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vi Preface
What Is New in the 17th Edition?

The 17th edition includes the following changes:
• All new Business Currents examples that call out the practical applications
of cost accounting in the real world.
• The Recall and Review exercises are now matched with similar end-of-
chapter exercises.
• The addition of critical thinking components to certain end-of-chapter
exercises and problems.
• The use of icons next to certain exercises and problems that relate back to
the appropriate Recall and Review exercises and Self-Study problems.
• The inclusion of an integrated example of a skateboard manufacturer that
continues throughout the first three job-order costing chapters.
• New coverage on enterprise resource planning systems has been added.
• Increased coverage of activity-based costing.
What Are the Features of the 17th Edition?

The 17th edition includes several features that facilitate the learning process
for the student and allow the instructor to teach with ease.
Practical Applications
A Business Currents feature calls out the practical applications of cost
accounting in the real world. This feature illustrates how cost accounting
concepts from the chapter are practiced in business today.
CengageNOW
Online homework is now a possibility with CengageNOW. CengageNOW is a
powerful course management and online homework tool that provides
robust instructor control and customization to optimize the student
learning experience and meet desired outcomes. CengageNOW offers
auto-graded homework and test bank, easy-to-use assignment options,
and “Smart Entry” to eliminate common data entry errors. Additional
algorithmic problems have been authored to give more flexibility in
assigning homework.
Directed Assignments
At specific points within each chapter, students are directed to appropriate
end-of-chapter assignments. This allows students to work practice items
without completing the entire chapter. Each of these points includes a Recall
and Review Exercise with its solution at the end of the chapter. These exer-
cises are referenced to similar end-of-chapter exercises.
Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Preface vii
Self-Study Problems
Two demonstration problems are included at the end of each chapter, with a
step-by-step explanation of how to solve them. These Self-Study Problems
are constructed from difficult concepts in the chapter and reinforce the tech-
niques and procedures discussed in the chapter. An added feature is end-of-
chapter problems that reference students back to Self-Study Problems that
are similar in topic and difficulty.
End-of-Chapter Materials
The end-of-chapter questions, exercises, problems, and mini-cases have been
carefully written, revised, added to, and verified to reflect the coverage as it
appears in the chapters. There has been a concerted effort to provide the
instructor with a wide choice of subject matter, degree of difficulty, and criti-
cal thinking opportunities when assigning end-of-chapter materials. Where
appropriate, comprehensive review problems have been added that cover con-
cepts from more than one chapter. Additionally, selected problems may be
solved using spreadsheet software.
Integrated Learning Objectives

Learning objectives begin each chapter. Each learning objective is indicated
in the text where first discussed. All end-of-chapter exercises, problems, and
mini-cases are identified by learning objectives.
Key Terms
Key terms are highlighted as they are introduced. They are listed, along with
page references, at the end of each chapter. A comprehensive glossary is
included at the end of the book providing definitions for all the key terms.
Appendices
The Institute of Management Accountants “Statement of Ethical Professional
Practice” is included in an appendix at the end of Chapter 1. An appendix at
the end of Chapter 8 illustrates the four-variance and three-variance methods
of analyzing factory overhead.
What Supplementary Materials

Are Available?
A complete package of supplementary materials is available with the 17th edition
of Principles of Cost Accounting to assist both instructors and students. The package
includes materials that have been carefully prepared and reviewed.
Available to Instructors
All instructor resources are available online on the Instructor Companion
Website at http://login.cengage.com.
viii Preface
Solutions Manual. The Solutions Manual contains the answers to all end-of-
chapter questions, exercises, problems, and mini-cases. The solutions are
author-written and have been verified multiple times for numerical accuracy
and consistency.
Test Bank. The test bank helps instructors efficiently assess their students’
understanding with problems and questions that reflect the material presented.
The Test Bank offers a variety of question types and has also been tagged to
distinguish difficulty level, learning objective, and AACSB and IMA standards.
Test bank files in Word format, along with versions to import into your LMS,
are available on the Instructor Companion Website. Cognero Test Banks are
available via Single Sign-on account at http://login.cengage.com.
Cengage Learning Testing Powered By Cognero. Cengage’s new test gener-

ator software, Cognero, allows authoring, editing, and managing of test bank
content from anywhere with internet access. It also allows for creation of
multiple test versions in an instant, or for delivery of tests from your Learning
Management System.
PowerPoint Presentations. Each presentation enhances lectures and clarifies
difficult concepts with concise slides designed to capture and keep your
students’ attention. These chapter-by-chapter slides are ideal as guides for
student note-taking and study.
Instructor Spreadsheet Templates. Increase student awareness and familiar-
ity with basic software applications by utilizing the spreadsheet templates.
These templates accompany many end-of-chapter items to assist students in
completing the problem. The Instructor Spreadsheet Templates show the
completed spreadsheet solutions in an easy-to-use format. Selected problems
that have an accompanying template are designated with a spreadsheet icon.
Instructor Companion Website. Access your needed supplements immedi-
ately with the companion website. This text-specific website organizes
resources by chapter and all instructor materials are password protected.
Access the site by going to http://login.cengage.com to create an account or
sign-in to your current account.
Available to Students
All student resources are available online on the Student Companion
Website. To access the text companion website, simply go to www.cengage
brain.com, search for the text ISBN or author’s last name and click on the
“Access Now” icon under Study Tools. Resources are organized at both the
chapter and book level.
Student Spreadsheet Templates. Familiarize yourself with current spread-
sheet software while completing your homework assignments easily
with these Student Spreadsheet Templates. These templates accompany
many end-of-chapter items to assist students in completing the problem.
Preface ix
Selected problems that have an accompanying template are designated with a

