TESTICLE (ABNORMAL ANATOMY). 



991 



anomaly, which is reported by Eckardt. In 

 this case, the testicle passed out at first 

 through the inguinal canal, but having been 

 returned by the patient into the abdomen, it 

 subsequently escaped at the femoral ring.* 



Inversion of the Testicle. It sometimes 

 happens that the position of the testicle in 

 the scrotum is reversed, so that the free sur- 

 face presents posteriorly, and the epididymis 

 is attached to the anterior part of the gland, 

 instead of to the posterior. t The first case 

 that I met with was that of a man who had a 

 swelling of the right testicle, which puzzled 

 his medical attendant. On examination 1 

 found this to be the epididymis thickened 

 from chronic inflammation. I was able clearly 

 to trace the vas deferens proceeding to it along 

 the front of the scrotum. The body of the 

 testicle was unaffected, and its posterior edge 

 was quite smooth and regular. The disposition 

 of the left testicle was normal. On visiting 

 the Hopital de Midi in Paris, in April, 1849, 

 M. Ricord showed me a case of epididymitis 

 on the left side, in which the gland was thus 

 inverted. He informed me that he had often 

 met with this arrangement. I have since had 

 two patients under my care, one of whose tes- 

 ticles was thus inverted. One was a lad in the 

 London Hospital affected with epididymitis. 

 The other was a gentleman who consulted me 

 for chronic orchids confined to the body of the 

 testicle. The epididymis being unaffected, the 

 inversion was less perceptible than in the three 

 preceding cases. M. Maissonneuve, in a thesis 

 published in Paris in 1835, I believe first 

 called attention to this irregular disposition, 

 which he states that he had met with many 

 times upon the dead body, and upon the 

 living, and he mentions what I remarked 

 myself in the four cases just noticed, that the 

 inversion was confined to one side. Surgeons 

 should bear in mind the liability tojthis dis- 

 position of the gland in making their diagnosis 

 of the diseases affecting it. 



Atrophy of the Testicle. The testicles, like 

 other organs formed for the exercise of tem- 

 porary functions, do not arrive at a perfect 

 state of development until a certain period of 

 life, after which their activity ceases, and 

 they become gradually and imperceptibly 

 diminished. Thus we find that in early life 

 they are small in proportion to the size o'f the 

 bod} r as compared with their condition at 

 puberty, and that as old age advances and the 

 generative functions cease to be called into 

 action, they undergo a diminution in size, 

 their vessels grow less, the seminiferous tubes 

 become small and contracted, and partially ob- 

 literated. In the lower animals these changes 

 are far more remarkable than in man, for as 

 the functions of the testicle are exerted only at 

 stated periods of the year, as the rutting or 

 copulating season advances these organs 

 rapidly increase in bulk, and in its decline 

 undergo a proportionate degree of wasting. 

 In man, it sometimes happens that the tes- 



* Loder's Journal fur die Chirurg. ii. Bd. 1 Stff. 

 s. 187. 



tides do not acquire their proper size at the 

 usual period, their development being from 

 some cause or other arrested ; and also, after 

 the organs have arrived at their full and perfect 

 growth, that occasionally one or both suffer 

 a premature decay. Under the head then 

 of Atrophy of the Testicle I shall consider : 

 1. Arrest of Development ; and 2. Wasting. 



Arrest of Development. - If the congenital 

 lesions to which the testicle is liable had not 

 been previously treated of, the cases of ab- 

 sence of the organ already described, might be 

 correctly referred to the present head, as the 

 deficiency in these cases was no doubt the 

 result of an arrest in the early development of 

 the organ. But the cases that 1 am now 

 about to consider are those in which the sub- 

 sequent evolution which the testicles undergo 

 at puberty is delayed beyond the usual period, 

 or never takes place at all. Mr. Wilson 

 relates a curious instance of his having been 

 consulted by a gentleman, twenty-six years of 

 age, on the propriety of entering the marriage 

 state, whose penis and testicles very little ex- 

 ceeded in size those of a boy of eight years 

 of age. He had never felt the desire for 

 sexual intercourse until he became acquainted 

 with his intended wife ; since that period he 

 had experienced repeated erections, attended 

 with nocturnal emissions. He married, be- 

 came the father of a family ; and these parts, 

 which at six and twenty years of age were so 

 much smaller than usual, at twenty-eight had 

 increased nearly to the usual size of those of 

 an adult man.* Mr. Wilson mentions this 

 singular case, as it will admit of questions 

 whether the parts alluded to became properly 

 formed as to size, and possessed of the power 

 of secretion, in consequence of being, although 

 so late in life, influenced by the passions 

 excited by attachment to a particular female ; 

 or whether the enlargement and proper action 

 of the parts beginning, occasioned such passion 

 first to exist. He thinks the probability in 

 favour of the former supposition, in which 

 opinion I certainly concur. Lallemand men- 

 tions having seen a man about thirty years of 

 age, extremely fat, and without a beard or hair 

 on the pubes, whose penis and testicle ap- 

 peared to belong to a child of from seven to 

 eight years : he had never experienced erec- 

 tions or venereal desires.f A young man 

 died in the London Hospital of disease of the 

 heart. He was seventeen years and nine 

 months old : the body measured five feet five 

 inches in height, and was plump and well 

 formed. There was no appearance of beard, 

 or whiskers, or of hair on the pubes. The 

 penis and testicles were very small, not larger 

 than they are usually found in boys of three 

 or four years of age. The testicles were about 

 equal in size, and one of them weighed only 

 two scruples and one grain. Both organs 

 were normal in structure, appearing like the 

 glands in early life, when the tubular structure 



* Lectures on the Urinary and Genital Organs, 

 p. 424. 



t Des Pertes Se'minales Involontaires, t. ii. p. 380. 



