Modern surgery, general and operative (1914) (14595924600)

Identifier: modernsurgerygen1914daco (find matches)

Title: Modern surgery, general and operative

Year: 1914 (1910s)

Authors: Da Costa, J. Chalmers (John Chalmers), 1863-1933

Subjects: Surgery Surgery, Operative

Publisher: Philadelphia, London, W. B. Saunders company

Contributing Library: Columbia University Libraries

Digitizing Sponsor: Open Knowledge Commons

Text Appearing Before Image:

., 1912). It is customary to consider a man well when, after he has been^\dthout treatment for one week, shreds and pus disappear from the urine,when an examination of expressed mucus on three successive days failsto find gonococci, and when there has been no discharge for ten days. Fur-thermore, we must be suje that the prostate, Cowpers glands, and the seminal^esicles are free from disease. Never declare a man well under three monthsfrom the start of the disease unless gonococci are positively absent from theurine and the expressed discharge. If a patient has no morning drop, has been apparently well for three orfour months, has no pus in the morning urine or in the expressed secretion ofthe urethra, prostate, and seminal vesicles, we can, without making cultures,afl&rm that he is well (Keyes, Ibid.). Keyes also maintains that a man with a pearly morning drop who passesa urine containing pus-shreds, but who has no free pus in expressed secretions,is probably free from gonorrhea.

Text Appearing After Image:

goi.—Bougie-a-boule. Treatment of Chronic Gonorrhea and of Chronic Urethritis FollowingGonorrhea.—^The first thing to do is to determine the cause of the prolonga-tion of the discharge. Valentines list of causes should be borne in mind(Med. Record, Jime 29, 1901). They are as follows: (i) Lack of treat-ment; (2) misdirected treatment; (3) insufficient treatment; (4) overtreat-ment; (5) infraction of dietetic or hygienic regulations; (6) constitutional dis-turbances; (7) congenital or acquired deformities and complications; (8) in-volvement of the urethral adnexa; (9) marital reinfection. In a case in whicha discharge persists or recurs the symptoms and general condition must beclosely studied, the discharge must be examined microscopically, the conditionof the urine must be determined, and the urethra must be explored. Exploration of the urethra is inaugurated by inspection and external pal-pation. Palpation detects induration, peri-urethritis, follicular abscess orinflammation, C

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1914

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