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with the microscope the fluid taken from hydroceles. I have made the examination in about thirty cases, and in two of them the fluid was ascertained, as in the former case, to contain living spermatozoa.
The next case was met with a few weeks after that which is stated above.
The patient was a widower, ætatis 63. He had had hydrocele for many years, and I had previously operated on him 15 or 16 times. The disease was on the left side. The testicle of the other side was perfectly healthy.
On this occasion I drew off sixteen ounces of fluid, of a greenish yellow colour, and so albuminous as to be quite adhesive.
The moment my patient had left me, I examined the fluid with the microscope, using the same magnifying power as in the former case, and at once perceived numerous living spermatozoa swimming about in every direction. A friend of mine who was in the house at the time, and who was familiar with the appearance of spermatozoa, examined them with me; and we continued to watch them for nearly three hours, during which time they were actively moving about. Some died sooner than others, but we left many of them in full play. They seemed to die as the fluid between the glasses on which they were placed, evaporated, those nearest the centre continuing longest in an active state ; and as they died, there was visible in them a heaving, an expansive motion, as if in the last extremity they were gasping for breath. It was impossible fairly to compare the motion to anything else. They evidently possessed the power of changing their form; they would at one time materially elongate, and at another time shorten their bodies. In their vigorous state their movements were very similar to that of a common tadpole.
In the fluid of this case there were likewise a few blood globules, transparent cysts, and small granular bodies ; also portions of epithelium, or what very much resembled it.
The 3rd case occurred in a man, of the age of 65, one of my hospital patients, and in whom the disease had existed for about twelve months. It commenced immediately after the testicle had been violently squeezed by an enraged and drunken man who was fighting with another, and whom my patient was endeavouring to separate.
The situation of the fluid appeared to be very much that of common hydrocele of the tunica vaginalis, and after the operation had been performed there was nothing peculiar to be observed in the testicle or its appendages. There were about four ounces of fluid abstracted, which was of paler colour than is usual in hydrocele, and displayed very much the appearance described by Mr. Liston as exhibited by the fluid of the encysted hydrocele, in which he had discovered spermatozoa. But in one respect it differed from that, as it contained a considerable quantity of albumen. There was also found in it much saline matter ; but the precise nature and proportions of which were not ascertained. The spermatozoa met with in the fluid were very numerous, and were seen in a living state, not only by myself, but also by Mr. F. Wood, surgeon, of Brownlow Street, and Mr. John Quekett, of the College of Surgeons
In this, as in the former cases, the fluid contained a few blood globules, transparent cysts, spermatic granules, and scales of epithelium.
This patient has been tapped a second time, and the fluid presented the same appearances as on the first occasion. It was examined, not only by myself, but also by Drs. Burrows and Russell, as well as by Messrs. Lawrence, Stanley, Paget, &c.
At present I am unacquainted with any facts that will satisfactorily account for the circumstances under which the spermatozoa in the preceding cases departed from their natural abode, and acquired a “ local habitation" in the situation in which they were discovered ; but the probability is, that the cases will be presented to me again, when I shall have an opportunity of further investigating the matter.
It may, however, be as well to state here, that the testicle having been wounded in the operation, would in no way explain the fact, for spermatozoa fully formed, and in an active state, are rarely met with in the human testis, and even in the epididymis or vas deferens there never exist, at one time, as far as I have had opportunities of judging, sufficient spermatozoa to yield anything like the vast number that were present in the cases of hydrocele adduced
above. In two cases of abscess communicating with the epididymis, which I have had under my observation lately, one of them a patient of Mr. Lawrence, in St. Bartholomew's Hospital, there have passed off very few spermatozoa. Spermatic granules have come away in great number.
REMARKS ON INSANITY.
BY JOHN WEBSTER, M.D.,
CONSULTING PHYSICIAN TO ST. GEORGE'S AND ST. JAMES'S DISPENSARY, &e.
READ JUNE 27TH, 1843.
The subject of insanity, at all times an interesting matter of inquiry to medical men, has of late engaged so much attention, and there prevails such a general desire for information respecting the disease, especially when any additional facts are brought forward in its illustration, that I am led to believe a statistical report of the principal occurrences met with at Bethlem Hospital, during the last and present century, may be of some use, particularly if the tables are so arranged as to give as well the number of admissions as the deaths, and the proportion of patients reported cured, during different periods, but of the same comparative duration. These classified statements are accompanied by a few general remarks on insanity; and, lastly, an account is