spreadsheet icon.
Experience Accounting Videos. Highlight progressive companies and allow
you to effectively visualize critical chapter concepts—enhancing what you
learn in class! The Experience Accounting Videos are available within the
Study Tools and Personalized Study Plan in CengageNOW. They can also
be bundled at no additional cost with new copies of the text or purchased sepa-
rately. You can access the videos at www.cengage.com/accounting/eav.
Key Term Testing. Test your knowledge of the key terms that are outlined in
the text through our online flashcards and crossword puzzles.
Acknowledgments
The authors and publisher would like to thank the following review participants
who helped us think about the many dimensions of this revision by providing
constructive comments and suggestions:
Angela Kirkendall
South Puget Sound Community College
Charles Kee
Kingsborough Community College
Cindy Bleasdale
Hilbert College
David Bland
Cape Fear Community College
David Forester
Haywood Community College
Frances Ford
Spalding University
Jamie Payton
Gadsden State Community College
Jeanine Metzler
Northampton Community College
Kevin Rosenberg
Southeastern Community College
Lana Tuss
Chemeketa Community College
Lecia Berven
Iowa Lakes Community College
Leslie Faistl
Surry Community College
x Preface
Marina Grau
Houston Community College
Marjorie York
Kennebec Valley Community College
Nancy Lee Howard
Mt. Hood Community College
Paul Keller
SUNY College at Old Westbury
Scott Wallace
Blue Mountain Community College
Shannon Ogden
Black River Technical College
Sharon Burnett
West Texas A&M University
Spencer Miller
Eastern Idaho Technical College
Stacey Mirinaviciene
Keuka College
Sue Castaldi
Albertus Magnus College
Theresa Laws-Dahl
Blackhawk Technical College
Theresa Meza
James Sprunt Community College
ABOUT THE AUTHORS
ED VANDERBECK was a professor of accountancy at Xavier University in

Cincinnati, Ohio for 32 years and chair of the Department of Accountancy for
24 of those years. Professor VanDerbeck specialized in teaching cost accounting
to accounting majors and managerial accounting to undergraduate and MBA stu-
dents. He also taught at the two-year college level at SUNY–Delhi. He has a
BA in Accounting from Binghamton University (formerly SUNY–Binghamton)
and an MS in Business Administration from the University of Albany (formerly
SUNY–Albany). He is licensed as a CPA (inactive) in the state of Ohio.
Professor VanDerbeck has worked as an internal revenue agent and performed
a faculty internship at what was formerly the Big Eight accounting firm of
Touche-Ross. He has served as a developmental editor and marketing manager
for accounting publications with South-Western College Publishing. Professor
VanDerbeck resides in San Diego, California, and is a kayaker, swimmer, tennis
player, and student of casino gaming strategies.
MARIA R. MITCHELL is an associate professor of accountancy at Thomas

More College in Crestview Hills, Kentucky. She teaches cost and advanced
accounting courses for accounting majors and introductory accounting courses
for traditional students and those in the college’s adult and professional pro-
gram. Prior to starting her academic career full-time, she worked on the audit
staff at KPMG and for a global industrial products company where she was
responsible for financial reporting and assisted with activities-based costing
implementation projects. She has also been an adjunct instructor at Xavier
University and Cincinnati State Technical and Community College.
Professor Mitchell is a CPA in the state of Ohio, has an MBA from Xavier
University, and a BS in Accounting from Northern Kentucky University. Outside
the classroom, she enjoys hiking, reading, gardening, cooking, and genealogy.
xi
BRIEF CONTENTS
Chapter 1 Introduction to Cost Accounting 1
Chapter 2 Accounting for Materials 67
Chapter 3 Accounting for Labor 131
Chapter 4 Accounting for Factory Overhead 181
Chapter 5 Process Cost Accounting—General

Procedures 255
Chapter 6 Process Cost Accounting—Additional

Procedures; Accounting for Joint Products
and By-Products 311
Chapter 7 The Master Budget and Flexible Budgeting 365
Chapter 8 Standard Cost Accounting—Materials, Labor,

and Factory Overhead 413
Chapter 9 Cost Accounting for Service Businesses, the

Balanced Scorecard, and Quality Costs 485
Chapter 10 Cost Analysis for Management Decision

Making 523
Glossary 575
Index 591
xiii
CONTENTS
1 Introduction to Cost Accounting 1

1.1 Uses of Cost Accounting Information 5
1.1a Determining Product Costs and Pricing 5
1.1b Planning and Control 6
1.2 Professional Ethics, CMA Certification, and Corporate
Governance 10
1.3 Relationship of Cost Accounting to Financial and Management
Accounting 11
1.3a Costs of Goods Sold 13
1.3b Inventories 14
1.4 Elements of Manufacturing Costs 17
1.4a Direct Materials 17
1.4b Direct Labor 17
1.4c Factory Overhead 18
1.4d Summary of Manufacturing Costs 18
1.4e Flow of Costs 19
1.5 Illustration of Accounting for Manufacturing Costs 19
1.6 Cost Accounting Systems 29
1.6a Special Order 30
1.6b Continuous or Mass Production 30
1.6c Combination of Systems 32
1.6d Standard Costing 32
1.7 Illustration of a Job Order Cost System 32
1.7a Work in Process in the Manufacturing Statement 36
Appendix: IMA Statement of Ethical Professional Practice 38
2 Accounting for Materials 67

2.1 Materials Control 68
2.1a Physical Control of Materials 68
2.1b Controlling the Investment in Materials 71
xv
xvi Contents
2.2 Materials Control Procedures 76

2.2a Materials Control Personnel 76
2.2b Control during Procurement 77
2.2c Control during Storage and Issuance 82
2.2d Computerized Materials Control 84
2.3 Accounting for Materials 85
2.3a Determining the Cost of Materials Issued 86
2.3b Accounting Procedures 92
2.4 Just-in-Time Materials Control 98
2.4a JIT and Cost Control 101
2.4b JIT and Cost Flows 101
2.5 Scrap, Spoiled Goods, and Defective Work 103
2.5a Scrap Materials 104
2.5b Spoiled and Defective Work 105
3 Accounting for Labor 131

3.1 Wage Plans 132
3.1a Hourly-Rate Plan 133
3.1b Piece-Rate Plan 133
3.1c Modified Wage Plans 134
3.2 Controlling Labor Cost 135
3.2a Labor Time Records 135
3.2b Payroll Function 136
3.3 Accounting for Labor Costs and Employers’
Payroll Taxes 140
3.3a Employers’ Payroll Taxes 143
3.3b Illustration of Accounting for Labor Costs 144
3.4 Payroll Accrual 149
3.5 Special Labor Cost Problems 152
3.5a Shift Premium 153
3.5b Employee Pension Costs 153
3.5c Bonuses 155
3.5d Vacation and Holiday Pay 155
3.5e Accounting for Bonuses, Vacations, and Holiday Pay 156
4 Accounting for Factory Overhead 181

4.1 Identifying Cost Behavior Patterns 182
4.2 Analyzing Semivariable Factory Overhead Costs 184
4.2a Observation Method 185
4.2b High-Low Method 185
4.2c Scattergraph Method 187
4.2d Limitations of High-Low and Scattergraph Methods 188
Contents xvii
4.2e Least-Squares Regression Method 189

