The pathology and treatment of stricture of the urethra and urinary fistulæ / by Henry Thompson.

  • Thompson, Henry, Sir, bart., 1820-1904.
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: The pathology and treatment of stricture of the urethra and urinary fistulæ / by Henry Thompson. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    381/488 (page 353)
    APPENDIX. \ 4h,JS$3 them. The operation employed here would rarely p rvl i ip>i»iiUjjM[j,.lM^*'^ be performed without more rest and preliminary treatment, by the aid of which it is quite possible, not to say probable, that the stricture might have been rendered amenable to dilatation, and further operative proceedings might perhaps thus have been dis- pensed with. Here is a man admitted in bad condition, with long standing urinary disease, submitted to a severe operation at the end of a week's rest only, the result of which is death. The repeated haemorrhage doubtless hastened the fatal issue. Such a case presents a useful lesson.* Case III. Gonorrhoea and chancres—Organic stricture neglected by the patient —Rapid occurrence of renal disease—Death and autopsy. W. 0., set. 20.—Admitted into University College Hospital, December 10, 1839. A bargeman on the river. Is rather slight in appearance. Complexion fair. Strumous habit. States that he has usually enjoyed good health, although his employ- ment frequently exposes him to wet and cold. One year and a half ago, had gonorrhoea. A week after, chan- cres on the glans penis appeared, close by the meatus externus. A\ as treated with mercury, and his mouth became very sore, but he still continued his work, and took no care of himself. His habits were more than ordinarily dirty, sensual, and careless. Six months ago, he first observed spots on his body, and about the same time discovered that his urine passed less freely than formerly ; this gradually got worse. For the last two months there has been incontinence of urine: he has been consequently compelled to relinquish work, and has fared very badly. State on admission.—Emaciated, and filthy in the extreme ; ex- hales a strong urinous odour. Large rupious spots about the body; a chancre on the glans penis. Urine dribbles from, him con- tinually. December 16.—Having had some warm baths, and been kept quiet in bed, a small catheter was passed for the first time to-day. December 19.—Catheters again passed and retained for some hours ; the urine at length flowed away freely by the side of the instrument. Complains of severe pain in the course of the urethra. * In this, and one or two other cases, the treatment adopted is referred to as being open to objection, as in this instance. Viewing a case retrospectively, it is often easy enough to recognise errors in treatment; hence the value of experience. It may be, however, right to say that the cases in question occurred some ten years ago and not in the practice of any living surgeon. A A