, showing bone, blood vessels
and other internal organs.]
Plate 42--Figure 6

[Illustration: Abdomen, showing bone, blood vessels
and other internal organs.]
Plate 42--Figure 7

COMMENTARY ON PLATES 43 & 44.

THE DISSECTION OF FEMORAL HERNIA, AND THE SEAT OF STRICTURE.

Whilst all forms of inguinal herniae escape from the abdomen at places
situated immediately above Poupart's ligament, the femoral hernia, G,
Fig. 1, Plate 43, is found to pass from the abdomen immediately below
this structure, A I, and between it and the horizontal branch of the
pubic bone. The inguinal canal and external abdominal ring are parts
concerned in the passage of inguinal herniae, whether oblique or direct,
external or internal; whilst the femoral canal and saphenous opening are
the parts through which the femoral hernia passes. Both these orders of
parts, and of the herniae connected with them respectively, are,
however, in reality situated so closely to each other in the
inguino-femoral region, that, in order to understand either, we should,
examine both at the same time comparatively.

The structure which is named Poupart's ligament in connexion with
inguinal herniae, is named the femoral or crural arch (Gimbernat) in
relation to femoral hernia. The simple line, therefore, described by
this ligament explains the narrow interval which separates both
varieties of the complaint. So small is the line of separation described
between these herniae by the ligament, that this (so to express the
idea) stands in the character of an arch, which, at the same time,
supports an aqueduct (the inguinal canal) and spans a road (the femoral
sheath.) The femoral arch, A I, Fig. 1, Plate 43, extends between the
anterior superior iliac spinous process and the pubic spine. It connects
the aponeurosis of the external oblique muscle, D d, Fig. 2, Plate 44,
with F, the fascia lata. Immediately above and below its pubic extremity
appear the external ring and the saphenous opening. On cutting through
the falciform process, F, Fig. 1, Plate 44, we find Gimbernat's
ligament, R, a structure well known in connexion with femoral hernia.
Gimbernat's ligament consists of tendinous fibres which connect the
inner end of the femoral arch with the pectineal ridge of the os pubis.
The shape of the ligament is acutely triangular, corresponding to the
form of the space which it occupies. Its apex is internal, and close to
the pubic spine; its base is external, sharp a