5^ 
Sea. 1%. 
A Description op all ThP 
in the ikin be joined by iUtches, will fcarcely be greater than where the Ikin 
alone is divided* 
By the by, I would here obferve, that the divilion of the tendon in the 
crural hernia Is not attended with that degree of danger which fome of the 
lateft and moll eminent writers have fuppofed (^), providing the edge of the 
knife be turned towards the umbilicus ; in which direaion both the epigallric 
artery and fpermatic cord are at the greateft diftanee from it ; and that the 
knife be ufed like a faw, dividing cautioufly with it one tendinous fafciculus 
after another, 
> 
If, after dividing the tendon, the bowels cannot be eafily returned into the 
abdomen, there may be room for fufpeding that they are confined by a llric- 
ture of the neck of the fac, efpecially in the hernia congenita j which mull 
therefore be in the next place removed. 
If the herniary fac under the ftraitened place of Its neck be thin and tranf- 
parent, and that there is little or no reafon to fufped an adhelion of the bowels 
with the fac, the bell method will be to make a fmall hole in the fac below 
the llridure, and then to introduce a fmall furrowed probe, and to cut cau- 
I 
tioully upon it : But if the fac be thick and dark coloured, and that there is 
likewife a fufpicion that the bowels may adhere to it, the ealiell and fafell 
manner will be to make the hole in the peritonaeum above the llridure ; then 
to introduce a common probe, bent near its point into a femicircle ; and to 
introduce this, with its point direded downwards, through the llridure into 
the fac ; and, upon the point of it, to make with great caution another fmall 
hole ; after which we may either cut upon the probe, or introduce a furrowed 
probe, and divide the neck of the fac (-6). 
After 
(^) Pott, p. 308. 
{h) In a cafe of crural hernia to which I was called along with Mr Dewar furgeon, in 1772, the 
fac was thick and opake, with a fufpicion of adhefion j for which I propofed this method ; and we 
executed 
1 
