chap, xviii.] PELVIS AND PERINEUM. 423 



organ, and it is well known that painful affections of 

 the perineum and anus may be associated with 

 priapism. The presence of the inferior pudendal 

 nerve in the perineum will explain the pain about the 

 buttock and down the back of the thigh that is often 

 complained of during the growth of perineal abscess 

 and in painful affections of the scrotum. This nerve 

 crosses just in front of the tuber ischii, and may be 

 so pressed upon by using a hard seat as to cause one- 

 sided neuralgia of the penis and scrotum. It is also 

 in close connection with the ischial bursa, and neu- 

 ralgia of the same parts has been met with in cases of 

 inflammation involving that structure. 



The testicle is supplied mainly by the spermatic 

 plexus. This plexus comes off' from the renal, 

 and thus the testicle is brought into close relation with 

 the kidney. This is illustrated by the pain felt in the 

 renal region in neuralgia of the testicle, by the pain 

 felt in the testicle, and by the vigorous retraction of 

 that organ observed in certain affections of the kidney, 

 such as in acute nephritis, and in the passage of renal 

 calculi. By means of the renal plexus the testicle is 

 brought into direct communication with the semi- 

 lunar ganglia and solar plexus. This communication 

 serves to explain the great collapse often noticed in 

 sudden injuries to the testicle, and especially the 

 marked tendency to vomit, so often observed in such 

 lesions. So far as its nerves arc concerned, the testicle 

 is nearly in as intimate relation with the great nerve- 

 centre of the abdomen as is a great part of the small 

 intestine, and one would expect a sudden crush of the 

 testis to be associated with as sevei'e general symptoms 

 as would accompany a sudden nipping of the ileum 

 in a rupture. Such a resemblance in symptoms is 

 Actually to be observed in practice, 



