One of the most interesting examples of the localization of tubercular infection has been brought to our attention through the very novel contribution of Loutham in the Medical Chronicle April 1892. In one case a consumptive had a large scrotal hernia which was found on operation to be irreducble from tubercular peritonitis in the sac. The sac and testicle were removed together with complete recovery. In the second case a six year old boy without evidence of tuberculosis elsewhere was operated on for hernia. The sac was found covered with milliary tubercules and it was extirpated high up with prompt recovery.
Bruns1 has lately studied thirteen cases of tuberculosis in the hernial sac. Of these seven were recognized as primary, while the remainder were simply part of a general peritonial tuberculosis.
It must then be concluded that primary (so called) tuberculosis of the hernial sac is simply a secondary