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
Catalogue details

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 discharge is not different; the pain is more itching than otherwise, hut this characteristic, though often well appreciated by the patient, is too slightly marked for us to attach much importance to it. The urinary jet is not diminished by the herpetic plates, and the bullet bougie does not give evidence of their existence: the first of these signs is absent in commencing blenorrhoea, and the second is so slightly marked that its absence should not affect the diagnosis. In fine, these symptoms, interesting in the study of the disease, cannot enable us to diagnose between the different species of discharge, if the endoscope did not aid us in the discovery of the blennorrhcea. In our last lesson, we saw that blennorrhagia, in its chronic state, fixes itself in the bulbo-membranous portion of the urethra, and that the mucous membrane of the diseased part, at first simply unpolished, soon becomes rough and uneven; these ine- qualities increase, multiply, and, in the end, become more prominent, and granulations are formed. Then the diseased portion presents a surface dark red, uneven, sown with rounded granulations, sometimes separated far apart, and then at other times so nearly together as to cover the entire diseased surface. The membrane, at this point, presents the appearance of a mul- berry, according to the spontaneous remark of one to whom I showed the lesion, as well by reason of its color, as on account of its granular aspect. The granulations vary in size from a grain of mustard seed, to that of a grain of millet, or even still larger; the smallest seem to be of more recent origin. In the cases we are now speaking of, the lesion confines itself to the bulbous and membranous portions of the canal. They constitute what we may call granular urethritis, which shows some resemblance to granular metritis, and still more to granu- lar conjunctivitis, owing, doubtless, to the fact that, in anatom- ical disposition and vital condition, the urethral membrane more nearly resembles the conjunctiva than the membrane of the uterine neck. It is impossible, when we examine these three affections, not to perceive a similar lesion in all, the expression of a like malady in three different organs. The granulations