1014 



cumference, and almost to reach the ground 

 when the patient is in the upright position. 

 In a case operated on by Clot Bey in Egypt, 

 the morbid mass, which weighed one hundred 

 and ten pounds, kept the patient's legs far 

 apart, and obliged him to remain constantly 

 on the ground ; it was so bulky that he could 

 even sit upon it. In the accompanying figure 



Fig. 656. 



TESTICLE (ABNORMAL ANATOMY). 



of a black man, affected with elephantiasis, 

 taken from Dr. Titley's work on " Diseases 

 of the Genitals, in the Male," the tumour de- 

 scended nearly to the ankles. 



Elephantiasis of the scrotum is a morbid 

 affection of the integuments, analogous to the 

 enlargement of the extremities commonly 

 known by the name of Barbadoes leg ; with 

 which, indeed, in those countries where the 

 disease is prevalent, it is liable to be com- 

 bined. Elephantiasis of the scrotum, how- 

 ever, grows to a greater size and makes more 

 rapid progress than the same disease in the 

 leg, owing to the very loose texture and de- 

 pending state of the parts. The labia pudendi 

 of females in warm climates are subject to a 

 similar change, though not to the same extent 

 nor so frequently as the scrotum. This dis- 

 ease appears to be the result of a low form of 

 inflammation of the veins, and to be analogous 

 to the affection termed plilegmasia dolens. It 

 is preceded by febrile attacks, attended with 

 pain and heat in the part, and swelling and 

 tenderness of the glands in the groin. After 

 a time, the scrotum continues to enlarge, in- 

 dependently of febrile attacks. In December, 

 1847, I saw a gentleman, from Barbadoes, 

 who had this disease in the early stage. The 

 whole scrotum was considerably enlarged, 



forming a doughy inelastic swelling, fissured 

 in two or three places. A portion of skin 

 at the root of the penis was a little red and 

 puffy as if affected in a slight degree. The 

 glands in the left groin were enlarged, but 

 those on the right side were unaffected. The 

 testicles were sound. 



Hypertrophy of the scrotum is an affection 

 of the same nature as the knotty and lobulated 

 growth of the skin occasionally observed on 

 the nose and in other parts. In this disease 

 the integuments appear as if composed of 

 lobes divided by fissures. In the Museum of 

 St. Bartholomew's Hospital there is a pre- 

 paration of this kind, but no history is at- 

 tached to it. The hypertrophied scrotum 

 appears to have been removed during life. 

 Many years ago I saw a case of the kind at 

 the hospital of La Charite in Paris. The 

 patient was a young man whose scrotum was 

 hypertrophied to about four times its natural 

 size. This disease is liable to be confounded 

 with elephantiasis, but differs from it in the 

 circumstance that the morbid enlargement is 

 entirely confined to the skin, the subcutane- 

 ous areolar tissue being unaffected. 



Cancer Scroti, or, as it is commonly called, 

 chimney sweeper's cancer, is a disease of the 

 skin, which attacks the scrotum of persons 

 who have been exposed to the contact of soot. 

 It is originally developed in the form of a 

 small pimple or warty excrescence, termed sool- 

 wart, which often remains on the scrotum for 

 months or even years without undergoing any 

 change. Usually, there is only a single wart 

 at the lower part of the scrotum ; sometimes 

 there are two or three of different sizes ; and 

 occasionally they are so numerous and so 

 abundantly and largely developed as to form 

 a considerable cauliflower excrescence. After 

 a time the wart becomes soft, excoriated and 

 red, and exudes a thin irritating discharge, 

 which becoming dry forms an incrustation 

 over the excrescence. After the scab has 

 been picked off, or rubbed off by friction against 

 the dress, ulceration ensues, destroys the wart 

 and produces a painful chronic sore, possess- 

 ing the ordinary characters of a carcinomatous 

 ulcer on the skin, thick, indurated and 

 everted edges, and an irregular excavated base, 

 the surface of which discharges a thin sanious 

 fluid. The ulcer, if suffered to proceed, in- 



Fig. 657. 



1 small soot warts ; 2, cancerous ulcer succeeding 

 the wart. 



