File:Annals of surgery (1885) (14793679533).jpg

Identifier: annalsofsurgery31philuoft (find matches)
Title: Annals of surgery
Year: 1885 (1880s)
Authors:
Subjects: Surgery
Publisher: Philadelphia Lippincott
Contributing Library: Gerstein - University of Toronto
Digitizing Sponsor: University of Toronto

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the ring, the genital branch of the genito-crural ap-pears. In the canal they usually are found anastomosed as onetrunk, the early cocainization of which at the deeper part of thecanal, after splitting the aponeurosis beyond the internal ring,is perhaps the most important step of the operation. As hasbeen stated above, this may result in no additional cutaneousanaesthesia. The usual anaesthetic sequel, however, is repre-sented by a complete loss of sensation of the entire scrotal 26 HARVEY CUSHINQ. contents, cord, hernial sac, and testicle, with the possible ex-ception of its lower vascular supply (superficial perineal), andby a cutaneous area of anaesthesia which occupies the innerside of Scarpas triangle, spreading over the adductor tendons.Division of the nerve is unassociated with any surface anaesthesiaof the scrotum whatever (cf. Fig. lo). It is ordinarily stated,to the contrary, that these nerves are a source of cutaneoussupply to the scrotum; for instance, Professor Thane says
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Fig, io.—Area of antesthesia of ilio-hypogastric, ilio-inguinal, and genital branchof genito-crural in a unilateral cocaine case, following operation. This beganto fade by the twenty-first day, with return of cremasteric reflex. This repre-sents the most complete type of anaesthesia in unilateral cases, and is the sameeven after division of the cord and castration, and consequent section of allpossible cutaneous filaments of the genital branch of the genito-crural andthe ilio-inguinal. (Quains Anatomy, Vol. iii, Pt. II, p. 341, 1895), The rootof the penis, on its dorsal aspect, and a part of the scrotumanteriorly are supplied by the ilio-inguinal and genito-cruralnerves. It was of extreme interest, consequently, to find thatthe ilio-inguinal, supplying most of the contents of the scrotum,was not represented by any cutaneous supply to the same. Theinferior pudendal of the small sciatic and superficial perineal ofthe internal pudic, therefore, supply in most cases, at all events,its e

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