APPENDIX, (59) 



tlie thlgli prefTes it inwards and downwards, and it then goes wraamnL 

 towards the labium. This I have inftances of in fome women 

 I have lately examined with hernise, 



" The appearances of the bubonocele, when fmall, vs^ill de- 

 ceive a practitioner if he is not on his guard, and make him ima- 

 gine it a femoral rupture. The marks by which the one may 

 be diftinguiflied from the other, though fituated in the fame 

 place, are few and fimple. 



*' As the fafcia of the thigh joins Pau part's Hgament, the 

 femoral hernia is always under this fafcia ; it is therefore more 

 comprefTed ; it is not loofe, and we cannot fo well grafp it with 

 the hand ; and, inftead of being rounded on the top, it is- more 

 or lefs flattened. The bubonocele again is only under the fkin 

 and cellular membrane, is therefore loofer, can be grafped, and 

 is rounded on the top. 



" In femoral hernia the fwelling begins at the edge of Pau- 

 p art's ligament, and goes down, and we feel the ring and the 

 parts above the ligament uncovered by the hernia. In the bu- 

 bonocele of women it goes over Paup art's ligament, and fome- 

 times up tipon the mufcles over the ring, and extends more to 

 each fide along the bending of the thigh than the other. 



** From thefe marks not having been attended to, I fufpedl 

 much that the place where the hernia lay was alone taken into 

 view, and cafes fimilar to mine had been called femoral rup- 

 tures. Indeed I have every reafon to fuppofe fo, as fome of the 

 cafes where I was mofl certain of their being bubonocele, had 

 been looked on as of the other kind. 



" I WOULD therefore recommend to practitioner's attention to 

 thefe marks, fo as to determine how^far the obfervations I have 

 been led to make are jufl. 



" Th e bubonocele in this fituation in women, from its often 

 lying in parts over the ring, makes the redudion much more 

 uncertain, as we cannot grafp the part of the hernia juft coming 



(H 2) through 



