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May 21, 1932


Author Affiliations


From the Department of Traumatic Surgery, New York Post-Graduate Medical School, Columbia University, and Reconstruction Hospital Unit.

JAMA. 1932;98(21):1785-1788. doi:10.1001/jama.1932.02730470007003

Ever since the word "rupture" was used to denote hernia, there has been a widespread opinion that trauma is the responsible factor in the causation of the condition. The supposed relationship between injury and hernia is still accepted almost universally by the public; but most surgeons and many physicians long ago abandoned this view, their disbelief being based largely on observations made at operation. In medicolegal cases this whole topic is a matter of controversial importance, often vexing and perplexing to all concerned.

Before the situation is considered in detail, one should familiarize oneself briefly with (1) the basic anatomy, (2) the surgical operative observations, and (3) the pathologic reports.

The anatomy of the inguinal region may be briefly said to consist of an avenue called the inguinal canal, the uptown end of which is the internal ring, and the downtown end the external ring. Marching along this avenue may