

Scrotum ; Testt's 427 



The lymphatics pass to the upper set of the inguinal glands. 

 In malignant disease of the testis the inguinal glands are implicated, 

 usually only when the disease has invaded the scrotum. In hot 

 countries the lymphatics of the scrotum are often dilated and varicose. 

 The disease is probably due to the irritation of micro-organisms circu- 

 lating in the vessels. The effect of the disease is an enormous thicken- 

 ing of the integument, known as elephantiasis. Such tumours may 

 attain enormous size, weighing more than the patient himself. The 

 late Mr. Wordsworth assured the author that he saw one in the West 

 Indies which was computed to weigh 200 Ibs. ; the patient had been 

 ' anchored ' to it for many years and declined separation by surgical 

 operation. 



The nerves are derived from the ilio-inguinal (of the first lumbar), 

 the genital branch of the genito-crural (second lumbar) lying in the 

 cremaster ; the superficial perineal branches of the internal pudic, 

 and the long pudendal branch of the small sciatic. 



In caries of the highest lumbar vertebrae, with inflammatory pres- 

 sure upon the afferent nerves, the patient may refer pain to the scrotal 

 region of one or both sides ; and, from an association between these 

 trunks and the renal and spermatic filaments of the sympathetic, there 

 may be similar complaints when calculi are passing down the ureter. 

 But, in the latter case, the neuralgic distress usually affects only one 

 side ; there might also be retraction of the testicle from stimulation of 

 the cremaster muscle. 



The covering's of the cord and the testis beneath the skin and 

 superficial fascia (which together constitute the scrotum) are con- 

 sidered elsewhere (p. 307) ; they are the intercolumnar, the cremasteric, 

 and the infundibuliform fasciae, and, as regards the testis itself, the 

 peritoneum, or tunica vaginalis. The intercolumnar, cremasteric and 

 transversalis fasciae form a thin and close, but a comparatively un- 

 important, investment of the testis and cord, quite distinct from the 

 scrotum, on the one side, and the tunica vaginalis on the other. 



THE TESTIS 



Early in foetal development, two important tubular organs are found 

 in the abdomen by the side of the spinal column the Wolffian bodies. 

 They probably play the part of rudimentary and temporary kidneys. 

 Before they are many weeks old they dwindle and make way for the 

 permanent kidneys, which appear from behind them, and for certain 

 organs of generation which appear in front of them. At this period 

 the foetus is sexless ; there is nothing in the structure of the genera- 

 tive organ to show whether it would be evolved into ovary or 

 testis (v. p. 399). 



Then, just above the generative organ, a slender duct commences, 

 which descends in front of the temporary kidney to open into that 



