The principles and practice of modern surgeryPark, Roswell
Science
The principles and practice of modern surgery
Park, Roswell
Surgery
=Treatment.=--In mild cases--_i. e._, those showing but little
destructive tendency--cleanliness and the use of hydrogen peroxide,
followed by local use of any of the ordinary antiseptic powders, or
even of calomel, will usually prove sufficient. Sodium sozoiodolate
makes an excellent application. It is odorless and non-toxic. At first
its use may be preceded by morphine or cocaine, but after a few days it
will prove a painless application. If the ulcer manifest any tendency
to spread, it should be cleansed, cocainized, and then cauterized with
nitric acid or the actual cautery, after which it should be so treated
as to encourage granulation. This plan should be followed in phagedenic
cases, which may call for general anesthesia, with the use of scissors
and a sharp spoon, followed by cauterization of every particle of raw
or diseased surface.
Widespread phagedena is more rare now than formerly. Cases which are
extensive do best when submitted to continuous immersion of the hips
in a sitz-bath as hot as can be tolerated. All aggravated cases call
for invigorating and tonic measures, laxatives, improved nutrition, and
stimulants.
_Suppurating buboes_ should be incised, usually curetted, and
thoroughly swabbed with pure carbolic acid, followed by pure alcohol
to neutralize the acid, then packed lightly with antiseptic gauze, and
allowed to close by granulation. Virulent cases will be accompanied by
sloughing of so much tissue that it is best to remove all sloughs with
scissors. Here even stronger caustics will be called for. _Phimosis_
often complicates chancroid, and will necessitate circumcision or
incision along the dorsum of the prepuce, with such attention to the
parts thus exposed as their condition may require.
=Mixed Chancre.=--Mixed chancre, or the combination of the two lesions,
has been already discussed.
=Extragenital Chancroid.=--Extragenital chancroid may occur upon any
portion of the body, but is more rare than extragenital chancre. It
is characterized by the same peculiarities as pertain to the venereal
sores already described, and is amenable to similar treatment.
CHAPTER XII.
GONORRHEA.
Gonorrhea is an acute infectious process, involving especially
the mucous membranes of the genito-urinary organs, but met with
elsewhere about the body, in both superficial and deep tissues. The
name itself is a misnomer, since it implies a flow of semen, whereas
the discharge which issues from the male urethra is simply mucopus,
and is the product of a severe inflammation of the mucous membrane.
A less inaccurate name for it is _blennorrhea_, although this is
usually limited rather to a discharge from the vagina, and indicates
a whitish and copious fluid exudate, mingled with pus corpuscles and
bacteria. It is stated that probably 80 per cent. of men have at some
time contracted this disease. Neisser claims that it is a more common
affection than measles.
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