62 SPRING-TIME SURGERY 



the complicating conditions. The cord which has 

 been grasped and pulled down into the canal is 

 held by the fingers of the free hand or by a pair 

 of heavy forceps. The hand in the canal is then 

 passed up along the cord and with the fingers, or 

 if need be the entire hand, in the peritoneal cavity 

 the structures are examined, remembering that 

 the testicle is attached to the lower end of the 

 doubled cord in the inguinal canal and that by fol- 

 lowing this out the testicle will be reached. Oc- 

 casionally it may be best to turn the cord loose, 

 especially if the entire hand is inserted into the 

 abdomen. Cases of these kinds are fortunately 

 rare and when one is met a little patience on the 

 part of the operator will allow him to make a 

 positive diagnosis of the complicating condition. 

 The treatment of adherent testicles is obvious. 

 The adhesions are broken up and the testicle 

 brought down. In the cases in which the tail of 

 the epididymis has descended through the internal 

 ring and is in the grasp of the ring the treatment 

 consists in pulling it back into the belly and out 

 through the opening and down the canal. The 

 handhng of enlarged testicles is a subject of more 



