4l8 DOURINE 



the sheath and penis gave rise to the idea that it was a form 

 of localized glanders. 



The duration of the disease is stated by Williams to extend 

 from three months to as many years. The prognosis is 

 unfavorable. 



§ 322. Morbid anatomy. In the early stages there are 

 phlegmonous or edematous swellings of the sheath, scrotum, 

 penis and inguinal glands and a yellowish liquid effusion into 

 the scrotal cavity. The skin covering the parts may show a 

 papular or vesicular eruption or if this has passed a mottling 

 with white spots shows where these lesions have been. Later, 

 the inguinal glands shrink and become firm, owing to the 

 development of fibroid tissue. The testicles, which are either 

 swollen or shrunken, contain foci of suppuration or caseation. 

 The connective tissue of the epididymis and the cord is the seat 

 of a gelatinous exudate. The walls of the scrotum may be 

 greatly thickened and be the seat of abscesses or of caseous 

 degenerations. In advanced cases the testicles are usually 

 abnormally small, even if the scrotal mass is enormously dis- 

 tended. The sheath and penis may be the seat of more or less 

 numerous ulcers and swellings. Contraction and contortions 

 of the penis are not uncommon. It may, however, retain its 

 normal dimensions. The walls of the lymphatics in the 

 inguinal region may be the seat of hyperplasia ; the thickening 

 causes them to stand out like cords as in glanders. In the 

 advanced stages the muscles, especially those of the hind 

 limbs, become pale and atrophied. The nerve centers under- 

 go profound changes which have been studied by Thanhoffer. 

 The pia mater in the affected part of the spinal cord is the 

 seat of active congestion and thickening. The central canal 

 of the cord is dilated more at one point than another, contains 

 more than the normal amount of liquid and the neuroglia 

 around it is thickened and fibrous. The substances of the 

 cord, both white and gray, show congestion, blood staining, 

 and points of softening and of hyperplasia of the neuroglia. 

 The nerve cells are modified in various ways, some being 

 granular, some discolored by fine granular pigment, some hav- 



Digitized by Microsoft® 



