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
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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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    ]y from hgemorrhago, some large vessel in tlic perinaeum being opened by the advancing ulceration. The diagnosis of epithelioma of the penis is often difficult in tJio early stages. All warty growths, especially if they are not much ele- vated and occur upon individuals past middle life, whose habits seem to be cleanly, and above all if there is even a shade of hardness around the base of the growth, all such excrescences should be regarded with suspicion, and their progress carefully watched. When ulceration com- mences, doubt may be laid aside, and then temporizing is of no avail. Active measures should be resorted to at once, unless the age of the patient or some other condition contraindicates an operation. Prognosis and Treatment.—Vigorous measures before the inguinal glands become involved afford the only chance of cure, and even then prognosis must be guarded, for relapse locally or in the glands is very common. Extensive local scraping and cauterization, if applied very early, may cure a superficial case ; but deep ulceration imperatively de- mands amputation at a point by so much the farther back as the ulcera- tion is extensive. It is mistaken kindness to spare tissue in such cases. If the inguinal glands are involved, they also should be thoroughly re- moved at the same sitting ; but even such removal affords little hope of permanent cure. In old cases of extensive disease, the bladder should be permanently drained above the pubes or through the peri- naeum for the patient's comfort, and anodynes used freely. DISEASES OF THE COEPOEA CAVERNOSA. Injuries of corpora cavernosa and cancer have been already de- scribed. Inflammation of the substance of the corpora cavernosa is very rare, except as the result of contusion, when it may run high, become excessively painful, and terminate in suppuration or gangrene. Spon- taneous inflammation occurs, very exceptionally, during the course of acute dyscrasial disease—typhus, small-pox, etc. It may complicate severe urethritis. It is always a dangerous affection, tending to termi- nate in gangrene. Treatment.—Beyond sustaining strength, but little can be done. Evaporating lotions may he used locally. If pus forms, it should be evacuated early, using care to distinguish between pus and effused blood. Ossification of the Penis is excessively rare. J. von Lenhossek * found what he helieves to be the first case observed, in an autopsy upoi a patient of forty-two, dead of typhus. There were dorsal and ventral bones, with channels for the vessels and the urethra. The point of origin seemed to be the septum of the corpora cavernosa. Haversian canals and true bone corpuscles were found. Demarquay f figures a specimen representing a large bone in the center of the penis reaching * Virchow's Archiv., Ix, April, 1874, p. 1. f Op. cit, 354.
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