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XL] Diagnosis.—It is important to be able to diagnose these tumours from hernia, for which they are often mistaken. This can be done by observing that they are not tympanitic on percussion; that though pressure causes them to diminish, they do so slowly; that there is no sudden dispersion accompanied by gurgling, as in hernia, on taxis being employed; that they convey



a relatively slight or no impulse on coughing; that they slowly subside on the patient lying down, and slowly return, even if pressure be applied over the saphenous or inguinal openings, on the erect posture being resumed. The cautious use of the hypodermic needle will confirm diagnosis; which would be further strengthened by the coexistence of lymph scrotum, chyluria, or chylous hydrocele, and the presence of filariæ in the blood. Chronic swellings about the groin,