414 SURGICAL APPLIED ANATOMY. [Chap. xvm. 



spermatic artery and forms the pampiniform plexus. 

 The posterior set is small and surrounds the vas, 

 running with the deferential artery. The veins of 

 the spermatic or pampiniform plexus are very 

 frequently varicose, and then constitute the affection 

 known as vai'icocele. Many anatomical causes 

 render these veins liable to this affection : they 

 occupy a dependent position, and the main vein is of 

 considerable length, and follows a nearly vertical 

 course ; the vessels are very large when compared 

 with the corresponding artery, and so the vis a tergo 

 must be reduced to a minimum ; they occupy a loose 

 tissue, and are lacking in support and in the. aid 

 afforded to other veins (as in the limbs) by muscular 

 contraction ; they are very tortuous, form many 

 anastomoses, and have few and imperfect valves ; they 

 are exposed to pressure in their passage through the 

 inguinal canal. The left veins are more frequently 

 affected than the right. Mr. Spencer has shown that 

 the veins in the left cord are always much larger 

 than those of the right. It may also be pointed out 

 that the left testicle hangs lower than ths right ; that 

 the left spermatic vein enters the left renal at a right 

 angle, while the right spermatic vein passes obliquely 

 into the vena, cava ; and that the left vein passes 

 beneath the sigmoid flexure, and is thus exposed to 

 pressure from the contents of that bowel. The congenital 

 origin of varicocele is now very generally allowed. 



When the varicose veins are exposed by operation it 

 is impossible to isolate or even recognise the arteries. 



The female generative organs require but 

 little notice in the present volume. The labia majora 

 have the same pathological tendencies as has the 

 scrotum, to which, indeed, they anatomically corre- 

 spond. They are liable to present large extravasa- 

 tions of blood, are greatly swollen when cedematous, 

 are prone to slough when acutely inflamed, and are 



