Weird Science is going up late this week, sorry guys. But it’s weird science AND historical science, which makes it double cool.
Also, NEW site from Zooillogix, and it’s the CUTEST THING EVER. Called zooborns, you just want to cuddle everything on the site. It will definitely cheer you up after a bad day.
So I like this paper partially because it reminds me of a guy I knew in college. He was telling me one time of the funny exploits he had in high school. Apparently there was a period where he would walk down the hall with his friend and spontaneously say, loudly “YEAH, THE DOCTOR SAYS IT’S ELEPHANTITIS OF THE LEFT TESTICLE.” I thought this was hilarious. Were I a guy I would totally have done this. Unfortunately, walking along the hall and yelling out “yeah, it’s elephantitis of the left OVARY” probably wouldn’t get as good a response.
With that preamble, here it goes.
Perkins, GW. “Double consecutive castration for primary tuberculosis of testicles.” Annals of surgery, 1889.
I suppose this paper continues my current fascination with all things TB. Most people think of tuberculosis as infecting only the lungs, but in fact it infects almost every part of the body (when paleomicrobiologists look for evidence of TB in skeletons, they actually look for characteristic bone lesions, which make your bones look like swiss cheese). Of course pulmonary TB is most common, accounting for about 70% of cases. Sometimes, people will get pulmonary TB and then it will spread or move to other parts of the body, though this usually only happens in immunosuppressed patients and young children.
This paper covers a 32 year old freight conductor who came to see the doctor in 1887. He apparently was entirely healthy and had no venereal disease or anything, but for about two years he had noticed that his left ball was swelling. A lot. He finally went to the doctor about it because he could no longer walk well enough to do his job. The author described the testicle as being about 5-6 times its normal size, and lessee, normal testicle size is what…about 18 square 18, and 5-6 times that is 90-108 square cm, which is about 16 inches square, which is one HUGE testicle. How big is 16 inches sq? I think it’s about the average size of a little decorative sofa pillow. Or a small footstool. And he had that thing hanging off him for MONTHS.
The doctor recommended castration. The man said no way. The doctor tapped the testicle and got some fluid out, and sent him home. But the man came back a few months later, completely unable to work, and with no libido whatsoever. He finally agreed to get the testicle removed. The operation went well (the doctor referred to antiseptic dressing), and when dissected, the author found that the testicle was full of little “cheesey masses” which were anywhere from 1/4 inch to 3/4 inch, and the larger ones breaking down in the center. He confirmed it as TB, but didn’t do a search for bacteria. The patient made a full recovery, and the doctor notes that he didn’t notice any symptoms in the right testicle.
But a few months later he was back. Now the RIGHT testicle was swelling, and fast enough that he could actually see it. This time the patient himself demanded castration, because he was practically sterile, and unable to support his family because he couldn’t work. So they had to take out the right testicle, and sure enough, it was also filled with “cheesy masses”, though not nearly so bad as the left one had been. The man made a full recovery and by 1889 apparently was just fine.
The doctor diagnosed this as two independant instances of testicular TB. I disagree, but then I’m not a doctor. He thought that there had been no transmission from the left to the right testicle, because he didn’t notice symptoms in the right testicle when the left was removed. But I think he would have seen something very different if he had done a biopsy (not that he could). I imagine the TB (if it was TB) was already starting to work on the right when the left was removed.
And I’m not so sure it was TB. Since TB rarely spreads from the lungs unless you’re immunocompromised, I think it’s more likely that this guy had testicular cancer, especially since the testicles were full of small masses, which could have been tumors. Additionally, when some tumor masses get large and are unable to recruit adequate blood flow, they can start to die in the center, like the doctor saw in the left ball. But then again, I am NOT a doctor. And I don’t know a lot about testicles. Neither do I know a lot about the prevalence of testicular TB.
So next time you’re walking down the hall of your high school, make sure you yell out “YES, THE DOCTOR SAYS IT’S TB OF THE LEFT TESTICLE”
G. W. Perkins (1889). Double consecutive castration for primary tuberculosis of testicles Annals of Surgery, 10 (3), 169-170