43O The Testis 



process up to the external ring; the swelling being conical or hour- 

 glass-shaped. It will differ from the variety just described, in that 

 the fluid cannot be squeezed up into the peritoneal cavity. This is 

 the Infantile nydrocele. 



If the funicular process be obliterated both at its abdominal and 

 testicular end, but, remaining pervious between these spots, become 

 filled with accumulating serum, a firm oval or round swelling appears 

 in the course of the cord. This is encysted hydrocele of the cord. 

 Sometimes the swelling is, from extreme distension, as hard as is the 

 testicle which hangs below it ; and it is often just about the size of 

 that gland. It is then apt to be mistaken for a third testicle ; a 

 puncture by a grooved needle at once explodes the fallacy and removes 

 the swelling. The cyst does not contain spermatozoa, for it has no 

 association with the testis, being a derivative from the peritoneum. 

 If the cyst be as large as a pigeon's egg, diagnostic aid may be 

 obtained by the light-test. 



As the funicular process descends in front of the cord, a congenital 

 hydrocele or hernia has the cord behind it. The finger shows the 

 external abdominal ring to be clear, and thus distinguishes the 

 encysted hydrocele of the cord from a hernia ; but if the cyst be 

 situated within the inguinal canal, the diagnosis may be difficult. 

 The history of the case shows that the swelling is not a strangulated 

 hernia; and, as in the other case, puncture with a fine grooved 

 needle solves the question. Encysted hydrocele in the canal of Nuck 

 (p. 391) is met with every now and then. , 



The commonest variety of hydrocele is that in which fluid collects 

 in, and distends, the isolated tunica vaginalis. The swelling is pear- 

 shaped, the stalk growing towards the external abdominal ring. The 

 testicle is, of course, towards the back of the cyst ; but, in tapping, it 

 is more important to know where it is not, than where it is. 



Haematocele. Sometimes in tapping a hydrocele a branch of 

 vein (spermatic?) is wounded, and blood oozes into the serous cavity 

 and quickly refills the sac ; but this time the cyst is opaque. 



Structure. The testis is composed of tubular gland tissue packed 

 in a tough, fibrous envelope, the tunica albuginca. Outside this is the 

 visceral layer of the tunica vaginalis, whilst upon its inner side, and 

 also supported upon the trabeculas which pass from its interior to 

 the fibrous septum at the back of the gland, is a close interlacement 

 of blood-vessels, which constitute the tunica vasculosa. A fibrous 

 partition the corpus Highmorianum separates a small piece at the 

 back from the rest of the gland. The somewhat conical spaces are 

 occupied by masses of coiled tubes, the lobuli testis, from which 

 straight vessels (vasa recta) convey the secretion to the network of 

 tubes behind the partition, the rete testis. From the rete the vasa 

 efferentia convey the semen through the upper part of the gland- 

 capsule into conical masses of tubes, the coni vasculosi, which make 



