The American Practitioner and News. Vol. XXV. No. 3. Feb. 1, 1898: A Semi-Monthly Journal of Medicine and Surgery — John Shaqi
The American Practitioner and News. Vol. XXV. No. 3. Feb. 1, 1898: A Semi-Monthly Journal of Medicine and SurgeryVarious
Science
The American Practitioner and News. Vol. XXV. No. 3. Feb. 1, 1898: A Semi-Monthly Journal of Medicine and Surgery
Various
Medicine -- Periodicals
_Discussion._ Dr. J. M. Ray: I do not know that the ocular symptoms will
throw any light upon the case. I remember that this young man came to me
some time ago to have his eyes examined. He stated that he had been
under the care of a prominent oculist in the South, and had been fitted
with glasses. When I saw him he had some trouble in the use of his
glasses, and also complained of defective sight of one eye. Upon
examination I found a spot of atrophy of the choroid, showing the
location of a former acute choroidal disease, and there was considerable
diminution in acuteness of vision in that eye, with a defect in
refraction in the other eye. Under mydriatics I fitted him with glasses,
since which time he has been perfectly comfortable so far as his eyes
are concerned.
He states that he remembers I said something to him at that time about
tubercular disease, after looking into his eyes, but I have forgotten
the circumstance; I only remember that I found choroidal disease.
Dr. J. A. Larrabee: Of course we are all led somewhat by the diathetic
history of our cases. Chronic inflammations tend to take on the part of
the diathesis. I did not understand the reporter to say that any test
had been made, by withdrawal of some of the fluid or otherwise, to
determine the exact nature of the condition. I desire to say, however,
that if this were my testicle I would have it removed. I believe that
would be the safest plan. An absolutely positive diagnosis would be
difficult to make without a microscopical examination for the tubercle
bacillus, but I can not help feeling prejudiced in that direction.
Dr. J. L. Howard: I agree with Dr. Larrabee as to what should be done
with this testicle; it should come out. I, too, think it tubercular,
although in all probability the gonorrhea is a factor in the case in
stimulating the growth of the testicle. I do not know that a
microscopical examination would give us much light upon the subject; in
fact I would not wait for that, I would simply remove the testicle at
once.
Dr. Wm. Bailey: The question is not by any means settled as to the exact
nature of the disease in the case before us, whether the patient, having
had repeated attacks of gonorrhea, has not also been so unfortunate as
to have syphilis. With a tuberculous history of course a tuberculous
condition of the testicle seems plausible; but inasmuch as tuberculous
disease of the testicle may remain for a long time possibly without
great danger in affecting the patient otherwise, and knowing the changes
that take place in the testicle from repeated attacks of gonorrhea,
orchitis, etc., I believe if it were mine I would be disposed to keep it
for a while, particularly as the other testicle seems to be somewhat
atrophied, with this one of pretty good size. I think I would keep the
larger one.
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