The principles and practice of modern surgeryPark, Roswell
Science
The principles and practice of modern surgery
Park, Roswell
Surgery
Belfield has recommended the use of the yellow hydrastia muriate in
connection with protargol. His formula is as follows: Yellow hydrastia
muriate 2.50, protargol 1.50, glycerin 15, water 500. After using
this for a few days the proportion of protargol may be doubled. Of
this preparation 15 to 20 Cc. should be injected several times a day.
The silver salts are the least irritating of all the stronger and
more reliable antiseptics, and drug manufacturers are putting upon
the market at frequent intervals new preparations for which much is
claimed. Among the latest of these is argyrol, a combination of silver
with albumen (vitellin), in such form as to make it antiseptic and
non-irritating. In solution it is of a dark mahogany color and stains
whatever it comes in contact with; these stains, however, are readily
washed out. Argyrol in solutions of 2 to 5 per cent. strength has
proved reliable, and if such a solution be retained in the urethra
for five minutes at a time a pronounced effect may be made upon the
disease. It is my custom to alternate the use of the bismuth formula
with a solution of argyrol as above, and in this way give the greatest
relief in the shortest time. It has been demonstrated that under the
influence of this preparation all gonococci which are reached by it
are destroyed; therefore the earlier it is employed the better. Before
using either of these formulas the anterior urethra should be washed
with hot water or with hot normal salt solution. No harm need be feared
should either of the above injections reach the deep urethra, and the
effort should be to make them reach at least as deeply as the disease
has gone.
When the discharge has reached what Finger has called “the mucous
terminal stage,” then the argyrol may be used two or three times a day
only, and one of the following solutions substituted for it part of
the time: Zinc sulphate 0.75, bismuth subnitrate 8, colorless liquor
hydrastis 15, cherry-laurel water 60. Of this solution 10 Cc. may be
used three or four times a day.
Belfield strongly recommends the use at this time of a solution of
muriate of berberine, in strength of ¹⁄₂ to 1 per cent., or the yellow
hydrastia muriate in about the same strength. He also recommends zinc
chloride 0.25, zinc iodide 0.50, water 500. Either of the above salts
may be added to this.
When nothing remains of the discharge but the so-called “morning” or
“military drop,” and the urine is almost clear, argyrol solution at
night and one of the above formulas once or twice through the day
will be sufficient. This, in brief, is a description of how a case of
urethritis may be satisfactorily treated.
The systematic use of potassium permanganate solutions was introduced
by Janet, and has been enthusiastically described and prescribed by
Valentine. The treatment is more complicated and less satisfactory than
that advised above.
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