e qu'elle se
rencontre un fois sur trois, ni sur cinq, ni meme sur dix, mais bien
seulement sur quinze a vingt." Monro (Obs. on Crural Hernia) states this
condition of the obturator artery to be as 1 in 20-30. Mr. Quain
(Anatomy of the Arteries) gives, as the result of his observations, the
proportion to be as 1 in 3-1/2, and in this estimate he agrees to a
great extent with the observations of Cloquet and Hesselbach. Numerical
tables have also been drawn up to show the relative frequency in which
the obturator descends on the outer and inner borders of the crural ring
and neck of the sac. Sir A. Cooper never met with an example where the
vessel passed on the inner side of the sac, and from this alone it may
be inferred that such a position of the vessel is very rare. It is
generally admitted that the obturator artery, when derived from the
epigastric, passes down much more frequently between the iliac vein and
outer border of the ring. The researches of anatomists (Monro and
others) in reference to this point have given rise to the question,
"What determines the position of the obturator artery with respect to
the femoral ring?" It appears to me to be one of those questions which
do not admit of a precise answer by any mode of mathematical
computation; and even if it did, where then is the practical inference?]

The taxis, in a case of crural hernia, should be conducted in accordance
with anatomical principles. The fascia lata, Poupart's ligament, and the
abdominal aponeurosis, are to be relaxed by bending the thigh inwards to
the hypogastrium. By this measure, the falciform process, 6, is also
relaxed; but I doubt whether the situation occupied by Gimbernat's
ligament allows this part to be influenced by any position of the limb
or abdomen. The hernia is then to be drawn from its place above
Poupart's ligament, (if it have advanced so far,) and when brought
opposite the saphenous opening, gentle pressure made outwards, upwards,
and backwards, so as to slip it beneath the margin of the falciform
process, will best serve for its reduction. When this cannot be effected
by the taxis, and the stricture still remains, the cutting operation is
required.

The precise seat of the stricture cannot be known except during the
operation. But it is to be presumed that the sac and contained intestine
suffer constriction throughout the whole length of the canal. [Footnote]
Previously to the commencement of the operation, the urinary