Surgery; its theory and practice . r, and even to the ureters and kid-neys. In some cases the testicle appears to be the starting pointof a general tuberculosis; in others, merely to be involved in com-mon with other organs in the general disease. In many in-stances, however, the disease may remain localized to the testicle,and no other manifestation of tubercle occur in the body. Theinflammatory products infiltrating the epididymis and testicle,have a great tendency to undergo caseation, forming the yellowmasses of cheesy-hke material so characteristic of the disease (Fig. 359)- Sip;ns.—The d
Surgery; its theory and practice . r, and even to the ureters and kid-neys. In some cases the testicle appears to be the starting pointof a general tuberculosis; in others, merely to be involved in com-mon with other organs in the general disease. In many in-stances, however, the disease may remain localized to the testicle,and no other manifestation of tubercle occur in the body. Theinflammatory products infiltrating the epididymis and testicle,have a great tendency to undergo caseation, forming the yellowmasses of cheesy-hke material so characteristic of the disease (Fig. 359)- Sip;ns.—The disease usually begins very insidiously and withlittle pain. The epididymis, especially the head, and later thebody of the testicle, are found enlarged. The testicle is usuallybut sightly tender on handHng, and the testicular sensation is notlost; a hydrocele may be present, or part of the tunica vaginalismay be obliterated. Subsequently the cord, especially the vas,becomes thickened and the skin adherent; whilst still later, the. 744 DISEASES OF REGIONS. skin may give way and a fungus composed of the infiltrated tubulesprotrude, or a discharging sinus be produced. The vesiculseseminales or prostate may now be felt enlarged on examining bythe rectum, and bladder or urinary troubles may set in; whilstsymptoms of tubercle in the lung, larynx or other organs maysupervene and the patient succumb to tubercular disease. Atother times no constitutional signs manifest themselves, and thepatient may comj^letely recover. Diagjwsis.—From syphilitic orchitis it may generally be dis-tinguished by the enlargement of the epididymis, thickening ofthe cord, adhesion of the skin, enlargement of the vesicul?e semi-nales, and concomitant signs of tubercle elsewhere. Treatment.— In the early stages, before the vas or vesiculseseminales have become involved, some Surgeons advise the removalof the organ, for the purpose of preventing, if possible, generaldissemination of the disease, and where b
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectsurgery, bookyear1896
