Part 8

In health and disease. Displacement of the lungs from pleuritic effusion. Paracentesis thoracis. Hydrops pericardii. Puncturation. Abdominal and ovarian dropsy as influencing the position of the viscera. Diagnosis of both dropsies. Paracentesis abdominis. Vascular obstructions and their effects.

COMMENTARY ON PLATE 27

THE SURGICAL DISSECTION OF THE SUPERFICIAL PARTS AND BLOODVESSELS OF THE INGUINO-FEMORAL REGION.

Physical causes of the greater frequency of inguinal and femoral herniae. The surface considered in reference to the subjacent parts.

COMMENTARY ON PLATES 28 & 29

THE SURGICAL DISSECTION OF THE FIRST, SECOND, THIRD, AND FOURTH LAYERS OF THE INGUINAL REGION, IN CONNEXION WITH THOSE OF THE THIGH.

The external abdominal ring and spermatic cord. Cremaster muscle--how formed. The parts considered in reference to inguinal hernia. The saphenous opening, spermatic cord, and femoral vessels in relation to femoral hernia.

COMMENTARY ON PLATES 30 & 31

THE SURGICAL DISSECTION OF THE FIFTH, SIXTH, SEVENTH, AND EIGHTH LAYERS OF THE INGUINAL REGION, AND THEIR CONNEXION WITH THOSE OF THE THIGH.

The conjoined tendon, internal inguinal ring, and cremaster muscle, considered in reference to the descent of the testicle and of the hernia. The structure and direction of the inguinal canal.

COMMENTARY ON PLATES 32, 33, & 34

THE DISSECTION OF THE OBLIQUE OR EXTERNAL, AND OF THE DIRECT OR INTERNAL INGUINAL HERNIA.

Their points of origin and their relations to the inguinal rings. The triangle of Hesselbach. Investments and varieties of the external inguinal hernia, its relations to the epigastric artery, and its position in the canal. Bubonocele, complete and scrotal varieties in the male. Internal inguinal hernia considered in reference to the same points. Corresponding varieties of both herniae in the female.

COMMENTARY ON PLATES 35, 36, 37, & 38

THE DISTINCTIVE DIAGNOSIS BETWEEN EXTERNAL AND INTERNAL INGUINAL HERNIAE, THE TAXIS, SEAT OF STRICTURE, AND THE OPERATION.

Both herniae compared as to position and structural characters. The co-existence of both rendering diagnosis difficult. The oblique changing to the direct hernia as to position, but not in relation to the epigastric artery. The taxis performed in reference to the position of both as regards the canal and abdominal rings. The seat of stricture varying. The sac. The lines of incision required to avoid the epigastric artery. Necessity for opening the sac.

COMMENTARY ON PLATES 39 & 40

DEMONSTRATIONS OF THE NATURE OF CONGENITAL AND INFANTILE INGUINAL HERNIAE, AND OF HYDROCELE.

Descent of the testicle. The testicle in the scrotum. Isolation of its tunica vaginalis. The tunica vaginalis communicating with the abdomen. Sacculated serous spermatic canal. Hydrocele of the isolated tunica vaginalis. Congenital hernia and hydrocele. Infantile hernia. Oblique inguinal hernia. How formed and characterized.

COMMENTARY ON PLATES 41 & 42

DEMONSTRATIONS OF THE ORIGIN AND PROGRESS OF INGUINAL HERNIAE IN GENERAL.

Formation of the serous sac. Formation of congenital hernia. Hernia in the canal of Nuck. Formation of infantile hernia. Dilatation of the serous sac. Funnel-shaped investments of the hernia. Descent of the hernia like that of the testicle. Varieties of infantile hernia. Sacculated cord. Oblique internal inguinal hernia--cannot be congenital. Varieties of internal hernia. Direct external hernia. Varieties of the inguinal canal.

COMMENTARY ON PLATES 43 & 44

THE DISSECTION OF FEMORAL HERNIA AND THE SEAT OF STRICTURE.

Compared with the inguinal variety. Position and relations. Sheath of the femoral vessels and of the hernia. Crural ring and canal. Formation of the sac. Saphenous opening. Relations of the hernia. Varieties of the obturator and epigastric arteries. Course of the hernia. Investments. Causes and situations of the stricture.

COMMENTARY ON PLATES 45 & 46

DEMONSTRATIONS OF THE ORIGIN AND PROGRESS OF FEMORAL HERNIA; ITS DIAGNOSIS, THE TAXIS, AND THE OPERATION.

Its course compared with that of the inguinal hernia. Its investments and relations. Its diagnosis from inguinal hernia, &c. Its varieties. Mode of performing the taxis according to the course of the hernia. The operation for the strangulated condition. Proper lines in which incisions should be made. Necessity for and mode of opening the sac.