484 



DAVID M. DAVIS 



mumps, according to military statistics, and in one case in five, according 

 to observers in civilian practice. In certain epidemics, all cases have 

 shown orchitic involvement. The condition is usually unilateral. The 

 testis swells, and there is an epithelial necrosis of the tubules, with degen- 

 eration of the inner layers of the coat, whereby they are obliterated. This 

 leads, in bilateral cases, to sterility. The interstitial cells are involved, 

 and in bilateral cases occurring before puberty, there may be eunuchism. 



Orchitis may occur 

 without parotitis. The 

 end result in about one- 

 third of the cases, which 

 are most severe, is a 

 fibrous atrophy at the 

 end of several months. 

 The rest recover at least 

 partially. It is stated 

 that late restitution of 

 an atrophic testicle may 

 occur, but this is doubt- 

 ful. 



Variola. -- Orchitis 

 occurs in 60-85 per cent 

 of cases of smallpox, a 

 g reater percentage than 

 i n anv other disease. 



A , . ... .-, ., 



Authorities consider it 

 as a regular manifesta- 

 tion of this disease. The 

 lesion consists of a 

 round and plasma cell 

 infiltration, diffuse or 

 nodular, of the stroma, 

 with vasodilatation, 

 hemorrhage, and epithe- 

 lial degeneration of the 



tubules. It is usually benign, leading to complete restitution, but may go 



on to suppuration or atrophy. 



Typhoid Fever. Orchitis is rather rare in typhoid, sixty-five cases 



having been reported. It usually occurs at the beginning of convalescence, 



may recur, and is generally benign, but may lead to suppuration or 



atrophy. 



Scarlatina. Orchitis is rare. A few cases, not beyond doubt, have 



been reported. 



Influenza and Pneumonia. A few cases of orchitis complicating 



Fig. 5. Acute pyogenic inflammation of the testicle, 

 high power. The same specimen as Fig. 4. X 320. 

 (Brady Urological Institute collection.) 



