Volume 3

The principles and practice of surgery, founded upon the most extensive hospital and private practice, during a period of nearly fifty years; with numerous plates, illustrative both of healthy and diseased structure ... / Edited by Alexander Lee.

  • Cooper, Astley, Sir, 1768-1841
Date:
1837-1843
Catalogue details

Licence: Public Domain Mark

Credit: The principles and practice of surgery, founded upon the most extensive hospital and private practice, during a period of nearly fifty years; with numerous plates, illustrative both of healthy and diseased structure ... / Edited by Alexander Lee. Source: Wellcome Collection.

    138/784 (page 110)
    Phymosis. muriate of mercury sprinkled on the sore is sometimes beneficial, but it is generally too irritating also. The unguentum hydrargyri nitrico oxydi I have seen of considerable use after a time, but it should not be applied at the beginning of the complaint, ihe unguentum hydrargyri is a bad application, it is too irritating. Sometimes it appears that the chancre goes into an indolent state, then it will be advisable to use the nitrate of silver, not with a view to destroy the part, but for the purpose of cleaning the sur- face, and thickening the edges of the wound ; the skin surround- ing the part is thin, and by the application of the nitrate of silver you thicken it, and thus enable it to carry a greater number of vessels to produce cicatrization. It not unfrequently happens that phymosis is the result of chancre. It is hardly necessary for me to say what phymosis is ; it sometimes arises from slight inflammation of the cellular tis- sue, and effusion of serous matter into it. Here I will observe that, should you find, during a mercurial treatment, considerable inflammation produced round the chancre, lay aside the use of mercury. The great secret, in the treatment of this disease, is knowing when to discontinue the use of mercury; you should always suspend it when the inflammation is increased during its employment; for if you persevere in the use of mercury, you will only add to the irritation, which will end in a sloughing process and destruction of the part. If I were to give to a patient mercury for chancre on the Saturday, and on the Monday following i perceived swelling and inflammation round the sore, I should immediately lay aside the mercury, give active purges, order poppy fomentations, and the part to be suspended. The black wash should be applied to the sore, injecting it under the skin, unless it should increase the irritability of the part. After the purges, administer opium in considerable quantities, and when you have reduced the inflammation, have recourse to the mercury again ; but if you had gone on with this medicine in the irritable state of the part, the result would be sloughing of the penis. When there is phymosis, together with sloughing, of the penis, ♦