432 The Test 2 s 



A urethritis extending backwards may invade the openings of the 

 common ejaculatory ducts, and, spreading along their lining membrane, 

 may reach the epididymis and the body of the testis. That the in- 

 flammation travels by continuity of tissue is evinced by the swollen 

 and tender condition of the vas, which thus becomes as large as an 

 ordinary cedar pencil. The term 'gonorrhceal orchids' is incorrect ; 

 the condition is almost invariably ' epididymitis ' to begin with ; and 

 for some time the soft and unaffected gland may be found in front of, 

 but obscured by, the enlarged epididymis. Epididymitis may come on 

 in the course of a gonorrhcea or gleet when no injection or instru- 

 mentation has been employed ; the use of an injection has, as a rule, 

 nothing to do with its occurrence. Epididymitis is sometimes caused 

 by a slight damage to the mucous membrane of the urethra by the 

 passage of a lithotrite or by the removal of a fragment of stone. 

 At times, too, it follows the passage of a catheter or sound when, in 

 all probability, not the least abrasion of the mucous lining has 

 occurred. 



In acute orchitis and epididymitis the pain is intense, on account 

 of the unyielding nature of the tunica albuginea. A few punctures of 

 the inflamed gland allow the escape of effusion into the tunica vagi- 

 nalis and afford almost immediate relief. Atrophy of the testis is apt 

 to follow acute inflammation, on account of the disturbance of nutrition 

 which was thereby caused. 



At an early period of fcetal life there is no connection between the 

 vas deferens and the testicle, but, like the Fallopian tube, the vas begins 

 by an open and disconnected extremity ; so, through an arrest of 

 development, the vas deferens may end blindly in the spermatic cord, 

 without association with the testis ; each organ may, however, be in it- 

 self thoroughly developed. The developmental distinction between the 

 vas deferens and the testis proper explains the frequency with which 

 an inflammation of the vas deferens and epididymis may extend 

 itself in those structures without implicating the immediately adjoining 

 testicular tissue, as in the case of gonorrhceal epididymitis. 



Vessels and nerves of the testis. As the testis was originally 

 formed in the neighbourhood of the kidney, the vessels and nerves which 

 supply it are all derived from, and kept in permanent communication 

 with, the corresponding systems of that neighbourhood (v. p. 353). 



Thus, the spermatic artery comes from the abdominal aorta close 

 to the renal artery, whilst the right and left spermatic veins empty into 

 the vena cava and the left renal vein respectively. As the testis de- 

 scends, the artery becomes elongated, and by the time that the gland has 

 reached the scrotum the blood-vessel has become so long and slender 

 that the student who does not understand the development wonders 

 why the blood was not supplied by one of the iliac trunks or by some 

 artery which was still nearer to the scrotum. 



In its downward course the spermatic artery lies behind the peri- 



