HER 
to the angle of the pubes, and extend the incifion as far as 
neceflary, by ie cautioufly from without inwards. 
owever, have arifen from the occa- 
courfe than appear:to be well founded. Monro computes, 
that the obturator artery may arife from the epigattrie once 
in twenty-five or thirty fubjects. But even fuppofing it 
pointe more frequently, it then does not always deviate 
from ufual cotirfe along the outfide of the fac. 
r acquaints us; that in all the cafes which he ues 
himfelF ‘diffeéted, where this variety exifted with crural 
On Cratal- 
reach of any danger from the knife. 
‘Congenital Hernia. Then me of inguinal aie aa ler- 
nia has been rate to that he of the dife afe, where the 
protruded vilcera have the tunica vaginalis as a hernial fac, 
and lie in immediate contaét with the fefticle. 
The eens in which this rupture was formed was not. un- 
deritood 
eran that the vifcera had made their way into its ca- 
refflure. It is now univerfally known that the tef- 
eae is orginally placed near ie kidney, where it receives. a 
covering of peritoneum the other abdominal vifcera ; 
that in the latter months 73 pregnancy it defcends through 
the abdominal ring into the ferotum, carrying with 
portion of peritoneum ; that t 
the membranous bag holdin 
cavity, is deltroyed before t 3 and that the 
peritoneal coat which furrounded the ape sabe in the abdomen 
forms the tunica albuginea, while the loofer privels that 
pafles with it oe the Eek makes the future tunica va- 
The ee of the communication. bier 
‘cavity of ee tun is and a moftly, 
before. Mints, though loge se not ntl after- 
wards, and fometimes even as late as manhood. | 
The epithet con; a nieaed feems liable to objestion, as con- 
ducing to an erroneous sel gk that the hernia is actually 
formed at the period of birth. aig true, that while a 
tunica vaginalis and 
operation ¢ t exctiing 
But fince in the ‘fetal ftate thefe caufes cannot aé, 
it ould be abfurd te fuppofe that the rupture was’ ftri 
Immediately, ver; the funétion of refpi- 
“ation begins, the difeafe may be ad es and although it 
mmon for it to exift at the time of 
is unco 
r birth, and fometimes not tl ‘long « after it. 
ee ‘might be Reker to charaterife the rr ‘the pecu- 
its being emer < wane ! . whi 
piece 
ri@ly down in the fac, while the tefticle | is full j in the groin, oF 
if the gut or caul’i se os and wher it 
| ene cer as: ic te a 
eommon hernial 
N I A. 
ferves in every refpe& as the hernial fac, 
Nofographie PTR ape tom. iil. p. 399. e 
We have faid that the hernia congenita ri t com. 
monly take place till after the period of oe ars that its 
formation requires the operation of the ordinary exciting 
— — 
we have now to acquaint the reader, that in a few inftances 
the fintate is already formed at the time of birth, and is 
ftritly congenital. Is OC 
(Comment. Reg. Soc. Scient. Goetting. 1778; 
71.) Soemmerring has. alfo feen ie appendix wernttfortiw 
adhering to the teilicle. (Danz PE em les 
ii he remarkable fre- 
cafes of exlgeaies] hernia, muft be well known to all expe- 
rienced furgeons. It was noticed the eth and more recently 
by that incomparable writer Mr. 
The anatomy of the congenital Hetiie 4 refembles tha 
the common panencerai: where the protrufion rail pens a 3 
inner openin ring, excepting that the a | 
appeal ig " 
the tunica - = inftegd of an ordinary hernial fac foes 
of the perit 
The exiftence of the difeafe from’ al is 
a eter for fufpeéting its nature ; but it is not a cer 
criterion, as very young = ev fs have a bubonocele. 
a cafe related by Mr. Lawrence, p. 59. 
The treatment of the conpennal Bernie is to be regaltd 
on the principles rep to ruptures in general. When 
returnable, it ought, like every other kind of repture, to be 
reduced, and conftantly kept up by a proper trufs; am 
when attended with sage cent ot Spee it requires ires the 
me: furgical affiftance as the ¢ ernia 
n very young children,” {ifs Mr Pott,) « there are 
pee circumitances relative to this kind of rupture, which 
are very well worth attending to, as they may prove of very 
material confequence to the pati a 
of inteftine or omen may get pretty low 
even within the abdomen, beth which I have feen. In this 
cafe, the appleation of a trufs would be highly improper + 
for in the latter, it mught prevent the defcent of the tef- 
ticle from the é belly into the ferotum ; in the former, it mutt 
neceflarily bruife and i injure it, give a great deal of unne- 
. pany — can prove of no ge ale ‘Such bandages 
he : never to be app a rupture in ap I~ 
fake, wile che peficke can be fairly fele ia in {erotum after 
an be fo felt, 4 
trufs can never be put on too foon eS 
ofifte hie indse saptiveis fubje€ to ftri€ture, with 
that which is contained poe: 4 
Such Avement'i is perfectly cere, He ithftanding 
3 
ee 
: 
4 
