14 Congenital Anomalies in a Native African Race 
reverse of what is known to occur among Europeans. On examination of 400 
consecutive men, adults, between the ages of 30 and 40 years, I found in 166 or 
41"5 7o the right testicle lower than the left. In the remainder or 58'5 7o the 
right testicle was on a level with the left, or rather higher in the scrotum. I also 
got the impression that, associated with right lower testicles, the testicles and 
penis were large. In another series of 280 men, the left was lower than or on the 
Fig. 10. Boy aged 18. 
same level as the right in 18.5 ; the right lower in 88. There were two cases of 
left cryptorchidism, one of right cryptorchidism ; one each left and right hydro- 
coeles and two right inguinal bubonocoeles. 
I have come across a number of cases of undescended testis among other 
natives, in some associated with a swelling in the inguinal canal, in others there 
was complete cryptorchidism. Inguinal hernia is not infrequent in adult males 
but I can give no figures relating to a large number of persons. In a single man 
it was associated with umbilical hernia. I have never seen a femoral hernia. 
Umbilical hernia is common enough especially in children. The following figures 
though small in number give some idea of the frequent incidence of the condition. 
They refer to all the children in a single village and may therefore be said to be 
unselected in any way. 
Age 
+ 
+ + 
0 — 1 year 
18 
13 
6 
1 — 2 years 
44 
27 
12 
3-10 „ 
102 
44 
10 
Totals 
164 
84 
28 
roughly 
60 7„ 
30 7„ 
10 7o 
= 276, 
40 7„ 
That the hernia diminishes in size even to disappearance after childhood, as 
indicated by these figures, is certainly true as the same incidence is undoubtedly 
not found among adults. The protrusion is sometimes very marked and takes the 
