INFLAMMATION OF THE COED. 443 



from the inferior vesical, and its veins, which empty themselves 

 into the vesical plexus, these vessels being derived from and 

 terminating in an altogether different region to those belonging 

 to the testicle, although there is a definite anastomosis between 

 them. Then follow in order of importance the spermatic vessels, 

 the artery being derived from the abdominal aorta, immediately 

 distal to the renal arteries, while the veins empty themselves 

 on the right side into the inferior vena cava and on the left 

 into the left renal vein. Next there are the spermatic nerves, 

 derived from the renal and aortic plexuses ; hence it is that 

 severe pressure upon the testicle is apt to induce serious collapse, 

 and that a calculus in the kidney may be associated with pain 

 referred to the testis. The spermatic lymphatics found in the 

 cord pass up to the lumbar lymphatic glands. In addition to 

 the above there are also in the cord the remains of the guber- 

 iiaculum testis in the form of unstriped muscle fibres, and the 

 obliterated portion of the processus vaginalis. 



Inflammation of the cord may occur either through the vas or 

 the veins. 



A vas which is transmitting bacteria is liable to have its own 

 walls infected, and the inflammation may spread beyond into the 

 tissues surrounding it. Therefore in certain cases, particularly 

 those of tuberculosis, the vas itself is thickened from the actual 

 tuberculous deposit in its walls, and not infrequently becomes 

 nodular to the touch ; whilst in cases of gonococcic invasion the 

 parts external to the vas itself sometimes become markedly 

 infiltrated and indurated, and in some of these instances a true 

 phlebitis of the spermatic veins may result. 



On the other hand a blow upon, or stretching of, the spermatic 

 cord may give rise to some extravasation of blood and subsequent 

 inflammation. Occasionally the vas itself may be ruptured, 

 either in the inguinal region or in the extra-peritoneal tissue of 

 the iliac fossa, and this may give rise to a dribbling of blood 

 from the urethra altogether apart from micturition, owing to the 

 direct connection of the vas with the prostatic portion of the 

 urethra by way of the common ejaculatory duct, 



