438 



SCROTUM. 



This fact is mentioned on Sir Charles Bell's 

 authority, from whom we also quote the fol- 

 lowing short passage : "We would do well to 

 remember this double office of the scapula 

 and its muscles, that whilst it is the very 

 foundation of the bones of the upper extre- 

 mity, and never wanting in any animal that 

 has the most remote resemblance to an 

 arm, it is the centre and "point d'appui " of 

 the muscles of respiration, and acts, in that 

 capacity when there are no extremities 

 at all. 



Percussion and auscultation are constantly 

 practised over the scapular region, the super- 

 ficial position of the spine of the scapula 

 causing it to furnish satisfactory results when 

 percussed, whilst the nature of the respiratory 

 sound, in the subjacent portions of the lung, 

 may be easily learned by applying the stetho- 

 scope to the supra- or infra-spinal fossa. 



The scapular region is sometimes the seat 

 of furuncu/ar inflammation, and of anthrax, 

 which selects in general the posterior aspect 

 of the body, where the sub-cutaneous areolar 

 tissue is most dense, often shows a special 

 preference for the scapular region. Here 

 likewise practical surgeons are well aware 

 that chronic abscesses ("absces froid ") not un- 

 frequently occur. 



Collections of matter in this situation are 

 generally unconnected with any other local 

 disease, but at the same time indicate consti- 

 tutional derangement, more or less profound. 

 Chronic abscess in this locality is not always 

 superficially seated ; it may have for its site 

 the loose areolar tissue beneath the scapula, 

 which connects the sub-scapularis to the ser- 

 ratus magnus muscle. Here it may attain a 

 great magnitude, and displace the scapula 

 outwards to a considerable distance from the 

 trunk. 



Fractures of the body of the scapula are 

 met with as the result of direct violence only, 

 and occur less frequently than the slightness 

 of the bone would lead one a priori to expect. 

 The numerous muscles covering the bone, 

 which form for it an elastic cushion, and its 

 strong projecting spine, are sources of protec- 

 tion to which the scapula is indebted for its 

 comparative immunity from this form of 

 injury. 



Ablation of large portions of the scapula, or 

 even the complete removal of that bone with 

 part of the clavicle, and the scapulo-humeral 

 articulation, has been had recourse to in cases 

 of extensive injury of the shoulder, as from 

 gunshot wounds. (Larrey.) 



In the Hopital des Invalides at Paris may 

 be still seen living examples of the success 

 which sometimes attends even such severe 

 mutilations; whilst the records of British sur- 

 gery also furnish successful instances of the 

 complete removal of the scapula, scapular 

 end of the clavicle, and upper extremity, for 

 tumours of great magnitude occupying the 

 region of the shoulder, of which the cases by 

 Mr. Fergusson and the late Mr. Liston are 

 amongst the most remarkable. 



(7^. Geo. M l Dowel.) 



SCROTUM. Latin, per metath. a SCOT- 

 turn, i. e. pellis ; KO^VKOQ, oaxtQ, X l ''C, Gr. ; 

 der Hodensack, Germ. Neither the English 

 nor French language appears to have retained 

 any word exclusively significant of this part 

 of the body. In the former tongue, the 

 Saxon word " cod," a husk, or shell, or bag, 

 seems to have been originally applied to it in 

 common with other tegumentary tissues ; 

 e. g. " peascods." Subsequently, however, 

 the meaning of the word was extended, and 

 from the containing tissues came to imply the 

 contents. It is now obsolete, and the only 

 term popularly retained in both languages is 

 " the purse," " les bourses," either in allusion 

 to the scrotum resembling a purse, or from its 

 tegumentary nature (/3i>p<ra, pellis). 



The scrotum is the pouch or fold of integu- 

 ment in which the testicles are placed, where 

 they occupy an external position. It is com- 

 posed of skin and areolar tissue, and is plen- 

 tifully supplied with vessels and nerves. It 

 contains the testicles, their cremaster muscle, 

 and serous membrane, together with their ar- 

 teries, veins, nerves, and efferent duct, and a 

 considerable length of the spermatic cord, 

 which continues these into the abdominal 

 cavity. 



The skin of the scrotum is continuous 

 above and in the middle line with that which 

 covers the inferior or urethral surface of the 

 penis, and on each side with that of the 

 lower part of the belly, the inguinal region, 

 and the inner side of the thigh ; behind, 

 it is continuous with the perineum. Its 

 colour is darker than the neighbouring in- 

 tegument, and in the adult its surface is 

 sparingly occupied with hair ; in health it is 

 rendered irregular by the presence of nu- 

 merous rugse or furrows, the larger of which 

 take a transverse direction. The median 

 line offers a prominence which extends back- 

 wards to the anus, and which, from its like- 

 ness to a suture, modern anatomists have 

 named the raphe * (p$/, sutura). 



The areolar tissue of the scrotum is conti- 

 nuous with, or, in anatomical language, de- 

 rived from, that of the perineal and inguinal 

 regions. The more superficial or subcuta- 

 neous fascia, together with that deeper layer 

 which is attached to Poupart's ligament and 

 to the ramus of the pubes, converges towards 

 the scrotum ; the two layers uniting to en- 

 sheath the spermatic cord and testicle of each 

 side in a cylindrical prolongation, the apposi- 

 tion of the two bags in the middle line form- 

 ing a common partition, the septum scroti. 



The texture of this covering of areolar 

 tissue is peculiar, or even sui generis, and 

 perhaps led to its receiving the appellation of 

 the dartos (cVtproc, tunica). It is very deli- 

 cate, and highly elastic, and is usually of a 

 reddish or pink colour ; but it is not unlikely 

 that this phenomenon may be of post-mortem 

 occurrence : and it has the additional pecu- 

 liarity of being destitute of the fat which is 



* Its proper Greek name is fyfa. The etymology 

 of the word is unknown, but it is used by Aris- 

 tophanes and Galen. 



