A systeme of anatomy, treating of the body of man, beasts, birds, fish, insects, and plants illustrated with many schemes, consisting of variety of elegant figures, drawn from the life, and engraven in seventy four folio copper-plates. And after every part of man's body hath been anatomically described, its diseases, cases, and cures are concisely exhibited. The first volume containing the parts of the lowest apartiments of the body of man and other animals, etc. / by Samuel Collins ...

CHAP. XI. Of the Diseases of the Scrotum and Testicles of Man.

THus having given a History of the Parts of Generation of Man, and the Males of Bruits, Fowl, Fish, and Insects, my Task at this time is to discourse the diseases and Cures belonging to the Genitals of Man.

The Scrotum and Testicles are afflicted with many sorts of Diseases, In∣flammations, Ulcers, several kinds of Hiernia's, Gangreens, &c.

Inflammations proceed either from a grosness, * 1.1 or a great quantity of Blood, lodged in the substance of the Scrotum or Testicles, brought in by the Spermatick Arteries to the Interstices of the Vessels, in so large a proportion that the Extremities of the Veins are not receptive of it, whence follow∣eth a Tumor of the Scrotum, or Testicles, or of both, accompanied with a beat∣ing Pain, * 1.2 a great heat, and a symptomatick Fever, derived from an exube∣rance of Stagnated Blood, whereupon the Serous and Chymous parts of it are often turned into purulent Matter, which being of a Corrosive temper, maketh its way through the more inward Recesses to the ambient parts, and dischargeth it self by way of Ulcer.

An Inflammation of the Scrotum and Testicles, * 1.3 as well as other parts of the Body, denoteth a free opening of a Vein in the Arm, especially in a Plethorick Body; as to inward Medicines, cooling Juleps and Apozemes are very proper to contemperate the Blood.

And afterwards, * 1.4 gentle repelling Medicines may be used, of Bean-Flower, Red-Rose Leaves, &c. boiled in Milk, and made into the Consistence of a Cataplasm with the Crums of White-Bread, &c. and to intercept the Flux of Blood into the Scrotum and Testicles, a defensative Medicine may be ap∣plied to the side of the Groins, made of Red-Rose Leaves, Bole-Armenick, Bean-Flower, boiled in Red Wine, or the Countesses or any other astringent Ointment may be administred to the said parts. If the Pains of the Parts affected be very urgent, Anodynes may be applied, mixed with Faenugreek and Lin-seed, boiled with Red-Rose Leaves in Milk thickned with White∣bread, to the consistence of a Pultice.

And if the humours, * 1.5 setled in the Tumefied Scrotum and Testicles, cannot be repelled nor discussed, gentle suppurating may be mixed with the said Medicines, as white Lilly-Roots, and a little Venice-Turpentine, dissolved with the Yolk of an Egg; and afterwards the Ulcer is to be treated with in∣ward Diet-Drinks, and outward cleansing, drying, and consolidating Appli∣cations, which do satisfie all the indications of Ulcers.

Many other Tumours discompose the Scrotum and Testicles, the Epiplo∣cele, Enterocele, Sarcocele, Hydrocele, Pneumatocele.

The Epiplocele and Enterocele are the Tumors of the Scrotum, * 1.6 as distend∣ed with the Caul or Intestines falling down into it, and proceeding either from the Rupture, which is very rare, or most commonly from the Relaxa∣tion of the Peritonaeum, in reference to its Process, through which the Sper∣matick Vessels do pass in their Progress to the Testicles.

In an Epiplocele I have seen one of the Testicles wholly encircled with the Caul, * 1.7 which highly tumefied the Scrotum, so that the Patient having

conversed with light Women, conceived the Tumor of the Testicles to be Venereal, and thereupon gave himself over to strong Purgatives, which spake a Period to his Life; whereupon I being sent for by worthy Mr. White, the Coroner of Westminster, to view the dead Body and see him Dissected, and his Belly being opened, we discovered many Pills in his Stomach undissolved, and afterwards his Scrotum being opened, a large Tumor appeared in one side of it, which was part of the Caul (encompassing the left Testicle) which being cut, the Testicle was found to have no greater Dimensions than the other, which were both duely proportioned.