4.3 Budgeting Factory Overhead Costs 191
4.4 Accounting for Actual Factory Overhead 192
4.4a Factory Overhead Analysis Spreadsheets 194
4.4b Schedule of Fixed Costs 195
4.4c General Factory Overhead Expenses 197
4.4d Summary of Factory Overhead 197
4.5 Distributing Service Department Expenses 197
4.6 Applying Factory Overhead to Production 205
4.6a Direct Labor Cost Method 208
4.6b Direct Labor Hour Method 208
4.6c Machine Hour Method 209
4.6d Activity-based Costing Method 210
4.7 Accounting for Actual and Applied Factory Overhead 213
5 Process Cost Accounting—General

Procedures 255
5.1 Comparison of Basic Cost Systems 256
5.1a Materials and Labor Costs 256
5.1b Factory Overhead Costs 258
5.2 Product Cost in a Process Cost System 258
5.2a Nondepartmentalized Factory 259
5.2b Departmentalized Factory 259
5.3 Work in Process Inventories 259
5.4 Cost of Production Summary—One Department, No Beginning
Inventory 263
5.5 Cost of Production Summary—One Department Beginning
Inventory 266
5.6 Cost of Production Summary—Multiple Departments, No
Beginning Inventory 269
5.7 Cost of Production Summary—Multiple Departments, Beginning
Inventory 279
5.8 Changes in Prior Department’s Unit Transfer Cost 286
6 Process Cost Accounting—Additional

Procedures; Accounting for Joint
Products and By-Products 311
6.1 Equivalent Production–Materials Not Uniformly Applied 311
6.1a Materials Added at Beginning of Process 312
6.1b Materials Added at End of Process 314
6.1c Materials Added at Different Stages of Process 317
xviii Contents
6.2 Units Lost in Production 320

6.3 Units Gained in Production 323
6.4 Equivalent Production: First-In, First-Out Method 325
6.4a FIFO versus Weighted Average-Materials Added at
Beginning 325
6.4b FIFO versus Weighted Average-Materials Added at End 330
6.4c FIFO versus Weighted Average-Pros and Cons 333
6.5 Joint Products and By-Products 334
6.5a Accounting for Joint Products 335
6.5b Accounting for By-Products 338
7 The Master Budget and Flexible

Budgeting 365
7.1 Principles of Budgeting 366
7.2 Preparing the Master Budget 367
7.2a Sales Budget 369
7.2b Production Budget 370
7.2c Direct Materials Budget 373
7.2d Direct Labor Budget 374
7.2e Factory Overhead Budget 375
7.2f Cost of Goods Sold Budget 376
7.2g Selling and Administrative Expenses Budget 376
7.2h Budgeted Income Statement 376
7.2i Other Budgets 378
7.2j Evaluating Budget Performance 378
7.3 Flexible Budgeting 379
7.3a Preparing the Flexible Budget 381
7.3b Preparing a Performance Report Based on Flexible
Budgeting 382
7.4 Preparing the Flexible Budget for Factory Overhead 384
7.4a Using the Flexible Budget 386
7.4b Semivariable Costs 388
7.4c Service Department Budgets and Variances 388
7.4d Summary of the Budgeting Process 389
8 Standard Cost Accounting—Materials,

Labor, and Factory Overhead 413
8.1 Types of Standards 415
8.2 Standard Cost Procedures 416
8.2a Determination of Standard Costs for Materials and Labor 416
8.2b Recording Standard Costs for Materials and Labor 417
Contents xix
8.3 Determination of Variances 418

8.3a Alternative Method of Recording Materials Cost 424
8.4 Accounting for Variances 425
8.4a Alternative Method of Recording Materials Cost 425
8.4b Disposition of Standard Cost Variances 426
8.5 Interpreting Variances 429
8.6 Features of a Standard Cost Accounting System 432
8.7 Illustration of Standard Cost in a Departmentalized Factory Using
Process Costing 433
8.8 Analysis of Factory Overhead Standard Cost Variances 440
8.9 Two-Variance Method of Analysis 441
Appendix: Four-Variance and Three-Variance Methods of Analysis 447
Four-Variance Method of Analysis 447
Three-Variance Method of Analysis 449
9 Cost Accounting for Service Businesses,

the Balanced Scorecard, and Quality
Costs 485
9.1 Job Order Costing for Service Businesses 486
9.1a Job Cost Sheet for a Service Business 487
9.1b Choosing the Cost Allocation Base 488
9.1c Tracing Direct Costs to the Job 488
9.1d Cost Performance Report 488
9.2 Budgeting for Service Businesses 489
9.2a The Revenue Budget 490
9.2b The Labor Budget 490
9.2c The Overhead Budget 491
9.2d The Other Direct Expenses Budget 492
9.2e The Budgeted Income Statement 492
9.3 Activity-Based Costing in a Service Firm 493
9.3a Converting Indirect Costs to Direct Costs 494
9.3b Multiple Indirect Cost Pools 495
9.3c Job Cost Sheet—Activity-Based Costing 496
9.4 Allocations Using Simplified Costing versus Activity-Based
Costing 497
9.5 The Balanced Scorecard and Quality Costs 501
9.5a The Four Categories of a Balanced Scorecard 501
9.5b Guidelines for a Good Balanced Scorecard 503
9.5c The Balanced Scorecard Illustrated 504
xx Contents
9.6 Meaning of the Cost of Quality 506

9.6a The Four Categories of a Cost of Quality Report 506
9.6b Prevention Costs 506
9.6c Appraisal Costs 506
9.6d Internal Failure Costs 507
9.6e External Failure Costs 508
10 Cost Analysis for Management Decision

Making 523
10.1 Variable Costing and Absorption Costing 524
10.1a Product Costs versus Period Costs 524
10.1b Illustration of Variable and Absorption Costing
Methods 525
10.2 Merits and Limitations of Variable Costing 530
10.3 Segment Reporting for Profitability Analysis 531
10.4 Cost-Volume-Profit Analysis 534
10.4a Break-Even Analysis 535
10.4b Break-Even Chart 538
10.4c Break-Even Analysis for Management Decisions 539
10.4d Effect of Sales Mix on Break-Even Analysis 541
10.5 Contribution Margin Ratio and Margin of Safety 543
10.6 Effect of Income Tax on Break-Even Point 545
10.7 Differential Analysis 546
10.7a Accept or Reject a Special Order 547
10.7b Make or Buy 548
10.8 Distribution Costs 549
Glossary 575
Index 591
CHAPTER 1
INTRODUCTION TO COST
ACCOUNTING Learning
OBJECTIVES
After studying this chapter, you
should be able to:
LO1 Explain the uses of cost
accounting information.
LO2 Describe the ethical respon-

