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SOME POINTS IN THE PATHOLOGY OF THE TESTICLE.
SOME POINTS IN THE PATHOLOGY OF THE TESTICLE. ventilation
that the men fall ill at an early age and the strongest constitutions are shattered. All this has been described in a special report published -on Nov. 30th, 1889, and we trust that the grisvances then brought forward will be related over and over again, with fresh cases and newer evidence, till at last the law relating to bakehouses is revised and the sanitary authorities are armed with sufficient power to sweep away the noisome cellars where the bread of the rich and the poor alike is now made. It is also a well-known fact, which Dr. Waldo does not seem this time to have mentioned, thatjourneymen bakers often sleep in the bakehouse. They lie down on the boxes where the dough is mixed, and a sack of flour does not make a bad pillow. Considering that these men have but little time or inclination to indulge in personal ablutions, the idea is not a pleasant one. When the hours worked are shorter the journeyman baker will have time to go home to sleep and to wash. Till then we can scarcely complain if he is dirty and careless ; but we can and must demand a complete reform of the whole system which produces such a revolting condition of affairs. so
completely neglected
____
SOME POINTS IN THE PATHOLOGY OF THE TESTICLE. DR. GRIFFITHS of Cambridge has continued his investigations into the pathology of the testicle and communicated (he results in the last volume of the J01l’rnal {If Araatomy and Physiology. We gave last year1 a summary of his observations with regard to the " structural changes in the testicles of " aged persons and the "structural changes in the testicle of the dog when it is replaced within the abdominal cavity." He has examined various examples in which the testicle has been retained in the abdomen in man and the dog and finds (1) that the retained testis in man and in the domesticated animals is of small size, and the seminal tubules, though smaller, are more distinct owing to the disproportionate amount of inter-tubular connective tissue ; (2) the walls of the tubules are thick from the formation of fibrous tissue on the inner surface of the tunica propria, the epithelium is scanty and columnar, and there are no traces of spermatogenesis ; (3) the testes in cryptorchids, though they are incapable of producing spermatozoa, are yet capable of exerting that influence which the natural testes exert upon çhe development of the penis and the growth of the body ; ’(4) the function of the testes --namely, that which influences the growth of the body at puberty-is distinct from that of the production of spermatozoa, the latter necessitating of the a moie specialised development of the tubules do and the testes not than the former ; acquire gland (5) their full (spermatozoa-producing) function except at the furthermost point of descent from their primary position. He has also examined the "testes and prostate gland in certain eunuchoid persons "-that is persons in all respects like eunuchs except that in them the testes, though small, .are in the scrotum. His conclusions with regard to them .are : 1. In eunuchoid persons the testes are of small size and almost entirely composed of fibrous tissue, the seminal tubules being represented by fibrous rods with fissure-like lumina containing atrophied epithelial cells. Although thus altered, the testes retain their normal shape and form. 2. The epididymes are large relatively to the bodies of the testes, and the tubules in most of the lobules of the globus major are natural, the tubules in some few lobules being altered as if by chronic inflammation. 3. The prostate gland is small, tough, and fibrous, and the glandular tubules are but few in number and but imperfectly developed ; the vesiculæ semimales are also of small size, and devoid of any secretion in their interior. 4. Where the testes lose their power of growth, from whatever cause, the individual develops at 1
THE LANCET,
July 29th and Sept. 30th, 1893.
879
like a eunuch deprived of his testes in early life. Such a person he has therefore called "eunuchoid." He further gives the following conclusions as the result of his investigations respecting the "appendix of the testicle and the cysts of the epididymis, the efferentia, and the rete testis." 1. That the appendix of the testicle, known as the collapsed or sessile I I bydatid of Morgagni," is a small, solid, corrugated body, best seen in early life ; it is covered by a single layer of columnar, non-ciliated, epithelial-like cells and is composed of fibrous connective tissue, in which there are numerous bloodvessels. It is not of a cystic nature, like the cysts (hydatids) found in this neighbourhood. 2. The small, sessile, or pedunculated spermatozoaless cysts, often multiple, originate as small buds or outgrowths of the tubules, which may or may not have originally been in connexion with the interior of the tubules. 3. The small spermatozoacontaining cysts originate in dilatations of the tubules of the coni vasculosi. 4. The large spermatozoa-containing cysts originate in dilatation of the tubules between the testis and epididymis. 5. The small cysts on the sides (chiefly outer) of the body of the testis originate in dilatation of lymph spaces in the superficial layers of the tunica albuginea.
