The endoscope, and its application to the diagnosis and treatment of affections of the genito-urinary passages : lessons given at Necker Hospital / by A.J. Desormeaux ; translated by R.P. Hunt.

  • Desormeaux, A. J. (Antonin Jean), -1894.
Date:
1867
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Licence: Public Domain Mark

Credit: The endoscope, and its application to the diagnosis and treatment of affections of the genito-urinary passages : lessons given at Necker Hospital / by A.J. Desormeaux ; translated by R.P. Hunt. 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 endoscope. In withdrawing the instrument and following the axis of the canal, the mucous membrane can be seen to contract upon the end of the sound, but when these pleats form after the urethra has lost its elasticity, they are at a certain distance from the instrument. Thus the walls of the urethra, in closing, form a funnel, the summit of which is truly pleated like a (cul de poule) pullet's tail. These pleats are not so regular as anatomists generally state them to be; their number and disposition is irregular, they vary according to the direction of the sound, and by pressing the sound upon different points of the urethral circumference, this linear contraction can be caused in the part pressed. It is necessary to be familiar with the manner in which the urethra closes over the sound, for if it does not do so uniformly and regularly, avc must believe that there is a pathological altera- tion, by which the suppleness of the walls of the urethra is impaired. Now that we know the normal condition of the urethral mu- cous membrane, as shown by the endoscope, we can investigate the diseases of the same membrane. Let us commence by acute urethritis, a disease which plays an important part in urethral pathology, and which may, in some means, be consid- ered as the father of many complaints. Writers have frequently confounded urethritis with Menor- rhagia, this, I think, is a great error. Urethritis is a disease, an inflammation, produced by many causes. Blenorrhagia is a disease produced by a special or specific cause, and transmissible contagiously, always preserving its peculiar characteristic of transmitting effect to cause, or, if you wish, cause to effect. Blennorrhagia being more frequent than all other urethrites may possibly be the cause of all the confusion existing in this diagnosis. Now we must state that, according to the symptoms alone, the difference is slight, and only found out in the march of the disease, and its cause, when chronic and when the lesions are consecutive. So long as the acute stage continues inflam- mation dominates and masks the peculiar characteristics of each affection.