Chapter 17 - Surgical Diseases
Modern Surgery
Inflammation
Suppuration and Abscess
Mortification
Pyaemia
Ulceration and Ulcers
Boils
Carbuncle
Malignant Pustule
Burns and Scalds
Frost Bite
Chilblains
Mechanical,Injuries
Septic Wounds
Incised Wounds
Rules for Examining and Dressing Wounds
Antiseptic Dressings
Way Wounds Unite
Punctured Wounds
Lacerated Wounds
Granulation and Scarification
Gunshot Wounds
Poisoned Wounds
Fractures
Way Broken Bones Unite
Dislocations
Different Diseases of Bones
Pereostitis
Necrosis
Coxalgia
White Swelling
Bunions
Whitlow
Stiff Joint
Tumors
Cancer
Polypus
Piles
Wens
Aneurisms
Bronchocele
Water in the Scrotum
Blood in the Scrotum
Phlebitis
Varicose Veins
Hernia
Varicocele
Deformities and Irritations of the Spine
Wry Neck
Foreign Bodies in the Eye
Stye
Inflammation of the Edge of the Eyelids
Disorder of the Lashes
Ptosis
Chronic Inflammation of the Lachrymal Sac
Opthalmia
Inflammation of the Cornea
Inflammation of the Iris
Weakness of Sight
Imperfect Vision
Short and Long Sight
Squinting
Affections of the Ear
Inflammation of the Meatus
Wax in the Ear
Earache
Inflammation of the Tympanum, Deafness
Bleeding from the Nose
Ingrowing Toe Nail
Chafing and Excoriation
Foreign Substances
Bleeding from Wounds
Proud Flesh
Ambrine
Compression of Arteries to Stop the Flow of Blood
Anesthetics
Care of the Teeth
Rotting of the Teeth
Tooth-Ache
Filling Teeth
The First Teeth
Cleaning the Teeth
Ulcer of the Stomach
Glanders
X-Ray
Radium
Trachoma
Arterio-Sclerosis
Flatfoot
Riggs' Disease
Bandages

17.42 Water in the Scrotum

Water in the Scrotum. Hydrocele.

As the name shows, this is a collection of water in the scrotum or bag which holds the testicles.

Symptoms. It presents a swelling, shaped like a pear, smoothon its surface, fluctuating if pressed, without pain, but causing a little uneasiness by its weight. On placing a lighted candle on one side of the scrotum, the light may be seen through it.

Distinction. This complaint may be distinguished from a solid enlargement of the testicle by its not being so heavy, solid, or painful, and by its fluctuating and being transparent; from rupture, by its forming slowly instead of suddenly, by the swelling beginning at the lower part of the scrotum instead of the upper, and by the enlargement not being increased by coughing as it is in rupture.

Treatment. In children, strong scattering washes (353) are sometimes successful. But most commonly a number of punctures are made with a large needle, to cause the fluid to escape into the cell tissue of the scrotum, whence it is removed by absorption.
To effect a radical cure in grown persons, the surgeon is to grasp the tumor behind, and introduce a trocar and canula into the sac, being careful to point the instrument upwards, so as not to wound the testicle. The trocar is then withdrawn, the canula being at the same time pushed well into the sac, so that none of the fluid may get into the cell tissue outside the sac. The fluid runs of~ through the canula. When this has all escaped, some stimulating fluid, as common lime water, or, still better, tincture of iodine, is to be injected through the canula into the emptied sac. After retaining this from two to five minutes, it is permitted to flow out. Inflammation follows, which breaks up the secretion of water, and effects a cure in two or three weeks. The amount of fluid thrown in should be about one or two teaspoonfuls of a mixture of one part of tincture of iodine and two parts of water. If the first operation does not effect a complete cure, it may be repeated. The most successful of all treatments, however, is to open the scrotum and dissect out the greater part of the tissue which covers the testicle and which secretes the fluid.
A suspensory bandage which, by relieving the weight from the spermatic cord will cause great relief, is desirable and in early cases may prevent the troubles becoming serious enough to warrant operation.

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