Some observations on the treatment of narrow and irritable stricture of the urethra : read before the Suffolk District Medical Society, May 1858 / by D.D. Slade.

  • Slade, D. D. (Daniel Denison), 1823-1896.
Date:
1858
Catalogue details

Licence: Public Domain Mark

Credit: Some observations on the treatment of narrow and irritable stricture of the urethra : read before the Suffolk District Medical Society, May 1858 / by D.D. Slade. 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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    be made. The hollow part of the instrument commences at about two and a half inches from the point, and a small eye is placed on the inner aspect of the curve. From this-part the instrument gradually increases in diameter. The whole is strengthened by a small steel rod or stylet, which accurately fills the interior, and to which the handle is affixed. The small eye can thus be kept clear of mucus and other matters. Mr. Thompson says: when the stricture has been passed, considerable care is necessary in guiding onward the point through the canal behind, to prevent it becoming engaged in the enlarged lacuna?, which are commonly found in the dilated urethra behind an old stricture. This being safely accomplished, and the stylet removed, the urine will issue by drops only, on account of the small size of the eye, but neverthe- less in a manner which will soon relieve the patient, and which at once assures the surgeons of his complete success. I cannot myself see any particular advantage to be derived from such an instrument as the one just described. After passing through the stricture, a considerable portion of the instrument must be push- ed on into the bladder, beyond the seat of the difficulty, before any urine could pass through the eye, and that too without any certain- ty that irreparable mischief may not be done to the parts. The probe-pointed bougie seems to me to be a much safer instrument, and much better adapted, in the majority of cases, to the proper treatment of narrow stricture. After either form of bougie of which I have spoken has been passed, and the retention, if it exist, has been relieved, their use can be followed by larger instruments of the same material, or the metallic ones may be substituted. We may not always succeed in passing instruments of such tenuity at the first trial, but by affording the parts an opportunity to rest, and the spasmodic action to subside, especially in those cases where violent measures have been pursued, success will finally reward our efforts. The perfect relaxation of all spas- modic action under the use of anaesthetic agents, often renders their administration extremely useful in our treatment of retention from a contracted stricture. I am of opinion that this is not borne in mind so generally as it ought to be. Temporary dilatation is, without doubt, the safest and surest method of treating organic stricture. Although slow, at the same time it can be easily managed and can be suspended at any mo- ment, according as circumstances require, and, above all, does not