gia) 
HERNIA. 
tion of the urinary bladder is protruded, its fundus and 
pofterior furface are dragged towards the ring, and even pafs_ 
through this aperture, together with the peritoneum, whic 
covers them. . . 
The portion of this membrane, which is thus drawn out 
by the protruded part of the bladder, and follows it, compofes 
a pouch, into which the omentum and bowels efcape, fo that 
a cyftocele is very commonly complicated with an ordinary 
inguinal hernia. 
A hernia of the bladder is charaGterized by a foft, oblong, 
filutuating tumour, fituated in th d of in3 1 
makes its firft app 
laft circumftance unequivocally diftinguifhes 
the difeafe from the encyfted hydrocele of the permatic 
cord, while the feel of fiu@uation exhibits its difference from 
an enterocele. It is alfo to be remembered that cyftocele 
feldom afflicts perfons unlefs they have been often troubled 
with retentions of urine. The patient in general makes water 
more frequently than natural.’ ; 
. 
on record, where portions ef this vifcus have been protruded 
prolapfed part being 
The fluid which it 
tion, except 
P hernia. - In 
fuch a cafe, great care fhould be taken to avoid making an 
epening unnceeffarily into the bladder, 
e hernia of the bladder is exceedin ‘ly uncommon 
_ under the crural arch. Verdier has rec nde an inftance 
in the Mém. de l’ Acad, de Chirurgie, tom, ii. p. 23. 
Calculi have often been obferved in the protruded portion 
of the bladder. They may 
p- 11— 
It is alerted that protrufions of the bladder may happen 
between the fibres of the elevatores ani, when torn a or 
violent abduétion of the lower extremities. The cafe could 
 fleéted hom tie re€tum to the vagina, or bladder, is at aco 
erable : from the peritoneum, it is not difficu ; 
: comprehend, ‘that a ‘protrufion may exill, without forming 
any external fwellir hen this is the cafe, the hernia 
ean only b diftinguithed in men by exdmining within the 
rectum ; ‘in wom en, the difeafe may be detected both in this 
way, and by feeling within the vagina, 
* 
be fafely extraéted through an _ 
“ incifion made for the purpofe. Acad. de Chirurg. tom. ii, 
a. | 
The contents of perineal herniz have been inteftines OF & g 
part of the urinary bladder. — The {welling becomes 
and more tenfe in the ereé& pofition, or when the patient 
or fofter materials, placed on the 
n females, a protrufion may be hindered by 
HE 
a fource of g 
may convince 
Surgery in France, 
which the pro- 
rupture; but in 
ia 1s generally brought on by a violent exertion. Its con- . 
tents may be‘readily pufied up by the hand, but they de- 
f All ative and 
