File:The cyclopædia of anatomy and physiology (1849) (20796342026).jpg

Title: The cyclopædia of anatomy and physiology
Identifier: cyclopdiaofana0402todd (find matches)
Year: 1849 (1840s)
Authors: Todd, Robert Bentley, 1809-1860
Subjects: Anatomy; Physiology; Zoology
Publisher: London, Sherwood, Gilbert, and Piper
Contributing Library: MBLWHOI Library
Digitizing Sponsor: MBLWHOI Library

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TESTICLE (ABNORMAL ANATOMY). above the testicle in close contact with the tunica vaginalis. Immediately above this cyst, but quite distinct from it, there was a narrow and empty serous sac three inches in length, with a contracted neck, and communicating with the abdomen. They are figured in the accompanying engraving, with the hernial sac Fig. 644.
Text Appearing After Image:
laid open, and part of the parietes of the encysted hydrocele cut away to expose their interiors. The position of the testicle is so changed that its anterior border is directed downwards. In the examination of the body of a man who died of disease of the heart, I found on the right side a thickened and empty serous pouch, extending for about an inch and a half below the external abdominal ring. Directly below it was an independent cyst, capable of containing a walnut, similar in structure to the hernial sac, but lined by a thin false membrane. The tunica vaginalis, which was healthy in structure, extended up the cord as far as the cyst, from which it was separated by a thick and firm partition. In opening the body of a sailor who died with ascites, I noticed at the internal ring a small, delicate, transparent, pedunculated cyst, not larger than a nut, projecting into the cavity of the abdomen. In the spermatic cord, there was a large serous cyst, which extended into the inguinal canal, and contained a small quantity of transparent fluid. A small orifice at its upper part opened into the peduncu- lated cyst, which proved to be a process from the cyst in the cord. In fig. 64+., I have given a representation of an inguinal hernia, combined with an elongated encysted hydro- cele of the cord; and in fig. 647., a repre- sentation of an encysted haematocele of the cord, in which the tunica vaginalis remained 1001 unobliterated as far up as the cyst, whilst a hernial sac is situated immediately above it. These dissections confirm the view taken by Sir A. Cooper, and now commonly adopted, of the mode of origin of encysted hydrocele of the spermatic cord in the adult. Complications of hydrocele.— The following are the principal: 1. Simple hydrocele, com- bined with encysted hydrocele of the testicle. 2. Simple hydrocele, combined with encysted hydrocele of the spermatic cord. 3. Simple hydrocele, combined with diffused hydrocele of the spermatic cord. 4. Oscheo-hydrocele, including both simple hydrocele and encysted hydrocele. combined respectively with inguinal hernia. 1. The first is not an uncommon compli- cation. In the dissection of these parts, I have often found the tunica vaginalis distended with three or four drachms, and even an ounce or two of serum, two or more small distinct cysts being at the same time connected with the upper part of the epididymis ; and I have twice met with this complication in both sides in the same individual. The small adventi- tious cysts appear to be the original disease, the irritation produced by them being in all probability the cause of the increased quan- tity of fluid in the tunica vaginalis. 2. The second complication is somewhat rare. In the pathological collection at the London Hospital, there are two specimens of a collection of fluid in the tunica vaginalis as- sociated with an encysted hydrocele of the spermatic cord. In one of them the tunica vaginalis is unobliterated for about two inches along the spermatic cord, and the encysted hydrocele is immediately above it. In the other preparation it is apparent that both sacs have been the seat of inflammation, false mem- branes being contained within them. This complication sometimes occurs in infants. 3. Simple hydrocele associated with dif- fused hydrocele of the cord is also rare. A good delineation of this complication is given in Scarpa's work. 4. Scrotal hernia may be combined with hydrocele. A voluminous hydrocele, if un- Fig. 645.

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