Hydrocele of the chord may either consist of an effusion of water into the cellular substance, or of a single cyst of various magnitude. if the former prove troublesome, a tree incision through it seems to be the only means of treatment ; the latter may be treated by the port wine injection.
is a swelling of the scro tum, caused by the effusion of blood into the tunics vaginalis. Its most common cause is the wound of a blood-vessel in tapping a bydroccle : the water, as it flows off, is generally discoloured, and the swelling soon after regains its former magnitude. Discutient lotions, as that of the sal ammoniac, or cerussa acetate and vinegar, will generally cause the absorp tion of the blood ; camphorated liniments and mercurial ointment may also be em ployed,' if the case be obstinate. Should these means fail entirely, an incision must be made through the integuments and tu. nica vaginal's, and the blood removed.
Sarcocele is a chrtmic fleshy enlarge ment of the testicle. It exhibits very different appearances in different cases. It may present a vascular mass of uni form appearance, without enlargement of the chord, or any very painful symp toms. It may have a white caseous sub stance intermixed with this ; or it may contain several cells, filled with different coloured fluids. But it is also liable to scirrhus and cancer; in which case it forma a hard brownish mass, with portions of a membranous or gristly firmness in termixed; attended with severe pain darting along the chords to the loins; and having an unequal knotty feel. 1 he chord too becomes 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 uaguinal glands, and soon after de stroys 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 em ployed in a case of scirrhus; for that affords no hope of cure. The operation would also be too late, if deferred until the chord has become indurated and knotty. Chronic enlargements of the
testicle are sometimes attended with an accumulation of limpid fluid in the tunics vagynalis ; and the disease is then termed hydro-sarcocele.
The operation of castration consists in making a longitudinal incision from the abdominal ring to the bottom of the tu mour ; in dissecting down each side of the spermatic chord, so as to be able to take it betty een 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 integuments 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.
Vancerele is an enlargement of the veins of the scrotum, or spermatic chord, attended with a very peculiar feel, and causing a tumour, which is generally in dolent, but may be troublesome. It is often mistaken for omental hernia; and sometimes is attended with wasting of the testicle. It' the swelling be painful, leeches, saturnine and discutient lotions, purgative medicines, horizontal position, and a bag-truss, are proper. The vari cous veins have been tied with success in very obstinate cases.
Hernia humoralis is an inflamed state of the testicle, in which that gland is much enlarged, and very painful. The scrotum is distended and red, and the pain shoots into the loins Irritation of the urethra is the most frequent cause, and particu larly that which takes place in gonorrhea. The unpleasant symptoms of the latter complaint cease when the testicle swells, and often recur when the hernia humo ralis abates. A recumbent posture, fre quent application of leeches, saline pur gatives, cold saturnine, or discutient washes, or in some cases poultices, and in all instances a suspensory bandage, aft the means of relief. Camphorated mercu rial ointment should be rubbed on the epididymis, when a hardness of that part remains.