562 DISEASES OF THE ORGANS OF GENERATION. 



sion along the inferior {upper) border or long axis of the 

 testicle, sufficiently deep only to divide the skin — which is here^ 

 remarkably thin — but of sufficient extent to reach from 

 one extremity of the gland to the other. This he follows 

 up by dividing, with a light hand, in like manner, the 

 cellular and fibrous substance underneath ; and lastly, by 

 similarly cutting through, in a more cautious way still, 

 so as not to wound the testicle uprising (from the com- 

 pression of the hand grasping it) all the while against 

 the knife, its immediate covering, the tunica vaginalis : 

 in doing which, we should not carry the incision further 

 than is absolutely necessary to make an aperture large 

 enough for the emission of the testicle. Some persons use the 

 actual cautery, instead of the knife, for the section of the 

 envelopes, assigning, as their reason for so doing, that not 

 only is any hemorrhage which is likely to annoy them 

 thereby suppressed, but that subsequent union by the first 

 intention is thereby efiPectually destroyed. The French 

 employ a bistoury for the same purpose ; a practice, I 

 think, as far as the vaginal tunic is concerned, which may 

 be worthy our imitation, from its guarding against all possi- 

 bility of wounding the substance of the testicle. No sooner 

 is its vaginal tunic sufficiently incised than the testicle starts 

 from its case, humid and shining upon its surface, and arbo- 

 rescently and beautifully venous : an event almost constantly 

 announced by a violent struggle, during which the cremaster 

 exerts such astonishing power that, unless we quickly seize 

 the spermatic cord with our left hand and firmly maintain 

 our hold, the testicle will be sure to escape and slip up into 

 its canal. Should one testis be comparatively small — which 

 is now and then the case — it may even be drawn up through 

 the ring, and occasion the operator considerable difficulty in 

 finding and securing it afresh, as well as delay in the opera- 

 tion. The subsidence of the struggle will be attended by 

 relaxation of the cremaster, the effect of which will be, to allow 

 of the elongation of the cord, and consequent complete pos- 

 session by the operator and control of the testicle. This is the 

 time to put on the clams. Prior to closing them, however, for 



