Practical surgery : with one hundred and twenty engravings on wood / by Robert Liston.

Date:
1837
Catalogue details

Licence: Public Domain Mark

Credit: Practical surgery : with one hundred and twenty engravings on wood / by Robert Liston. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    can occasionally be remedied; attempts have been made by per- forating the glans in the course ot the natural canal, and by the insertion of a tube, to carry forward the current and elongate the urethra permanently; this method does not answer; there is a want of substance in the part, and sloughing is generally the con- sequence of the attempt. I have sometimes succeeded, and in cases where other means had been tried unsuccessfully, in pro- tecting the exposed and irritable lining membrane of the passage, and carrying that forwards to the apex of the organ by turning back a portion of the prepuce and uniting it without any twist, the lining membrane presenting outwards; patients have been thus relieved from the frequent calls to make water, the nocturnal emissions, and other unpleasant consequences. twenty-three years of age when he applied for relief; he wished at first to make it appear that the affection was the result of in- jury ; but after submitting to an operation, which w^as most per- fectly successful, he acknowledged that it was a connate deficiency, and attributed it to some impression made upon his mother’s ima- gination. The operation consisted in paring the edges thoroughly, and putting them together over a catheter, by the introduction of many points- of twisted suture. I saw the patient some years after the operation, and touched for him, with a heated needle, a very minute fistulous opening near the pubes, through which not more than a drop of urine oozed during micturition ; this had the desired effect, and the organ was then, as he stated, in all respects and for all purposes as perfect as he could desire. The prepuce, when deficient or short, may be supplied or elongated, as recom- This deficiency, epispadias, is very rarely met with; the subjoined sketch represents a very complete instance of it; nearly four inches of the urethra w^ere exposed, the mucous membrane not being much changed, perhaps a little paler, and with its lacunae beauti- fully perfect. The man was about