File:Clinical lectures on stricture of the urethra and other disorders of the urinary organs (1878) (14595097259).jpg

Identifier: clinicallectures00harr (find matches)
Title: Clinical lectures on stricture of the urethra and other disorders of the urinary organs
Year: 1878 (1870s)
Authors: Harrison, Reginald, 1837-1908
Subjects: Urologic Diseases Urethral Stricture Urethra Urinary organs
Publisher: London : J. & A. Churchill Liverpool : Adam Holden
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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in the accompanyingdrawing. (Plate J.) These growths, so long as theydo not give rise to haemorrhage, or obstruct the orificeof the urethra, may exist for a considerable time with-out causing much inconvenience. Occasionally, bythe irritation they give rise to, they simulate stone. Isaw a case some years ago, where the weight of sus-picion that there was a calculus was increased by apeculiar gritty sensation being felt as the sound wasmoved about the bladder; this, I believe, was explain-able by the villi being encrusted with phosphates, as Ihave endeavoured to shew in the Plate, where asimilar condition existed. As these growths are of such a flocculent nature,their presence during life cannot with certainty be as-certained, either by digital examination or by the intro-duction of the sound ; the persistence of haemorrhagein the urine, aggravated by the passage of instrumentsinto the bladder, together with the evidence which the process of exclusion affords, will point to the Plate J
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SEVENTEENTH LECTURE. 170 probable cause. Unmistakable proof, however, is notunfrequently afforded by microscopical examination ofthe clots and broken tissue which either spontaneouslyescape, or are entangled in the eye of a catheter thatmay have been introduced. Such occurred in thespecimen (Plate J) removed from a patient of Mr.Longs, where, during life, the nature of the growthwas in this way discovered. Again, in a case of Dr.Davidsons, at the Northern Hospital, where the patientwas admitted for severe hematuria, the existence of avillous growth, as the probable cause, was determinedin a similar manner. The microscopical appearanceof these growths is well shewn in the Transactions ofthe Pathological Society of London. * In the treatment of villous growths, it must beremembered that when they prove fatal, it is by thesevere haemorrhage they occasion; consequently it isvery desirable to avoid lacerating them by any un-necessary introduction of instruments into the bladder.It must not

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