Clinical report [on cases in the Edinburgh Surgical Hospital] for the winter session 1834-35.

  • Syme, James, 1799-1870.
Date:
1835]
Catalogue details

Licence: Public Domain Mark

Credit: Clinical report [on cases in the Edinburgh Surgical Hospital] for the winter session 1834-35. Source: Wellcome Collection.

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    walked with great difficulty to his master's house, which was about a quarter of a mile distant. The scrotum was much swollen and discoloured. About the middle of it there was an irregularly shaped wound, somewhat more than an inch wide, looking as if it had been inflicted by repeated application of a cutting instrument. When the finger was introduced into this opening, it entered a cavity in the si¬ tuation of the testicles. But as the sides of this cavity were very thick and dense, it could not be readily determined whether they were constituted by the lacerated organs themselves, or merely the surrounding parts in a swollen state. The patient complained of intense pain in the seat of the injury, and the lower part of the abdomen. He had been bled from the arm previous to admission, and while weak and stupid from the com¬ bined effects of drink, pain, and loss of blood, was extremely agitated both in body and mind. The scrotum was kept cool with wet cloths, and supported by a bandage, and an antimonial solution was prescribed. He continued very restless, and on the 4th complained of pain so much that it was thought necessary to take Jxviii. of blood from his arm. He had a very anxious look, and hurried breathing, with a profuse thin bloody discharge from the wound. On the 8th, a counter opening was made at the lower part of the scrotum, which gave vent to a quantity of fetid matter, and afforded great relief to the patient. The swelling then gradual¬ ly diminished, when it became evident that both the testicles were gone, and that the firm swelling which had occupied their place depended on thickening of the tunica vaginalis. He suffered little after this, except from weakness and pain in the region of the spermatic cords, and was dismissed cured on the 10th of February. The judicial authorities investigated the case, in order to discover the perpetrator of this cruel injury, but did not succeed in penetrating the mystery which involved it. Being asked if the patient's story was credible, I stated my opinion, that, how¬ ever improbable it might seem, there was no impossibility in the affair happening as he related, since, after a sufficient wound had been inflicted on the scrotum, the testicles might be very quickly protruded, and either cut or torn away, as in the ordi¬ nary process of gelding young animals. The patient declared that the men he saw were entire strangers to him, and offered to substantiate the whole of his statement by oath ; but as his character for truth and other moral qualities was far from being good, it seems, on the whole, most likely that he sustained the injury under circumstances which rendered him unwilling to divulge the real history of the transaction.