Another kind of Hiernia is called Enterocele, * 1.8 which is the Swelling of the Scrotum upon the descent of the Guts into its Cavity, where the Pas∣sage in the Process of the Rim of the Belly, designed for the Entertainment of the Spermatick Vessels, is too much dilated, which may sometimes happen in persons upon going to Stool, whose Intestines are constipated with hard Excrements, whereupon the Guts being often pressed downwards, by frequent holding the Breath, are forced toward the Groin into the Origen of Process, relating to the Rim of the Belly, whose Cavity is thereby opened, and the Guts have freedom to pass into the Scrotum. * 1.9

In order to the Cure of this Disease, the Guts are to be reduced into the Cavity of the Belly with a gentle hand (to avoid their Contusion) the Bo∣dy being placed in a supine posture, with elevated Thighs, which may be easily performed if the Intestines be empty, but if they be full of Excrements, or Wind, Cataplasms or Fermentations may be applied, made of emollient, discutient, and anodyne Ingredients.

When the Intestines are reduced into their proper place, * 1.10 vulnerary and consolidating Apozemes may be advised, compounded of Cumphrey, Sanicle, Ladies-mantle, Solomons-Seal, Pentaphyl, Tormentil, Mouse-eare the great∣er, boiled in water, and incorporated with Honey after the Liquor is strain∣ed.

Topicks also may be safely applied to the Groins, made of astringent and consolidating Medicines, to shut up the over-much dilated Cavity of the Pro∣cess, relating to the Rim of the Belly, as also Arnoldus de Villa Nova his Plai∣ster de Pelle Arietis, or the Plaister good against a Rupture, and astringent Ointments, as the Countesses Liniment, and the like.

If Apocemes be not pleasant to the Patient, Electuaries may be advised, * 1.11 mixed with astringent, vulnerary, and consolidating Medicines, taken in Posset-drink made with Rib-wort, Plantain, Horse-tail, &c.

Another kind of Tumor, belonging to the Testicles, is called Sarcocele. * 1.12 An∣tient Authors have various Sentiments concerning this Disease. Celsus, Lib. 7. Cap. 18. Raro, inquit, sed aliquando, Caro quo{que} inter Tunicas increscit, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 Graeci vocant. Galenus, Lib. de Tumoribus. P. M. Testiculos vocat induratos, & Lib. 14. Meih. Med. eundem Scirrhis non improvide comparat. But the Mo∣dern Physitians give a more clear account of this disease, and do give it the Appellative of Sarcocele, when some fleshy substance groweth to the Testi∣cles within the Scrotum, of which Hildanus and other Physicians give many Examples, but most commonly when the Testicle is tumefied it proceedeth from the enlarged inward Recesses of it, and not from carnous matter adhe∣ring to the outward parts of the Testicle.

The cause of this disease proceedeth (as I conceive) from the softer parts of the Blood, and Succus Nutricius, the Alimentary Liquor of the Testicles, * 1.13 which being too exuberant, doth highly encrease the substance of them, com∣monly called Sarcocele. Olaus Borichius informeth us of this case, Observ.

97. Actor. Bartholin. Annor. 1671, 1972. Mercatori Samio ablatus Ferro Chy∣rurgi Ramicosus Testis, pendebat semuncias 34. Durus ille quidem toto Corpore, & Massae Carneae Nervosis hinc inde Gyris distincte similis, sed ne{que} ad Latus, ne{que} in Gremio suo ullum alium Testiculum naturalem complexus; Dissecta enim quaquaversum informi mole, ut Testiculus verus quem intus delitescere quidam sus∣picabantur, in conspectum veniret, deprehensum clarissime fuit, totum illud enorme Corpus Testem fuisse, sed Testem a Sanguine, ut conjicere licet, admisso, verum ob, vel Contusionem, vel Frigus, vel Pituitam nimiam ad superiores partes non remisso, eo{que} in Carnem degenerem coagulato distentam.

