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This small monograph is devoted chiefly to a consideration of inguinal hernia. The chapters on etiology and anatomy are complete. The author gives much space to the congenital or saccular theory, and believes that it should be generally accepted as the cause of all oblique inguinal hernias. He states that "even when a potential sac is present no hernia results if the shutter action of the internal oblique is effective." This fact explains why a small empty congenital sac may remain empty throughout one's life. If surgeons will make a practice of doing a bilateral operation on patients who believe they have only a single hernia, they will almost always be rewarded by finding a small or large empty sac on the so-called sound side. The diagnosis and differential diagnosis of inguinal hernia are thoroughly discussed, and Cowell describes in detail his flap operation, which gives a high percentage of
Hernia and Hernioplasty. JAMA. 1927;89(9):715. doi:10.1001/jama.1927.02690090065037
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