1006 



epididymis, appears to prevent the oblitera- 

 tion of the duct of which it is composed, and 

 thus accounts for atrophy occurring much 

 more rarely after consecutive orchids than 

 after inflammation originating in the body of 

 the gland, where the delicate seminal tubes 

 are enclosed in the firm unyielding tunica 

 albuginea. 



Chronic orchids. The testicle is liable to 

 a form of inflammatory swelling of a distinct 

 and chronic character, which occasionally 

 succeeds acute orchids but far more com- 

 monly arises spontaneously. The disease is 

 of importance ; for, if unchecked, it tends to 

 disorganise and destroy the gland. The chief 

 anatomical character of this form of inflam- 

 mation is the deposit of a peculiar yellow, 

 homogeneous, inorganic matter in the struc- 

 ture of the testicle. This substance when 

 first formed is of soft consistence, but after- 

 wards becomes firm and solid, and so closely 

 adherent and intimately blended with the 

 proper structure of the organ as not to admit 

 of separation without much difficulty. In 

 some instances there is a single deposit of 

 this substance in the centre of the glandular 

 structure, as in the preparation from which 

 the annexed woodcut was taken. In others 



Fig. 649. 



TESTICLE (ABNORMAL ANATOMY). 



several are interspersed throughout the tes- 

 ticle, portions of sound gland intervening. 

 In a case of chronic enlargement of both 

 testicles taken from a patient who died of 

 ramollissement of the medulla spinalis, I 

 found six or seven separate deposits of this 

 yellow matter in the substance of the right 

 testicle, and a single one only in the body of 

 the left. The small masses as they enlarge 

 coalesce, or the single one increases, until 

 the whole testicle presents an uniform yel- 

 lowish-white appearance. The epididymis is 

 frequently invaded at the same time by a 

 similar kind of morbid deposit, which also 

 tends to obliterate its tubular structure. This, 

 however, is not, as some pathologists suppose, 

 a constant occurrence ; for in the majority of 

 testicles thus diseased that 1 have examined, 

 the epididymis had entirely escaped. I have 



never succeeded in injecting this deposit, or 

 in tracing vessels into it. But the vessels of 

 the testicle generally are enlarged. Patholo- 

 gists have differed as to the particular tissue 

 in which this yellow matter is deposited. Sir 

 A. Cooper and Cruveilhier describes it to be 

 seated in the areolar tissue between the 

 tubuli; whilst Sir B. Brodie is of opinion, 

 that it is secreted from their inner surface, 

 as he discovered the yellow substance in the 

 canal of the epididymis and also in the vas 

 deferens which are continuous with the 

 tubuli. I have had the opportunity of in- 

 specting a testicle affected with this disease, 

 in what seems to me to be its early stage 

 from which examination I think I have been 

 able satisfactorily to confirm this opinion. 

 The testicle was injected with red size, and a 

 section then made of it. The surfaces of the 

 tunica vaginalis were partly adherent, and 

 about three drachms of serum were collected 

 in one part of the sac. The body of the tes- 

 ticle was not much enlarged : it contained, 

 however, an abundant deposit of a firm opaque 

 matter. Near the anterior edge of the testicle 

 this deposit appeared in the section like round 

 isolated yellowish-grey bodies, separated from 

 each other by portions of the sound structure 

 of the gland : about the centre of the organ it 

 assumed a beaded arrangement, and towards 

 the mediastinum formed a number of closely- 

 set yellow lines or processes, radiating towards 

 the posterior part of the testicle, where they 

 were amalgamated into one uniform mass. 

 Further examination perfectly satisfied me 

 that this matter was lymph deposited in the 

 tubuli seminiferi. The isolated and beaded 

 appearances in the section resulted from 

 breaks in the lymph thus deposited. The real 

 seat of the effusion was very evident, from the 

 arrangement described near the mediastinum. 

 With a good lens some of the convoluted 

 tubuli could be distinctly seen, filled with and 

 dilated by the morbid deposit. A portion 

 was carefully examined in the microscope 

 with a similar result. The epididymis was 



Fig. 650. 



1, fistulous sinus leading to the suppurating ca- 

 vity in the head of the epididymis ; 2, concrete ab- 

 scess in the tail of the epididymis. 



