A practical treatise on the causes, symptoms, and treatment of spermatorrhoea / by M. Lallemand ; translated and edited by Henry J. McDougall.

  • Lallemand, F. (François), 1790-1853?
Date:
1848
Catalogue details

Licence: Public Domain Mark

Credit: A practical treatise on the causes, symptoms, and treatment of spermatorrhoea / by M. Lallemand ; translated and edited by Henry J. McDougall. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    % The Prostate double its normal size and projecting into the rectum; hard on the sides of the neck of the bladder, soft in the centre. Its fibrous envelope having been divided with a bistoury, an opaque, thick, ropy, elastic matter escaped, like pus in colour, and the mucus of the nostrils in consistence. There was a cavity occupying the whole of the anterior and middle parts of the prostate, about fifteen lines in size in every direction, when the purulent matter had been removed; the gelatinous mass was observed to divide into a number of filaments which became impacted in numerous small foramina; the canal of the urethra being closed, these filaments came out by the openings of the mucous follicles of the prostate. When this cavity was emptied it became evident that the two inferior thirds df the prostatic part of the urethral mucous membrane had been detached and had covered the cavity in the prostate in the same manner that the cribriform lamella of the ethmoid bone covers the nasal fossae in the dried skull. The openings of the Ejaculatory Duds in place of being circular and nipple shaped, formed a long slit, which was ulcerated, especially on the side towards the bladder; two probes of considerable size introduced through the vasa deferentia passed easily through these openings. The ejaculatory ducts were long and thin, as though dissected, and formed part of the superior wall of the cavity in the prostate. The posterior border of the prostate was not destroyed but was pale, soft, and easily torn, like all the parts in the neighbourhood of the principal abscess. The Urethra presented no remarkable appearances. The Testicles were small, flaccid, and pale. I leave this case just as I wrote it when under impressions formed at the time, because its recital is well fitted to show those serious errors in diagnosis, which are much more common than might have been suspected. Now that we have seen the more obscure parts of this case cleared up by degrees, let us consider the chronological order of the facts:— An urethral discharge, badly treated in the beginning, reappeared from very slight causes, whose action, however, was easily appre- ciable. The follicles of the prostate from repeated attacks of inflam- mation, became disorganized; the ejaculatory ducts were laid bare, and their orifices became ulcerated; the inflammation extended to the seminal vesicles, and the peritoneum adjoining. Soon after, a new train of symptoms set in, which became much aggravated after the patient's marriage, in consequence of the unac- customed exercise of the disordered organs. Ejaculation was rapid, because the ejaculatory ducts were in a state of irritation. The erections were incomplete, and at length ceased altogether, because the semen was habitually expelled as soon as secreted. This dis- charge was considerable, for the testicles shared the irritation of the other parts. During all this time inflammation was creeping along the urinary apparatus, and ended by destroying the right kidney. Hence the symptoms observed previous to death; hence the very remarkable appearance of the urine, an excretion, to whose changes sufficient importance is not attached at the present day, from its exa-