On the Sarcocele of Egypt. 293 
T did not know of the success of his operation when I per- 
formed a similar one, (the case I have cited,) and proposed 
to extirpate several other enormous saxcocelas; when the 
army was removed. 
When the complaint is recent, it may be treated with the 
remedies hereafter described; but in an advanced stage there 
is no other resource but extirpation, preceded, however, by 
remedies proper to remove the cause of the disease. Among 
the internal remedies antimonials combined with mercurial 
medicines, and convenient doses of sudorifics, continued for 
some time, or alternated with small doses of the mineral 
acids, diluted in some mucilaginous fluid, produce the best 
effects, but particularly the sulphuric acid, lowered and ap- 
plied in form of lotion to the parts, or a weak solution of 
miuriate of mercury, or oxide of copper, or muriate of am- 
monia, the effects uf which are increased by gentle and uni- 
form pressure on the disease. The success of these means 
will be evident in the diminution of the bulk’of.the tumour, 
the retraction of the skin, and the amendment of the pa- 
tient’s countenance. If this be the case, the remedies 
should be continued until the disappearance of the disease. 
Incisions or caustics seem to me to be useless. I rest my 
opinion on the little success which the Spanish and English 
surgeons had in one ef the cases related. It is even possi- 
ble that these means, if followed by the astringent remedies 
I have mentioned, may produce cancerous ulceration, But 
after the use of these remedies differently combined, and 
for a sufficient time, if the sarcocele continues in the same 
state, I do not hesitate to pronounce the necessity of am- 
putation, and the possibility of performing it without dan- 
ger. Its necessity is marked by the failure of all other 
means, and the certainty that the disease will continue to 
increase ; and though the inconveniences are not intense, 
they lead with certainty to the grave. 
It now only remains for me to describe how the operation 
is to be performed. The vessels which supply the tumour 
arise from thre external pudic artery, and some branches of 
the internal pudic artery. The spermatic arteries are sent 
wholly to the testes, and are therefore out of the way; and 
the hemorrhage which the other vessels produce is not of 
much importance, and the arteries are easily secured by a 
ligature when they are divided. The operation is long and 
tedious, but not highly painful. The removal of the tu- 
mour being complete, if the disease even has been compli- 
cated with clephantiasis, which I have usually seen, there 
T3 is 
