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:
1858
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Licence: Public Domain Mark

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 the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    I have already said respecting the different modes by means of which anal fissures may cause pollutions. The action is precisely the same as that of hemorrhoids. The indication to be fulfilled is of course to obtain a cure of the fissure, and this is only to be accomplished in severe cases by di- viding the sphincter ani.1 Thi3 operation must be performe'd to- wards the side opposite to that on which the fissure is situated.2 With regard to the treatment after the operation I must remark, that I consider the plan of stuffing the wound with charpie injurious and inconvenient; great irritation often results from it, and fre- quently hemorrhage is kept up, which would otherwise speedily cease. The wounds heal just as perfectly without this dressing, and I have lately given up its use in all cases where division of the sphincter ani is required.3 There are some cases of anal fissure which apparently depend.on a syphilitic taint. These are readily cured by the introduction of a small suppository containing mild mercurial ointment.4 Pollutions produced by Constipation.—Constipation is sometimes the cause of spermatorrhoea; but it is much more frequently one of the results of the disease; at all events, costiveness is almost always an accornpanimentof it. Inallcasesit is undoubtedly of importance to relieve the constipation, even when it is not the primary cause of the disease. Both surgeons and patients, however, have for the most part fallen into a strange error in considering that to cure the pollutions it is sufficient to procure free evacuations of the bowels. Diurnal pollutions, indeed, which are simply accidental, disappear as soon as the momentary costiveness causing them has been relieved; 1 The free application of the nitrate of silver in substance -will relieve many cases of fissure of the anus, even when very severe. The application gives sharp momen- t a v pain, but this soon passes off, and great relief is immediately afterwards expe- rienced. [11. J. McD.] - When the fissure is not situated in the anterior portion of the anus—the direction of the urethra—this operation may be performed by simply dividing the parts through the fissure. The irritable surface is thus converted into a simple wound, which in- flames, suppurates, and generally heals without further trouble. In all cases of fissure of the anus, as well as in cases of hemorrhoids—indeed, in all affections of the lower bowel—too much attention cannot be paid to the state of the digestive organs and liver. It must be recollected that disorder of these viscera is by far the most frequent cause of rectal disease, and that without first removing such cause no local treatment can be permanently successful. [IT. J. McD.] :; There can be no doubt as to the propriety of avoiding the filthy dressings still too often used, and the abominable practice of stuffing up wounds made by operation on ver bowel. In all cases when any dressing is required, a narrow strip of lint, dipped in a little tepid water, suffices. In the after treatment of divided sphincter ani, an aromatic lotiun—the red wash of the University College Hospital—consisting of about a scruple of sulphate of zinc, four drachms of spirits of rosemary, one drachm apound tincture of lavender and ten ounces of water—is generally the only ap- plication necessary. [II. J. McD.] 1 The origin of such fissures from a syphilitic taint, I cannot but consider very doubtful. Certainly the local application of the mild mercurial ointment would, ac- cording to the generally received notions of constitutional syphilis, be of very little efficacy in curing a secondary sore. [H. J. McD.]