North American Medical and Surgical Journal, Vol. 2, No. 3, July, 1826Various
History
North American Medical and Surgical Journal, Vol. 2, No. 3, July, 1826
Various
Medicine -- Periodicals
At eight o'clock, P. M. of the 1st of Feb. he tried to urinate, but
could not succeed. He suffered great pain. Pulse agitated; face flushed;
belly swelled, and globular at its inferior part; the subcutaneous
abdominal veins distended, and the penis in a state of semi-erection.
All attempts to urinate were painful and ineffectual. At ten o'clock, A.
M., on the 2nd, M. AMUSSAT visited him, and passed a bougie. This was
arrested by a contraction near the bulb of the urethra, and caused the
discharge of some blood. No urine had been passed for 14 hours, while
ordinarily he urinated 12 or 16 times through the night. The obstruction
was so great, that none of the usual means of relief remained, except
_the forcible introduction of the catheter_, or the _puncture of the
bladder_. M. AMUSSAT resorted to the following plan which he had
devised, and which completely succeeded. He injected warm water
forcibly, but gradually, into the urethra, which, dilating the orifice
of the stricture, forced backwards the thickened mucus which had
obstructed it. As soon as the liquid injection met the urine, the
patient cried out that he was saved, and immediately was able to urinate
as formerly. At two trials, he discharged nearly two pints of thick
urine. There was no return of the retention, the patient continuing
well.
Should subsequent experience confirm this experiment of M. AMUSSAT, this
simple measure will be a most valuable substitute for those dangerous
measures hitherto resorted to for retention of urine, in cases where the
obstruction arises from thickened mucus, from small calculi closing the
orifice of a stricture, from inflammation, or from what are termed,
(justly or not,) spasmodic strictures.
51. _Tracheotomy._--In the Amer. Med. Review for April, Dr. JOHN ATLEE,
of Lancaster, mentions that on Wednesday, Aug. 11th, he was consulted by
a child ten years old, who had that morning, while running, put a
button-mould into his mouth, which during respiration was drawn into the
trachea. He complained of uneasiness in respiration, with a slight
rattling, and pointed towards the upper part of the sternum, as the
situation of the button. On coughing, a rattling was heard, and
immediately after, a sudden check to expiration, from the lodgment of
the button near the rima glottidis, requiring a sudden and violent
effort of inspiration to remove the sense of suffocation. An emetic was
given with no advantage. During the night, he had two or three spells of
coughing, threatening suffocation.
An operation was urged, to avoid immediate and subsequent dangers from
the lodgment of this extraneous body, and was agreed to by the parents,
and by Dr. HUMES, who was called in consultation. It was performed on
the 14th of Aug.; a cathartic, and afterwards an opiate, having been
given.
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