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for every trifling alteration of form or change of structure. I have made inquiries on the subject, and have examined carefully various preparations. In some, cysts are formed behind the testis; others in the fore part, projecting into and covered by the reflected tunica vaginalis, and no doubt by the tunica albuginea also; other, and in some instances numerous cysts are seen above the testicle—multilocular hydrocele of the chord. There is one specimen which, through the kindness of our President, I had the opportunity of examining, which seems to throw more light on the subject than any other which I have seen. The description of it is copied from the catalogue of preparations in the collection belonging to the Bartholomew Hospital School. There is no history attached, and no account of how it was obtained.
"Testicle with part of the spermatic chord; along the epididymis there is a series of membranous cells communicating together, and having for their outer boundary the tunica vaginalis, and its reflexion between the testicle and epididymis. These cells contained a transparent and colourless fluid. A bristle is passed beneath the vas deferens near its connexion with the epididymis."
Here the sac is closely connected with the epididymis, if not an actual dilatation of its lesser head*
* There is also a preparation in the collection of Mr. Bransby Cooper, in which a cyst is seen connected with the upper part of the epididymis, pushing the tunica albuginea of the testis before it, and projecting into the cavity of the tunica vaginalis. Mr_
This subject deserves further investigation, to discover, first, if the limpid fluid drawn from cysts of the scrotum and inguinal region, uniformly or often contains spermatazoa.
Secondly, what connexion subsists betwixt the seminiferous tubes and their cysts.
Thirdly, whether or not dilatation of parts of the epididymis or vas deferens, obstruction or otherwise, may not, in some instances, give rise to these collections.
If so, this being a pouch lined by mucous membrane, we should have an easy solution of the difficulty regarding a radical cure, not following injection as in the serous cyst. The microscopic examination of the lining membrane of a recent cyst would easily settle the nature of the secretory surface.
RS.—The preceding observation has been confirmed by examination of the fluid from a small cyst above the testicle of a man aet. 53.
He applied to be treated for bad stricture of the urethra, which had frequently given rise to retention of urine.
The fluid of the hydrocele, in this case, was
Cooper punctured this cyst, and drew off three or four ounces of limpid fluid, which contained scarcely a trace of albumen. The patient died of pneumonia a few months after the operation, and the preparation being obtained, showed the sac somewhat contracted, though gradually refilling.
nearly transparent and colourless. It was found, on examination, to contain numerous spermatazoa, some of which continued to move actively for some considerable time after the fluid was drawn from the cyst.
This was made manifest to some practitioners who were present, and to many of the pupils of the hospital.
WHICH PREVAILED AT TEHERAN, IN THE MONTHS OF JANUARY AND FEBRUARY 1842.
IN A LETTER TO GEO. JOS. BELL, M.D.,
TRAVELLING FELLOW OF OXFORD.
By C. W. BELL, M.D.,
ATTACHED TO H. B. M.'s MISSION AT THE COURT OF PERSIA.
Communicated By ALEXANDER SHAW, Esq.
READ MAY 23rd, 1843.
Teheran, 22nd Feb. 1842.
I Have had much trouble and anxiety of late, with a very curious new disease, which made its appearance in our neighbourhood, and thence spread to different parts of Teheran.
It occurred nearly simultaneously with an anomalous complaint in Baghdad, and was, probably, analogous. This, I understand, has been described by Dr. Ross, of Baghdad, in a report (which I have not seen) under the title of epidemic angina pectoris. I give you, however, an extract from his letter to me on the subject, dated Baghdad, Dec. 30, 1841 :— "We have got a most curious disease raging here, just now, more like angina pectoris than any thing else. But it proves fatal in an hour or two. In fact, though eight or ten of my personal friends have died from it, I have not yet been in time to see a case while life remained. You knew several of them while here. Old Mahomed Aghaiba, Chederakee, Ismael Beg, &c."
The only thing that I have to remark of that disease, before proceeding to a detail of cases, is, that in the one I am about to describe, the fits appeared to be always accompanied by a nervous excited action of the heart and arteries, periodical, but neither preceded by chill nor succeeded by perspiration. Those who suffered from numbness and sleeping of the hands and feet alone, had always more or less palpitation of the .heart, at the same time, sometimes amounting to pain.
The first patient I saw, which was a short time before the receipt of Dr. Ross's letter, was Syad Khan, who happened to be my neighbour. Having stomach-ache, to which he was subject, he took ten drops of the oil of peppermint, instead of the spirit which he was in the habit of taking, and it produced inflammation of the stomach. I applied 30 leeches to the epigastrium, by which, and other means, the inflammation was subdued. He was convalescent and in good spirits, only considerably reduced in strength, when he was suddenly attacked, about ten at night of the 20th of January, with a fit resembling epilepsy; became insensible, and died in half