A treatise on the venereal disease / by John Hunter ; with notes by George G. Babington.
- John Hunter
- Date:
- 1841
Licence: Public Domain Mark
Credit: A treatise on the venereal disease / by John Hunter ; with notes by George G. Babington. Source: Wellcome Collection.
Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)
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![lias never been supposed or known to be the cause of a stricture. Further, some have injected by mistake very irritating liquors,'such as the undiluted extract of lead, and caustic alkali, without giving the least tendency towards a stricture, although they produced violent inflammation and even sloughing of the internal membrane of the urethra. By many they have been supposed to have arisen from the heal- ing of ulcers in the urethra; but as I never saw an ulcer in these parts, except in consequence of a stricture, and as I do not believe there ever is an ulcer in the case of a common gonorrhoea, I can hardly subscribe to that opinion.* §1.0/ the Bougie. The bougie, with its application, is perhaps one of the greatest improvements in surgery which these last thirty or forty years have produced. When I compare the practice of the present day with what it was in the year 1750, I can scarcely be persuaded that I am treating the same disease. I remember when, about that time, I was attending the first hospitals in this city, the common *'[Many well-authenticated facts disprove the common prejudice which attri- butes stricture invariably to gonorrhoea or to the use of injections. But when the author goes so far as to question whether it ever arises from these causes, his opinion is contradicted both by reason and by experience. It would appear that any irritation on the urethra, if sufficiently long continued, may give rise to stricture. It may be consequent on stone in the bladder, on disease of the prostate or disease of the bladder, on acid urine, on repeated attacks of strangury occa- sioned by the application of a series of blisters. But of all sources of irritation which can affect the urethra, the most common and the most severe is gonorrhoea, and hence a large proportion of cases of stricture follow so immediately on this disease as to be justly attributable to it. There are few cases of gonorrhoea in which the stream of urine is not diminished in size, from the existence of some degree of spasmodic contraction in the membranous portion of the canal. If the gonorrhoea lasts long, this spasm may become habitual, and terminate in stricture : and the likelihood of such a result is much increased if the inflamma- tion is not confined to the extremity of the urethra, but extends to the bulb and neck of the bladder. How far injections have a tendency to produce the same effect is more doubtful. When they are successfully used on the first appearance of the discharge, it is probable that, by cutting short the disorder, they rather prevent than promote stricture. But where injections fail, they unquestionably in many cases extend the sphere of the inflammation, and involve those parts of the urethra which are in the vicinity of the bulb, and are especially liable to this affection. Again, the discharge, as the author has elsewhere observed, relieves the spasm of a stricture. In cases where [there exists already spasmodic contraction of the urethra, in- jections, tby diminishing or arresting the discharge, will undoubtedly tend to increase the spasm and to render it permanent. The old opinion was, that a stricture was the cicatrix of an ulcer which existed during a gonorrhoea. This notion the author justly repudiates. But he must not be understood to mean that ulceration may not sometimes arise from other causes, and leave behind it a stricture. When the urethra has been lacerated by external violence, as by a blow on the perinseum, stricture will usually follow, and will in most cases be of a kind which is peculiarly intractable and obstinate.]](https://iiif.wellcomecollection.org/image/b21131508_0104.jp2/full/800%2C/0/default.jpg)