BUSINESS CURRENTS 1.1 sibilities and certification
Cost Accounting in Hollywood requirements for manage-
ment accountants, as well as
As Hollywood film budgets continue to grow, an article in corporate governance.
Bloomberg Businessweek reported that Universal Studio’s
Despicable Me 2 grossed more than $840 million globally, LO3 Describe the relationship of
cost accounting to financial
but cost only $76 million, making it one of the most prof-
and management
itable movies in the studio’s history. The film’s producer,
accounting.
Chris Meledandri, who also produced Dr. Seuss’ The
Lorax, is credited with successfully managing the film’s LO4 Identify the three basic ele-
budget. Meanwhile, Jeffrey Katzenberg, CEO of Dream- ments of manufacturing
works Animation SKG, announced plans to decrease the costs.
budgets of the company’s animated films by $30 million LO5 Illustrate basic cost
each, to an average cost of $120 million. accounting procedures.
This article raises several questions that may be
LO6 Distinguish between the two
answered using information introduced in this book: basic types of cost account-
• Which cost accounting system is best suited for ing systems.
accounting for the costs of producing a film? LO7 Illustrate a job order cost
• How does one determine which studio costs are system.
included in making a movie?
• What measures may be undertaken by other studios to
successfully reduce their budgets?
Source: Palmeri, Christopher, “Despicably Profitable,” Bloomberg

Businessweek, September 23, 2013, Issue 4347, p. 21–22.
2 Principles of Cost Accounting
T he importance of cost accounting information to the successful operation of a

business has long been recognized. However, in the current global economic
environment, such information is more crucial than ever. Automobiles from South
Korea, compact fluorescent light bulbs from China, electronic equipment from
Japan, and aircraft from Europe are just a few examples of foreign-made products
that have provided stiff competition to U.S. manufacturers both at home and
abroad. As a result of these pressures, companies today are placing more emphasis
on controlling costs in an attempt to keep their products competitive. For example,
U.S. companies are outsourcing production and service activities to other coun-
tries, such as production operations in Honduras and Vietnam, and technical sup-
port call centers in the Philippines. However, as Business Currents 1.2 indicates,
some “offshore” manufacturing is headed back to the United States.
BUSINESS CURRENTS 1.2

“Reshoring” a Continuing Trend
Recently, Wal-mart announced plans to relocate $50 billion in
manufacturing to the United States and General Electric has begun
manufacturing in Louisville, Kentucky a hybrid water heater that was pre-
viously outsourced to a Chinese company. These are just a few examples
of the “reshoring” or “onshoring” efforts undertaken by an increasing
number of American businesses. Reasons cited for this shift include:
• Pay rates in China have increased at least 15% annually for the past
few years. In addition, there has been recent labor unrest in China.
• Oil prices have increased and become more uncertain, resulting in
higher shipping costs and energy costs in China, but domestic
energy prices are relatively less expensive;
• Companies want more control or protection for their intellectual
property;
• Productivity has increased in the United States due to automation;
• Because the customer base is located in the United States, there is a
desire to be closer to the customer;
• A declining dollar results in less advantageous exchange rates for
imports.
Sources: Kilzer, Lou, “Top U.S. Manufacturers Returning Jobs Back to States from
China,” McClatchy-Tribune Business News, published by The Pittsburgh Tribune-
Review, January 5, 2014.
Nash-Hoff, Michele, “How San Diego Reflects National Manufacturing Trends,” Industry
Week, January 24, 2014.
Northam, Jackie, “As Overseas Costs Rise, More U.S. Companies Are ‘Reshoring,’”
www.npr.org, January 22, 2014.
Cost accounting provides the detailed cost information that management

needs to control current operations and plan for the future. Figure 1-1
illustrates the production process for goods and services for which cost
Chapter 1—Introduction to Cost Accounting 3
Figure 1-1 Production Process for Goods and Services
Inputs (factors of production) Outputs

Raw materials Natural resources Goods
Conversion process
Human resources Capital Services
accounting provides information. Management uses this information to decide

how to allocate resources to the most efficient and profitable areas of the
business.
All types of business entities—manufacturing, merchandising, and service
businesses—require cost accounting information systems to track their activi-
ties. Manufacturers convert purchased raw materials into finished goods by
using labor, technology, and facilities. Merchandisers purchase finished
goods for resale. They may be retailers, who sell products to individuals for
consumption, or wholesalers, who purchase goods from manufacturers and
sell to retailers. For-profit service businesses, such as health clubs, account-
ing firms, and NFL football teams, sell services rather than products. Not-
for-profit service agencies, such as charities, governmental agencies, and
some health care facilities, provide services at little or no cost to the user.
It is necessary for any organization to have a set of procedures in place to
provide the financial information needed by that organization. The accounting
information systems of manufacturers must be designed to accumulate
detailed cost data relating to the production process. Cost accounting systems
are accounting information systems used by manufacturers to track the costs
incurred to produce and sell their diverse product lines. While the cost account-
ing principles and procedures discussed in the text mostly emphasize manufac-
turers, many of the same principles apply to merchandising and service
businesses. Cost accounting is essential to the efficient operation of fast-food
restaurants, athletic teams, fine arts groups, hospitals, colleges, social welfare
agencies, and numerous other entities. Chapter 9 and other sections throughout
the text illustrate cost accounting systems for service businesses.
In many ways, the activities of a manufacturer are similar to those of a
merchandiser. They purchase, store, and sell goods; both must have efficient
management and adequate sources of capital; and they may employ hundreds
or thousands of workers. The manufacturing process itself highlights the
4 Principles of Cost Accounting
differences between the two: merchandisers, such as Target, buy goods

