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. 



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. 



1, testicle; 2, hemial sac ; 3, encysted hsematoeel<a 



