The Brooklyn Medical Journal. Vol. II. No. 2. Aug., 1888Various
Science
The Brooklyn Medical Journal. Vol. II. No. 2. Aug., 1888
Various
Medicine -- Periodicals
The entrance to the opening of the vaginal process is found covered by a
valve arrangement, and the same is particularly noticeable in the canal
of Nuck. The opening of the vaginal process can be caused to gape
through a spreading out of the mesentery attached to the ilium or that
of the sigmoid flexure. The diameter of the opening is, in general,
greater on the right side than on the left in boys, while in girls this
difference is not observed. Further, the different forms of the
incompletely obliterated opening of the vaginal process agrees with the
most frequently occurring forms of the hernial sac in inguinal hernia.
The relations of the vaginal process to the elementary parts of the
spermatic cord are not constant. On the contrary, the relations which
the smooth muscular structures of the cord bear to the vaginal process,
in so far as their arrangement into bundles, and their positive relation
to the posterior and lateral walls of the same are concerned, are quite
constant, and almost form an integral part of the same. The obliteration
of the vaginal process depends upon a granulating process, which begins
in the middle third of the funnicular portion, and from thence proceeds
more rapidly in a downward than in an upward direction. This granulation
formation takes place essentially during the first ten to twenty days
after birth; after this time it takes place more slowly. The canal of
Nuck, on the contrary, is found to have almost entirely disappeared at
the time of birth. They are both found to be more frequently open upon
the right side.
From these observations it would appear that it is not essential to the
production of inguinal hernia that a broad and short inguinal canal
should be present. The only essential predisposing cause, in children at
least, depends upon the condition of the vaginal process of the
peritoneum itself.
The question of the legal responsibility of employers is an interesting
one, in connection with this question. Hernia cannot be considered as an
accident, in the surgical sense, according to Socin (Korrespondenzblatt
f. Schweizer Aertze, 1887, No. 18), but is really a slowly occurring
disease, to which certain well-defined anatomical peculiarities act as
predisposing causes.
ACID SUBLIMATE SOLUTION IN SURGERY.
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