Porneiopathology: A Popular Treatise on Venereal and Other Diseases of the Male and Female Genital System; With Remarks on Impotence, Onanism, Sterility, Piles, and Gravel, and Prescriptions for Their TreatmentCulverwell, Robert James
Science
Porneiopathology: A Popular Treatise on Venereal and Other Diseases of the Male and Female Genital System; With Remarks on Impotence, Onanism, Sterility, Piles, and Gravel, and Prescriptions for Their Treatment
Culverwell, Robert James
Genitourinary organs -- Diseases; Sexual health; Sexually transmitted diseases
The dark marginal line denote the calibre of the urethra, and the inner
lines the actual diameter of the obstructed passage. Figure 1 shows the
stricture to be on the lower part of the urethra. Figure 2 the upper
part. Figure 3 exhibits a stricture of some length, and a somewhat
contracted state of the whole canal. Figure 4 denotes a very common
form of stricture, which resembles a flour-bag tied in the middle; it
is the least difficult to cure of any, because it signifies that the
seat of irritation is limited; but these cases are generally precursory
to severer forms, if not promptly attended to. Figure 5 represents
a stricture of considerable length, and of course very difficult of
removal.
There are many provocatives to stricture, and when once mischief is
progressing, it makes up for its slow initiation by giant strides. A
patient may have a trifling stricture for years without experiencing
much inconvenience. He takes cold, fatigues himself, commits some
stomachic or other excess, may possibly have fever, all of which more
or less disturb the general economy, alter the character of the urine,
and in that manner doubly accelerate the disorganization going on in
the urethra. A small abscess may spring up _in_ the urethra, or _below_
it among the cellular membranes and integuments. In either case, it
chances now and then to burst an opening and create a communication
externally with the urinary passage, constituting what is called
_fistula_. A person laboring under stricture is always liable to these
occurrences. As much mischief is done oftentimes by mismanagement
as by neglect. The clumsy introduction of a bougie, or, in other
instances, the unjustifiable introduction of one, is likely to, and
very frequently does, lacerate the delicate and irritable membrane,
and make a false passage. Figure 6 exhibits an instance at Nos. 1 and
2; the upper numerical shows a false passage made by a bougie, and an
obliteration of the ordinary passage of the urethra, the result of
inflammation, constituting an impassable stricture; the lower figure
exhibits a false opening made, in the first instance, by a fruitless
effort at passing an instrument, when inflammation completed the
process. No urine escaped from it of course, because communication was
cut off from the bladder by the impassable stricture; the outlet for
the discharge of that fluid being through a sinuous opening marked No.
2, the No. 3 denoting the closed end of the urethra. The case happened
to a man in very ill health, who was prone to ulceration, and he
gradually sunk under exhaustion from debility and premature old age.
Figure 7 exhibits a stricture where the posterior part was enlarged
by the constant pressure of the urine to escape through the narrowed
part of the urethra; ulceration ensued, and a fistulous opening was
the consequence; the stricture was seated high up, and the fistulous
canal was several inches long, terminating in the upper and posterior
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