in marketable form to resell to their customers; manufacturers, such as
Kellogg’s, produce the goods that they sell. Once a merchandiser has acquired
goods, it can perform the marketing function. The purchase of raw materials
by a manufacturer, however, is only the beginning of a long and sometimes
complex chain of events that results in a finished product for sale.
The manufacturing process requires the conversion of raw materials
into finished goods through the use of labor and other factory resources. A
manufacturer must make a major investment in physical assets, such as prop-
erty, plant, and equipment. To produce finished goods, a manufacturer must
purchase appropriate quantities of raw materials and supplies, and develop a
workforce. In addition to the cost of materials and labor, the manufacturer
incurs other expenses in the production process. Many of these costs, such
as depreciation, taxes, insurance, and utilities, are similar to those incurred
by a merchandising concern. Costs such as machine maintenance and repair,
materials handling, production setup, production scheduling, and inspection
are unique to manufacturers. Other costs, such as selling and administrative
expenses, are similar to those incurred by merchandisers and service busi-
nesses. The methods of accounting for sales, cost of goods sold, and
selling and administrative expenses for a manufacturer are similar to those of
merchandisers. Service businesses, by comparison, have no inventories
because the service is consumed at the time it is provided. The opportunity
to sell an empty seat on a flight, for example, is lost once the flight takes
off. Service businesses have revenue and operating expenses, but no cost of
goods sold.
Note that product quality is as important a competitive weapon as cost
control in the global arena. Originally issued for companies marketing products
in Europe, but now widely accepted globally, the ISO 9000 family of standards
for quality management was designed by the International Organization for
Standardization, based in Switzerland. The standards are based on eight quality
management principles, including focus on customer needs, employee involve-
ment and supplier relationships, management and integration of processes and
continuous improvement.1 Major U.S. companies such as Boeing require sup-
pliers to have such quality management systems in place.2
The ISO 14000 family of standards addresses various aspects of environ-
mental management. The premise of these standards is that activities that
benefit the environment, such as becoming more energy efficient and con-
suming fewer resources, and reducing waste through recycling and other
initiatives, may have substantial economic benefits as well.3 It is becoming
common for companies to implement sustainability programs designed to
1 International Organization for Standardization, “Quality Management Principles,” www.iso.org.

2 Boeing, “Doing Business with Boeing Mc-Donnell Douglas Aerospace & Defense Systems
Terms and Conditions Guide,” www.boeingsuppliers.com.
3 International Organization for Standardization, “Environmental Management. The ISO
14000 Family of International Standards,” www.iso.org.
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Fig. 602 Fig. 603 Fig. 604
Congenital inguinal hernia. Infantile or encysted Hernia of the funicular

hernia. process.
In the female the canal of Nuck is a matter of minor importance,

containing only the round ligament. Nevertheless along it may
proceed an indirect inguinal hernia corresponding to that in the male.
The so-called acquired indirect hernia, according to the above
views, would not occur were it not for the opportunity—as it were, the
temptation—already afforded by some deviation of the peritoneal
arrangement in this locality. In these cases, however, the sac
appears to be new and is pushed along the inguinal canal anteriorly
to its normal contents. This may be the result of violent strain, or of
one which is apparently disproportionately small, but frequently
repeated.
Direct inguinal hernia is generally an occurrence of adult life, takes
place commonly as the result of accident, is a direct protrusion
through the abdominal wall at the triangular weak spot, whose outer
limit is the deep epigastric artery, with the obliterated hypogastric
artery to the inner side and Poupart’s ligament below, i. e., the so-
called triangle of Hesselbach. This hernia appears always at the
external ring, from which it may descend and become scrotal.
Fig. 605
Scrotal hernia. (Richardson.)

With complete or scrotal hernia there is usually little difficulty of
diagnosis (Fig. 605). An incomplete hernia, protruding at the external
ring, covered with considerable fat, and perhaps shifted a little in
position, is sometimes hard to distinguish from a hernia through the
femoral opening. The inguinal form escapes above Poupart’s
ligament, the femoral always below it, and Poupart’s ligament is to
be located by a line drawn from the anterior superior spine to the
spine of the pubis. The inguinal forms are usually nearer the middle
line. If the epigastric artery can be identified, either before or during
operation, the character of the hernia will be promptly demonstrated
by its relations to the neck of the sac.
Hernial protrusions give a familiar impulse on coughing unless the
incarceration of an epiplocele may mask this feature. By it they are
to be distinguished from hydrocele, varicocele, aneurysm,
undescended testicle, and the like.
Fig. 606
Hernia of liver through congenital opening in the umbilicus. (Richardson.)
Femoral Hernia.—Femoral hernia is much more common in women

than in men, and constitutes about one-tenth of all cases. This form
is also nearly always congenital in the above sense, and is
particularly liable to strangulation. It escapes through the femoral
ring into the femoral canal, to the inner side of the femoral vein, and
then, passing forward through the femoral opening, finds its direction
of least resistance upward. In consequence a loop of bowel thus
escaping from the abdomen may first pass downward, then forward,
and then upward, which will illustrate the futility of the ordinary
methods of taxis in the effort to reduce it by manipulation. These
hernias are usually small, hence their greater danger. These cases
have especially to be differentiated from psoas abscess, from
inguinal lymphatic enlargements, and tumors. If the sac be entirely
filled with omentum diagnosis is often difficult.
Umbilical Hernia.—Umbilical hernia is primarily permitted by failure
in obliteration of the opening at the navel for the omphalomesenteric
duct and for the urachus. Originally small, it may yet assume
enormous dimensions. Though actually of congenital origin, as just
stated, it may not be discovered until the later years of life. It occurs
much more commonly in females than males, and usually in
connection with a large deposit of fat in the abdomen, by which its
existence, or, at least, its limits and dimensions are masked.
Through the umbilical opening, which in the majority of cases is
small, may escape other of the abdominal viscera, as is shown in
Fig. 606, illustrating hernia of the liver. Fig. 607 illustrates the
pendulous form which many of these cases assume.
An infantile form (umbilical) is known, in which the actual
protrusion does not occur until the infant is several months old, and
which appears to be due to frequent strain, on a weak or
incompletely closed fenestrum, by coughing, crying, efforts to expel
urine through a strictured prepuce, and the like. These tumors at first
are small and always intestinal. It is often possible to so adjust a
small pad over these openings as to secure subsequent closure by
natural processes. On the other hand, the forms which come on in
later life, acquired during pregnancy, ascites, or in connection with
excessive obesity, assume sometimes relatively enormous size.
Here the hernial contents may be solely omental, but are usually at
least partially intestinal. Strangulation occurs in a large proportion of
these instances and incarceration is nearly always observed.
Naturally, in consequence, the patient complains of gastric
disturbances, as well Fig. 607
as of chronic
constipation, with
frequent colicky
attacks.[61]
[61] A rare form of

