In the examination of a man, age sixty, I found the right testicle just external to the abdominal ring ; it was small in size, and closely adherent to a portion of omentum. A young man was under my care for many months, on account of an imperfect transition of the testicle on the left side. The gland moved backwards and forwards through the external abdominal ring. By pressure above, it could be forced down sufficiently to admit of being examined. This testicle was much smaller than the right, which was in the scrotum, and I could distinctly make out a portion of intestine closely adherent, which accompanied the organ in all its movements. It is probable that the smallness of the opening in the internal abdominal ring is sometimes a cause of the detention of the testicle, especially in those cases in which the organ is retained within the inguinal canal. Mr. Wilson, an accurate anatomist, was of this opinion*, which is supported by the fact, that the testicle is oftener found in the groin than in the cavity of the abdomen. M. Dela siauve mentions a case, in which, he states, the organ was retained by the border of the outer column of the ring.t Mr. Hunter was inclined to suspect that the fault originates in the testicles themselves. It is difficult to un derstand how this can be, for as the gland is passive in this process, it can offer no obstacle, unless it grows too large to pass the opening in the abdominal parietes ; whereas, it is ad mitted that the gland when retained is usually below the natural size. Nor does it appear, that the interruption is owing to any want of proper length in the vas deferens, for in a case of imperfect transition in a boy, whose body I examined, I particularly noticed that this duct was so long as to be doubled on itself, and tortuous, a circumstance which has been remarked in other cases by Mr. Mayor, Rosen merhel§, and others. It may be concluded then, that the causes of a failure in the pas sage of the testicle are various ; that this imperfection may result from want of power, or paralysis of the cremaster muscle; from adhesions retaining the gland within the ab domen ; and from a contracted state of the opening of the external abdominal ring.
Mr. Hunter states, that when one or both testicles remain through life in the belly, he believes that they are exceedingly imperfect, and probably incapable of performing their natural functions ; and that this imperfection prevents the disposition for descent taking place. That they are more defective even than those which are late in passing to the scrotum, he infers from the circumstance, that in quadrupeds, the testicle that has reached the scrotum is considerably larger than the one which remains in the abdomen. Mr. Hunter had seen only one case in the human subject where both testicles continued in the abdomen, but this proved an exception to the above observation, since we are led to con clude that they were perfectly formed, as the person had all the powers and passions of a man.* Professor Owen in commenting upon these observations, states, " It seems remark able that with this experience Mr. Hunter should have formed from inconclusive analogy, and promulgated, an opinion tending to occa sion so much unhappiness as that which attri butes exceeding imperfection and probable incapacity of performing their natural func tions to testes which in the human subject are retained within the abdomen. That there
is nothing in such a situation which neces sarily tends to impair their efficiency is evident, from the number of animals in which they constantly form part of the abdominal vis cera; and in those in which the testes na turally pass into a scrotum, their continuance in the abdomen, according to our author's own observation, is accompanied only with a difference of size or shape ; now we may readily suppose that this may influence the quantity, but not necessarily the quality, of the secretion." There are very few accounts on record of the dissection of undescended testicles. In a case, in which M. Cloquet found the left testicle situated within the abdomen, the gland was well formed, and of the same size as the right, which had de scended into the scrotum. The parts taken from an apprentice of Sir A. Cooper, who unfortunately committed suicide in conse quence of the infirmity, are preserved in the Museum of Guy's Hospital. I have ex amined the preparation ; and the testicles, which are both within the abdomen, close to the internal ring, appear to be nearly, if not quite, the natural size, and it is stated that the ducts contained semen. In a lad, aged nineteen, whose left testicle was found, by Dr. Bright, within the abdomen, near the brim of the pelvis, the gland was considerably smaller than natural, but the ducts and se creting structure were quite perfect.t These are the only cases of testicles situated within the abdomen in which we have any account of the anatomical condition of the gland. In addition to the evidence they afford of the ca pability of testicles thus placed to exercise their tbnctions, may be adduced the case of Mr. Hunter, just alluded to, in which a person, both of whose testicles continued in the ab domen, had all the powers and passions of a man ; and a case recorded by Mr. Poland, of a man so formed, who was aged twenty nine. He had all the signs of virility, had married twice, and was the father of two children.* On the other hand, Mr. Wilson mentions the case of a young man, twenty-five years of age, whose testicles never descended. He had some beard, and not an unmanly ap pearance ; but although an imprudent, and in some things a dissipated person, he had never shown the least desire for women, or disposition for sexual intercourse.f John West, a lad, aged sixteen, died in the London Hospital, in a state of universal anasarca. There was no appearance of beard, and only a few hairs were scattered over the pubes. My attention was particularly directed to the state of the genital organs, by observing that the scrotum, which was greatly distended with serous effusion, was not fully developed on the right side. I found the right testicle within the abdomen, about an inch and a half above the internal ring. It was very small, not larger than that of a child two years of age ; and on cutting into it, the gland pre sented the granular appearance usually re marked at that early period.