Remarks on the operation of the perineal section : for the cure of stricture of the urethra and fistula in perineo / by F.G. William Mullar.

  • Mullar, William.
Date:
1850
Catalogue details

Licence: Public Domain Mark

Credit: Remarks on the operation of the perineal section : for the cure of stricture of the urethra and fistula in perineo / by F.G. William Mullar. Source: Wellcome Collection.

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    Mr Syme in his several communications on Stricture of Urethra, which he has published, has not, as far as I remember, stated on what theory he has based his operation. It is not enough for him to state that such an operation has been performed ; he is in duty bound by the situation he holds, to state candidly and openly his grounds for this proceeding,—especially as his work on Stricture of the Urethra, contains opinions which do not agree with each other, or with the opinions he promulgates in his other publications. At the end of the work on Stricture of the Urethra, Mr Syme states, “ from what has been said in the foregoing pages I trust it will appear established,— “ 1st, That division of a Stricture by external incision is sufficient for the complete remedy of the disease in its most inveterate and obstinate forms. “ 2d, That in cases of less obstinacy, but still requiring the fre¬ quent use of bougies, division is preferable to dilatation, as afford¬ ing relief more speedily, permanently, and safely Upon what principle has Mr Syme been led to constitute the first of these facts ? Surely not upon the cases published. Is it possible to reconcile the assertions made by Mr Syme— of its being the one simple, quick, safe, and sure cure—with the facts of the cases recorded (see cases 11,15, 16. and 17), or with his own contradictory statement which I have taken the liberty of reverting to, as evidences of the operation being an operation which ought only to be had recourse to in those cases of danger¬ ous distention where there appear evidences that the Bladder or Urethra, behind the point of Stricture, are liable to be ruptured, and therefore, of two evils, we ought to choose the least ? Why, may I ask, should any Surgeon undertake this serious operation, requiring, according to Mr Syme, the nicest manipu¬ lations ? It is an operation recommended by Mr Syme, it is true, but that is not sufficient ; we require more than that; the Profession requires proper and sure principles promulgated, and well-esta¬ blished facts recorded, before they are justified in undertaking the responsibility of such a proceeding. By whomsoever an operation is recommended—whether by a Liston, a Lizars, or one suggested even by Mr Syme—it is the bounden duty of every surgeon to examine thoroughly, and for
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