The venereal diseases : including stricture of the male urethra / by E.L. Keyes.

  • Edward Lawrence Keyes
Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: The venereal diseases : including stricture of the male urethra / by E.L. Keyes. Source: Wellcome Collection.

    310/372 (page 290)
    STRICTURE OF LARGE CALIBRE. Stricture of the Male Urethra.—Spasmodic Stricture.—Examples of this Form of Stric- ture.—Stricture of Large Calibre : Symptoms, Diagnosis, Treatment.—Besiliary Strictures of Large Calibre.—Internal Urethrotomy in the Pendulous Urethra, the Limit of the Cut, the Result, and the After-treatment. A VERY common result of gonorrhoea in the male is the formation of stricture of the urethra. Stricture may be due to many other causes, such as trumatic violence of any sort, mechanical or chemical, especially any kind of bruising of the canal transversely; or to congenital imperfec- tion of the urethra, particularly common at the meatus; or to spasmodic action of the muscles of the deep urethra, sometimes reflex; yet all these causes combined only yield a small proportion of the cases of real stricture— stricture producing symptoms as encountered in ordinary practice. Many cases of gonorrhoea get well and leave the urethra sound, even although the urethral inflammation has been intense and prolonged. On the other hand, many cases of mild urethritis, which are not due to gonorrhoeal poi- soning and have never run high in the suppurative stage, prolong them- selves indefinitely in the shape of a gleet, and exploration of the urethra demonstrates that there is a tight place in the canal yielding a tinge of blood to the exploring instrument, manifestly excoriated upon its surface, and clearly the lesion whence proceeds the oozing which constitutes the gleet. The question of spasmodic stricture is so interwoven with that of organic stricture, that neither of them can well be considered apart from the other; and although, accurately speaking, stricture of the urethra is no more a venereal disease than uraemia is scarlet fever, yet it is so closely related in many ways to gonorrhoea that its description naturally falls into place here, and the various forms of stricture call equally for a certain amount of detail. I shall describe the three forms of stricture inversely as to their im- portance, taking up first the spasmodic stricture, next the stricture of large calibre, and, finally, the stricture of small calibre. SPASMODIC STRICTURE OF THE URETHRA. The existence of spasmodic stricture of the urethra has been doubted, but it plainly is a reality, as may be easily demonstrated. It is indeed the least venereal of all strictures, and may depend upon a multitude of causes, general as well as local, moral as well as physical. Moreover, it may complicate either of the other forms of stricture and give to them an importai]ce which they would not otherwise possess. In this way spas- modic stricture earns for itself a right to respectful consideration; its ex- istence cannot be ignored.