TESTICLE (ABNORMAL ANATOMY). 



994 



atrophied, and they lost the power of pro- 

 creation.* Mr. Peacock also noticed a wasting 

 of the testicles in several cases of elephan- 

 tiasis in the Leper Hospital of Colombo, in 

 Ceylon.-]- A similar condition of these glands 

 was remarked in a case of this disease, so 

 rare in this country, narrated by Mr. Law- 

 rence J, and also in another case at the 

 London Hospital, which I recorded many 

 years ago.$ In a confirmed case however 

 of this disease, in a boy aged thirteen, who 

 was under my care in the year 1849, there 

 was no diminution in the size of these glands. 

 Wasting of the testicles is liable to occur 

 after injuries of the head. 



Some years ago I saw a man who had met 

 with an injury of this description, which had 

 been followed by wasting of the testicles, and 

 the development of tumours on each sideof the 

 chest, resembling mammae. He was about 

 fifty- nine years of age, a married man, and the 

 father of several children. He had belonged 

 to the legion in the Queen of Spain's service. 

 About two years and a half previously, in an at- 

 tempt to jump over a trench, he fell backwards 

 and injured the posterior part of his head. 

 Whilst on the ground he received a bayonet 

 wound on the side, and a sabre cut on the fore- 

 head. He recovered from these injuries and 

 returned to England. Since the accident he 

 had completely lost his virility. He had no 

 desire for sexual connection ; his penis had 

 dwindled in size ; his right testicle had gradu- 

 ally wasted, and was no larger than a horse 

 bean, and the left gland was also a good deal 

 diminished in bulk. The skull at the occiput 

 seemed somewhat flattened. Baron Larrey 

 records the case of a man who was wounded 

 in the back of the neck by a musket ball 

 which grazed the inferior occipital protuber- 

 ance. He recovered from the injury, but the 

 testicles were reduced to a state of atrophy, 

 and the penis shrunk and remained inactive. 

 He also relates the case of a man of strong 

 constitution and vigorous passions who re- 

 ceived a sabre wound which cut off all the 

 convex projecting part of the occipital bone, 

 and exposed the dura mater. The patient lost 

 the senses of sight and hearing on the right 

 side, and his testicles sensibly diminished, 

 and in fifteen days were reduced, especially 

 the left, to the size of a bean.[| Lallemand 

 had under his care a man thirty years of age, 

 who, in the expedition to Algiers had received 

 a sabre wound at the nape of the neck. His 

 testicles were wasted, and venereal desire as 

 well as erections had entirely ceased. f We 

 cannot doubt that in these cases the loss of 

 sexual desire, and the wasting of the testicles 

 were the direct results of the injury to the 

 brain, and they go far to prove the essential 

 dependence of the functions of these glands 



* On Morbid Poisons, p. 265. 

 f Edinb. Medical and Surgical Journal, vol. liii. 

 p. 139. 



t Medico-Chirurgical Transactions, vol. vi. p. 214. 

 | Vide Medical Gazette, vol. vii. p. 447. 

 Memoires de Chirurgie Militaire, p. 262. 

 f Pertes Se'miuales Involontaires, t.ii. p. 41. 



upon the cerebral organ. The physiologist 

 cannot fail to notice the rapidity with which 

 the atrophy is stated in some of the cases to 

 have succeeded the injury and the extent to 

 which it proceeded. The withering of the 

 testicles, was, indeed, so remarkable, that it 

 can only be attributed to the sudden and 

 complete extinction of the sexual instinct 

 resident in the brain, and (if I may so express 

 myself) to the immediate impression on the 

 system of the future uselessness of these 

 organs. In old age and in lingering diseases 

 the decay of the testicles is extremely slow 

 and gradual, and is never carried to the extent 

 observed in cases of injury to the brain. In 

 fact, men have survived the power or desire 

 of performing the sexual act many years 

 without the testicles being materially reduced 

 in size. We have seen, too, that in the lower 

 animals the testicles have been rendered use- 

 less by interrupting the vasa deferentia, with- 

 out any such striking effect being produced 

 on the glands as occurred in these cases of 

 cerebral injury. 



Inflammation of the tunica vaginalis, or acute 

 hydrocele. The inflammatory changes of the 

 tunica vaginalis resemble those of the other 

 serous membranes. M. Roux injected a 

 hydrocele in a middle-aged man : inflamma- 

 tion was developed, but on the fourth day, 

 gangrenous erysipelas attacked the scrotum, 

 and caused the patient's death on the tenth 

 day after the operation. On examining the 

 tunica vaginalis, he found that it contained a 

 large quantity of whitish serum, in the midst 

 of which floated flakes of albumen ; other 

 flakes of the same kind formed a thick coating 

 over the testicle and internal surface of the 

 membranous pouch. The serous membrane 

 beneath appeared slightly thickened, and of 

 a deep red colour. The epididymis and the 

 lower part of the cord were swollen, and con- 

 stituted the more solid part of the tumour 

 produced by the inflammation. The body of 

 the testicle was not increased in bulk, and it 

 retained its natural consistence.* In the mu- 

 seum of the College of Surgeons, there is a 

 beautifully injected preparation of hydrocele, 

 showing the effects of inflammation after the 

 application of the caustic. It is represented 

 in the annexed wood-cut, which exhibits the 

 sac with part of it cut away to show the 

 swollen state of the epididymis, and the 

 aperture made by the caustic (1); the tunica 

 vaginalis is coated with flocculi of lymph. 

 The sac of an inguinal hernia is seen above 

 the hydrocele. The sound state of the body 

 of the testicle, though surrounded by an in- 

 flamed serous tunic, whilst the epididymis 

 partakes in the disease, has been accounted 

 for by Gendrin. He says, when the sub- 

 serous cellular tissue, which always partici- 

 pates in the inflammation of a serous mem- 

 brane penetrates into the interior of an organ, 

 it becomes a ready means of communicating 



* Journal Ge'ne'ral de Medicine, &c. t. Iviii. p. 25. ; 

 quoted from Gendrin, Histoire Anatomique des In- 

 flammations, t. i. p. 143. 



