I950 HUMAN ANATOMY. 



when the canal retains its connection with the epididymis or testis, may contain 

 spermatozoa. 



The paradidymis, or organ of Giraldes, consists of an irregular group of blind 

 tubules (from 5-6 mm. in extent) that lie within the lower end of the spermatic cord, 

 above but close to the globus major and always in front of the venous plexus. This 

 organ (upper paradidymis of Toldt) is regarded as representing a partial per- 

 sistence of the rudimentary tubules of the Wolfftan body (page 1936) and is, there- 

 fore, the homologue of the paroophoron. It is essentially a foetal structure, usually 

 entirely disappearing after the first few years of childhood. The tubules (from .1-2 

 mm. in diameter and lined with ciliated epithelium) rarely give rise to cysts. 



The vasa aberrantia (ductuli aberrantes) include tubular appendages^ — usually 

 two, but sometimes only one — that extend for a variable distance within the epididymis 

 and end blindly. The ttpper and shorter one is attached to the rete testis and pur- 

 sues a downward course within the epididymis. The lower and larger one, often 

 30 cm. (12 in. ) or more in length, passes upward from the lower part of the canal 

 of the epididymis and consists of one or more convoluted tubes of considerable size. 

 Both are to be regarded as probably originating from the Wolffian tubules. 



PRACTICAL CONSIDERATIONS : THE TESTICLES. 



Alonorchism — the absence of one testicle (not to be confounded with cryptor- 

 chism, vide infra^ — has been shown at autopsies to occur occasionally. It is 

 attended by no symptoms. 



Anorchism — the absence of both testicles — may be inferred when the scrotum 

 is also absent or incompletely developed, and there is a rudimentary condition of 

 the external genitalia ; impotence, sterility, and the physical and mental attributes 

 of eunuchism appear later. 



Arrest of descent of one or both testicles (page 2040) may occur at any point 

 between the lower border of the kidney and the bottom of the scrotum. The chief 

 forms are : {a) Abdominal Retention (cryptorchism, unilateral or bilateral) : the 

 testicle may be applied to the posterior abdominal wall in close relation to the lower, 

 outer border of the kidney ; it may be provided with a long mesorchium, allowing 

 it to move freely in the abdominal cavity, or it may lie in the iliac fossa close to the 

 internal ring ; (^) Inguinal Retention : the testicle may be arrested at the internal 

 ring, in the inguinal canal, or at the external ring. It is usually extremely mobile 

 until subject to repeated attacks of inflammation and fixed by adhesion, (f) Crnro- 

 Scrotal Retention : the testicle may pass through the external abdominal ring, but 

 fail to descend completely, lying in close relation to the ring or at a varying distance 

 below it. Of these, inguinal retention is the most common. Adhesions from prenatal 

 peritonitis in a, small size of the external ring in b, and undue shortness of the cord 

 or of one of its constituents in c have been thought to explain some of these cases. 



Aberrant desceiit (ectopy), in which the testicle leaves its normal route, may 

 occur in one of several forms. («) \r\ pcno-pubic ectopy the testicle is found beneath 

 the skin of the abdomen above the root of the penis, i^b) In perineal ectopy the 

 testicle is felt as a freely movable, ovoid tumor, sensitive to pressure, lying on one 

 side of the central raphe, and placed in front of the anus ; the cord can often be 

 traced from the tumor to the external abdominal ring. The overlying skin some- 

 times exhibits rugae, and the corresponding side of the scrotum is often atrophied. 

 ic) Femoral ectopy 2iTppta.rs as a movable tumor exhibiting the physical character- 

 istics of the testicle and the peculiar sensitiveness. Its position is that of complete 

 femoral hernia or of the inflammatory swellings which so commonly affect the glands 

 overlying the saphenous opening. 



Of these, perineal ectopy is the usual form. Irregular development of the 

 gubernaculum may explain a and r, as certain of the fibres of the genito-inguinal 

 ligament run to the pubic, lower inguinal, and inguino-femoral regions, and their 

 over-development might draw the testicle in front of the pubes or into the femoral 

 canal. Exceptional attachments (which have been shown to exist) of the guber- 

 naculum below to the tuber ischii or sphincter ani may account for at least some of 

 the cases included in b. 