hernia into the umbilical
cord has been
described by Moran. It
has been known as
hernia funiculi
umbilicalis, and has
been held to be due to
abnormal persistence of
the vitelline duct, which
holds the loop of
intestine to which it was
attached inside the
abdominal wall, the
intestine continuing to
grow, the umbilical ring
remaining open and the
hernia thus enlarging. Umbilical hernia of pendulous form. (Park.)
Occurring in this way it
happens about the tenth week of fetal life. Such a hernia has no covering
except the peritoneum and the amnion—i. e., is without muscle or skin
covering. It would be probably first noted when the cord is about to be tied,
when at its loop, as a translucent tumor, varying in size from that of a small
cherry to a lemon, the cord being distended and assuming its own natural
size only after it has left the hernial tumor. The bloodvessels will run on one
side of the amniotic sac. Such sacs rupture easily, perhaps during crying
efforts or even during parturition. The condition is serious, and when
present no traction should be made on the cord. If easily reduced by taxis
an antiseptic compress should be fastened over the opening. Should
anything like strangulation occur operation is imperative and should be
done immediately.
Ventral Hernia.—Ventral hernia is of two types—the spontaneous,
usually epigastric, which is an omental escape in the middle line
above the umbilicus, occurring most often in fat women, in whom it is
likely to be mistaken for a hernia of ordinary umbilical type. By
fixation of its contained intestine and omentum there is more or less
dragging upon the upper abdominal viscera, with consequent
disturbance of function.
Postoperative Hernia.—Postoperative hernia often also spoken of as
ventral, occurs through the cicatrix of the wound which has permitted
it, whether this be in the middle line or elsewhere. It is an
unfortunately frequent sequel of laparotomy wounds which have
required drainage, but occasionally occurs in perfectly clean wounds
which have closed satisfactorily in the first place, but which have
subsequently parted because of unsatisfactory methods of bringing
together their deeper portions. (See p. 778.) Consequently it should
be sufficient here to remind the reader that the more accurate the
method of approximating the margins, layer by layer, and effecting a
complete and perfect union between them individually the less the
tendency to this unpleasant sequel.
Postoperative hernia may be so small as to be kept under
subjection with some form of abdominal support, or it may call for
operations for radical cure, as do other cases. They are subject to
the same dangers of strangulation of their contents.
Diaphragmatic Hernia.—Diaphragmatic hernia may be congenital, as
when occurring through a defect in this partition, or acquired, as
when under stress or strain some of the abdominal contents are
forced into the thorax, either through natural openings or through a
rent or tear. Such escape may include but a small portion of bowel;
in congenital cases one-half the abdominal contents have been
found within the thorax. The left side seems more often involved than
the right. Serious wounds of the diaphragm may be followed by this
condition. Under these circumstances the thoracic viscera are more
or less displaced, and the heart may be pushed considerably out of
place. In cases with a history of violent accident the surgeon may
more readily suspect and recognize the condition than in congenital
cases, where anatomical relations have long been disturbed, but
apparently more or less adjusted or compensated.
Pelvic Hernia.—In the lower part of the pelvis, under rare
circumstances, hernial protrusions occur either through the
sacrosciatic foramina, in which case they are known as gluteal or
ischiatic (Fig. 608), or through the obturator foramen, when they are
known as obturator hernias, the latter occurring more often in stout
women. Unless these constitute some form of recognizable tumor, or
produce acute obstruction by strangulation, they will pass quite
unrecognized. A perineal form of hernia is also known, which occurs
in Douglas’ cul-de-sac, behind the bladder or uterus, the levator ani
muscle being more or less disturbed, and the protrusion occurring
somewhere between the labium and the anus. In such hernial sacs
the ovary has been found, as well as intestinal loops, and the so-
called ovarian hernia includes some anatomical anomaly of this kind.
Fig. 608 Fig. 609
Ischiatic hernia. (Richardson.) Hernia into foramen of Winslow.
Lumbar Hernia.—In so-called lumbar hernia, which is very rare, the

hernia escapes along the outer border of the quadratus lumborum
muscle into the triangle of Petit. Such a tumor, usually small, may be
easily mistaken for lipoma or for cold abscesses.
Other anomalous types of hernia may occur in connection with
congenital defects of the bones or the less dense structures of the
pelvis proper.
Retroperitoneal and Properitoneal Hernia.—Retroperitoneal and
properitoneal hernia are types which seem to corroborate the views
already enunciated concerning the essentially congenital origin of
the ordinary forms. The former implies a protrusion into an internal
peritoneal pouch, and is usually found in the upper abdominal cavity
in the duodenojejunal fossa, although it may also occur lower down
on either side. It will not be recognized save by its effects, which will
usually be those of acute intestinal obstruction, and even then will
only be diagnosticated after the operation which the condition will
necessitate. Hernia through the foramen of Winslow has already
been mentioned in the chapter on the Small Intestines. (See Fig.
609.)
Properitoneal hernia implies usually the existence of a double sac,
with a common opening, its inner portion lying between the
peritoneum and the abdominal musculature, while its outer portion
takes the usual position of the hernial sac, either the inguinal, the
femoral, or the umbilical form. It may be suspected when reduction
which has been apparently successful has later evidently failed. It
occurs most often in the inguinal region, where it is usually referred
to as inguinoproperitoneal hernia, and where it was first recognized
by Parise, and later fully described by Krönlein. It may be with equal
propriety called interstitial hernia, and is often associated with
imperfect descent of the testicle, which perhaps has served to
deflect the descending hernia in an unusual direction. The
properitoneal sac is most often found between the internal ring and
the anterior spine, although it may be directed downward and inward
toward the bladder, or backward toward the iliac fossa. In size it is
usually small as compared with the external portions. Its existence
may be suspected when a patient with a hernia previously easily
reducible suddenly develops strangulation, which is apparently
relieved by taxis, only to recur a little later. So far as its radical
treatment is concerned all that is necessary is the extirpation of the
extra sac, with perhaps separate treatment of its neck, when dealing
with the greater and more completely filled pouch in front (Fig. 610).
Fig. 610
Properitoneal hernia. This illustrates also incomplete reduction of hernia.

