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Show 1:38 or iirmioerzL e or HYDRoane. The 113 droc11e of the tunica V'gainalisis for the most pair in a slight degree transpaient. '10 aseeitain this, we grasp sometimes forced out from the puncture, in what is called the testicle there is often water collected betwixt the coats, it, we may discan a slight degree of tiansparent3' hydrocelc.'1he w11'ht; the pain cccasione d by handling I11 chil- we next examine the state of the spermatic cord. The vessels of the cord willingeneral be felt distinctly betwixt the top of the tumour and the abdominal ring. When this is the case, we {no relieved from the fear 01 a hernia; and it remains for us only to determine whether it may not be an elastic 1111110111 of the body of the testicle. 11hen the apex of the liydrooele extends up into the ring, then we must ascertain the nature of the complaint by other tests. 1. By the history. The hernia begins above, the 11V- drocele in the bottom of the scrotum, and ascends gradually. In schirrus of which may to the unexperienced touch give the feeling of it; the s1ght degree of inequality; the varicose state of the vessels of the surface-distinguisl'. sc"hiiins. And by continuing the pressure of'the finger, you will often be abl: in displacing the water, to feel the enlarged body of the testicle. Further, it must be reecileeted, that with hydroeele there is often an enlargement of the testicle, and a thickening of the coats. But sometimes, on the Contrary, there is relaxation of the cord and of the coats, and a softness and diminution of the body of the testicl'. Timeis an Obsthdtit1n conihmcd‘by Sir .111111:5 Earle' s ex- sure makes no change upon it. The patient being iaisel again, is made to cough; and if thereis now no impulse upon tensive practice, which I cannot omit lure. " 1. can positively assert that the apparent schirrhosity which often accompanies 113'111'0131les of long stinding, is often nothing more than a thickness of the coats of the testicle, from long distention, and an enlarge nent of the gland itself from pressure, which being removed, the parts become thinner, softer, and gradually as- the tumour, from the coninlsive shock given to the gem-1211 1'1vity of the belly, thereis no likelihood of this 11111111111 the nature of hernia. O ~nine nearly their natural state-#5:." If a hydrocele is burst by accident, no bad sheets will fol- iow', unless the testicle itself be injured. It requires no punc- This is a circumstance which the patient will be enabled to 11., the sorofulous testicle. This disease of; the testicle is not described. the scrotum 1n 111011211111, and gather the scrotum behind in such a way as to smooth the rugze; then placing the other hand over the tumour, so as to direct the strong light through dren, the transpaiflencyis particularly clean. QJDUW 151' determine. 2. We may now place the patient on his back, and grasping the tumour, we shall find that pesition and pres- Tlieie is a greater (1111.111113 of distinguishing hydroceir. 1"».0m enlargement of the testicle. I have twice dissected test1« rles which had been pierced for hydrocele and found them ture or incision to evacuate the water. An injury of this kind the tumour not to be a hydrocele, I could not yet distinguish altords no motive for determining upon any operation. On the contrary, it is an improper time to operate. If the scrotum has been punctured before, it may happen (as I have seen) that the testicle is attached to the fore part of the sac, the part formerly punctured, owing to the partial inflammation occasioned by the operation. Wherever I have any peculiarity in the touch and feelmg, by which I might seen this, I have performed the Operation by inclsion. to connst of a peculiar V"a5sacul1', daik, and bloody stiuctuie. as if CflntlSt'.11g chiefly of varicose veins, which distendt 11 1111‘ mats with an elasticity so like that of :1 1111111, that knowing In future determine its 11ature>x-. A grey pulpy matter is ' This 1111 0011211111}, and 1111> frcquenc3 01 113' drocele being niistakm for Had it been done by the trocar, the instrument would have entered the body of the testicle. , .- -.«- .. ..-..1<._s >‘ I'11'mm of the 1511,de made You. puncune the testicle 3113 .135 pr'eVious to 91.111"11.11111 * A Treatise on the Hydrocele, by 811' James Earle, Preface, p. XL'iii. |