On erysipelas of the kidney and urinary tract : with some remarks on the disease generally called surgical kidney / by James F. Goodhart.

  • Goodhart, James Frederic, 1845-1916.
Date:
[between 1880 and 1889?]
Catalogue details

Licence: Public Domain Mark

Credit: On erysipelas of the kidney and urinary tract : with some remarks on the disease generally called surgical kidney / by James F. Goodhart. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    saved, or have life prolonged, let us hope, to use their brains for the benefit of their fellows. The preventive treatment may be carried out under two different conditions, that is to say, by anticipating the chance of decomposition of the urine, or by destroying the putrefactive property when it has arisen, and curing the cystitis which such a state has caused. To ensure the first, it has been proposed to use carbolized oil in place of the common oil when lubricating catheters previous to their passage, and to this I have only to add that in all cases where it is necessary or advisable to retain an instrument in the bladder, in case of paraplegia, enlarged prostate, &c., it would surely be not too much to ask that the same method should be adopted as is used in paracentesis thoracis, viz. that an india- rubber tube should be attached to the catheter as soon as the latter has been passed, and the urine then be allowed to drain away under water, the free end of the tube being immersed in some disinfectant fluid by the bedside. In the other class of cases, where the bladder is already inflamed and the urine decomposing, we have to aim at the complete evacuation of the urine and an adequate disinfection of the bladder. To accomplish these ends is not easy. The disinfectants in vogue at present, or rather as at present used, are utterly incompetent, I believe, for the purpose, from the fact that they can only be used in diluted solutions, and are only temporary in the benefit they impart. To make their applica- tion of permanent service some means must be devised for their constant contact with the diseased surface, though it is diffi- cult to see how this can be effected. There can be little doubt that, could it be performed without setting up inflammation, the best thing in many cases would be to lay open the bladder by the median or lateral lithotomy incision, taking care by this means that the urine should run away as it formed. This cannot be done, however, because, as I think statistics show, operations about the bladder considerably enhance the probability of the occurrence of suppurating kidney. Thus, though we may see that where the bladder is closely contracted, or thoroughly drained by a fistulous opening, disease of the kidney is less liable to occur, we are unable to take advantage of this plan of treatment. Failing this, it is indeed difficult to