A TREATISE ON INGUINAL HERNLT:. 
373 
Inguinal hernia commonly exists in the foetus in utero. M. Linguenard, 
V.S., who has praetised for twenty years in Normandy, where breeding is 
pursued on a very large scale, has ascertained, by a great number of obser¬ 
vations, that this hernia is invariably present at birth, even in abortions and 
in subjects still born. 
At whatever period congenital hernia may form, we include in this class 
all such as make their appearance a few days after birth, in w hich cases the 
gut becomes hernial in the same manner in which it does in others: it slips 
throK’gh the peritoneum at the ring, gets imprisoned within the inguinal 
canal, and either drags dow n the testicle along with it, or follow s that uigan 
in its descent; the testicle, in ordinary cases, descending prior to the sixth 
or seventh month. 
At this stage of the inquiry we feel desirous to know whether the hernias 
anterior to birth spring from the same causes as those in the grown-up sub¬ 
ject, w Inch are almost invariably ascribable to efforts of violence. Congenital 
hernias appear to ns to be the result of circumstances connected either with 
defective organization or a special irritation. In the only instance in which 
we have had an opportunity of investigating this part of our subject, we found 
the testicles in a state of atrophy, whitened, and imperfectly developed. 
To whatever cause congenital hernia may be ascribable, we are 
not justified in seeking for one out of the ordinary course of events, 
since M. Languenard has found hernia invariably present at 
birth.’’ By defective organization” we presume that our author 
means the incomplete formation of parts, and alludes more par¬ 
ticularly to the ring and inguinal passages, which we know at 
. this early season to be lax, and open to receive any small uncon¬ 
fined abdominal viscus. We would not attach any importance to 
the accidental circumstance of a shrunk atrophic testicle; and we 
must confess we are not able just now to unsolve the apparent 
mystery in which he has left part of this subject by the phrase 
special irritation.” 
Certain movements of the full-grow n foetus appear very likely to produce 
hernia, when we see that the passages through which it has to pass are so 
lax as even almost to invite it: the ring and inguinal canal appear to he both 
larger than in the adult, and evidently possess more extensibility. The neigh¬ 
bouring parts, the fibrous aponeurosis of the abdomen, the lips of the exter¬ 
nal ring, the dartos and cremaster, being 5 *et but imperfectly developed, 
have little power to oppose rupture. But as soon as the foetus leaves the 
womb, these parts begin to aequire strength, and at length attain such a 
degree of energy as, by contraction, to re-act upon the incarcerated hernia, 
raise it upward, and ultimately force it back again into the abdominal 
cavity, and there retain it. These reflections on the development and dis¬ 
appearance of hernia at birth, serve to explain, also, why inguinal herniae 
suffer no engorgement or strangulation until they arrive at the chronic stage. 
For, as the ibal advances in age, the protruded mass becomes considerable; 
his food becomes more fibrous and substantial: thus every thing conspires 
against the spontaneous reduction of the gut; nay, even superinduces those 
consequences which result from its continuance. 
In this and the preceding paragraph we have abundance of evi¬ 
dence froni the author himself, that he attaches no weight either 
