File:The cyclopædia of anatomy and physiology (1849) (20813131322).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). 995 the inflammatory action ; but when the con- tiguous organ or subjacent part is of a dif- Fig. 638.
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ferent structure from that of the cellular tissue, the extension of inflammation inwards is checked. Thus, in the case of the inflamed tunica vaginalis, the cellular tissue readily transmitted the morbid action to the epididy- mis, but the tunica albuginea arrested its progress to the body of the testicle ; and this explains the fact that after inflammation of the tunica vaginalis, excited by injection, the body of the gland is rarely found to suffer. On the other hand, the epididymis is seldom attacked with inflammation without the disease being quickly propagated to the tunica vagi- nalis. The lymph effused in inflammation very often forms adhesions between the opposed serous surfaces, and these after some time are rendered very firm and dense, and in old cases are often converted into a fibro-cartilaginous structure. In a testicle which I examined some little while after an attack of acute in- flammation, I found the lymph on both sur- faces of the tunica vaginalis presenting a honeycomb or lace-like appearance, similar to that often met with on the pericardium. In- flammation, if violent, may end in the forma- tion of pus ; suppuration is, however, a rare occurrence, unless artificially excited, for the cure of hydrocele. Inflammation of the tunica vaginalis is not only the most frequent disease of the testicle, but it is also one of the most common affections to which the body is liable. In the different disorders of the gland this membrane usually becomes inflamed at some period or other, and adhesions between its opposed surfaces are scarcely less common than those of the pleura. In examining the testicles of twenty-four adults, I found ad- hesions of greater or less extent in one or both glands in as many as nine instances. Hydrocele of the tunica vaginalis. — The sac of the tunica vaginalis, like other serous ca- vities, is liable to dropsical effusion. The fluid effused is usually transparent, and of an amber, pale yellow, citron, or straw co- lour, and resembles the serum of the blood, but is occasionally thick. According to Dr. Marcel's analysis*, 1000 grains of this fluid of the specific gravity 102<i'3 contained 80 grains of solid matter, of which 71'5 con- sisted of animal, and 8*5 of saline ingredients : hence it appears that this fluid only differs from the serum of the blood in possessing rather less animal matter. In an analysis of the fluid of hydrocele made by Dr. Bos- tockf, lOO'OO parts of the specific gravity 102-t were found to contain Water Albumen - Uncoagulable matter - Salts 100-00 A quantity of flakey matter or flocculent albumen is sometimes found floating in the fluid ; and it frequently contains, especially in old people, cholesterine in the form of a multitude of minute shining particles. The quantity of cholesterine contained in nine- teen ounces of dark fluid full of these shining particles, which I removed from an old hy- drocele, amounted to nine grains. In the examination of a testicle from a man of co- lour who died at an advanced age, I found the tunica vaginalis and its investing tissues very thick and firm, and the seat of cartilaginous and osseous deposits ; it contained about three drachms of a thick brownish substance, which was almost entirely composed of cholesterine. This was no doubt a very old case of hydro- cele, in which, the more fluid parts having been absorbed, the cholesterine was left be- hind within the indurated sac. The quantity of serum which is suffered to accumulate varies considerably. In this country it seldom exceeds twenty ounces, though it has been known to amount to several pints. The largest quantity which I have met with is forty-eight ounces. Mr. Cline is said to have removed from Gibbon the historian as much as six quarts.J In simple hydrocele the testicle is usually found at the posterior part, and rather below the centre, of the sac : its situation however is subject to variations. Before the occur- * Medico-Chirurg. Trans, vol. ii. p. 372. t Ibid. vol. iv. p. 72. \ Sir A. Cooper's Lectures, by Tyrrell, vol. ii. p. 92. 3s 2

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