Page:Tropical Diseases.djvu/778

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726
FILARIASIS
[CHAP.

Anatomical characters.—There are certain points in the anatomy of scrotal tumour which the operating surgeon must bear in mind. These tumours consist of two portions (Fig. 121): first, a dense rind of hypertrophied skin (A e), thickest towards the lower part and gradually thinning out as it merges above into the sound skin of the pubes, perineum, and thighs; second, enclosed in this rind, a mass of lax, blubbery,

Fig. 120.—Elephantiasis of scrotum; left leg slightly affected.
(Photograph by Dr. Turner, Samoa.)

dropsical, easily-torn-through, areolar tissue in which testes, cords, and penis are embedded. The shape of the tumour is more or less pyriform. The upper part, or neck, on transverse section (B) is triangular, the base (B k) of the triangle being in front, the apex (B j)—usually somewhat bifid from dragging on the gluteal folds—towards the anus, the sides (B h) towards the thighs. In the latter situation the skin, though usually more or less diseased, is, from pressure, softer and thinner