In the second form the earthy matter is deposited in an irregular mass, containing very little animal matter ; in appearance re sembling mortar, and very similar to the earthy substance found in the lungs and bronchial glands. It is generally met with in the head of the epidiclymis, and sometimes in the lower part, and but very seldom in the body of the testicle. As I have already stated, it is most probable that this earthy matter results from the transformation of tubercular matter deposited in the testicle in early life.
Loose bodies in the tunica vaginalis. — Loose bodies are occasionally found in the cavity of the tunica vaginalis. They are small in size, and of an oval flattened shape, and their sur face is smooth and polished. Their texture is in most instances elastic and homogeneous, resembling the unattached cartilages found in joints, and points of ossification are often contained in their interior. In some speci mens I have observed the cartilaginous matter to be arranged in concentric lamina:. The loose body is sometimes entirely composed of bony matter. On examining a thin lamina of i one in the microscope, I could distinctly see small oval corpuscules with a number of lines proceeding from them very similar to those of bone. They seldom exceed three in number, and they occur generally in combination with hydrocele, the loose bodies being the original disease.
remains in the testicle.— The remains of a foetus have been found in some rare instances, in the scrotum, in connection with the testicle. Several examples of the kind have been collected by 011ivter (D'Angers),* In all these cases it was evident that the scrotal inclusion had succeeded to an inclusion origi nally abdominal ; that is to say, that the organic debris were first situated in the ab domen in connection with the testicle, and had accompaniad the gland in its passage out of that cavity. In the cases in which the particular testicle was indicated, the right was the one affected.
Varicocele is a term applied to a morbid dilatation of the spermatic veins. On dis section they are found dilated, elongated, and more tortuous than natural, and apparently more numerous, owino. to the enlargement of the smaller vessel's. In an advanced stage of the disease, their coats are thick ened ; so that when divided the vessels re. main patent, and thus present the appear ance of arteries. The enlarged veins hang down below the testicle, and reach upwards into the inguinal canal ; and when very volu minous conceal the gland, encroach on the septum, and extend to the other side of the scrotum. In a specimen which I carefully examined, the vessels were arranged in three clusters (fig. 655). One formed of the larger vessels proceeded from the inferior ex tremity of the testicle ; the second, in which the vessels were less in size, but more numer ous and tortuous, arose from the upper ex tremity of the testicle ; whilst the third and smallest cluster surrounded and accompanied the vas deferens (I). The dilatation is not con
fined to the veins exterior to the gland ; even those in the organ itself are varicose, and enlarged veins may often be distinctly seen ramifying between the tunica vaginalis and tunics albuginea. The veins occasionally con tain phlebolites which are lodged in dilatations of the vessels. The veins of the left testicle are more subject to varicocele than those of the right. In upwards of 120 operations per formed by Breschet, in only one instance was the varicocele on the right side.* Pott met will this disease on both sides of the body in only one instance. The disease, however, is far from being so rare on the right side as is generally supposed, and often exists on both at the same tune, although the varicose, state of the right spermatic veins is always much less than that of the left. Of the causes of varicocele, some operate on both sides, others only on one. The most influential of the former is the hydrostatic pressure consequent upon the depending position of these veins, which have to support the weight of a column of blood extending from the testicle to the second dorsal vertebra. The absence of valves is mentioned as a circumstance conducing to this disease ; but this is an error, for the larger spermatic veins are always furnished with valves, though the dilatation which takes place in varicocele prevents them per forming their office. There are several anato mical circumstances, which, taken together, are sufficient to explain the frequency of vari cocele on the left side. On the right side the spermatic vein joins the vena cava nearly parallel to the axis of that vessel, so that the blood enters in the course of the circulation ; but on the left side the spermatic vein termi nates in the emulgent vein at a right angle, and in a direction perpendicular to the venous current from the kidney, which is less favour able to the return of blood from the testicle, since the two currents pursue a different di rection. The left testicle hangs lower than the right, consequently the veins must be longer, and the pressure produced by the column of blood greater on the left side than on the other. The accumulation of the faeces in the sigmoid flexure of the colon previous to an evacuation tends to produce pressure on the spermatic vein, and impede the return of blood from the left testicle, especially in persons whose bowels are habitually con stipated. Some persons subject to varicocele suffer from it only when the bowels are in this condition. But even the natural daily accu mulation may be sufficient to produce ob struction. To this cause, we must chiefly attribute the circumstance that a varicose di latation of the veins of the ovary in the female is nearly always confined to the left side.