There is no lack of recent literature on the subject of inguinal hernia, and no lack of variety in the operations suggested for its relief. All manner of technical procedures have been described; and varying degrees of success have been reported. These articles, however, have dealt with details. There has been a surprising absence of any effort to submit the principles governing all the accepted operative procedures to a really adequate analysis and criticism.
The abdomen forms a closed sac, and its walls are exposed to a slight constant intra-abdominal pressure. In addition to this, whenever the trunk is in the upright position, the lower part of the abdominal wall must withstand a supplementary pressure approximately equal to that of a column of water 25 cm. high. If observations at operation can be trusted, these factors are trifles compared with the strain put on the wall in coughing, heavy