. A manual of operative surgery . gthe superficial layers of the cord and in its outer segment(Fig. 183). Of the three arteries only the spermatic and the deferentialsupply the testicle, and chiefly the former. But as shown bythe results of operation for varicocele (in which the spermaticartery is almost invariably tied), the deferential artery iscapable of sufficient enlargement to carry on the blood supplyof the testis. One of us (J. H.) investigated the veins of the cord in a seriesof dissections and microscopic sections. The examination wasmade on thirty subjects, and the results given (Fi
. A manual of operative surgery . gthe superficial layers of the cord and in its outer segment(Fig. 183). Of the three arteries only the spermatic and the deferentialsupply the testicle, and chiefly the former. But as shown bythe results of operation for varicocele (in which the spermaticartery is almost invariably tied), the deferential artery iscapable of sufficient enlargement to carry on the blood supplyof the testis. One of us (J. H.) investigated the veins of the cord in a seriesof dissections and microscopic sections. The examination wasmade on thirty subjects, and the results given (Fig. 182)agree closely with those deduced by Mr. W. G. Spencer from asimilar research. The veins are divided roughly into two sets. The anteriorand by far the larger set runs with the spermatic artery, isbound together by a good deal of connective tissue, and formsthe pampiniform plexus. The posterior set is small, and sur-rounds the vas deferens, running with the deferential artery. 665 666 OPERATIONS ON SCROTUM AND PENIS [part ii. The spermatic artery in the great majority of cases runs inthe middle of the anterior bundle of veins, from which it ispractically impossible to isolate it. Both anterior and posteriorsets lie within all the coverings of the cord. A few isolated veins, independent of thesesets, are found among thetissues of the cord. It would appear from inquiries that theveins in the left cord arealways larger than those ofthe right ; and in connectionwith this point it may beobserved that the congenitalorigin of varicocele is verygenerally allowed. In severe cases of vari-cocele all the veins of thecord would appear to be in-volved. In ordinary casesthe veins only of the pam-piniform plexus are sufficientlydilated to require the operation for varicocele it is important to deal onlywith the anterior bundle of veins, and to spare those aroundand behind the vas deferens. It must be remembered that the testicle is a vascular gland,and that it is
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