Mathiolus and Scultelus have persuaded themselves, * 1.14 that they have Cured this disease by the Powder of Restharrowe, but I humbly conceive, with the Pardon of these Learned Men, that it was not a true Sarcocele, but rather a Hydrocele, not proceding from a fleshy or glandulous Tumour of the Te∣sticles, but a quantity of watry Recrements, distending the Scrotum, or lodg∣ed in the Body of the Testicles, so that the said Powder being an excellent Diuretick, may much alleviate, if not wholly take away, the Hydrocele, by Purging the watry Faeces, the cause of this Disease, by the free excretion of Urine.

Bartholine, and other Physicians and Chyrurgeons, deem this Cure to be performed by cutting the Groin, and extracting the Testicle, or by the In∣cision of the Scrotum, as Bartholine hath it, Observ. 28. Sectioni (ait ille) Sarcocelis in Milite interfui faeliciter, & dextre Administratae: Aperta Cute In∣guinis dextri, Testiculus dexter, qui ad Capitis Puerilis magnitudinem excreverat, separato 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 Scroto extractus & resectis Vasis Spermaticis, prorsus exemptus fuit, magno Militis, alias cordatissimi Ejulatu; ligatis Vasis, consutum Scrotum, & caetera ut Vulnus decet, Curata.

Dissectus sui dextri Testiculi Tumor, Glandulosam substantiam ostendit, ex mag∣nitudine auctam, ut Oneri esset Militi satis valido; infima vero parte Vesiculas in∣tra Membranam continebat, Sanguine plenas, qua parte de maximo semper dolo∣re, ob distentionem tunicae sensilis, conquestus fuerat; Tormentorum oblitus, ad Mi∣litares Functiones postea rediit.

Another kind of Hiernia may be called Varicosa, * 1.15 according to vulgar ac∣ception, though improperly, by reason no Hiernia can be truly so called, ex∣cept it proceed from the Rupture, or Relaxation at least, of the Process be∣longing to the Peritonaeum, but the Hiernia varicosa supposeth neither of these, but is derived from a quantity of Blood, stagnant in the Spermatick Vessels, whence ariseth Nodes or Varices in the Testicles.

And also another Hernia (commonly, * 1.16 and unreasonably so called) is sti∣led Hydrocele, which taketh its rise from a quantity of watry Faeculencies, discharging themselves, in Hydropick Bodies, by the preparing Arteries into the Glands of the Testicles, wherein the watry Liquor is stagnant some time in the Interstices of the Vessels, whereupon the Body of the Glands is tume∣fied, and other times the watry Liquor is carried by the termination of the Spermatick Arteries, inserted into the Membranes enclosing the Testicles, so that sometimes it is lodged between their Coats, and sometimes it destilleth into the Cavity, interceding the other Membranes, and the Scrotum, where∣upon its Confines are unnaturally enlarged.

Learned Dr. * 1.17 Horstius giveth an Instance of both these Hiernias in one Case, Observat. Anatom. 6. upon a Wound in the left Buttock. Nob. Ram∣saeus (ait ille) accepit in sinistrae natis partem superiorem & externam introrsum & deorsum leviter tendens Vulnus, ex quo statim concidit: Huic accessit Vulneri, inter alia Symptomata, sinistri Testiculi, cum Tumore & summo dolore, Inflamma∣tio,

quae tamen post magnam partem sublata, remanente solum levi duritie, rubore & dolore, vocatus deprehendo Herniam, non ventosam, ob defectum flatuum; nec simplicem aquosam, quia Scrotum nec lucidum, nec Aqua turgidum, nec Carnosum simplicem, ob dolorem, sed Herniam ex aquosa, carnosa, & varicosa conflatum: Aquosam quidem inculcat Tumor instar Ovi oblongus, cum Testiculi occultatione quoad tactum & visum: Accedit & hoc quod sinistro lateri aquosae Herniae sunt valde familiares, quod nempe Vena Spermatica sinistra oriatur ab emulgente; Car∣nosae Vulnus ad sinistrae natis partem superiorem vergens ansam dare potuit & cau∣sam; Generatur enim haec Hernia ex sanguine Testes & Scrotum obruente, ibi{que} in molem carneam mutato; cui affluxui Vulnus potuit, ut dixi, ansam dare, ut non solum in Principio statim Testiculi sinistri Inflammatio, sed & Dolor secutus fuerit: suppetias fert Sanguis adustus melancholicus a vitio lienis oriundus, Renis{que} sinistri debilitas: varicosam monstrat dolor, qui exacerbatur in distentione Vasorum Sperma∣ticorum, unde erectionem Penis cruciatus intensisimi comitantur: Omnia incassum Remedia, nam sequenti Mense moritur.

