A review of the development of the surgical treatment of hernia shows that the interest in this subject has been focused largely on the technic of operative repair and that only cursory attention has been given to the preoperative diagnosis of the types of inguinal hernia. The explanation for this is apparent in that the surgeon depends ultimately on his actual observations at operation for the determination of the surgical procedure that he will use. In other words, the differentiation between direct and indirect types of hernia has not been of particular preoperative importance. The determination of the presence of a hernia has been sufficient.
During the past few years, while engaged in the study of the injection method in a series of 300 cases,1 we have felt the need for such a presurgical differential diagnosis and have developed certain diagnostic points which heretofore have not been described or,
HARRIS FI, WHITE AS. THE LENGTH OF THE INGUINAL LIGAMENTIN THE DIFFERENTIATION BETWEEN DIRECT AND INDIRECT INGUINAL HERNIA. JAMA. 1937;109(23):1900–1903. doi:10.1001/jama.1937.02780490038010