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
Even in this very simple operation, a certain dexterity is requisite;
for the direction of all urethræ is not alike, and the mere pushing
a bougie against a contracted part is not the only likely method
of effecting a free passage. Much also depends upon the nature of
the bougie—the elastic ones, although assisted in their attempted
passage to the bladder, by the smooth and well lubricated sides of
the urethra, have a tendency to straighten; and unless considerable
rotatory motion be observed, are apt to hitch in a fold of the urethra,
especially if the case befall a person of relaxed fibre, and he be
much worn down by suffering. The bougies that I employ are constructed
upon an improved plan to those in general use, being prepared of a
material that will preserve the shape I adapt them to, previously to
introducing them, but at the same time sufficiently soft to yield to
any accidental tortuosity of the tube they are intended to explore.
The bougie then is to be pressed softly, but steadily, against the
obstruction, now and then withholding for a minute the bearing, so as
to allow a respite to the stretched membrane; then renewing by, what
is better done than expressed, an “insinuating” pressure for the space
of the time advised above. The patient should not be dispirited, even
if the bougie do not perforate the stricture at the first trial; it
would doubtless do so, if longer time were employed, but that is rarely
advisable, except in cases where the urine can scarcely escape, or much
expedition be requisite. Should the operation even be unsuccessful in
this first attempt, the patient will find his ability to micturate much
greater than before the introduction; but, save in long-standing and
obstinate strictures, I rarely find myself foiled, nor do those who
practise the same method, if they have patience and skill enough, in
overcoming the difficulty at the first interview. A great advantage of
the cure by dilatation, independently of its safety and efficacy, is
the insignificant pain it occasions; the sensation produced being only
like a pressing desire to make water, which immediately subsides on
withdrawing the bougie.
Another method of dilating a stricture, where it happens to be of
chronic existence, is the passing a plastic catheter into the bladder,
and suffering it to remain all night, or even for several nights,
stopping up the handle end with a cork or wooden peg, which the patient
can remove when he desires to urinate. The urethra, by this means,
becomes quickly dilated, and much beyond the size of the instrument. It
necessarily confines the patient to his room and couch; but where an
expeditious cure is the object, as much may be effected in this manner
in six days, as by the ordinary method in as many weeks. Time, however,
it must be remembered, is the working _material_ of nine tenths of
strictured invalids, and a week’s lay-up may cost a twelve-month’s
salary—a purchase too dear to be generally incurred.
Public-domain text, read in full here on John Shaqi.
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