Aperto Corpore, Renum loco portionem pinguem quasi, Lienis vero loco Ovi Gallinacei quantitate nigrum frustum, sanguinis coagulati facie, inveniebamus: Cavitas (circa vesicam) Abdomenis, aqua erat repleta, ut & Scrotum circa sinistrum Testiculum potissimum, dextro longe minorem: Vasa Testiculorum varicum more consistebant; dextri Testiculi substantia spongiosa & putrida, Tunicae{que} adnata erat, in dextra Scroti parte Caro adiposa.

As to the Cure of an Hydrocele, * 1.18 I conceive it proper to advise gentle Hy∣dragogues, and Diureticks, propounded in the Cure of a Dropsie; and af∣terwards Fomentations may be applied, made of discutient and emollient In∣gredients, viz. Bean-flower, Bay-berries, Flowers of Chamomel, Melilote, Elder, of the Seed of Faenugreek, Flax, wilde Carret, Caroways, the Leaves of Penniroial, Calaminth, Wormwood, Centaury the less, Rue, &c. of these Ingredients may be made Ointments, Cataplasms, &c.

And if the Tumor of the Scrotum cannot be discussed, * 1.19 the Scrotum may be opened in the lower part, to let out the watry humours. Gulielmus Fa∣bricius telleth us, Cent. 4. Obs. 66. That John Grigton, a Chyrurgion, did e∣very Year make an Incision in the Scrotum of a Man, sixty Years old, and Cured the Ulcer, by cleansing, drying and consolidating Medicines, where∣upon the Patient lived long, and arrived to great Age by the Art and Care of this learned Chirurgeon.

Another Disease of the Scrotum is called by the Greeks 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, * 1.20 by the Latins, Hernia Ventosa, which is sometimes single, and other times is compli∣cated with a Hydrocele, and is produced by a flatulent matter, transmitted from the Abdomen, and neighbouring parts, by the Process of the Peritonae∣um, into the Cavity of the Scrotum, or by the Spermatick Vessels into the sub∣stance of the Testicles, whereupon their Body is puffed up and distended. This Distemper is more familiar to Children than to those of Riper Years. * 1.21

This Disease may admit a Cure by gentle Purgatives, and by topick Applications of Fomentations, Ointments, Cataplasms, and Plaisters, made of emollient and discutient Ingredients, of which I have given an account in the Cure of the Hydrocele.

The Testicles are also liable to the Hydatides, * 1.22 which are little Bladders full of Lympha, distending their tender thin Coats, and are seated principally in the second Membrane, called Dartus, lodged under the Bursa, or Cod. These Lymphaeducts, if overcharged with thin Liquor, are Lacerated, where∣upon the Cavity of the Scrotum is unnaturally swelled, which is one kind of Hydrocele, in which, as well as the other kind, the Apertion of the Scrotum

is very beneficial (and taketh away the Tumor) except sometimes in an ill Habit of Body, * 1.23 wherein the Testicles are corrupted, and the Scrotum Gan∣greened, of which Learned Dodonaeus giveth an account, in Obs. Medi. 40. In Generoso quodam Viro (ait ille) quam omnis periculi plena sit Scroti, & Ery throidis Membranae in Hydrocele, Scalpello apertio, Teste non sublato compertum est: ab aliquot Annis sinistra parte Hydrocele huic molesta fuerat; frustra ata∣plasmata, ac aliis Remediis usus Crebro, tandem temerarii Chirurgi consilio ac∣quiescens, aperiri sibi Scalpello tumorem permisit: Effluxit cito omnis humor, Tu∣mor quo{que} subsidit; sed cum Testis ipse omnino esset corruptus, vicinas partes fa∣cile infecit: Subsecuta mox Scroti universi, ac etiam Penis, cum Tumore ac in∣genti Dolore, Gangraena: Delirium cum vehementi Febre, propter Doloris magni∣tudinem, supervenit, ac ita non multo post Mors successit.

