140 



and dullness. In bad cases tlie scanty urine may be reddish and the 

 swelling may extend to the skin and envelopes of the testicle, which 

 may become thickened and doughy, pitting on pressure. The swelling 

 may be so much greater in the convoluted excretory duct along the 

 upper border of the testicle as to suggest the presence of a second stone. 

 Even in the more violent attacks the intense suffering abates some- 

 what on the second or third day. If it lasts longer it is likely to give 

 rise to the formation of matter (abscess). In exceptional cases the tes- 

 ticle is struck with gangrene or death. Improvement may go on slowly 

 to complete recovery, or the malady may subside into a subacute and 

 chronic form with induration. Matter (abscess) may be recognized 

 by the i^resence of a soft spot, where pressure with two fingers will 

 detect fluctuation from one to the other. When there is liquid exu- 

 dation into the scrotum, or sack, fluctuation may also be felt, but the 

 liquid can be made out to be around the testicle and can be pressed 

 up into the abdomen through the inguinal canal. When abscess occurs 

 in the cord the matter may escape into the scrotal sack and cavity of 

 the abdomen and pyaemia may follow. 



Treatment consists in perfect rest and quietude, the administration 

 of a purgative (1 pound to 1^ pounds Glauber's salts), and the local 

 application of an astringent lotion (acetate of lead 2 drams, extract of 

 belladonna 2 drams, and water 1 quart) upon soft rags or cotton wool, 

 kept in contact with the j^art by a suspensory bandage. This bandage, 

 of great value for support, may be made nearly triangular and tied to 

 a girth around the loins and to the upper i^art of the same surcingle 

 by two bands carried backwai'd and upward between the thighs. In 

 severe cases scarifications one-fourth inch deej) serve to relieve vascu- 

 lar tension. When abscess is threatened its formation may be favored 

 by warm fomentations or poultices, and on the occurrence of fluctua- 

 tion the knife may be employed to give free escape to the pus. The 

 resulting cavity may be injected daily with a weak carbolic acid lotion, 

 or salol may be introduced. The same agents may be used on a gland 

 threatened with gangrene, but its promj)t removal by castration is to 

 be preferred, antiseptics being applied freely to the resulting cavity. 



SARCOCELE. 



This is an enlarged and indurated condition of the gland resulting 

 from chronic inflammation, though it is often associated with a specific 

 deposit like glanders. In this condition the natural structure of the 

 gland has given place to embryonal tissue (small, round cells, with a 

 few fibrous bundles), and its restoration to health is very improbable. 

 Apart from active inflammation, it may increase very slowly. The 

 diseased testicle is enlarged, firm, non-elastic, and comparatively in- 

 sensible. The skin of the scrotum is tense, and it may be cedematous 

 (pitting on pressure), as are the deeper envelopes and spermatic cord. 

 If liquid is present in the sack the symjitoms are masked somewhat. 



