TESTICLE (ABNORMAL ANATOMY). 



995 



the inflammatory action ; but when the con- 

 tiguous organ or subjacent part is of a dif- 



Fig. 638. 



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 



