A practical treatise on the diseases, injuries and malformations of the urinary bladder, the prostate gland, and the urethra / by Samuel D. Gross.

Date:: 1876

Credit: A practical treatise on the diseases, injuries and malformations of the urinary bladder, the prostate gland, and the urethra / by Samuel D. Gross. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

538/582 (page 534)

$slioiikl ever be given coneerning any tnmor in this situation without a thorough examination, botli tactile and visual. A case is mentioned, under the head of Inversion of tlie Blad- der, where a tumor, formed by a ]>rolapse of the organ, came very near being mistaken for a vascular growth. It happened in a child between two and three years of age; the swelling was about the size and shape of a walnut, with a rough, granular surf}\ce,not unlike that of a large strawberry. The professional attendant proposed to remove it with a ligature, wliich he was about to apply, wlien another surgeon, who was called into con- sultation, fortunately detected the true character of the disease, and thus saved the child’s life. Although these tumors are, in general, not dangerous, yet they may, by the protracted irritation to which they give rise, occasionally destroy life, or reduce the patient to the very verge of the grave. When extirpated, or removed by caustic or liga- ture, they are apt to return, and to acquire, in a short time, their original volume. Occasionally they assume a malignant tendency, and gradually degenerate into open sores, which manifest no disposition to heal, and which discliarge a thin, foul, irritating ichor. The treatment of this variety of tumor is strictly of a local character. Constitutional remedies, beyond their effect of im- proving the secretions and imparting tone to the system, are of no benefit. Attempts have been made from time to time to repress this morbid growth by astringent and sorbefacient appli- cations, such as acetate of lead, ^loulard’s extract, tincture of iodine, and nitrate of silver; but without success. Instead, therefore, of wasting his time in this way, the surgeon should proceed at once to the employment of the only remedy known to be capable of affording permanent relief, namely, excision. This may be accomplished either with the knife or the scissors, according to the situation of the tumor. Seizure is effected with a small double hook, or a pair of broad-bladed forceps; the morbid growth is put gently on the stretch, or, if situated far back, carefully drawn forward, and then pared or snipped off with one stroke of tlie instrument, close to the mucous surface, or, if possible, so as to include a portion of this. Where this cannot be done, the surgeon waits till the bleeding has censed, and then touches the cut surface with chromic acid, followed by$