he other, the more likely are they to be mistaken the
one for the other. An internal hernia may enter the inguinal canal, and
become oblique; while an external hernia, though occupying the canal,
may become direct. It is only when these herniae occur at the situations
commonly described, and where they manifest their broadest contrast,
that the following diagnostic signs can be observed.

The external bubonocele, H, Plate 37, G, Plate 38, when recently formed,
may be detected at a situation midway between the iliac and pubic
spinous processes, where it has entered the internal ring. When the
hernia extends itself from this part, its course will be obliquely
inwards, corresponding with the direction of the inguinal canal. While
it still occupies the canal without passing through the external ring,
it is rendered obscure by the restraint of the external oblique tendon;
but yet a degree of fulness may be felt in this situation. When the
hernia has passed the external ring, T, Plate 36, it dilates
considerably, and assumes the form of an oblong swelling, H, Plate 36,
behind which the spermatic vessels are situated. When it has become
scrotal, the cord will be found still on its posterior aspect, while the
testicle itself occupies a situation directly below the swelling.

The internal hernia, H, Plate 38, also traverses the external ring, T,
where it assumes a globular shape, and sometimes projects so far
inwards, over the pubes, C, as to conceal the crista of this bone. As
the direction of this hernia is immediately from behind forwards, the
inguinal canal near the internal ring is found empty, unswollen. The
cord, Q, lies external to and somewhat over the fore part of this
hernia; and the testicle does not occupy a situation exactly beneath the
fundus of the sac, (as it does in the external hernia,) but is found to
be placed either at its fore part or its outer side. This difference as
to the relative position of the cord and testicle in both these forms of
herniae, is accounted for under the supposition that whilst the external
variety descends inside the sheaths of the inguinal canal, the internal
variety does not. But this statement cannot apply to all cases of
internal hernia, for this also occasionally enters the canal. Both forms
of inguinal herniae may exist at the same time on the same side: the
external, G, Plate 38, being a bubonocele, still occupying the inguinal
canal; while the internal, H, protrudes through t