SURGERY. 
Femoral hernia is formed by the protru- daction or dimimitioii; often there is a de^ 
Bion or some or tne abdominal contents un- 
der the inferior margin of the external ob- 
lique muscle (which part is called also Poii- 
part’s ligament): and the swelling is situated 
towards the inner part of the bend of the 
thigh. It is much the most frequent in 
women, and is generally very small ; hence 
it may be mistaken for a swollen gland, 
unless great attention be paid to the symp- 
toms. The precise point at which this her- 
nia descends is the space left under the 
crural arch between the femoral vein and 
the thin posterior edge of Poupart’s liga- 
ment. Tlie latter part has a broad inser- 
tion into the pubes, and this insertion ends 
in a thin and very sharp margin, turned to- 
wards the vein. The contents of the abdo- 
men cannot escape in any other situation, 
because the crural aich is filled by parts 
going under it, and covered by a fascia ex- 
^nding over the iliacus internus muscle. 
The rupture first descends, and then conies 
forward, to which we must attend in en- 
deavouring to reduce it. The peritoneal 
sac is covered by a very complete exterior 
investment, as in the ingninal species. The 
spermatic chord, or round ligament, passes 
directly over the mouth of the sac, and the 
epigastric lies on its outer edge. The stric- 
ture, which is always very close, should be 
relieved by detaching the thin edge of 
Poupart’s ligament from the pubes. 
Umbilical hernia, exomphalos, or ompha- 
locele, is formed by the protrusion of the 
y^cera through the tendinous opening term- 
ed the navel. An elastic truss for this rup- 
ture is described by Mr. Hey,and is the best 
hitherto contrived. 
There is nothing peculiar in the treat- 
ment or operation, nor in tliose of the ven- 
tral and congenital kinds. The surgeon, 
however, in the latter will be aware that the 
hernial contents lie in the same bag with the 
testis, in consequence of the communication 
that exists in one period of the fetal exist- 
ence between the abdomen and tunica 
vaginalis testis never having been closed. 
Hence, in such a case, the testis cannot be 
felt distinctly from the hernial swelling. 
Hydrocele is a collection of watery fluid 
in the cavity of the tunica vaginalis testis, 
or in the spermatic chord. The former is 
exactly similar in its nature to the drop.sical 
affections of the peritoneum, pleura, or peri- 
cardium. Theswellingis colourless, smooth, 
and pyriform; extending slowly and gra- 
dually upwards from the lower part of the 
scrotum; fluctuating and incapable of re- 
gree of transparency, so that the light can 
be discerned through it ; but as the tunica 
vaginalis is frequently thickened, neither 
this circumstance, nor the fluctuation, can 
be entirely depended on. The testis cannot 
be felt, but the spermatic chord may be 
discerned clearly, in a natural state, above 
the swelling. The cure is either radical, or 
palliative : the latter consists in letting out 
the fluid with a trochar, after which a piece 
of soap plaister may be applied, and a bag- 
tniss worn. The fluid accumulates again. 
In the radical cure, the hydrocele should 
be tapped with a trochar at its anterior and 
inferior part, and as soon as the fluid is en- 
tirely discharged, the cavity of the tunica 
vaginalis is to be distended to its former 
dimensions, with an injection composed of 
two parts of red wine, and one of warm 
water. The injection may remain in the 
part about five minutes, after which it is to 
be discharged through the trochar. The 
consequence of this treatment is a consider- 
able inflammation of the part, terminating 
in the effusion of coagulating lymph, and 
the consequent obliteration of the cavity of 
the tunica vaginalis. The inflammation is 
to be treated like hernia huraoralis, if it 
runs too high. 
Hydrocele of the chord may either con- 
sist of an effusion of water into the cellular 
substance, or of a single cyst of various 
magnitude. If the former prove trouble- 
some, a free incision through it seems to be 
the only means of treatment; the latter 
may be treated by the port wine injection. 
Hannatocele is a swelling of the scrotum, 
caused by the effusion of blood into the 
tunica vaginalis. Its most common cause 
is the wound of a blood-vessel in tapping a 
hydrocele: the water, as it flow’s off, is 
generally discoloured, and the swelling soon 
after regains its former magnitude. Discii- 
tieiit lotions, as that of the sal ammoniac, or 
cerussa acetata and vinegar, will generally 
cause the absorption of the blood ; cam- 
phorated liniments and mercurial ointment 
may also be employed, if the case be obsti- 
nate. .Should these means fail entirely, an in- 
cision must be made through the integuments 
and tunica vaginalis, and the blood removed. 
Sarcocele is a chronic fleshy enlargement 
of tile testicle. It exhibits very different 
appearances in different cases. It may pre- 
sent a vascular mass of uniform appearance, 
without enlargement of the chord, or any 
very painful symptoms. It may have a 
white caseous substance, intermixed wi^ 
