Varicocele and its radical cure / by Octavius A. White, A.M.

  • White, Octavius A.
Date:
1873
Catalogue details

Licence: Public Domain Mark

Credit: Varicocele and its radical cure / by Octavius A. White, A.M. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

    14/18 (page 12)
    Too much prejudice, we Lave reason to believe, has lately arisen against operative procedures for the radical cure of vari- cocele. Without pausing to consider whether this may not have resulted from the many discouraging failures which have attended most of the methods detailed, or from the many ter- rors and dangers with which attempts at cure have been en- compassed, we desire to record our opinion that indiscrimi- nate resort to operation should by no means be entertained. Mr. Hunter long ago computed the frequency of varicocele among male adults as one in every ten. Prof. Humphrey, of Cambridge, the monographist upon this subject in Holmes's great work on surgery, who rather discountenances active in- terference for its relief, admits the same ratio. From that ample field of observation, the conscript service in the South during our late civil war, together with experi- ence derived from private practice for over a quarter of a cen- tury, we have deduced a rate of one in eighteen. Out of this large proportion of cases, however, the propor- tion of those whose condition may demand surgical interfer- ence will be found comparatively small. Operative proced- ures in this, as in every other disease, should be instituted with due caution, and I might add, only as a dernier ressort. Mr. Erichsen has noted that varicocele seldom begins later ' than the thirtieth year. ISTeither this high authority nor any other has yet declared the earliest age at which it may become urgent and demand the surgeon's attention. Most of the cases operated upon by us, we find, were be- tween the ages of eighteen and twenty-eight. Observation convinces us that ordinarily varicocele begins to develop at or about puberty, when natural afflux is directed to the spermatic vessels, and unnatural practices, if indulged in, irritate and congest these organs. As a general rule, we deprecate operating for radical cure of varicocele before the age of fifteen, and advise against posi- tive interference until physical development may be consid- ered complete. In this connection we desire* to record our ex]3erience in two remarkable cases, undertaken, contrary to our established views above expressed, before the age specified. In one the operation resulted successfully, though I have no confidence in