480 DAVID M. DAVIS 



were in ectopic testes, but Schoedel reported the frequency as five in forty- 

 one, and Chevassu (a) (b) as fifteen in 128; of these fifteen, ten were in- 

 guinal and five abdominal. Bulkeley, after a careful study of the litera- 

 ture, concludes that the best statistics show that there is about one abdom- 

 inal cryptorchid in 800 men, and one malignant abdominal cryptorchid in 

 60,000 men. Therefore, one in seventy-five of abdominal retained testes 

 becomes malignant. In normal testes, records of hospital patients show one 

 malignant tumor to about 160 males. If the general population were taken, 

 this proportion would be even less. Therefore, while retained testes are at 

 least twice as apt to become malignant as normal testes, it cannot be said 

 that a very large proportion of them do so. 



Aside from ectopias, there are cases of congenital azoospermia in 

 apparently normal men. 



Degenerative Changes 



Degenerative changes may involve the spermatogenic tissue alone or 

 both it and the interstitial cells, 



Ectopic Testes. The degeneration of ectopic testes has been discussed 

 above, 



Degenerations Secondary to Changes in Other Endocrine Glands. 

 Frohlich (1901) first described the genital aplasia in acromegaly. Gush- 

 ing and Goetsch placed our understanding of this syndrome on a firm 

 experimental basis. Insufficiency of the anterior lobe of the pituitary 

 body, from any cause, produces an atrophy of the testicle involving all 

 its elements and followed by sterility, impotence, and the constitutional 

 changes associated with genital insufficiency. The testis become small and 

 fibrous. Hyperpituitarism, occurring in hyperplasias or early tumors of 

 the pituitary, or caused by feeding the powdered gland (anterior lobe), 

 produces sexual precocity, with hypertrophy and hyperactivity of all the 

 elements of the testis, which can be observed microscopically. The hyper- 

 plasia of the interstitial cells, while definite, is not proportional to that 

 of the spermatogenic elements. Extracts of the posterior lobe of the 

 hypophysis, and of the ovary, have a retarding effect on the testis, with 

 decreased development of all testicular elements, and subnormal sper- 

 matogenic activity. Genital precocity and hyperplasia have also been 

 observed in tumors of the adrenal. Endocrine syndromes are undoubtedly 

 responsible for many of the so-called idiopathic testicular atrophies. 



Senility. In old age, the testis may become smaller, softer and 

 browner, or harder and more fibrous. The first form is considered normal, 

 and in it, while the tubules are narrowed and somewhat thickened, sper- 

 matogenesis persists. In the second form, there is an overgrowth of 

 fibrous tissue, the epithelial elements disappear, the Sertoli cells persisting 



