Surgical diseases and injuries of the genito-urinary organs.

  • Thomson-Walker, John, Sir, 1871-1937.
Date:
[1914]
Catalogue details

Licence: Public Domain Mark

Credit: Surgical diseases and injuries of the genito-urinary organs. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    Hale White describes five cases of renal hsematuria in wKich the kidney was explored by nephrotomy and no lesion found. Two of these cases had a recurrence of haemorrhage, in three there was none. Decapsulation may be combined with nephrotomy, but the results are similar to those of nephrotomy alone, the haematuria recurring in rare cases. Treatment of hzematuria.—It is only in exceptional cases that treatment of haematuria apart from operative measures is required. The following drugs may be used, viz. morphia, ergot, ergotine, tincture of hamamelis, and calcium chloride or lactate. Of these, morphia and calcium lactate are the best. A hypodermic injection of morphia is given, and the patient placed on calcium lactate, 10 gr. in cachets being given every four hours for forty-eight hours. After this period the calcium lactate should be omitted. Local treatment.^In renal hsematuria, dry cupping over the loin, and icebags over the kidney, may be employed. Adrenahn has been injected into the renal pelvis through a ureteric catheter, 1 drachm of a l-in-5,000 solution being used. Vesical haematuria.—A catheter should be passed and the bladder washed out with hot boric solution, or with a hot, very weak solution (1 in 15,000) of silver nitrate. Large quantities of these solutions must be used, the stream being supplied from an irrigatoi' or a large glass hand-syringe. A double-way catheter with continuous irrigation is often useful. After washing the bladder, 10-12 oz. of a solution of antipjrrin (10 per cent.) are introduced and left in for a few minutes, or 1 or 2 drachms of adrenahn solution (1 in 2,000) are injected into the bladder, left for a few minutes, and then run out. If clots are present in the bladder they may be washed out through a large catheter, or, better, through a large evacuating catheter such as is used in lithotrity. The rubber lithotrity bulb may be attached and the clots sucked out. 1) These methods should^not be persisted in for long, and, if the clots are of large size and the bladder has become distended with them, suprapubic cystotomy should be performed, the clots cleared out, and a stream of hot boric solution (115° to 120° F.) passed through a catheter in the urethra, and allowed to well out of the suprapubic opening. A large drainage tube (1 in. diameter) should then be placed in the bladder, and the foot of the bed raised on blocks. LITERATURE Albarran, Prcssc Med., 1904, p. 657. Fenwick, Clinical Cystoscopy. London, 1904, Graff, Folia Urol., 1908, p. 274.