Bilharziosis / by Frank Cole Madden.

  • Madden, Frank Cole.
Date:
1907
Catalogue details

Licence: Public Domain Mark

Credit: Bilharziosis / by Frank Cole Madden. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    Symptoms.—The symptoms of early bilharziosis of the male urethra are usually localised pain in the perinseum and a hard, tender lump at the seat of the pain. There is a certain amount of difficulty in pass- ing urine, and this symptom may be so marked that many cases are sent into hospital as impacted stone in the urethra. On careful examination with the sound it will be found that, though there is often some little difficulty in passing the instrument beyond the lump in the perinaeum, it goes fairly easily, with a little coaxing, into the bladder; and, except for some roughness at the thickening, no stone is to be felt. The point of the sound may catch in the wall of a small thick-walled cavity in passing, and the grating thus produced may be easily mistaken for the rubbing against a stone impacted in this situation. As the disease advances the lump becomes larger and softer and approaches the skin surface in the posterior part of the scrotum, or just behind it, with all the symptoms of a subacute periurethral abscess. Eventually this leads to a thinning of the skin and a discharge of thick offensive pus and granular debris, and, very soon, a slight leakage of urine from the opening during the act of micturition. In this way a urinary fistula is produced and will persist indefinitely unless radical treatment is adopted. On cutting down in such a case one opens into a thick-walled cavity, which has a small connection with the urethra and is filled with pus, granular debris, and a few drops of urine. The granular tissue will contain ova ; the walls of the urethra above