DOI: 10.7925/drs1.ucdlib_280047
title: Double encysted hydrocele of the testis

description: Watercolour medical illustration depicting double encysted hydrocele in a man. It has the alternative reference numbers 1158 and P5 on the front. The artist's name is in the bottom right corner 'J. Connolly fec.t'. Also contains an illustration of a beaker and petri dish. The Richmond Hospital Museum reference is A.a.54. The entry for this in P263/1 pg. 5 reads 'Double encysted hydrocele of the testis. J. McDonnell aet 70. Dr Fleming'.
description: Users are advised that this item contains graphic images which may cause upset or distress.
description: Scope and content: The handwritten note on the back has a typed note stuck over it. Therefore the typed note reads 'Encysted hydrocele of the testicle. Dr Fleming exhibited a drawing, illustrative of this form of hydrocele. The disease occurred in a man, aged 70 years, and the case was remarkable, both for the size to which the tumour [sic] had attained, and as an instance of double hydrocele of the species above mentioned. The man applied at the Richmond Hospital for a truss for a supposed inguinal hernia, he had been in the habit of wearing one for a long time. On being examined, no hernia was found, but symptoms of encysted hydrocele of the testicle, both at the right and left sides, were manifest. In the more advanced stages of this disease when it had reached the size represented in the drawing, it deserved, perhaps, the name of encysted hydrocele of the cord. In the present instance the tumor resembled a scrotal hernia in the position of the testicle, which was, which was situated at the lowest part of the scrotum, but the isolation of the abdominal ring and translucent condition of the sac pointed to hydrocele. It was tapped and about fourteen ounces of fluid were drawn off. The fluid secreted in such cases, and now exhibited to the Society, had been by many writers compared to the milk of the cocoa nut, but no matter what it's colour may might be, Dr Fleming had generally found, on examining it by the microscope, large numbers of spermatozoa – a circumstance which he had never observed in cases of simple hydrocele of tunica vaginalis, neither is it to be expected in such, unless some disease of the testis has coexisted whereby the surface of the organ and its coverings have been frayed and injured, allowing spermatozoa to escape. In the special forms of hydrocele now under consideration they are almost invariably present, and it is of interest, in a pathological point of view, to investigate their source. Several hypotheses have been advanced, but Dr Fleming was inclined to agree with Dr Paget, who believed that a cyst possesses the power of forming material resembling that of structures in its immediate vicinity. Thus, in cases of what is termed the chronic mammary tumor, we find a tissue very much resembling the mammary structure. Thus, again, in some cases of lacteal tumor, the contents of the cyst have all the appearance of milk. From these and other similar facts, it may perhaps be inferred that cysts in the vicinity if secreting organs may have a power of generating contents of a similar character with those organs. Mt Curling, in an able discussion on the subject, questions the accuracy of this opinion. Dr Fleming was inclined to think, however, that the views of Dr Paget were deserving of serious consideration. December 12 1863'. This typed note is then followed by a handwritten note that reads 'The subject of the above case was under treatment in hospital at the same time with John O'Neill, a drawing of whose hydrocele is to be found in this museum collection. Mr Fleming June 1860. Surg.n Fleming's case. May 22nd 1860'.
description: Numbering/sequence: Original reference number: 1158.