Manual of surgery / by Alexis Thomson and Alexander Miles.

  • Thomson, Alexis, 1863-1924
Date:
1904
Catalogue details

Licence: Public Domain Mark

Credit: Manual of surgery / by Alexis Thomson and Alexander Miles. Source: Wellcome Collection.

    681/764 (page 661)
    * raised, Above the testis, the twisted cord may be recognised cedematous, and the swelling is rounded, tense, and exceedingly tender. There is no impulse on coughing. If necrosis ensue, the pain becomes less severe. In some cases the symptoms are less severe, the patient merely suffering from occasional attacks of sickening pain, which is relieved by gently stroking the testis. One of these attacks may, however, culminate in complete torsion. Torsion of the cord is to be diagnosed from strangulated hernia, acute orchitis, and acute suppuration of a lymphatic gland. In many cases an exact diagnosis can only be made by means of an exploratory incision. The treatment consists in exposing the testis by dissection. When situated in the inguinal canal the gland should be excised, as it is usually functionless, or is likely to become so as the result of the congestion. When situated in the scrotum it is sometimes possible to save the testis by undoing the twist. If necrosis has ensued the organ must be removed. INFLAMMATORY AFFECTIONS OF THE TESTIS AND ITS APPENDAGES, Any portion of the spermatic tract—testis, epididymis, vas deferens or seminal vesicles—may be the seat of inflammation, and, according to the cause and nature of the inflammatory pro- cess, it may remain confined to one or other of these structures, or may spread to adjacent parts. The term orchztes is applied when the body of the testis is chiefly involved, and epididymitis when the epididymis suffers most. When both are implicated, the term eprdidymo-orchitis is employed. Inflammation of the cord and vas deferens (funiculitis), or of the seminal vesicles (vesiculites), seldom occurs apart from a similar affection of other segments of the tract. The more acute inflammations are due to infection with some form of pyogenic bacteria, and particularly with the gono- coceus, while the more chronic forms are usually tuberculous or syphilitic in nature. Acute Epididymitis and Acute Orchitis.—In considering the acute inflammations of the epididymis and testis, it is con- venient to distinguish between those varieties which are due to direct infection from the urethra, for example, in urethritis of gonorrheal origin, and those in which the infection takes place