puberty
BARON HIRSCH’S GIFTS TO MEDICAL CHARITIES. BARON HIRSCH, who last year distributed among selected of about £42,000, has this year provided a to be divided among London hospitals and charitable institutions. The London Hospital is the recipient of £1000 and the Brompton Hospital for Consumption receives :E600, while St. George’s Hospital and CharingThe remaining amount cross Hospital each receives 500. has been divided among the various other charities in sums of from C500 to 100, the French Hospital and the Jewish Convalescent Home both participating in the distribution. The amount given by Baron Hirsch to charities last year represented his gross turf winnings in public stakes for the years 1891-92. At the end of the season 1893 his winnings amounted to 7500, but, this sum being so small in comparison with his bequests of last year, he has generously doubled the amount. Baron Hirsch’s example is well worthy of imitation by other magnates of the turf. So far as our recollection carries us, the Duke of Portland affords the only other instance, nowadays, of a racing man who makes the pursuit of what is practically a pleasure contribute to the relief of his less-fortunate and suffering fellow creatures. charities sum
of
a sum
15,000
THE PASTEUR INSTITUTE. IN the annual report of the Pasteur Institute it is stated that 1648 persons have come under the antirabic treatment during the past year, and that amongst this large number of patients bitten by rabid animals there were only six fatal cases. Of these six fatal cases it is pointed out that in two the first symptoms of hydrophobia made their appearance within fifteen days after the last inoculation, and the treatment had not a fair chance of success. Leaving these two deaths out of account there were four deaths in 1648 cases, giving an average mortality of 0-24 per cent., a mortality as low as that of the two previous years, 1891 and 1892. Three of the four fatal cases were attacked by the disease during the course of inoculation, and the fourth died during the course of treatment, in spite of all efforts to save the patient. It will thus be seen that in none of these four cases had the treatment been completed when the patient succumbed. The following is the resume of the three sets of patients treated during the year : (a) Patients bitten by animals which were after experiment proved to have suffered from rabies : wounds on the head, 12 ; on the hands, 80; on the limbs, 40. Total, 132 (without a single fatal case). (b) Under the second heading come those bitten by animals which had been
that the men fall ill at an early age and the strongest constitutions are shattered. All this has been described in a special report published -on Nov. 30th, 1889, and we trust that the grisvances then brought forward will be related over and over again, with fresh cases and newer evidence, till at last the law relating to bakehouses is revised and the sanitary authorities are armed with sufficient power to sweep away the noisome cellars where the bread of the rich and the poor alike is now made. It is also a well-known fact, which Dr. Waldo does not seem this time to have mentioned, thatjourneymen bakers often sleep in the bakehouse. They lie down on the boxes where the dough is mixed, and a sack of flour does not make a bad pillow. Considering that these men have but little time or inclination to indulge in personal ablutions, the idea is not a pleasant one. When the hours worked are shorter the journeyman baker will have time to go home to sleep and to wash. Till then we can scarcely complain if he is dirty and careless ; but we can and must demand a complete reform of the whole system which produces such a revolting condition of affairs. so
completely neglected
____
SOME POINTS IN THE PATHOLOGY OF THE TESTICLE. DR. GRIFFITHS of Cambridge has continued his investigations into the pathology of the testicle and communicated (he results in the last volume of the J01l’rnal {If Araatomy and Physiology. We gave last year1 a summary of his observations with regard to the " structural changes in the testicles of " aged persons and the "structural changes in the testicle of the dog when it is replaced within the abdominal cavity." He has examined various examples in which the testicle has been retained in the abdomen in man and the dog and finds (1) that the retained testis in man and in the domesticated animals is of small size, and the seminal tubules, though smaller, are more distinct owing to the disproportionate amount of inter-tubular connective tissue ; (2) the walls of the tubules are thick from the formation of fibrous tissue on the inner surface of the tunica propria, the epithelium is scanty and columnar, and there are no traces of spermatogenesis ; (3) the testes in cryptorchids, though they are incapable of producing spermatozoa, are yet capable of exerting that influence which the natural testes exert upon çhe development of the penis and the growth of the body ; ’(4) the function of the testes --namely, that which influences the growth of the body at puberty-is distinct from that of the production of spermatozoa, the latter necessitating of the a moie specialised development of the tubules do and the testes not than the former ; acquire gland (5) their full (spermatozoa-producing) function except at the furthermost point of descent from their primary position. He has also examined the "testes and prostate gland in certain eunuchoid persons "-that is persons in all respects like eunuchs except that in them the testes, though small, .are in the scrotum. His conclusions with regard to them .are : 1. In eunuchoid persons the testes are of small size and almost entirely composed of fibrous tissue, the seminal tubules being represented by fibrous rods with fissure-like lumina containing atrophied epithelial cells. Although thus altered, the testes retain their normal shape and form. 2. The epididymes are large relatively to the bodies of the testes, and the tubules in most of the lobules of the globus major are natural, the tubules in some few lobules being altered as if by chronic inflammation. 3. The prostate gland is small, tough, and fibrous, and the glandular tubules are but few in number and but imperfectly developed ; the vesiculæ semimales are also of small size, and devoid of any secretion in their interior. 4. Where the testes lose their power of growth, from whatever cause, the individual develops at 1
THE LANCET,
July 29th and Sept. 30th, 1893.
