File:The cyclopædia of anatomy and physiology (1849) (20829707981).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). glandular structure of the testicle sometimes disappears in the same manner as in old cases of hydrocele, atrophy being occasioned by the long continued pressure arising from the ex- travasated blood. Sir B. Brodie has recorded two cases of old hgematocele, in which the testicle was completely atrophied.* In the examination of a large hasmatocele which had existed for many years, and was removed by operation, under the impression that it was a solid enlargement of the testicle, I found the tunica vaginalis nearly half an inch thick, and full of a soft friable substance of a chocolate colour; the testicle, which was situated at the posterior part of the cavity, was some- what flattened, and partly imbedded in the thickened cyst; but the glandular structure was perfectly healthy, and the bulk of the organ scarcely less than natural. The haenia- tocele, with the sac and testicle laid open, is represented in the accompanying figure. The Fig. 646.
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structure of the testicle is usually indeed sound in haematocele, but its nutrition becomes im- paired when the disease is of very old stand- ing. Encysted hcematocele of the testicle, or effusion of blood in a cyst connected with the testicle, is an extremely rare affection. The following is the only case of the kind that I have met with. I was requested by one of my colleagues at the London Hospital to examine a case of painful tumour connected with the left testicle. The patient, aged eighteen, had injured the part three months before. The scrotum was much swollen at the time of the accident, and the tumour formed afterwards. It was about the size of a chesnut, * Lond. Med. and Phn-s. Journal, vol. Iviii. p. 299. 1003 quite moveable, but attached to theepididymis. The cyst was opened with a lancet, and exit given to a quantity of dark coagula lodged in a thickened cyst, the interior of which was lined by a rough false membrane. No doubt the cyst existed before the injury, which caused effusion of blood and inflammation, and thickening of the cyst. Hcematocele of the spermatic cord is an affection which was first noticed by Mr. Pott. It is generally produced by the accidental rupture of a spermatic vein, during violent and sudden exertion, as in straining to lift a heavy weight, when blood immediately es- capes into, and infiltrates the loose areolar tissue along the cord, where it accumulates, its further diffusion being prevented by the fascious envelope of this part. Mr. Pott has related three cases, all of which happened in this way. I have met with this variety of hasmatocele, coupled with extravasation in the scrotum, in two or three instances of contusion, of this part. In one case in which the effusion in the cord was on the left side the spermatic veins were varicose. Encysted hcematocele of the spermatic cord results from the effusion of blood into the cyst of a hydrocele of this part. But it is an affection only known to me from preparations. In the Museum of St. Bartholomew's Hos- pital there is a specimen of the kind. The cyst is empty : but it is described to have contained blood, and its walls are deeply stained with the colour of partially decom- posed blood. Its lining membrane is wrinkled and coarsely granular, and the tissues around Fig. 647.

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