Observations on visceral pain with special reference to pain originating in the testis

1. Visceral pain in general is discussed, special reference being made to pain originating in the testis, to the nerve supply and to the development of the testis in the light of the various theories mentioned.2. Case reports are summarised especially with reference to: (a) Patients suffering from pain resulting from disease of the testis. (b) Testicular pain sensation in various clinical states. (c) Patients suffering from hydrocoele of the tunica vaginalis testis who were investigated to determine their ability to detect pain arising in the tunica.3. After study of these cases and the evidence available in the literature, the following conclusions are reached: (a) Early in the pathological process pain arising in the testis is referred to the lower abdomen or groin and not to the scrotum. (b) Ignorance of this fact may well account for the late diagnosis of such lesions as torsion of the testis. (c) The tunica vaginalis testis is not supplied by the genito-femoral nerve and indeed the tunica itself appears to have no afferent supply which responds to the stimuli used. (d) Capps' (1932) theory of the sensitivity of the peritoneum may not be valid. (e) The afferent pathway of testicular pain appears to enter the spinal cord over a number of spinal segments, Thoracic 10, 11 and 12 being the most common. (f) Raising of the pressure within the testis is a stimulus which evokes pain. (g) The theory of Cohen (1947) regarding the summation of visceral and cutaneous afferent impulses and that of Ruch (1949) regarding the sharing of a common spino-thalamic secondary afferent neurone for these impulses, are supported by the evidence presented. (h) The theory of Brown (1942) that the site for reference of pain can be explained by the primitive embryological position of the viscus concerned is also supported by the evidence presented

Volume 20, issue 4

The mission of CJS is to contribute to the effective continuing medical education of Canadian surgical specialists, using innovative techniques when feasible, and to provide surgeons with an effective vehicle for the dissemination of observations in the areas of clinical and basic science research. Visit the journal website at http://canjsurg.ca/ for more.https://ir.lib.uwo.ca/cjs/1148/thumbnail.jp

Volume 05, issue 4

The mission of CJS is to contribute to the effective continuing medical education of Canadian surgical specialists, using innovative techniques when feasible, and to provide surgeons with an effective vehicle for the dissemination of observations in the areas of clinical and basic science research. Visit the journal website at http://canjsurg.ca/ for more.https://ir.lib.uwo.ca/cjs/1061/thumbnail.jp

Volume 02, issue 1

The mission of CJS is to contribute to the effective continuing medical education of Canadian surgical specialists, using innovative techniques when feasible, and to provide surgeons with an effective vehicle for the dissemination of observations in the areas of clinical and basic science research. Visit the journal website at http://canjsurg.ca/ for more.https://ir.lib.uwo.ca/cjs/1043/thumbnail.jp

Volume 01, issue 3

The mission of CJS is to contribute to the effective continuing medical education of Canadian surgical specialists, using innovative techniques when feasible, and to provide surgeons with an effective vehicle for the dissemination of observations in the areas of clinical and basic science research. Visit the journal website at http://canjsurg.ca/ for more.https://ir.lib.uwo.ca/cjs/1040/thumbnail.jp

A general hospital experience of polymyalgia rheumatica and giant cell arteritis

Imperial Users onl