SURGERY. 
this ; or it may contain several cells, filled 
with different coloured fluids. But it is also 
liable to schirrus and cancer ; in which case 
it forms a hard brownish mass, with portions 
of a membranous or gristly firmness inter- 
mixed ; attended with severe pain darting 
along the chord to the loins ; and having an 
imequal knotty feel. The chord too be- 
comes enlarged, and the health is affected. 
.Sometimes this kind of sarcocele forms a 
foul ulcer, with bleeding fungus, &c. When 
the chord is affected, the disease generally 
appears in the inguinal glands, and soon 
al ter destroys the patient. A mild sarcocele 
may be treated with leeches and discutient 
lotions, setons, and mercurial frictions, with 
the view of dispersion; but if these fail, 
castration is the only remedy. The same 
means should be immediately employed in 
a case of schirrus ; for that affords no hope 
of|pure. The operation would also be too 
late if deferred until the chord has become 
indurated and knotty. Chronic enlarge- 
ments of the testicle are sometimes attend- 
ed with an accumulation of limpid fluid in 
the tunica vaginalis ; and the disease is then 
termed hydro-sarcocele. 
The operation of castration consists in 
making a longitudinal incision from the ab- 
dominal ring to the bottom of the tumour ; 
in dissecting down on each side of the sper- 
matic chord, so as to be able to take it be- 
tween the finger and thumb; in dividing 
the chord, and tying any bleeding vessels 
on its surface ; and then in dissecting away 
the testis, by free sweeps of the knife, from 
the scrotum. All bleeding vessels should 
be carefully secured ; the edges of the in- 
teguments retained by two or three points 
of suture, and in their intervals by sticking- 
plaster; over which a pledget, compress, 
and T bandage, are to be applied. 
Varicocele is an enlargement of the veins 
of the scrotum, or spermatic chord, attend- 
ed with a very peculiar feel, and causing a 
tumour, which is generally indolent, but 
may be troublesome. It is often mistaken 
for omental hernia; and sometimes is at- 
tended with wasting of the testicle. If the 
'swelling be painftd, leeches, saturnine and 
discutient lotions, purgative medicines, hori- 
zontal position, and a bag-truss, are proper. 
The varicous veins have been tied with 
success in very obstinate cases. 
Hernia tmmoralis is an inflamed state of 
the testicle, in which that gland is much 
enlarged, and very painful. Tiie scrotum 
is distended and red, and the pain shoots 
into the loins. Irritation of the urethra is 
the most frequent cause, and particularly 
that which takes place in gonorrhoea. The 
unpleasant symptoms of the latter com- 
, plaint cease when the testicle swells, and 
often recur when the hernia hiimoralis 
abates. A recumbent posture, frequent 
application of leeches, saline purgatives, 
cold saturnine, or discutient washes ; or in 
some cases poultices, and in all instances a 
suspensory bandage are the means of relief. 
Camphorated mercurial ointment should be 
rubbed on the epididymis, when a hardness 
of that part remains. 
Cancer scroti, or chimney-sweeper’s can- 
cer, commences in the scrotum with an 
ulcerated wart, or rugged ill-looking sore, 
with hard and elevated margin. It penetrates 
the scrotum, affects the testis, ascends along 
the chord, contaminates the inguinal glands, 
and terminates the patient’s existence in a 
most deplorable way. Extirpation in the 
early state is the only effectual mode of 
treatment. 
Gonorrhoea is the discharge of a mucous 
or purulent fluid from tlie urethra, occasi- 
oned by the application of infectious matter 
from another subject labouring under the 
disorder, and generally communicated by 
coition. The urethra may be irritated, so 
as to furnish a preternatural quantity of se- 
cretion, by other causes ; as strictures, use 
of bougies, &c. It generally comes on 
from six to twelve days after the infection ; 
and commences with an itching and fulness 
of the mouth of the urethra. A discharge 
follows, first of a watery and transparent 
kind, and then becoming thicker and white, 
yellow or greenish. The glans swells, and 
the membrane at the mouth of the urethra 
becomes smooth, red, and swoln. An acute 
scalding pain is experienced in making 
water, which is voided frequently, and in a 
diminished stream. Troublesome erections 
are experienced at night. Various sympa- 
thetic affections often attend ; as pain and 
soreness over the whole pelvis, in the scro- 
tum, testicles, anus, &c. ; enlargement of 
the inguinal glands, forming sympathetic 
bubo, and irritability of the bladder. It 
has been much disputed whether the matter 
of gonorrhoea and chancre be the same, and 
consequently whether the constitution can 
be affected from a gonorrlioBa. But at pre- 
sent most surgeons are inclined to support 
the negative side of the question ; and all 
act in the treatment of the complaint on 
this supposition. 
In ordinary cases the affection does not 
seem to extend more than about two inches 
