The Harveian lectures on twenty-five years' experience of urinary surgery in England : delivered before the Harveian Society of London / by G. Buckston Browne.

  • Browne, G. Buckston (George Buckston), 1850-1945.
Date:
[1901]
Catalogue details

Licence: In copyright

Credit: The Harveian lectures on twenty-five years' experience of urinary surgery in England : delivered before the Harveian Society of London / by G. Buckston Browne. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    gentleman with retention of urine and a long history of urethral stricture. The case was urgent and with great care and not easily I passed a No. i silver catheter and drew off a large quantity of urine. Next day I found the patient comatose and so ill from urinary fever that both Dr. Duncan and I thought he would die. He responded, however, to active treatment and made a good recovery. The question then was, what was to be done to the stricture ? It must be treated, but if the simple passage of a No. i silver catheter was nearly followed by death, what would happen if the interference was more radical than that ? Sir William Broadbent supported me in my proposal to perform my operation of internal urethrotomy at one sitting under an anaesthetic. A clean cut through the fibres of the stricture was followed by the best results. There was no fever, no illness of any kind, and the patient lived for several years in perfect urethral comfort. We often find in practice that the stricture patient can bear a certain sized bougie well, but if an instrument at all larger is used its introduction is sure to be followed by fever. I have often found that a medical friend is very much surprised when it is pointed out to him that however often he has had to deal with urinary fever in male adults he has never had to do with it in women or in children of either sex, for women and children never suffer from this fever. Now do not all these facts prove that the fever is due to nervous tshock, to urethral shock ? The male adult’s urethra is a sexual as well as a urinary tract, his penis is highly endowed with nerves, and it is precisely he who suffers from this fever. The urethra of the woman and child is a urinary tract only and they do not suffer. Deal gently with the male urethra and all will probably be well; use violence and the results may be disastrous. Narcotis^the patient with opium or with chloroform and you may use violence up to a certain point and still have no fever. You may often cut the urethra, if you do not stretch it, and have no fever. You may one day pass a catheter and have no fever, and next time and on the same patient you may not be so skilful and successful, you may blunder and hurt the patient and make him bleed, and severe fever will follow. Then, again, it is impossible to practise for many years among patients troubled with urinary disorders without observing that certain nationalities are more prone to this fever than others. The French are certainly much more susceptible than the Germans, and among the British the Irishman is far more likely to suffer than the Englishman. These more susceptible people are certainly the most nervous, this term being used in its highest and best sense, for many