Scientific American Supplement, No. 648, June 2, 1888.Various
Science
Scientific American Supplement, No. 648, June 2, 1888.
Various
Science -- Periodicals
In the following lines I wish to direct the attention of my English
_confreres_ to the value of the electro-endoscopic mode of examination of
the male urinary bladder, invented by me. I believe I could not have
chosen a more suitable theme for that purpose than a short report of the
bladder tumors diagnosed by me cystoscopically; for the diagnosis of these
new formations offers the greatest difficulty, and in most cases it has
been impossible till now to prove their existence with accuracy without
digital exploration of the bladder. By the new method of cystoscopical
examination the conditions have entirely changed. One look into the
bladder, illuminated as if by daylight, is generally sufficient to afford
means for forming an opinion of all the questions coming into
consideration--viz., size, form, and site of the tumor. The accompanying
diagrams (Figs. 1, 2, 3, 4) may give an idea of the appearances which the
different forms of bladder tumors present endoscopically. I regret that
they cannot show the brightness of the light by which one sees the tumors
during examination. The celebrated Vienna specialist, V. Dittel, is right
in saying that "they offer sometimes truly charming pictures;" especially
certain kinds of villous tumors, whose long slender villi floating in the
liquid often present a splendid appearance. The following are the cases
cystoscopically diagnosed by me.
[Illustration: FIG. 1.]
_Case 1._--A man, aged fifty-five, under the care of Dr. Ch. Mayer,
suffered from attacks of hæmaturia for thirty years. During the last six
years he has had dysuria and inability to empty the bladder completely.
The patient had been examined by the sound repeatedly by eminent surgeons
and specialists, but none could give a certain diagnosis. On Nov. 11,
1886, I undertook the cystoscopic examination. I found on the anterior
wall of the bladder a puffy swelling covered with white masses of mucus.
(See Fig. 1.) The trigone was covered by a mass consisting of pointed
papillæ. On account of the weakness of the patient extirpation was
impossible. The patient became weaker and weaker, and died in June, 1887.
The post mortem examination showed the internal orifice of the urethra
surrounded by a swelling representing a continuous tumor as large as a
small apple. It was found that the instrument had penetrated through the
middle of this swelling, which bled easily on pressure. In spite of this,
the clearness of the picture was not interfered with in the least.
[Illustration: FIG. 2.]
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