SURGICAL ANATOMY. 27 



should be wiped dry with sterilised wadding. The operator's 

 hands and arms should He treated in exactly the same way, 

 particular care being taken of the nails. It is wise to have two 

 nail brushes, one being kept for the hands alone. 



Surgical Anatomy. — In the inguinal region, after carefully 

 cutting through the skin almost immediately over it, a little 

 more forward than in the operation for ordinary castration, the 

 operator will encounter a large plexus of veins. These are 

 often of great volume, and must be carefully pushed aside, the 

 hand and fingers (held wedge-shaped) boring their way by a 

 rotatory movement through a quantity of loose connective tissue 

 up the inguinal canal. This is easily found, and if there is no 

 trace of testicle the fingers seek the upper inguinal ring, turn 

 inwards to the abdominal wall, and penetrate it about an inch 

 on this side. If the fingers cannot feel the missing organ the 

 whole hand must be introduced. One is then in contact with 

 a large mass of intestine, amongst which a careful search is 

 made. As rational guides it must be remembered that the 

 abdominal testicle is denuded of its normal coverings, that 

 it has at one end the spermatic artery, and at the other the 

 epididymis and vas deferens. The spermatic arteries spring 

 from the aorta just behind the kidneys, one on each side, 

 and descend backwards towards the internal abdominal ring, 

 being smoothly covered by parietal peritoneum during a con- 

 siderable portion of their course. 



The vas deferens, a long tube about two-thirds the thickness 

 of an ordinary lead pencil, is a continuation of the epididymis, 

 and finds its way to the side and neck of the bladder, where it 

 dilates, forming what is known as the "bulbous" portion. 

 The latter is an excellent guide to commence with, as from it 

 the hand can make a start towards the testicle; following up 

 the course of the vas deferens until the epididymis is reached. 



Description of the Operation.— A shallow incision about 

 four or five inches long is made through the skin almost directly 

 above the inguinal canal, care being taken not to injure any of 

 the large vessels which lie immediately underneath. These large 