879
like a eunuch deprived of his testes in early life. Such a person he has therefore called "eunuchoid." He further gives the following conclusions as the result of his investigations respecting the "appendix of the testicle and the cysts of the epididymis, the efferentia, and the rete testis." 1. That the appendix of the testicle, known as the collapsed or sessile I I bydatid of Morgagni," is a small, solid, corrugated body, best seen in early life ; it is covered by a single layer of columnar, non-ciliated, epithelial-like cells and is composed of fibrous connective tissue, in which there are numerous bloodvessels. It is not of a cystic nature, like the cysts (hydatids) found in this neighbourhood. 2. The small, sessile, or pedunculated spermatozoaless cysts, often multiple, originate as small buds or outgrowths of the tubules, which may or may not have originally been in connexion with the interior of the tubules. 3. The small spermatozoacontaining cysts originate in dilatations of the tubules of the coni vasculosi. 4. The large spermatozoa-containing cysts originate in dilatation of the tubules between the testis and epididymis. 5. The small cysts on the sides (chiefly outer) of the body of the testis originate in dilatation of lymph spaces in the superficial layers of the tunica albuginea.
puberty
BARON HIRSCH’S GIFTS TO MEDICAL CHARITIES. BARON HIRSCH, who last year distributed among selected of about £42,000, has this year provided a to be divided among London hospitals and charitable institutions. The London Hospital is the recipient of £1000 and the Brompton Hospital for Consumption receives :E600, while St. George’s Hospital and CharingThe remaining amount cross Hospital each receives 500. has been divided among the various other charities in sums of from C500 to 100, the French Hospital and the Jewish Convalescent Home both participating in the distribution. The amount given by Baron Hirsch to charities last year represented his gross turf winnings in public stakes for the years 1891-92. At the end of the season 1893 his winnings amounted to 7500, but, this sum being so small in comparison with his bequests of last year, he has generously doubled the amount. Baron Hirsch’s example is well worthy of imitation by other magnates of the turf. So far as our recollection carries us, the Duke of Portland affords the only other instance, nowadays, of a racing man who makes the pursuit of what is practically a pleasure contribute to the relief of his less-fortunate and suffering fellow creatures. charities sum
of
a sum
15,000
THE PASTEUR INSTITUTE. IN the annual report of the Pasteur Institute it is stated that 1648 persons have come under the antirabic treatment during the past year, and that amongst this large number of patients bitten by rabid animals there were only six fatal cases. Of these six fatal cases it is pointed out that in two the first symptoms of hydrophobia made their appearance within fifteen days after the last inoculation, and the treatment had not a fair chance of success. Leaving these two deaths out of account there were four deaths in 1648 cases, giving an average mortality of 0-24 per cent., a mortality as low as that of the two previous years, 1891 and 1892. Three of the four fatal cases were attacked by the disease during the course of inoculation, and the fourth died during the course of treatment, in spite of all efforts to save the patient. It will thus be seen that in none of these four cases had the treatment been completed when the patient succumbed. The following is the resume of the three sets of patients treated during the year : (a) Patients bitten by animals which were after experiment proved to have suffered from rabies : wounds on the head, 12 ; on the hands, 80; on the limbs, 40. Total, 132 (without a single fatal case). (b) Under the second heading come those bitten by animals which had been