urned behind. The tunica vaginalis, like the serous
spermatic tube, may, in consequence of inflammatory fibrinous effusion,
become sacculated-multilocular, in which case, if a hydrocele form, the
position of the testis will vary accordingly.--See Sir Astley Cooper's
work, ("Anatomy and Diseases of the Testis;") Morton's "Surgical
Anatomy;" Mr. Curling's "Treatise on Diseases of the Testis;" and also
his article "Testicle," in the Cyclopaedia of Anatomy and Physiology.]

[Illustration: Abdomen and scrotum, showing bone, blood vessels
and other internal organs.]
Plate 40--Figure 3.

PLATE 40, Fig. 4.--The serous spermatic tube remaining pervious, a
congenital hernia is formed.--When the testicle, 7, has descended to the
scrotum, if the communication between the peritonaeum, 6 a, and the
tunica vaginalis, 6 c, be not obliterated, a fold of the intestine, 13,
will follow the testicle, and occupy the cavity of the tunica vaginalis,
6 d. In this form of hernia (hernia tunicae vaginalis, Cooper), the
intestine is in front of, and in immediate contact with, the testicle.
The intestine may descend lower than the testicle, and envelope this
organ so completely as to render its position very obscure to the touch.
This form of hernia is named congenital, since it occurs in the same
condition of the parts as is found in congenital hydrocele--viz., the
inguinal ring remaining unclosed. It may occur at any period of life, so
long as the original congenital defect remains. It may be distinguished
from hydrocele by its want of transparency and fluctuation. The impulse
which is communicated to the hand applied to the scrotum of a person
affected with scrotal hernia, when he is made to cough, is also felt in
the case of congenital hydrocele. But in hydrocele of the separate
tunica vaginalis, such impulse is not perceived. Congenital hernia and
hydrocele may co-exist; and, in this case, the diagnostic signs which
are proper to each, when occurring separately, will be so mingled as to
render the precise nature of the case obscure.

[Illustration: Abdomen and scrotum, showing bone, blood vessels
and other internal organs.]
Plate 40--Figure 4.

PLATE 40, Fig. 5.--Infantile hernia.--When the serous spermatic tube
becomes merely closed, or obliterated at the inguinal ring, 6 b, the
lower part of it, 6 c, is pervious, and communicating with the tunica
vaginalis, 6 d. In consequence of the closure of the tube at the
inguinal ring, if