Acute gonococcal urethritis in the male / by Victor Cox Pedersen.

  • Pedersen, Victor Cox, 1867-1958.
Date:
1913
Catalogue details

Licence: In copyright

Credit: Acute gonococcal urethritis in the male / by Victor Cox Pedersen. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    The indications of the expectant treatment are to dilute and neutralize the urine so that it shall not irritate the inflamed mucous membrane and so that, through its increased quantity, it shall wash away the pus at frequent intervals, but only under natu- ral pressure. It matters very little what alkali is used to neutralize the acidity, potash, soda, lithia, and the like. Caution through frequent uranalyses must be exercised to avoid precipitation of crystals, such as sodium urate, which may, by mechan- ical irritation, offend the mucosa as much or more than the acidity. The drinking of ordinary water is efficient in diluting and increasing the urine, but the patient had best cease forced water drinking about five hours before going to bed, otherwise the activ- ity of the bladder will disturb rest and provoke chordee. Chordee is the mark of severe infection and may be very troublesome. Cold applications reduce the congestion and the erection, urination then relieves the bladder whose distention is a basis of the symp- tom. The tendency toward chordee is avoided by emptying the bladder and bowels just before going to bed, sleeping on the side rather than the back, under light in preference to heavy bedclothing, and by taking the fluid extract of aconite in minimum doses every one or two hours through the day. Last, but not least, the patient must not associate with women, especially one of whom he is fond, in order to avoid the inevitable sexual stimulation incident thereto. Complications of acute anterior gonococcal ureth- ritis are the next topic and are, fortunately, rather trivial in character. They are avoided by as much general rest as possible, consonant with social and commercial duties, such as most patients must inev- itably continue. Extreme edema of the foreskin is one of them, due to lymphostasis and inflammatory swelling. Heat to tolerance in penile or sitting baths, local dressings, and subpreputial irrigations