A case of hypospadias through five generations / by T.J. Strong.

  • Strong, T.J.
Date:
1906
Catalogue details

Licence: In copyright

Credit: A case of hypospadias through five generations / by T.J. Strong. 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.

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    sules” and other medicines internally but no injections or local treatment. Present History: Claims to have a dis- charge from urethra and at times a burning sensation on urination—these constituting practically all his symptoms. Examination: Patient has a purulent dis- charge from the meatus, which is situated about half-way from end of penis to the corona glandis. Penis is normal in shape and at the end is an indenture where the normal opening should be. Below this and leading to the meatus is a slight furrow or groove in the median line. The pus was secured and, ex- amined and showed numerous gonococci. The opening in the penis looked nearly downward and patient stated he generally held his penis out straight to urinate to avoid soiling his clothing. He was asked if he was born with that condition to which he replied in the af- firmative and then stated the following curious family history: His great grandfather, grand- father, father and three brothers were all af- fected in the same way. Although he said that he had never seen his greatgrandfather’s nor grandfather's penis, he had been told the above facts. He had seen however, his father’s and three brothers organs, and one of them was “worse” than his own. He had one brother who had escaped the affliction, and to cap the curious state of affairs said a brother who was married (had hypospodias) had a child who “had the same thing,” thus making five gen- erations in direct descendency with a hypos- podias. The urethritis was treated by irrigations— no stricture was present—a bent glass nozzle being inserted into the abnormal meatus more easily than a straight one. The case pro- gressed favorably and owing to inability of the patient to come for office treatment as often as desired he took the alternative—use of in- jections—at his cjuarters, and only recently re- ported to say that he was rapidly improving. BULLET WOUNDS OF THE INTESTINE. Report of a Case by E. JV. Melville, il/. D., of St. Albans, Vt. On Tuesday, Mar. 6 at 4 P. iM., C. H. S., a brass moulder, while examining a 38 calibre Smith & Wesson revolver, shot himself about the centre of a triangular space, whose apices were the pubis, the umbilicus and the left an- terior superior spine of the crest of the ilium. That the weapon was held against the belly, was proven by the fact that the clothing and flesh of the abdomen were burned. Patient passed immediately into a state of collapse, from which he rallied somewhat by 6 P. M., aided undoubtedly, by saline enemas and hypo- dermics of strychnine, glonoin and atropine. Removed to hospital at 7 P. M. and usual preparation given for an abdominal section. The condition of the patient was by this time excellent; he was able to get out of bed with- out assistance and walk some distance to the urinal. While the surgical stage was being reached a second shaving and scrubbing of the abdomen was done. The incision was made with the bullet wound as a centre, down through the peri- toneum, and the descending colon carefully drawn out of the six inch incision. Four punctures were found, which were closed by purse string sutures of medium sized catgut, the openings inverted into the lumen of the bowel, by a probe and the suture drawn tight. The whole clamaged area was now turned in and held by an uninterrupted catgut ligature; and the mesentery drawn over all. The whole peritoneal cavity was of course flooded with fecal material, but no further openings were found. No search was made for the bullet. Several gallons of hot sterile saline solution were poured into the peritoneal cavity, until it returned perfectly clear. The peritoneum was now sewed up by an uninterrupted catgut suture, the different sets of muscles were treated likewise, and the skin by interrupted silkworm gut. A piece of iodoform drainage tape was left in the lower angle of the wound. His recovery was almost without incident. The tape was taken out on the second day, the skin sutures on the fifth day. The opening made by the tape was all closed on the twelfth day. He was given two grains of calomel on the day following the operation, which was very effectual. His temperature reached 100° on two OjDcasions but soon reached and re- mained normal. It was necessary to use the catheter for three days following the opera- tion. He was discharged from the hospital, on the twenty-first day, and within a month from the date of the accident was again at work. Drs. Gibson and Arnold assisted me at the operation.
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