Genito-urinary surgery and venereal diseases / by J. William White and Edward Martin.

  • White, J. William (James William), 1850-1916.
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: Genito-urinary surgery and venereal diseases / by J. William White and Edward Martin. Source: Wellcome Collection.

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    on '^eneral principles,-rest, elevation, pressure by narrow gauze bLclages, the application of evaporating lotions, and, for the purpose nf hn^tening absorption, general massage. Exten swelLg and discoloration need not occasion anx.ety, unless there has been rupture of the spongy or cavernous bodies or of the urethra. When gangrene is threatened on account of the ev rity of the lesion or because of interference with circulation oc- alioned by the pressure of effused blood, hot antiseptic fomenta- tTons frequently repeated are indicated. These dressings are made by wr nging fifteen or twenty layers of antiseptic gauze out of a hot 1 to 10,000 bichloride solution. They may be covered with waxed paper to prevent evaporation. If the symptoms are still Zgreslve, free incision and ligation of bleeding vessels, followed by suture of the wound, are indicated. Emphysema is always a serious symptom, and usually calls for free incision, as it probably results from infection with saprophytic organisms m addition to those of suppuration. _ . . . ij On the first sign of suppuration after contusion, mcision should be made sufficiently free to secure thorough drainage. Wounds of the Penis.—These are classified according to gen- eral surgical principles as incised, lacerated, punctured, and contused. Incised wounds, if superficial, are readily closed, and heal qmckly. Deep wounds, that is, those involving the erectile tissue, bleed freely, and, if-transverse and extensive, are liable to be followed by loss of erectile power in the tissue lying anterior to the wound. When the penis is completely divided, hemorrhage is so rapid that, unless it is promptly arrested, a fatal issue is probable. Treatment—The treatment of these wounds is conducted on gen- eral principles. Violent hemorrhage is checked by ligatures: the sur- faces are brought in apposition and held there by sutures passed through the fibrous sheath of the erectile tissue, but no deeper. This simple fixation is usually sufficient to stop the venous oozing. If not, a stiff English catheter is passed into the urethra, and a pressure bandage is applied for some hours. Inflammatory reaction always excites erection. This interferes with primary healing, and should be prevented by full doses of bromide {m daily), by opium and bella- donna suppositories, or by hypodermics of morphine. Even if the penis is almost completely severed, hanging by a small strip of tissue, an effort should be made to suture it in place. When the penis is completely cut off, the bleeding vessels are tied, the cavernous bodies are covered in by suture of their fibrous envelopes, the skin is drawn forward and sewed over the closed ends of the corpora cavernosa,