ernia. Its position varies in respect to
the internal hernia, (op. cit. prop. 52.)]

[Illustration: Abdomen and scrotum, showing bone, blood vessels
and other internal organs.]
Plate 42--Figure 2

PLATE 42, Fig. 3.--Every internal hernia, which does not rupture the
peritonaeum, carries forward a sac produced anew from this membrane,
whether the hernia enter the inguinal canal or not. But this is not the
case with respect to the fibrous membrane which forms the fascia
propria. If the hernia enter the inguinal wall immediately on the inner
side of the epigastric artery, Fig. 1, Plate 42, it passes direct into
the ring of the fibrous tube, 2, 2, already prepared to receive it. But
when the hernia, 11, Fig. 3, Plate 42, cleaves the conjoined tendon, 6,
6, then the artery, 9, and the tube, 2, 2, remain in their usual
position, while the bowel carries forward a new investment from the
transversalis fascia, 5, 5. That part of the conjoined tendon which
stands external to the hernia keeps the tube, 2, 2, in its proper place,
and separates it from the fold of the fascia which invests the hernial
sac. This is the only form in which an internal hernia can be said to be
absolutely distinct from the inguinal canal and spermatic vessels. This
hernia, when passing the external ring, 4, has the spermatic cord on its
outer side.

[Illustration: Abdomen and scrotum, showing bone, blood vessels
and other internal organs.]
Plate 42--Figure 3

PLATE 42, Fig. 4.--The external hernia, from having been originally
oblique, may assume the position of a hernia originally internal and
direct. The change of place exhibited by this form of hernia does not
imply a change either in its original investments or in its position
with respect to the epigastric artery and spermatic vessels. The change
is merely caused by the weight and gravitation of the hernial mass,
which bends the epigastric artery, 9*, from its first position on the
inner margin of the internal ring, 1, till it assumes the place 9. In
consequence of this, the internal ring of the fascia transversalis, 2,
2, is considerably widened, as it is also in Fig. 2, Plate 42. It is the
inner margin of the fibrous ring which has suffered the pressure; and
thus the hernia now projects directly from behind forwards, through, 4,
the external ring. The conjoined tendon, 6, when weak, becomes bent upon
itself. The change of place performed by the gravitating hernia may
disturb the order a