The principles and practice of modern surgeryPark, Roswell
Science
The principles and practice of modern surgery
Park, Roswell
Surgery
It has been the custom to speak of _urethritis_ as a synonym for
gonorrhea, and to divide it into the specific and non-specific forms,
including under the former expression cases where the gonococcus can
be demonstrated, and under the latter term those which do not seem
to show it. There is no doubt but that urethritis may be set up by
the introduction of a foreign body, such as a sound or catheter, as
well as by some irritating discharge from the vagina, and also as the
result of excess of uric acid in the system, perhaps even of alcohol.
These, if occurring in a previously uninfected urethra, may be regarded
as distinctly non-specific lesions. It is also supposed that under
certain circumstances inflammation may be set up by other organisms
than the gonococcus; nevertheless almost all cases of so-called clap
are positively gonococcus infections, simple or mixed, and have but one
origin.
=Diagnosis.=--_Diagnosis can be made positive only with the
microscope._ A recognition of the gonococci by staining them and then
watching the effect of iodine in their decolorization will be of
great importance and reliable. The affinity of these germs for basic
aniline dyes, and the fact that they do not take the iodine stain
of Gram, will serve to differentiate them from the numerous other
organisms with which they may be found mixed. By staining a cover-glass
preparation first with methyl blue or other basic color, then placing
it in Gram’s solution, and finally in a solution of Bismarck brown,
the true gonococci which have been made visible by the methyl blue
will have disappeared under the influence of the iodine, while other
bacteria will be stained by it. It has been mentioned that the germ
is a diplococcus of rather ovoid form, met in clusters but not in
chains, and in groups of four or multiples of four; it may be attached
to epithelium and pus corpuscles, or found within them, and is rarely
found free in fluid except when present in large numbers. These
organisms are capable of cultivation, growing best upon a mixture of
human serum and neutral agar, at a temperature of 36° C.
_The urethra may be infected from without and from within_, and this
infection may be either of a truly specific type (gonococcus) or of the
pyogenic type; as between these forms information may be gained by the
history and the clinical course, but the minute diagnosis is only to
be made with the microscope. This is of more than theoretical value,
inasmuch as it substitutes a certainty for a working hypothesis. It is,
moreover, sometimes of great value, as when the question of infection
of one of the opposite sex comes up, or it may have at times even an
important medicolegal value, as in cases of rape.
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Elsewhere in the archive
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account