Section Ii. of the Scrotum.

=Hypertrophy.= Common hypertrophy of the integument of the corium sometimes occurs; in this there is no alteration of the subcutaneous tissue.

In Elephantiasis of the scrotum, however, the epidermis, the corium, and the subcutaneous areolar tissue, are all, especially the latter, greatly hypertrophied. The areolar tissue is converted into a large mass of fibrous material, infiltrated with an albuminous and fibrinous fluid. “When the disease is confined to the scrotum, and the enlargement becomes great, the penis becomes drawn in and ultimately disappears, while the elongated prepuce is continuous at a navel-like opening in the skin of the surface of the tumor.” The enlargement sometimes is enormous, such a mass having been known to weigh two hundred pounds, more than the weight of the rest of the body.

=Inflammatory Œdema= of the scrotum is an erysipelatous inflammation of this region, giving rise to great effusion into and swelling of the areolar tissue, with a tendency to the rapid formation of a slough, by which the integument may become so affected as to leave the testes and cords entirely denuded. A peculiar form of this disease occurs as a sequence of small-pox and scarlet fever. Here there is a tendency to speedy gangrenous disorganization of the areolar tissue, and of the covering of the generative organs.

Morbid Growths.

Cancer. Epithelial cancer is the common form under which it attacks the scrotum. This disease has appropriately been called chimney-sweeper’s cancer, as it appears to arise from the irritation of the soot lodging in the folds of the scrotum. It commonly commences as a tubercle or wart, which, after a time, cracks or ulcerates. It spreads rapidly, involving at last the greater part of the scrotum, and sometimes invading the testes, even extending to the groin and thigh, destroying life by perforating the coats of some of the large vessels. The glands of the groin are not always affected.

Melanotic cancer of the scrotum has been observed.

Fibrous tumors are sometimes developed in this part, and may form a large mass when several are grouped together.