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Show 168 VARIETIES or HERNIA. stance yields to the unremitting pressure, and the occasional exertion of the muscular walls of the original cavity. Thus there is a perpetual tendency to an increase in the quantity of the protruded bowel ; and also a surcharge of blood in its vesselsae. Our general definition implying that the contents of hernia are enveloped in the membrane of the cavity (as the peritoneum in the abdomen) excludes from consideration under this head the protrusions of the brain, or the disease which is called hernia cerebri ; and also the protrusion of the lungs in consequence of wounds in the thorax. It keeps us simply to the consideration of the displacement of the abdominal viscera. CONCEALED HERNIA. 16$ Varieties : Inguinal hernia (bubonocele)--when the bowel just protrudes, and lodges in the groin. Scrotal hernia (oscheocelej-when the bowel descends into the scrotum. Hernia of the labium pudendi-when the bowels descend in women. A hernia may be lodged here which has come down by the side of the vaginaa‘e. Hernia through the ring and through the spermatic pro- cess of the peritoneum; being in contact with the testicle, and CONGENITAL, or appearing at birth, or at least with the descent of the testicle. Hernia into the spermatic passage, behind the tendon ot‘ the external oblique muscle. VARI ETIES 0F HERNIA. II. Hernia under the crural ligament, viz. crural or femo\ ral hernia (merocele). A NATURAL division of hernia: is, into those which are dis tinguishable by tumour, and those which are concealed. III. Hernia through the ring for the passage of the umbil- ical vessels, viz. umbilical hernia (exomphalos, emphalocele). I. 01' HERNIA \VI'I‘H TUMOUR. IV. Hernia through any preternatural opening of the mus-4 (TlCS of the belly or their tendons, viz. ventral hernia. "THEN hernia takes place, through the dilated natural pas-sages of the abdominal muscles and their tendons, the tumour II. OF CONCEALED IIERNIA. gives indication of its nature and precise seat, and is the sub ject of surgical operation. are, The varieties of these tumours Tins kind of hernia is without any tumour, or external mark, or possibility of distinguishing the nature of the dis. ease by the touch. We have the following examples :- I. Hernia through the abdominal ring-This hernia comes down through the tendons of the muscles, where they split. to allow the passage of the spermatic cord; or in women to admit the passing of the round ligament of the womb. I. Hernia through preternatural holes inthe diaphragm, or through the dilated passage for the oesophagus'f. * Mr. A. Cooper. if \Vhen any of the viscera of the abdomen are thrust through the dia" And here we may observe how well Mr. Wilmer of Coventry's practice Corresponds with this view, by applying a weight on the herniary tumour, which gently, but with continual pressure, operates to return the contents of the gut into the abdominal portion ofthe canal. of this practice, howey- phragm, they are very apt to be strangulated, in the abdomen is constant. The pressure on the viscera When they are in the cavities of the chest, they suffer alternate compression and relaxation ; and during the expansion of the chest, the stomach or intestine, or whatever forms the hernia, is more er, I cannot here speak in commendation, not having seen its success I" and more drawn "ithin the hole in the diaphragm, until the breathing is practice. (Ready afl‘ected, or the bowel strangulatcd. Yo r. l. r ‘. «pi , Lands 1 ..,, ill"? " 'lm |