TESTICLE (ABNORMAL ANATOMY). 



developed under two forms. In one, it occurs 

 in combination with carcinomutous deposit : 



Fis. 654. 





Section of a cystic tumour of the testicle, showing a 

 multitude of cysts of various shapes and sizes, with 

 solid matter interposed betwen them. The natural 

 glandular structure is wholly destroyed. 



in the other and more common form, the 

 tumour is of an innocent character, and free 

 from the risk of disease attacking other parts 

 after removal of the organ. In the former 

 the cysts are larger and less numerous than 

 in the latter. By careful examination and 

 with the aid of the microscope the coexist- 

 ence of the two diseases may generally be 

 made out. 



Ossific deposits in the testicle. Earthy 

 matter occurs in the testicle under two forms : 

 1. Laminated, and often mixed up with car- 

 tilage ; and 2., as an inorganic deposit. In 

 the first form it is usually deposited between 

 the tunica vaginalis and tunica albuginea, in 

 little bony or cartilaginous patches, in which 

 a fibrous arrangement may be recognised. I 

 have frequently found one or two irregularly- 

 shaped projecting ossific bodies scarcely larger 

 than a pin's head attached to the upper part 

 of the testicle. Ossific matter occurs also on 

 the adherent surface of the tunica vaginalis 

 in old cases of hydrocele, where it has been 

 found so abundant as to form a complete 

 ossific capsule. It has been said that the 

 epididymis alone may be encased in bone, the 

 testicle being free ; this I have never seen. 

 Bony matter occurs, however, in the sub- 

 stance of the epididymis as the result of ossi- 

 fication of the product of inflammation. 

 Earthy matter in this form is not often ob- 



1011 



served in the substance of the testicle. The 

 gland, however, when atrophied and reduced 

 to a mere fibrous tissue, occasionally under- 

 goes both the cartilaginous and osseous trans- 

 formation. The cysts developed in the tes- 

 ticle, as I have already shown, are liable to 

 similar changes. 



In the second form the earthy matter is 

 deposited in an irregular mass, containing 

 very little animal matter ; in appearance re- 

 sembling mortar, and very similar to the 

 earthy substance found in the lungs and 

 bronchial glands. It is generally met with in 

 the head of the epididymis, and sometimes in 

 the lower part, and but very seldom in the 

 body of the testicle. As I have already 

 stated, it is most probable that this earthy 

 matter results from the transformation of 

 tubercular matter deposited in the testicle in 

 early life. 



Loose bodies in the tunica vaginalis. Loose 

 bodies are occasionally found in the cavity of 

 the tunica vaginalis. They are small in size, 

 and of an oval flattened shape, and their sur- 

 face is smooth and polished. Their texture 

 is in most instances elastic and homogeneous, 

 resembling the unattached cartilages found in 

 joints, and points of ossification are often 

 contained in their interior. In some speci- 

 mens I have observed the cartilaginous matter 

 to be arranged in concentric laminae. The 

 loose body is sometimes entirely composed of 

 bony matter. On examining a thin lamina of 

 one in the microscope, I could distinctly see 

 small oval corpuscules with a number of lines 

 proceeding from them very similar to those 

 of bone. They seldom exceed three in number, 

 and they occur generally in combination with 

 hydrocele, the loose bodies being the original 

 disease. 



Foetal remains in the testicle. The remains 

 of a foetus have been found in some rare 

 instances, in the scrotum, in connection with 

 the testicle. Several examples of the kind 

 have been collected by Ollivier (D' Angers),* 

 In all these cases it was evident that the scrotal 

 inclusion had succeeded to an inclusion origi- 

 nally abdominal ; that is to say, that the 

 organic debris were first situated in the ab- 

 domen in connection with the testicle, and 

 had accompaniad the gland in its passage out 

 of that cavity. In the cases in which the 

 particular testicle was indicated, the right 

 was the one affected. 



Varicocele is a term applied to a morbid 

 dilatation of the spermatic veins. On dis- 

 section they are found dilated, elongated, and 

 more tortuous than natural, and apparently 

 more numerous, owing to the enlargement 

 of the smaller vessels. In an advanced 

 stage of the disease, their coats are thick- 

 ened ; so that when divided the vessels re 

 main patent, and thus present the appear- 

 ance of arteries. The enlarged veins hang 

 down below the testicle, and reach upwards 

 into the inguinal canal ; and when very volu- 



* Memoire sur la Monstruosite par Inclusion; 

 Archives Gonerale cle Medicine, t. xv. p. 540. 



3 T 2 



