Bauhaus-Universität Weimar

Titel:
The Cyclopaedia of Anatomy and Physiology, vol. 4: Pla [corr.: Ple] - Wri
Person:
Todd, Robert Bentley
PURL:
https://digitalesammlungen.uni-weimar.de/viewer/image/lit29465/1005/
TESTICLE (ABNORMAL ANATOMY). 
the inflammatory action ; but when the con¬ 
tiguous organ or subjacent part is of a dif- 
Fig. 638. 
ferent structure from that of the cellular 
tissue, the extension of inflammation inwards 
is checked. Thus, in the case of the inflamed 
tunica vaginalis, the cellular tissue readily 
transmitted the morbid action to the epididy¬ 
mis, but the tunica albuginea arrested its 
progress to the body of the testicle ; and this 
explains the fact that after inflammation of 
the tunica vaginalis, excited by injection, the 
body of the gland is rarely found to suffer. 
On the other hand, the epididymis is seldom 
attacked with inflammation without the disease 
being quickly propagated to the tunica vagi¬ 
nalis. 
The lymph effused in inflammation very 
often forms adhesions between the opposed 
serous surfaces, and these after some time are 
rendered very firm and dense, and in old cases 
are often converted into a fibro-cartilaginous 
structure. In a testicle which I examined 
some little while after an attack of acute in¬ 
flammation, I found the lymph on both sur¬ 
faces of the tunica vaginalis presenting a 
honeycomb or lace-like appearance, similar to 
that often met with on the pericardium. In¬ 
flammation, if violent, may end in the forma¬ 
tion of pus ; suppuration is, however, a rare 
occurrence, unless artificially excited, for the 
cure of hydrocele. Inflammation of the tunica 
vaginalis is not only the most frequent disease 
of the testicle, but it is also one of the most 
common affections to which the body is liable. 
995 
In the different disorders of the gland this 
membrane usually becomes inflamed at some 
period or other, and adhesions between its 
opposed surfaces are scarcely less common 
than those of the pleura. In examining the 
testicles of twenty-four adults, I found ad¬ 
hesions of greater or less extent in one or 
both glands in as many as nine instances. 
Hydrocele of the tunica vaginalis. — The sac 
of the tunica vaginalis, like other serous ca¬ 
vities, is liable to dropsical effusion. The 
fluid effused is usually transparent, and of 
an amber, pale yellow, citron, or straw co¬ 
lour, and resembles the serum of the blood, 
but is occasionally thick. According to Dr. 
Marcet’s analysis*, 1000 grains of this fluid 
of the specific gravity 1024*3 contained 80 
grains of solid matter, of which 71*5 con¬ 
sisted of animal, and 8*5 of saline ingredients : 
hence it appears that this fluid only differs 
from the serum of the blood in possessing 
rather less animal matter. In an analysis 
of the fluid of hydrocele made by Dr. Bos- 
tockf, 100*00 parts of the specific gravity 
1024 were found to contain 
Water - 
91*25 
Albumen - - - 
6*85 
Uncoagulable matter - 
1*1 
Salts - 
*8 
100*00 
A quantity of flakey matter or flocculent 
albumen is sometimes found floating in the 
fluid ; and it frequently contains, especially 
in old people, cholesterine in the form of a 
multitude of minute shining particles. The 
quantity of cholesterine contained in nine¬ 
teen ounces of dark fluid full of these shining 
particles, which I removed from an old hy¬ 
drocele, amounted to nine grains. In the 
examination of a testicle from a man of co¬ 
lour who died at an advanced age, I found the 
tunica vaginalis and its investing tissues very 
thick and firm, and the seat of cartilaginous 
and osseous deposits ; it contained about three 
drachms of a thick brownish substance, which 
was almost entirely composed of cholesterine. 
This was no doubt a very old case of hydro¬ 
cele, in which, the more fluid parts having 
been absorbed, the cholesterine was left be¬ 
hind within the indurated sac. The quantity 
of serum which is suffered to accumulate 
varies considerably. In this country it seldom 
exceeds twenty ounces, though it has been 
known to amount to several pints. The 
largest quantity which I have met with is 
forty-eight ounces. Mr. Cline is said to have 
removed from Gibbon the historian as much 
as six quarts.J 
In simple hydrocele the testicle is usually 
found at the posterior part, and rather below 
the centre, of the sac : its situation however 
is subject to variations. Before the occur- 
* Medico-Chirurg. Trans, vol. ii. p. 372. 
f Ibid. vol. iv. p. 72. 
I Sir A. Cooper’s Lectures, by Tyrrell, vol. ii. 
p. 92. 
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