988 



TESTICLE (ABNORMAL ANATOMY). 



form of a blindly-ending canal running tor- 

 tuously in the shape of the letter S. The left 

 testicle was sound.* 



Mr. Paget has happily explained the origin 

 of these several defects in the vas deferens, by 

 reference to the mode of development of the 

 special organs of generation. He observes t, 

 after Miiller and Valentin, that, in the normal 

 course of human development the proper ge- 

 nital organs are in either sex developed in two 

 distinct pieces : namely, the part for the for- 

 mation of the generative substance, the testicle 

 or ovary, and the part for the conveyance of 

 that substance out of the body, the seminal duct 

 or ovi-duct. The testicle or ovary as the case 

 may be, (and in their earliest periods they 

 cannot be distinguished), is formed on the 

 inner concave side of the corpus Wolffianum, 

 and the seminal or ovi-duct, which is originally 

 an isolated tube closed at both extremities, 

 passes along the outer border of that body 

 from the level of the formative organ above to 

 the cloaca or common sinus of the urinary, 

 genital, and digestive systems below. The 

 perfection of development is attained only by 

 the conducting tube acquiring its just connec- 

 tions at once with the formative organ, and, 

 through the medium of the cloaca, with the 

 exterior of the body. The sexual character is 

 first established, when, in the male, the for- 

 mative and conducting organs become con- 

 nected by the development of intermediate 

 tubes which constitute the epididymis ; or 

 when in the female, a simple aperture is formed 

 at the upper extremity of the conducting tube, 

 and is placed closely adjacent to the formative 

 organ. In both sexes alike, the lower ex- 

 tremities of the conducting tubes first open into 

 the common cloaca, and subsequently, when 

 that cavity is partitioned into bladder and rec- 

 tum, or bladder, vagina, and rectum, they ac- 

 quireineach their just connections, and become 

 in the male the perfect vasa deferentia, and 

 in the female the Fallopian tubes and uterus. 



The inquiry is not without interest, what 

 influence have these deficiencies and imperfec- 

 tions in the vas deferens on the evolution and 

 subsequent condition of the testicle ? In the 

 case of the adult which occurred at St. Bar- 

 tholomew's Hospital, the testicle was small, 

 and its structure appeared granular, like the 

 undeveloped testicle of a youth, but as it had 

 not descended into the scrotum, and was com- 

 bined with hernia, there may have been other 

 causes impeding its due evolution. In Mr. 

 Hunter's case, the testicles which were in the 

 scrotum were very sound. In the case of the 

 man related by Brugnone, the testicle on the 

 side corresponding to the defective vas de- 

 ferens was perfectly sound, and nearly of the 

 same size as the other. So also in Bosscha's 

 case, it is stated, that the testicle was sound. 

 Although either of these defects in the vas 

 deferens renders the gland an useless organ, 



* Diss. sistens Obs. de vesiculte seminalis sinis- 

 traj defectu, integris testibus, vase vero deferente 

 clause, quoted by Dr. Vrolik, Handbook der Ontleed- 

 kundige Ziektekunde, 1st Decl. p. 210. 



( Loc. cit. p. 818. 



and if it occurred on both sides of the body, 

 would necessarily cause impotency, these 

 cases, nevertheless, tend to shew that the 

 absence or imperfection of the excretory duct 

 does not prevent the development of the tes- 

 ticle at the proper period, and has no direct 

 influence in causing it to waste; and these 

 inferences are fully confirmed by experiments 

 on animals, performed by Sir A. Cooper and 

 by myself.* These cases and experiments 

 show, then, that the testicles may be properly 

 developed, though a physical obstacle to the 

 elimination of their secretion is present from 

 birth ; and that so long as the testicles exist 

 entire, though to no purpose, the individual 

 acquires and preserves all the marks of the 

 male sex ; the secretory organ alone appear- 

 ing to be that upon which the sexual charac- 

 ters depend. The engorgement of the se- 

 minal ducts with sperm is liable, it is true, to 

 cause inflammation of the testicle, which may 

 end in atrophy, but this is only a secondary 

 and occasional effect of the interruption in 

 the excretory duct. 



Imperfect transition. It occasionally hap- 

 pens that at birth one or both testicles have 

 not passed into the scrotum, being detained 

 either in the abdomen near the groin, in the 

 inguinal canal, or in the groin, just outside the 

 external ring. In a table of one hundred and 

 three male infants, examined by Wrisberg at the 

 time of birth, it appears that seventy-three had 

 both testicles in the scrotum ; in twenty-one, 

 one or both were in the groin. Of these, five 

 had both, seven the right, and nine the left in 

 the groin ; in twelve, four had both, three the 

 right, five the left, only in the abdomen.-)- 

 According to this table, the imperfection occurs 

 rather more frequently on the left side than on 

 the right, in the proportion of seven to five. 

 In twenty-five cases examined at different ages, 

 varying from five to sixty, sixteen of which 

 came under myown observation, the remainder 

 being taken from the recorded experience of 

 others, in thirteen the imperfection was on 

 the right side, and in twelve on the left. Dr. 

 Marshall states, that in the examination of 

 10,800 recruits, he had found five in whom 

 the right, and six in whom the left testicle 

 was not apparent. In two of these cases there 

 was inguinal hernia on the side where the tes- 

 ticle had not descended. J He met with but 

 one instance in which both testicles had not 

 appeared. The testicle sometimes remains 

 permanently fixed in the situation in which it 

 is placed at birth || ; but in some instances the 

 passage, though delayed, is completed at some 

 period previous to puberty, and often within 

 a few weeks after birth. Mr. Hunter was of 

 opinion that this completion most frequently 



* Vide Sir A. Cooper on Anatomy of the Testis, 

 p. 51., and my Treatise on the Diseases of the Testis, 

 p. 64, and seq. 



f Commentatio Soc, Eeg. Scient. Goetting. 1778. 



I Hints to Young Medical Officers in the Army, 

 p. 83. 



Ibid. p. 207. 



|| Persons whose testicles had not made their ap- 

 pearance were called xpu^opx.idis, or testicondi, by the 

 ancients. 



