482 DAVID M. DAVIS 



Traumatism 



Contusions. Simple contusions of the testicle result in edema and 

 punctate hemorrhage, with resulting fibrous change of greater or less 

 extent. Extensive hemorrhages do not, as a rule, occur. Very severe 

 contusions may result in an induration or fibrous atrophy, or rarely may 

 suppurate. The latter alternative is usually the result of tuberculosis 

 latent at the time of injury. In the most severe form of contusion, the 

 tunica albuginea is ruptured, usually with formation of a fungus testis, 

 and destruction of the organ. 



Wounds. Wounds of the testicles are usually perforating. Their 

 pathology is of little interest in relation to endocrinology, except as it 

 may result in destruction, partial or complete, of testicular tissue. 



Inflammation 



The division of inflammations into acute and chronic must be more or 

 less empirical. Inflammations usually acute may become chronic. Fibro- 

 sis testis has not been considered as a separate subject, but it is discussed 

 under various diseases which may cause it. 



Acute Orchitis 



By the Efferent Duct. Gonorrheal. Gonorrheal infections are the 

 most frequent and important of those affecting the testicle, yet they 

 usually involve it only in an indirect manner. Following a gonorrheal 

 urethritis, the infection reaches the epididymis, either by extension 

 through the vas deferens, or by the carriage of infectious matter through 

 it by antiperistalsis. An acute inflammation occurs in the epi- 

 didymis, which may resolve or suppurate. If it suppurates, the abscess 

 or abscesses may open to the outside, or into the tunica vaginalis, or the 

 pus may be encapsulated. In any case, however, scar formation occurs, 

 with atresia of the duct of the epididymis. This is almost without excep- 

 tion, since the duct is single and very convoluted. As a result, no sper- 

 matozoa can leave the testis. When obstruction occurs from this cause, 

 there is, strangely enough, no ill effect on the testicle, except in very rare 

 instances. The epithelium is not degenerated, spermatogenesis apparently 

 continues, perhaps at a reduced rate, and the interstitial cells are un- 

 harmed. The individual is therefore sterile if the lesion is bilateral, 

 but suffers no other inconvenience. If it is possible to relieve the stricture 

 at a later date, fecundity is usually at once restored. Chevassu reports a 



