PLATE 41, Fig. 4.--If the serous spermatic tube, 11, be obliterated or closed at the internal ring, 1, thus cutting off communication with the general peritonaeal membrane; and if, at the same time, it remain pervious from this point above to the tunica vaginalis below, then the herniary bowel, when about to protrude at the point 1, must force and dilate the peritonaeum, in order to form its sac anew, as stated of Fig. 1, Plate 41. Such a hernia does not enter either the serous tube or the tunica vaginalis; but progresses from the point 1, in a distinct sac. In this case, there will be found two sacs--one enclosing the bowel; and another, consisting of the serous spermatic tube, still continuous with the tunica vaginalis. This original state of the parts may, however, suffer modification in two modes: 1st, if the bowel rupture the peritonaeum at the point 1, it will enter the serous tube 11, and descend through this into the cavity of the tunica vaginalis, as in the congenital variety. 2nd, if the bowel rupture the peritonaeum near the point 1, and does not enter the serous tube 11, nor the tunica vaginalis, then the bowel will be found devoid of a proper serous sac, while the serous tube and tunica vaginalis still exist in communication. In either case, the hernia will hold the same relative position in regard to the epigastric artery and spermatic vessels, as stated of Fig. 1, Plate 41. [Illustration: Abdomen, showing bone, blood vessels and other internal organs.] Plate 41--Figure 4 PLATE 41, Fig. 5.--Sudden rupture of the peritonaeum at the closed internal serous ring, 1, though certainly not impossible, may yet be stated as the exception to the rule in the formation of an external inguinal hernia. The aphorism, "natura non facit saltus," is here applicable. When the peritonaeum suffers dilatation at the internal ring, 1, it advances gradatim and pari passu with the progress of the protruding bowel, and assumes the form, character, position, and dimensions of the inverted curved phases, marked 11, 11, till, from having at first been a very shallow pouch, lying external to the epigastric artery, 9, it advances through the inguinal canal to the external ring, 4, and ultimately traverses this aperture, taking the course of the fibrous tube, 3, down to the testicle in the scrotum. [Illustration: Abdomen, showing bone, blood vessels and other internal organs.] Plate 41--Figure 5