The surgical anatomy of inguinal herniæ, the testis and its coverings / by Thomas Morton.

  • Morton, Thomas, 1813-1849.
Date:
1841
Catalogue details

Licence: Public Domain Mark

Credit: The surgical anatomy of inguinal herniæ, the testis and its coverings / by Thomas Morton. Source: Wellcome Collection.

Provider: This material has been provided by Kings College London. The original may be consulted at Kings College London.

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    Sometimes an hydrocele of the tunica vaginalis is divided into several compartments, by numerous membranous septa, which spring from the inner surface of the sac. In many cases these cells or sacculi communicate freely with each other, while in others they form separate and distinct cavities. An hydrocele may attain an immense size. iMr. Gibbon, the celebrated historian, laboured under this complaint, and was tapped for it by Mr. Cline, who drew off six quarts of fluid.|* AV^ien an hydrocele is very large, it is not advisable to inject it at once, for the irritation of so extensive a surface might be produc- tive of very dangerous consequences; on the contrary, it would be much better to tap it repeatedly, and at short intervals ; and when it has been reduced by this means to a moderate size, then the cure of it by injection may be safely undertaken. Effusion of urine.—Extravasation of urine into the cellular tissue of the scrotum is a frequent consequence of injuries done - to the urethra by rude and awkward attempts to introduce a catheter or bougie in cases of retention from stricture : it may, also, ensue upon the bursting of the urethra behind a tight and old strieturc, for in this situation the canal is not only greatly dilated, but its coats are weakened by inflammation and ulcer- ation ; or it may take place when the urethra has been torn by falls or blows upon the perinseum. In all these cases the urine generally makes its way from the perineeum into the scrotum with destructive rapidity, being directed in this eourse by the connections of the superficial fascia with the arch of the pubes and the triangular ligament. The scrotum may be distended to the size of a child’s head; it is of a dusky red colour, pits and crepitates on pressure with the finger, and these symptoms are usually accompanied with a burning pain in the affected parts ; which soon fall into gan- grene if relief be not speedily afforded by incisions of sufficient length and depth. In neglected cases the urine ascends upon the front and sides of the belly, and may even reach as high as the scapula*, diffusing itself through the delicate cellular tissue which con- nects the superficial fascia of the abdomen to the outer surface of the external oblique muscle. In this situation it is usually 1 Sir Astley Cooper’s Lectures on Surgery, by F. Tyrrell, vol. ii. p. 92.