BISTOURNAGE. 



227 



and spermatic cord just above the half-rotated testicle. The hands 

 now occupy their original position and the manipulation is repeated. 



Third stage (Fig. 248). The right hand grasps the testicle and turns 

 it from left to right, the left hand at the same time pressing the sper- 

 matic cord from right to left. This produces a half-turn in the 

 spermatic cord ; the part played by the hands is now reversed, the 

 left hand pushes the testicle from left to right, the left hand thrusting 

 the spermatic cord from right to left, making the twist complete. This 

 manipulation is repeated from two to four or iive times, depending on 

 the length of the spermatic cord. 



Fourth stage. The above operations having been performed on 



Fig. 246. Fig. 247. 



each of the testicles, the lower part of the scrotum is grasped with both 

 hands and the testicles pushed as far towards the inguinal canal as 

 possible. Both should rest at the same height. \\'hilst the empty 

 lower part of the scrotum is held fast with the left hand just below the 

 testicles, the right hand passes a loop of cord (one end of which the 

 operator holds in his teeth) three or four times around the scrotum, 

 between the left hand and the testicles, so that the latter cannot slip 

 downwards, and ties the ends together (Fig. 249). The loop, however, 

 must not be drawn so tight as to stop circulation in the lower part of 

 the scrotum ; it is only required to keep the testicles in the position 



