Senium Praecox

SENIUM PRAECOX. The vas deferens is supplied from the hypogastric plexus. Along the vas deferens, the nerves form a rich plexus of branchlets. The vas deferens is covered by a thin adventitia, a sheath consisting of connective tissue and elastic fibers; beneath it lie three layers of smooth musculature: external and internal longitudinal, and a middle circular one. The lumen of the vas deferens is lined by a mucosa with two layers of cells: a superficial cylindrical one and a deep cubic one. On transverse section, the mucosa of the vas deferens is folded, which is particularly prominently expressed in the region of the ampulla. The physiology of the vas deferens boils down to conducting semen from the epididymis, which is achieved by peristaltic movements of the musculature of the vas deferens. The independent movement of spermatozoa plays a small role. In pathological cases, antiperistaltic movements of the vas deferens are possible, which promotes the penetration of infection from the posterior part of the urethra to the epididymis. Pathological changes in the vas deferens can be of a congenital character; this includes the complete absence of the vas deferens and the obliteration of its lumen. Acquired changes are associated mostly with diseases of neighboring organs: the epididymis or seminal vesicles, prostate gland, and posterior urethra. Inflammation of the vas deferens—see Deferentitis. Therapeutic measures of a surgical character—see Vasostomy, vasotomy, vasectomy, vasoligation, vasopuncture. The operation of vaso-testiculoneostomia, proposed by Razumovsky and developed by Bogolyubov, is performed to restore the patency of the seminal ducts during resection of the epididymis in its tubercular lesion. It is applicable in those cases where there is a full guarantee of the absence of a tubercular process in the corresponding seminal vesicle and prostate, and also provided there is a sufficient length of the stump of the vas deferens after excision of the epididymis. The end of the stump of the vas deferens is split in the longitudinal direction for a distance of 0.5–1 cm and sutured with fine catgut sutures to that part of the testis where the head of the epididymis was severed, i.e., to the rete and ductus efferentes testis. Suturing can be performed with the implantation of the stump ofência of the vas deferens into the parenchyma of the testis.

V. Ilyinsky.

SENIUM PRAECOX, premature oldage. In psychiatry, this term is applied to cases where individuals who had developed normally up to a certain age, and sometimes even presented phenomena of early awakening and a bright but brief flourishing of mental powers, long before the onset of the age in which the phenomena of regressive development of the organism usually begin, show features characteristic of the onset of old age: emotional fading, especially in the psychosexual sphere, decrease in initiative, limitation of the range of interests, and also, in connection with the joining early general and cerebral arteriosclerosis, a noticeable weakening of memory and intellect. Close to the phenomena of senium praecox are cases of early decline of creative powers in some talented people who in youth showed great productivity, but quickly exhausted themselves and throughout their further life did not rise above the level of mediocrity (among writers and artists—the so-called "authors of one work"). A significant difficulty is the differentiation of senium praecox from the phenomena of mildly progressing schizophrenia in cases where it is not accompanied by clearly expressed psychotic symptoms. The main differential signs here must serve the presence or absence of such symptoms of initial states of schizophrenia as violation of the integrity of personality, stereotypies, and so on. Literature—see literature to the article Progeria.