(Richardson.)
Littre’s or Richter’s Hernia.—These terms have reference to
strangulation of intestine in which,
nevertheless, the entire lumen of the bowel is not completely
involved, rather only a small area, which soon becomes sacculated,
or perhaps by a diverticulum becoming involved in the occlusive and
later gangrenous process. These forms are most frequently seen in
women and at the femoral ring. They are peculiarly dangerous in that
they produce symptoms which do not include those of total and
acute bowel obstruction, and hence are often allowed to go
unoperated until gangrene has already occurred. These forms, then,
will produce signs and symptoms of partial strangulation, with
incarceration, followed after hours or perhaps days by those of local
cellulitis, with perhaps necrosis; conditions which when opened may
expose gangrenous bowel and promptly become fecal fistulas.
Treatment of Hernia.—Hernia is treated for three different
purposes: for the relief of strangulation, i. e.,
as an emergency, for palliation, or for radical cure, according to the
nature of the case and the wishes of the patient.
The relief of strangulated hernia becomes a measure of instant
importance so soon as the condition is recognized, mortality being
due to delay, practically every case being curable could it be
recognized and operated promptly. The symptoms of strangulation,
as repeatedly indicated, are those of acute obstruction of the bowel,
including fecal vomiting with meteorism, and the local indications
which may be trifling, as in very small hernial protrusions, or
unmistakable, as in large hernial masses. The indication in every
instance is to restore the occluded bowel to the abdominal cavity.
Occasionally this may be effected by the method of manipulation or
by taxis, which should never be thought of save at the very outset,
and which may be aided by the local use of cold, or especially by the
Trendelenburg position, which may be exaggerated. Under these
circumstances, as Richardson has said, minutes are precious and
delay adds materially to the danger, so that usually all non-operative
methods are to be condemned.
PLATE LIV
Strangulated Right Inguinal Hernia. (Richardson.)

The sac has been opened and its edges are drawn apart by means of forceps.
The inguinal canal and spermatic cord have been dissected.
Taxis.—The principal danger in connection with taxis is that of
doing harm to the occluded bowel by rough manipulation. The
method includes a coaxing pressure in the proper direction, with
more or less compression of the external mass, the effort being to
gently persuade it back into the abdominal cavity. In this effort the
temptation, especially among the inexperienced, is to use too much
force, by which extravasation is produced, exudate increased, and
the local condition in every way made worse. That which is possible
during the first hour after strangulation has occurred may be
impossible a little later, when edema and exudate have distorted the
parts or cemented them together. The effort should not be
prolonged, but rather very brief, and if after a very few moments no
gain be made it should be discontinued.
Reduction “en bloc” is an unusual but ever-present danger. It
implies forcing back the peritoneal sac as well as its contained
intestine unreduced, so that while the external tumor is dissipated
the actual condition of strangulation is not influenced. Its effect would
be in no way to diminish the danger of the condition, but rather to
more seriously menace the patient, under the supposition that
reduction had been accomplished satisfactorily.
Two or three axioms in the treatment of strangulated hernia are
imperative:
Very little time, if any, should be wasted in manipulation or taxis.
Taxis failing or there remaining any suspicion of reduction en bloc,
open operation is imperative.
The time to operate is just after the diagnosis has been made and
the condition recognized. Every hour of delay increases danger of
obstruction and of gangrene.
Operations for strangulated hernia should thus always be done
early and before much exudate or local disturbance has occurred, as
when thus performed they may be combined with measures for
radical cure, which are hardly to be thought of when infection has
occurred. (See Plate LIV.)
Strangulated hernia, then, being always a dire emergency, is in
nearly every instance best treated by herniotomy, whose principles
are the same, no matter whether applied to inguinal, femoral, or
umbilical hernia. By a suitably planned incision the sac is exposed.
In the inguinal region this follows the general direction of the cord
and inguinal canal. In the femoral region it is best to raise a flap,
while in umbilical hernia, although the first incision may be in the
middle line, it will usually be found necessary to make an elliptical
excision of the overlying skin, in order that both it and the sac may
be removed. Under conditions of long existent hernia, plus
strangulation, the original anatomical conditions are much altered,
and it is not necessary to waste time in the endeavor to recognize
the various coverings of the sac. One cuts directly down upon it with
such care that he may recognize it as he comes upon it, usually by
its color and by the sensation of proximity to its strangulated
contents. This is ordinarily not a difficult matter; all bleeding vessels
should be secured before the sac is finally opened. Final and
complete identification may be made by finding that the sac itself
may be pinched up between the fingers or forceps, while the
underlying contents slip away. Only when parts are bound together
in exudate will there be difficulty in this regard. The surgeon should
still proceed with caution, although the sac will usually contain
sufficient fluid of transudation to protect against injury to the
enclosed bowel. Nevertheless the greatest care should be observed
not to wound the intestine, which sometimes lies very closely under
the skin, especially in the middle line of an umbilical hernia, although
there may be masses of fat on either side of it. Sometimes the sac
distended with discolored fluid is itself mistaken for the bowel. Error
can usually be avoided by following it upward and identifying its
continuity with the surrounding tissues.
When opened its contained fluid may be found quite clear, blood-
stained, purulent, extremely offensive, or even fecal, according to the
relative age of the condition and the degree and results of
strangulation. Under all circumstances it is advisable to disinfect the
sac and its contents before endeavoring to release them. This may
be done with dilute peroxide of hydrogen or with any ordinary
irrigating fluid.
Within the sac, when thus identified and opened, may be
imprisoned omentum or bowel, or both, in any degree of
preservation from that which is almost normal, and with circulation
but slightly disturbed, to that which is absolutely gangrenous.
Congested bowel will nearly always be more or less discolored. So
long as it is dusky or even almost black, but has not lost its luster, it
may probably be safely returned to the abdominal cavity; but if green
or if luster be gone, or if the contained fluid be distinctly putrefactive,
then serious doubt as to its viability will arise. In case of actual
perforation, gangrene, or fecal abscess there will be no doubt as to
the danger of returning such bowel, and other measures should be
adopted.
The viability of the bowel having been determined and the sac
disinfected the location and degree of tightness of the constricting
ring should now be determined. In inguinal hernia the constriction
may occur either at the external or internal ring; in femoral hernia it is
usually at the femoral ring; in umbilical hernia, at some portion of the
umbilical opening; while in all three forms constriction may occur
within the sac itself and with little reference to the ordinary hernial
outlets; all of which needs to be clearly kept in mind. This
identification is usually done with the tip of the little finger, gently
insinuated and used as a probe. The operator who is sure of his
methods does not necessarily need to expose the constricting ring in
order to nick it or divide it, but he who is not as proficient should
extend and deepen his incision until the parts are clearly exposed,
so that he may be sure of not doing more harm than good.
Ordinarily it is necessary only to nick at one or two points the
margin of the ring, which will feel much like a wire loop, and then to
use the finger as a dilator, stretching and perhaps tearing, i. e.,
making the knife do as little and the finger as much work as possible,
in order to so loosen up the constricted canal that by gentle taxis or
manipulation reduction can now be accomplished. The text-books on
anatomy give minute descriptions of the relations of these hernial
outlets to important bloodvessels, with which even the student
should be perfectly familiar. Nevertheless by following the subjoined
rule, and never departing from the principle thereby indicated, the
operator may safely proceed in practically every instance. This is to
cut in the direction of the patient’s nose. The knife used for this
purpose is ordinarily the herniotome, i. e., a blunt, slightly curved
bistoury, with but a small exposed cutting blade, whose dull point is
passed along the finger until the constriction is reached, and then, by
the sense of touch, beneath and beyond it, until the wire edge of the
ring rests upon the cutting part. The handle is then turned until this
edge points upward and is moved with a gentle sawing action always
in the above-specified direction, until the peculiar resistance is felt to
have yielded. It may then be turned a little and another nick be
similarly made. These nicks should not be more than one-quarter of
an inch deep, after which the knife is withdrawn and the finger now
made to dilate and tear. With these precautions there is very little
danger of dividing an anomalously placed vessel.
Dilatation of the ring being now sufficient it is well to pull the
hernial mass a little downward, in order that the condition of the
bowel at the point of constriction may be exactly noted. It should
therefore be gently coaxed into the wound, once more subjected to
inspection, and then to disinfection. The surgeon should now
determine what to do both with the bowel and the omentum.
Omentum which is covered with exudate or darkly discolored, or
surrounded by offensive material, should be first liberated, then
ligated, above the original point of constriction, and the undesirable
part removed, the stump being returned to the abdominal cavity. The
bowel, if decided by above indications to be viable, may then be
gently coaxed back if handled with care.
But gut which has perforated, or is so compromised as to be
threatening gangrene, should not be returned into the abdominal
cavity, but treated by resection, or by fixation and the formation of an
artificial anus, decision depending both upon the condition of the
patient and of the bowel. Some of these cases are too nearly
moribund when operated to justify such procedures as resection,
and are suffering too profoundly from the consequences of
obstruction to make it advisable to do more than open the bowel for
its immediate relief. Artificial anus is, therefore, the inevitable
necessity in some forms of strangulation. When the bowel is
gangrenous it is not necessary even to endeavor to draw it farther
down into the sac, but it may be simply opened in situ.
Intestinal resection and suture instituted under these
circumstances are essentially the same as those already described
in the chapter on the Small Intestines. With the formation of an
artificial anus there results the inevitable fecal fistula which will
require subsequent operation, probably secondary resection.
In non-septic and favorable cases, the reduction having been
accomplished, the operator then may proceed to extirpation of the
sac and the closure of the hernial outlet, i. e., operate for radical
cure, this being a modern extension and addition to the old operation
for relief.
If obstructive symptoms should persist after operation the
possibility of twisting of the intestine, or a possible reduction en bloc,
may be feared, which is not likely to occur if the open part of the
operating have been done thoroughly.
Clean cases of strangulation may be closed without drainage. In
case of doubt, however, it is advisable to provide at least a capillary
drain, while every case known to have been contaminated should be
perfectly drained.
Fig. 611
Bassini’s operation. Ligation of the sac by means of a purse-string suture passed