The same Author giveth an Instance of a Spaniard, * 1.24 who had a violent Pain occasioned by a quantity of Seminal Liquor lodged in the substance of the Testicles, as not Imported by the common Duct, and the deferent Vessels, into the Seminal Vesicles and Prostats. Ait, Hispanus quidam Testis Dolore into∣lerabili diu vexatus, frustra tentatis omnibus, maluit sibi amputari Testem inte∣grum & incorruptum quam diutius in tormentis vitam trahere. Extractum Te∣stem cum adhuc calentem per medium Dissecarem, in faciem ipsius erupit & pro∣siliit Semen.

The Testicles are also highly affected with Tumors in Gonorrhaea virulenta, * 1.25 caused by an undue suppression of the tainted Semen, or rather purulent matter, upon the taking of astringent Medicines, whereupon the corrupted Semen, or rather Ulcerous matter, is detained in the Substance of the Glands relating to the Testicles, * 1.26 when the Seminal Vesicles and Prostats are filled with putrid matter, which seeing it cannot be discharged by the Ure∣thra, must of necessity clog the Seminal Vessels, and common Duct of the Testicles, whereupon their Dimensions grow very much enlarged to a mon∣strous magnitude.

As to the Cure of this Venereal Disease, it denoteth opening and Diure∣tick Medicines of Venice-Turpentine, mixed with proper Purgatives, and a Diet-drink of Sarsa, China, Lignum Sanctum, &c. as also Medicines procu∣ring Salivation, which taketh away the malignity of this Distemper; and in point of the Ulcer of the Testicles, Seminal Vessels, and Prostats, healing, cleansing, drying and astringent Medicines are to be advised, which, after the Blood is refined, and the Seminal Liquor rectified, do perfect the Cure.

Notes

• * 1.1

  The Inflam∣mations of the Scrotum and Testicles.
• * 1.2

  The Inflam∣mations of the Genitals is at∣tended with a Symptoma∣tick Fever.
• * 1.3

  A Vein is to be opened in the Inflamma∣tion of the Genitals.
• * 1.4

  Repelling Me∣dicines may be applied af∣ter bleeding.
• * 1.5

  Suppurating Medicines are to be used when Tumors cannot be Cu∣red by repel∣ling nor discu∣tient Applica∣tions.
• * 1.6

  The Tumors of the Scro∣tum called E∣piplocele and Enterocele.
• * 1.7

  The Epiplo∣cele.
• * 1.8

  The Entrocele.
• * 1.9

  The Cure of an Enterocele.
• * 1.10

  Astringents are to be ap∣plied in an En∣terocele, after the Guts are reduced.
• * 1.11

  Astringent de∣coctions are proper in an Enterocele.
• * 1.12

  Sarcocele.
• * 1.13

  The cause of a Sarcocele.
• * 1.14

  The Cure of a Sarcocele.
• * 1.15

  Hernia Vari∣cesa.
• * 1.16

  The Tumor of the Scrotum called Hydro∣cele.
• * 1.17

  An instance of a Hernia vari∣cosa and Hy∣drocele.
• * 1.18

  The Cure of an Hydrocele may be per∣formed by gentle Hydra∣gogues, and Diureticks, & afterwards E∣mollients and Discutients may be appli∣ed.
• * 1.19

  The Scrotum may be open∣ed if a Hydro∣cele cannot be discussed.
• * 1.20

  Hernia ventosa.
• * 1.21

  The Cure of the Hernia Ventosa.
• * 1.22

  Hydatides.
• * 1.23

  The Scrotum may be open∣ed in a Cor∣rupted Testi∣cle.
• * 1.24

  A great Pain Produced from Seed lodged in the Testicles.
• * 1.25

  The Testicles highly affect∣ed in a Go∣norrhea.
• * 1.26

  The Glands of the Testicles disordered by Astringents, unduly sup∣pressing the evacuation of Seed in a Go∣norrhea.