The surgical diseases of the genito-urinary organs including syphilis / by E.L. Keyes ; a revision of Van Buren and Keyes's text-book upon the same subjects.

  • Edward Lawrence Keyes
Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: The surgical diseases of the genito-urinary organs including syphilis / by E.L. Keyes ; a revision of Van Buren and Keyes's text-book upon the same subjects. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    and middle fingers of his right hand longitudinally along the lower sur- face of the penis, and the pulp of his thumb on the dorsum of the glans penis and the oodematous ridge in front of the point of stricture. By firm pressure crowding down the swollen mucous layer of the pre- puce, he endeavors to insinuate the end of the thumb-nail under the stricture. If he succeeds in this, grasping the penis and the two fin- gers of the right hand beneath in a circular manner with the left hand, he draws the strictured point up over the thumb-nail. Bardinet's* method—inserting the rounded end of a hair-pin under the stricture on each side, and with these making lateral pressure upon the glans while the prepuce is worked forward—is simple and often effective. If a prolonged, careful attempt . Fio.^mmps). at reduction fails, the strictured point must be divided. To accom- plish this subcutaneously, a tenotomy-knife is introduced flatwise along the sheath of the penis under the stricture, and is made to cut outward, until all tension is re- lieved. Instead of this, a simple incision may be made through the skin down to the sheath of the penis. Inflammatory con- solidation of tissue may make it necessary to divide the stricture at several points. After reduction, the treat- ment consists in position, rest, and cleanliness, syi'inging the preputial cavity with warm water hold- ing a small amount of disinfectant, or mild astringent, in solution. If any contagious ulcer has been the cause of paraphimosis, the surgeon should carefully examine his fingers for cracks or fissures before commencing manipulation. So much handling is required that infection is very apt to occur unless the epidermis of the hands is sound. In Paraphimosis without Stra]Sgulatiox, if the case is recent, reduction must be effected or inflammation will surely set in and com- plicate the situation. Eeduction may be accomjilished as detailed above, or by the method successfully employed in the Children's Hos- *L'Union Medicale, ISIS, p. 900.
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