4o8 DISEASES Of UNCERTAIN /ETIOLOGY 



The microscope shows the veins of the pampiniform plexus dilated 

 with pus cells and thrombi ; the coats of the veins and the vas deferens 

 are infiltrated by small cells. 



SYMPTOMATOLOGY. 



The onset is sudden. The patient after a day of hard work feels 

 tired, takes a bath, and has a shivering fit and a rise of temperature. 

 There may be vomiting. 



There is pain along the cord and epididymis. 



The condition becomes rapidly worse. 



On the third dav there mav be continuous vomiting and some 

 hiccough. 



The temperature is about 102° F., the pulse small and rapid. 



The cord is swollen, hard and tender. 



The skin over it is normal. 



The condition is usually unilateral. 



There are no signs of gonorrhoea or trauma. 



If left, a septic^emic condition sets in, the skin becomes jaundiced, 

 cutaneous hemorrhages, the fever rises and the pulse cjuickens, the 

 hiccough is worse, and death follows in a few days. 



Spontaneous recovery is the exception. 



TREATMENT. 



The only effective treatment is prompt surgical interference. 



The inflamed cord should be excised as high as affected. 



The testis loses its generative function in all but the mildest cases. 



EPIDEMIC GANGREXOl\S RECTITIS. (Ackers.) 

 DEFINITION. 



A very rapidly fatal and spreading phagedasnic disease about the 

 anus and the lower part of the colon, confined to the natives of the 

 northern provinces of South America, Fiji and other islands of the 

 South Pacific. 



It occurs amongst the children of poor natives and also in animals. 



SYMPTOMATOLOGY. 



There is anal itching, tendency to frequent defalcation, inflam- 

 mation of the rectal mucous membrane, the latter developing in about 

 three days, followed by acute dysenteric symptoms, mucus, blood, 

 sometimes bile with much tenesmus. 



There is some fever, thirst and anorexia. 



A semi-liquid, slimy, foetid, blood-stained, greenish stool comes 

 awav. 



