fundus of a femoral hernia
lies in the neighbourhood of the inguinal canal, 3, yet the swelling can
scarcely be mistaken for an inguinal rupture, since, in addition to its
being superficial to the aponeurosis which covers the inguinal canal,
and also to the femoral arch, it may be withdrawn readily from this
place, and its body, 12, traced to where it sinks into the saphenous
opening, 6, 7, on the upper part of the thigh. An inguinal hernia
manifests its proper character more and more plainly as it advances from
its point of origin to its termination in the scrotum. A femoral hernia,
on the contrary, masks its proper nature, as well at its point of origin
as at its termination. But when a femoral hernia stands midway between
these two, points--viz. in the saphenous opening, 6, 7, it best exhibits
its special character; for here it exists below the femoral arch, and
considerably apart from the external abdominal ring.

[Illustration: Abdomen, showing bone, blood vessels
and other internal organs.]
PLATE 46.--FIGURE 2

PLATE 46, Fig. 3.--The neck of the sac of a femoral hernia, 2, lies
always close to, 3, the epigastric artery. When the obturator artery is
derived from the epigastric, if the former pass internal to the neck
behind, 8, Gimbernat's ligament, it can scarcely escape being wounded
when this structure is being severed by the operator's knife. If, on the
other hand, the obturator artery descend external to the neck of the
sac, the vessel will be comparatively remote from danger while the
ligament is being divided. In addition to the fact that the cause of
stricture is always on the pubic side, 8, of the neck of the sac, 12,
thereby requiring the incision to correspond with this situation only,
other circumstances, such as the constant presence of the femoral vein,
11, and the epigastric artery, 1, determine the avoidance of ever
incising the canal on its outer or upper side. And if the obturator
artery, [Footnote] by rare occurrence, happen to loop round the inner
side of the neck of the sac, supposing this to be the seat of stricture,
what amount of anatomical knowledge, at the call of the most dexterous
operator, can render the vessel safe from danger?

[Footnote: M. Velpeau (Medecine Operatoire), in reference to the
relative frequency of cases in which the obturator artery is derived
from the epigastric, remarks, "L'examen que j'ai pu en faire sur
plusieurs milliers de cadavres, ne me permet pas de dir