Cases of vascular tumour of the urethra : with remarks / by H. Burford Norman.

  • Norman, Henry Burford, 1819-1900.
Date:
1849
Catalogue details

Licence: Public Domain Mark

Credit: Cases of vascular tumour of the urethra : with remarks / by H. Burford Norman. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    10/18
    Case 111.—Occurred in the person of a young woman,a prostitute, who was under my care for primary syphilis and vaginal discharge. The excrescence was very like the last, but far less sensitive. I did not think it right to inter- fere with it, whilst the syphilitic sores existed, for fear of inoculating a fresh place, and before they were quite cured. I lost sight of the patient, and con- sequently the opportunity of doing anything to the tumour. Case IV.—I was called (November 7th, 1848) to see Mrs living near the Middlesex Hospital. She was said to be suffering from sickness and vomiting, which had lasted two days, and was connected with a hernia. On visiting her, 1 found her suffering from bilious vomiting and constipation, the latter being al- most an habitual state—her tongue was furred, and her pulse a little quickened. Her belly not at all tender or distended. She had been the subject of femoral hernia for many years, but had always kept the bowel in place by a truss—it was not at this time protruding. She was a nervous excitable person, fifty-five years of age, and a widow. She had had several children, but had ceased to menstruate some years. She complained of great pain in making water. It had lasted two years, and was equally bad whatever the state of her urine. She had never passed any blood. Walking occasioned severe pain in the vulva, in consequence of which she had confined herself to the house for many months previously. She had consulted two medical men, and taken various medicines, without benefit; and with the hope of procuring some relief from her sufferings, had entirely given up all stimulating food and drink. She had never been examined, or had any local treatment to the painful part. I prescribed a few grains of calomel, to be followed a few hours after by a black draught, and directed that some urine should be kept for my next visit. The bowels having been freely opened by the medicine given, the sickness and vomiting ceased, and the tongue became clean, but the pain in making water continued. I found the water kept for me at my next visit clear, of an amber colour, and quite free from deposit. On examining the vulva, however, which I obtained permission to do, I found within the orifice of the urethra a small bright scarlet body, of very delicate texture, highly vascular, and per- fectly smooth, not much larger than a barley corn, attached to the lining of the under surface of the canal, from which, by pressing back its borders, the excrescence]could scarcely be made to protrude. It was scarcely pediculated, but grew up like a large granulation. The borders of the orifice of the meatus had a similar florid appearance. The parts were excessively tender to the touch. There was little or no increase of the vaginal secretion. A ligature was applied to the excrescence as in the preceding cases, but it was necessary to dilate the urethra, in order to expose the growth and enable me to transfix its base. This was effected by passing a pair of forceps into the canal, and separating the blades. After the ligature was secured, the borders of the orifice were rubbed with potassa fusa ; a sponge full of vinegar being used immediately to prevent the caustic from spreading. The urine was passed involuntarily that day and part of the next ; and the evening succeeding the operation it was necessary to give a dose of laudanum, in consequence of the severe pain arising from the irritated parts. The excrescence and ligature were thrown off in a few days ; a considerable puriform discharge from the urethra and vagina was excited by the operation, but it readily yielded to the application of the goulard lotion and cold ablu- tions. She is now perfectly free from the complaint; walking and passing her water quite easily. It is rather remarkable that of the four preceding cases, three should have occurred in patients of advanced years, who had ceased to men- struate. Since writing the above, I have been consulted by my friend, Mr Preston, on another.
    digitised image 1
    digitised image 2
    digitised image 3