HERNIA, 
Mr. A. Cooper informs us, however, that fuch change Hematocele, ora collection of blood in the tunica vaginalis, 
-produces no alteration in the relative pofition of the epigaf- 
tric artery, except in giving it a greater curve. 
” The hernial fac is commonly in front of the fpermatic 
{permatic cord is feparated, and the hernial fac protrude 
make their fir incifions without caution and confideration. 
‘at the lower part of the fcrotum, 
and tefticle can only be felt with 
the fenfation of a fluétuation, when 
has f 
when a lighted candle is put behind it 
Wh 
readily difcriminated by their not being conne 
abdomen. When it reaches within the 
of complaints induced by a kick in the groin, 
under the idea of the cafe being a ftrangulated 
herni 
Ww po 
fluid which it contained was difcharged, an 
is very apt to be 
its generally proceeding from a blow, and having the fame 
fhape as the laft difeafe. But, fays Mr. Altley Cooper, the 
firmnefs of hematocele, the rednefs of the fkin accompany- 
taken for a hernia. When large it dilates upon coughing, 
but not otherwife. It appears in the ereét, and retires m 
the recumbent pofture. It is firlt obferved near the ring. 
The only fure method of diftinétion with which Mr. Aftley 
Cooper is acquainted, is to make the patient lie upon his 
back and then to empty the {welling by preffure upon the 
fcrotum. The fargeon now putting his fingers firmly upon 
the MPP part of the abdominal ring, the patient is de- 
while the preflure upon the ring is continued, But if it isa 
varicocele the {welling returns with increafed fize in confe~ 
“quence of fuch preflure, See Cooper on the Anatomy, &cs 
of Inguinal Hernia. 
Operation far the Strangulated Inguinal Hernia.—When re- 
lief cannot be obtained from the plans already detailed in 
diffecting down to the fac, and opening it ; removing the 
ricture, and replacing the protruded vifcera. The ex- 
et 
i=} 
og 
gains room where it 1s much n 
t i ‘z. the incifion of the ftricture, and for th 
he cellular and adipous fubitance, in this fitua- 
tion, ought to be divided, fo as to bring the a neurofis of 
the external oblique mufele fairly into view. - Ei i 
firft incifion, or in the fubfequen 
e femoral artery may be di- 
vided, and ought to be tied when the hemorr! i 
be e 
d not only elevate the layers of cellular fubftance 
apg dt take care i divide them with the 
ing a little in one p I ut elect 
oe the objeét in view at any point till after a confiderable 
t T ired is to make an opening into the fac 
a can be accomplifhed with 
» molt fecurity at of the tu » becaufe fi 
# the fac, and, in that cafe, always 
of the {welling. An open 
be enla rag az bai 
. by t ger or 
direét cavity J! A n, The prefence 
of fluid is nftant circumftance, and, therefore, can- 
: 2S ar ich will always 
ular arrangen t 
fmooth furface, diftinguith it from the 
ther rdugh and cellular on its furface, 
connected with the furroundir 
| = he ae: Tels are for vet $ to « a 
pa wi vise 
