A memoir on stricture of the urethra / by John P. Mettauer.

  • Mettauer, John Peter, 1787-1875.
Date:
1849
Catalogue details

Licence: Public Domain Mark

Credit: A memoir on stricture of the urethra / by John P. Mettauer. 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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    t)ii horse back, variable temperature, sexual intercourse, cr what- ever may tend to irritate the urethra. Most commonly in this stage, the puruloid discharge becomes more copious, arid it is some- times confounded with the discharge of gonorrhoea. Nocturnal emissions, too, are more frequentj and are generally attended with more or Less pain ; and, occasionally, with Lilood. Frequently du- ring the emission, the semen regurgitates upon the bladder, and is discharged afterwards with the mine ; and these regurgitations are most apt to take place when the stricture is seated near the prostate gland. Ceition is commonly attended with pain, or a sensation of uneasiness, especially at the moment of emission, or immediately after it takes place. I have known individual ed with very close stricture, to suffer acute pain at th< it of emission, followed by smarting and stinging s< rtsations, and ai mina-,which continued for one or two days. The most (Tromii symptoms of this stage, however, are the small, feeble, 01 dribl stream of water; and the lengthened time required to evacuate the bladder, after becoming filled with urine. But, after all. diffi- culty, or impracticability in penetrating the stricture with sounds or bougies; and the impressions left, upon the waxen bougie after passing and remaining in the strictures a short lime, furnish the least equivocal signs of the existence of stricture, of the kind now under consideration. Lesions Constituting Stricture. These are found to exist un- der several different forms, such as thickening and induration of the walls of the urethra; brides or bridles; and engorgement of the capillaries of its mucous and submucous textures. Thicken- ing, and more or less Induration, however, are the lesions usual- ly met with; and to them the term permanent stricture is most properly applicable, as, in truth, no other form is attended with an abiding contraction or diminution of the urethra. In some instan- ces the indurations acquire almost a cartilaginous hardness; and, by every degree of this degeneration of structure, the elasticity of the urethra is impaired more or less. The mucous lining of the urethra is also changed in its secreting function, so as to render it dry to some extent, which causes difficulty in (he passage of the bougie, or catheter, and very often subjects it to the painful action of the urine during urination. In no case have I been able to detect material change of structure, in any of the textures exte- rior to the submucous, except when rupture, incision or ulceration had implicated the entire walls of the urethra. As the thickening- increases, the mucous membrane at the part affected is forced into the canal which if, lines, so as to narrow its caliber, and, finally, to close it completely. In some instances the contractions, or thick- ened portions are an inch in extent, and lobulaled.