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.

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    process kills the chancroid outright and repair commences with the sepa- ration of the slough, just as it does after elective cauterization. A more disastrous result of inflammatory phymosis is the possibility of many new points of auto-inoculation within the cavity of the prepuce, the retained poisonous pus excoriating the surface of the glans penis and perhaps inoculating the meatus. Portions of the new chancroids may then slough, and considerable loss of the glans penis ensue, with stricture of the meatus from cicatrization. The liability of causing bubo by allow- ing an inflamed prepuce over a chancroid to remain long unrelieved is to be borne in mind, and the possibility of extensive denudation of the penis by the backward burrowing of the retained chancroidal pus has been clin- ically proved (Vidal). Inflammatory paraphymosis may complicate a chancroid when the prepuce is short. The swelling encircling the penis may become so great that the circulation of that portion of the penis lying in front of the constriction is menaced. The treatment of inflammatory complications of chancroid is obvi- ous. Rest must be insisted upon, the penis elevated and covered with moist, cooling, evaporating lotions, or with astringent solutions. Among the former, one of the best is: ]^. Glycerinae fl^xx. Spts. rect 3 i.—ij. Liquor, plumbi sub-acetat. dil q. s. ad § i. M. It is to be kept constantly applied cold upon a thin cloth on the outside of the penis. Solutions of tannin act exceedingly well as astringents in some con- ditions of oedema of the penis. The main objection to it is that it stains white fabrics. From gr. x.—xx. in ^ i. of water is strong enough. It must be constantly applied fresh, and the penis kept well elevated. These applications are palliative. The treatment of the chancroid, meantime, goes on by sub-preputial injections, idoform applications, or whatever it may be. If the sub-preputial discharge of pus gains in quan- tity, if the inflammation fails to yield and gangrene is to be feared, then but one course is left, namely: to slit open the cavity of the prepuce, cut away the redundant tissue, circumcising the patient, and dress un- sparingly with iodoform. Cauterization in these cases will not prevent the wound from becoming inoculated, and only prolongs the duration of the sore. In cases of paraphymosis the line of stricture of the prepuce must be divided with the knife as soon as the circulation of the penis in front of it is threatened. If the circulation continues perfect it is better in most cases not to attempt to reduce the paraphymosis, since the latter insures the advantage of leaving the ulcers exposed to view. A patient with para- phymosis is generally confined to bed, and the odor of iodoform ceases to be an objection to its use. Chancroid complicated by phagedaena.—This is the most formid- able of all the local complications of chancroid. Phagedsena occurs in two forms: (1), sloughing phagedeena; (2), serpiginous phagedsena. The predisposing general causes of phagedsena are not fully known. It some- times attacks a florid, healthy-looking youth, and often spares a cadaver- ous consumptive, or a patient debj^'tated by excesses of all sorts. It is a