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
(a) Patients suffering from pain resulting from
disease of the testis.
(b) Testicular pain sensation in various clinical
(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
(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
(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.