TESTICLE (ABNORMAL ANATOMY). 



plication for the removal of a certain form of 

 sarcocele ; a suggestion, the credit of which 

 has been improperly assumed in recent years 

 by C. J. Maunoir, of Geneva. The influ- 

 ence of pressure in causing partial atrophy 

 of the testicle, is somtimes remarked in old 

 cases of hydrocele and hcematocele, in which 

 the gland has been long subjected to com- 

 pression from the retained fluid. 



It has been said that the testicles waste in 

 those persons who strictly adhere to their 

 monastic vows, but I am not aware that there 

 is sufficient authority for this remark. In 

 persons who marry, after many years of ab' 

 stinence from sexual intercourse, the testicles 

 undergo a certain degree of enlargement. It is 

 a great error to suppose that sexual connec- 

 tion in early life is essential for the preservation 

 of these organs. In cases of enlargement of 

 the prostate the ejaculatory canals sometimes 

 become completely obstructed. Under these 

 circumstances, the semen secreted under ex- 

 citement having no means of escape, encum- 

 bers the testicles for a time, but afterwards 

 becomes absorbed, and it is said that atrophy 

 of these glands sometimes follows ; but I 

 have never observed any instance of wasting 

 of the organs from this cause. As examples of 

 atrophy of the testicles from loss of nervous in- 

 fluence, may be adduced cases of paraplegia, 

 in which these organs have been known to 

 waste. Portal mentions the case of a robust 

 man, aged thirty-five, who was attacked with 

 painter's colic, attended with great debility 

 of the lower extremities. The testicles dimin- 

 ished considerably ; and although he after- 

 wards recovered " from the paralysis of his 

 limbs, these glands always remained wasted ; 

 and the man was incapable of the act of gene- 

 ration.* In the xxth volume of the " Medical 

 and Physical Journal," there is an account of 

 a case of recovery after fracture, with partial 

 dislocation of the first and second lumbar 

 vertebrae, followed by paraplegia, in which, 

 three years afterwards, the testicles were 

 found entirely obliterated. It has been stated 

 that the testicles sometimes waste from in- 

 juries, or from compression of the spine at 

 the origin of the spermatic nerves. In a 

 man who had received a blow on the lum- 

 bar region, the testicles gradually wasted 

 away.-f- 



The most common cause of atrophy of the 

 the testicle is the disturbance in its organisa- 

 tion consequent upon inflammation. As the 

 inflammatory process ceases, the enlarged 

 gland not only becomes reduced to its original 

 size, but it sometimes slowly but steadily 

 diminishes, till at length very' little vestige of 

 it remains Mr. Hunter has related three 

 cases in which the testicle decayed in this 

 way.J 1 have met with several instances of 

 atrophy arising from this cause, and there are 

 few surgeons of experience who have not 

 witnessed cases of the kind. Wasting of the 



* Cours d' Anatomic Medicale, t. v. p. 434. 

 f Baillie's Works, by Wardrop, vol ii. p. 315. 

 { Treatise on the Venereal Disease. 

 VOL. IV. 



993 



testicle has been observed to occur after an 

 attack of orchitis in mumps, arising as it is 

 supposed from the translation of inflamma- 

 tion from the parotid to the testicle. Two 

 cases of cynanche parotidea in the adult, in 

 which atrophy took place in the gland chiefly 

 affected, are related by Dr. R. Hamilton.* I 

 have witnessed one case, in which the patient 

 attributed the loss of the gland to an attack 

 of mumps in his infancy. Wasting is more 

 liable to occur after inflammation of the body 

 of the gland than after consecutive inflamma- 

 tion in which the epididymis is the part 

 chiefly affected. One or both testicles have 

 been found to waste in persons who have 

 indulged too much in sexual intercourse or 

 been addicted to onanism. Baron Larrey met 

 with several cases of atrophy from excessive 

 venery and abuse of strong' drinks amongst 

 the soldiers of the Imperial Guard.f Sir B. 

 Brodie has recorded two cases in which 

 wasting was occasioned by over- excitement ; 

 in one from onanism, in the other from 

 sexual intercourse.:}: I have also witnessed an 

 instance of total atrophy of the left testicle in 

 a person addicted to excessive masturbation. 

 In this case, and probably in the others just 

 quoted, the wasting was preceded by an 

 attack of inflammation induced by inordinate 

 excitement. 



It is a common belief that wasting of the 

 testicle is liable to be induced by the long- 

 continued use of iodine. I have not met with 

 any instance of it, and there are few cases in 

 which the evidence is such as to render it at 

 all clear that the decay of the gland was really 

 occasioned by the remedy. M. Cullerier has 

 published the case of a young man who took 

 from twenty-five to thirty drops of the tinc- 

 ture of iodine for a period of three months 

 for the cure of an obstinate gonorrhoea. This 

 was followed by a state of impotency and 

 partial wasting of the testicles, which lasted a 

 twelvemonth, and the organs never regained 

 their former size and vigour. M. Cullerier 

 mentions another case of temporary loss of 

 virile power occurring from the use of the 

 iodine of iron.$ I feel convinced, however, 

 that if iodine produces wasting of the testicle 

 at all, it does so so rarely, that the liability 

 cannot be regarded as any objection to the 

 free and long-continued use of this valuable 

 remedy. Atrophy of the testicle has been 

 remarked in elephantiasis of the Greeks, a 

 disease in which tubercles are developed in 

 various parts of the skin. Dr. Adams, in an 

 account of the cases of that disease observed 

 in Maderia, states that all those who were 

 attacked with it before the age of puberty 

 never acquired the distinguishing marks of 

 that change in the constitution, and their 

 testicles diminished in size, and that in those 

 affected later in life the testicles became 



* Philos. Trans. Edinb. vol. ii. art. ix. p. 59. 



f Memoires de Chirurgie Militaires, vol. ii. p. 66. 



t London Medical and Physical Journal, vol. Ivi. 

 p. 297. 



Me'moires de la Societe' de Chirurgie de Paris, 

 t. i. 



3 s 



