The next, in order of frequency, is the colon; 
ies the cecum, and often the jejunum. But thank thefe 
are the parts contained in ordinary herniz, all the reft of the 
abdominal vifcera have been known.to be protruded in rarer 
e exception of the sorte and duode- 
to the a connection they have 
with the pie only admit of being fufficiently difplaced. 
Only art of the circle of an inteftine, or a mere fold 
may oe the conterts of a hernia; but nearly thes whole 
alimentary canal has been been contained ; in fome enormous . 
= Beatie of the large inteflines generally confifl, either 
of the cecum, or figmoid flexure of the co spe thele bask 
the parts leait fixed. The cecum is u otruded on 
the right fide ; the figmoid flexure on the 4 ae - Yet 
imes been found 
imperfect, they may happen in 
ue Kidnis I have sAivalli been prota (Cooper on 
where r ¢.p. So} fe )s hel y take ae 
bited | . 
fmooth elaitic membrane, named he peritoneum, which 
dingo pare eg a al 
ae Cs eae 
ve. fore them the part o Be ieperee e ee 
