516 V. D. LESPINASSE 



4 



turn: there is a scarcely noticeable prostate; the seminal vesicles are not 

 palpable. 



Practiced coitus daily. Erection short duration. Orgasm came 

 quickly, ejaculation sparse, watery and thin. Evidently this man had a 

 compensating function develop from either the pituitary or adrenal cortex 

 that almost completely replaced the testicular hormone. 



Report of Case. A man, aged 38, consulted me in January, 1911, 

 to determine if anything could be done for him to compensate for the loss 

 of both testicles. One testicle which had been retained was removed dur- 

 ing a hernia operation ; the other had been lost by an accident about two 

 years previous to his consultation with me. He was unable to have inter- 

 course, which was his chief reason for coming to me. 



A testicle 'from a normal man was easily obtained. In fact, I was sur- 

 prised at the number of testicles that are available for transplantation 

 purpose. 



The two patients were anesthetized at the same time, and the recipient 

 prepared as follows: The scrotum was opened high up and a bed pre- 

 pared in the same way as we prepare the bed for the reception of an 

 undescended testicle. Hemostasis was carried out with great care. An- 

 other incision was made over the rectus abdominalis muscle; this in- 

 cision was carried down through the skin and fascia. The fibers of the 

 rectus muscle were exposed and these fibers separated by opening an artery 

 forceps plunged into the muscle. Hemostasis was carried out and then 

 the testicle to be transplanted was removed. It was immediately stripped 

 of the epididymis, cord and tunica vaginalis, and then sliced transversely 

 to its long axis, these slices being approximately 1 mm. in thickness. The 

 central slice and the one next to it were taken out and placed among the 

 fibers of the rectus muscle. Another slice was placed in the scrotum. 

 The wounds were closed without drainage and healed by first intention 

 throughout. 



On the fourth day after the operation the patient had a strong erec- 

 tion accompanied by marked sexual desire. He insisted on leaving the 

 hospital to satisfy this desire. The desire and power of erection con- 

 tinued for five years, since which time I have lost track of him. All 

 eunuchs should have the benefit of a testicular transplant. 



Eunuchoidismus 



Etiology. The usual cause of eunuchoidismus is given as congenital. 

 This simply means that there has been for some reason or other a lack of 

 development of the testicular elements to a greater or less degree. To go 

 further, this lack of development may have been simply an embryological 

 omission or a non-development of the formed bud. Many of these cases 