through the internal surface of its neck. The cord is drawn to one side. The
aponeurosis of the external oblique is drawn apart with forceps. (Richardson.)
Fig. 612
Bassini’s operation. Suture of the conjoined tendon to the internal surface of

Poupart’s ligament. Fortification of the posterior surface of the canal. (Richardson.)
Radical Cure of Hernia.—From the earliest times rude and crude

methods of endeavoring to effect a
radical cure of hernia have been in vogue. While sometimes effective
they have always been dangerous and always clumsy. Not until the
antiseptic method was introduced could they be regarded as in any
way safe or reliable. With the introduction of Listerism it became
practicable to do this work, upon principles simple in character and
ordinarily easy of performance, which may be summed up in the
formula: Isolation and obliteration of the hernial sac, with permanent
closure of the hernial outlet. Easy as such description may sound it
has been found more or less difficult in practice, and numerous
methods, apparently both simple and ingenious, have proved
defective and have called for the most pronounced modification.
Considerable space could be devoted to operations for radical cure,
but the intent here shall be to simplify the subject as well as the
method, and consequently but two or three will be described. Suffice
it to say that while all are based on the same principle they vary
somewhat in detail, and that some of these details have to be
adapted to the special requirements of individual cases.
With increase in experience has come enlarged confidence in the
operation, and it is now regarded as justifiable in nearly every
instance among individuals otherwise in good condition. It has a
double purpose—namely, the avoidance of the danger of sudden
strangulation and the riddance of necessity for wearing trusses, or
suffering the discomforts of hernia without any mechanical control.
Some modern methods include the utilization of some portion or all
of the sac, while in others it is entirely cut away. Consequently some
operators have endeavored to utilize such portion of the sac as could
be made available for either purpose, either as plug or suture
material.
The method of Bassini for relief of inguinal hernia, more or less
modified to meet individual demands, seems to have become of late
years the most popular and widely adopted. The incision is made
over the most prominent part of the tumor, extending as far
downward upon the scrotum as necessary, and upward to near the
anterior superior spine. Through it the external ring, with its pillars, is
exposed, and then the sac, by a dissection long and sufficiently wide
to fully reveal it. The exposure is made more complete by dissection
of the aponeurosis of the external oblique from the level of the
external ring upward and outward for an inch or so above the
external ring. By seizing the edges of the aponeurosis on each side
with forceps and retracting there is now afforded an excellent view of
the hernia proper. (See Fig. 611.)

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Congenital inguinal hernia. Infantile or encysted Hernia of the funicular

In the female the canal of Nuck is a matter of minor importance,

Scrotal hernia. (Richardson.)

Hernia of liver through congenital opening in the umbilicus. (Richardson.)

Femoral Hernia.—Femoral hernia is much more common in women

[61] A rare form of

Fig. 608 Fig. 609

Ischiatic hernia. (Richardson.) Hernia into foramen of Winslow.

Lumbar Hernia.—In so-called lumbar hernia, which is very rare, the

Properitoneal hernia. This illustrates also incomplete reduction of hernia.

Strangulated Right Inguinal Hernia. (Richardson.)