A practical treatise on the causes, symptoms, and treatment of spermatorrhoea / by M. Lallemand ; translated and edited by Henry J. McDougall.

Claude François Lallemand

Date:: 1847

Credit: A practical treatise on the causes, symptoms, and treatment of spermatorrhoea / by M. Lallemand ; translated and edited by Henry J. McDougall. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

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$the posterior border of tlie prostate, ati-ophied and surrounded by a very dense fibrous cellular tissue, which was very difficult of dissection. The Prostate double its normal size and projecting into the rectum ; hard on the sides of the neck of the bladder, soft in the centre. Its fibrous envelope having been divided with a bistoury, an opaque, thick, ropy, elastic matter escaped, like pus in color, and the mucus of the nostrils in consistence. There was a cavity occupying the whole of the anterior and iniddle parts of the prostate, about fifteen fines in size in every direction, when the purulent matter had been removed ; the gelatinous mass was observed to di\dde into a number of filaments which became impacted in iiumerous small foramina ; the canal of the urethra bein^ closed, these filaments came ont by the openings of the mucous follicles ot the prostate. When tins cavity was emptied it became évident that the two inferior thirds of the prostatic part of the urethi'al mucous membrane had been detached and had covered the cavity in the prostate in the same manner that the cribriform lamella of the ethmoid bone covers the nasal fossæ in the dried skull. The openings of the Ejaculatory Ducts in place of being circular and nipple shaped, formed a long slit, which was ulcerated, especially on the side towai’ds the bladder ; two probes of considérable size iutroduced through the vasa deferentia passed easily through these openings. The ejaculatory ducts were long and thin, as though dissected, and formed part of the superior wall of the cavity in the prostate. The pos- terior border of the prostate was not destroyed but was pale, soft, and easily torn, like ail the parts in the neighbourhood of the principal abscess. The Urethra ])resented no remarkable appearances. The Testieles wmre small, flaccid, and pale. I leave this case just as I wrote it when under impressions formed at the time, because its récital is well fitted to show those serions errors in diagnosis, which are much more common than might hâve been suspected. Now that we hâve seen the more obscure parts of this case cleared up by degrees, let us consider the chronological order of the facts :— An uréthral discharge, badly treated in the beginning, reappeared from very slight causes, whose action, however, was easily appré- ciable. The follicles of the prostate from repeated attacks of inflammation, became disorganiscd ; the ejaculatory ducts were laid bare, and their orifices became ulcerated ; the inflammation extended to the séminal vesicles, and the peritoneum adjoining. Soon after, a nevv train of symptoms set in, which became much aggravated after the patient’s marriage, in conséquence of the unaccustomed exercise of the disordered organs. Ejaculation was rapid, because the ejaculatory ducts were in a state of irri- tation. The érections were incomplète, and at length ceased altogether, because the semen was habitually expelled as soon as secreted. This discharge was considérable, for the testieles shared the irritation of the other parts. During ail this time inflamma-$