Practical remarks on the treatment of spermatorrhoea and some forms of impotence / by John L. Milton.

  • Milton, J. L. (John Laws), 1820-1898.
Date:
1854
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Licence: Public Domain Mark

Credit: Practical remarks on the treatment of spermatorrhoea and some forms of impotence / by John L. Milton. 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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    » torrboea from menorrhagia, venereal, or non- venereal, and often useful in atony; it is not of much value in cases of irritation, but even here it may aid by modifying the tissues.” Mr. Phillips, in the answers he was kind enough to send to some queries I laid before him, says that “ it has uot only often failed to effect a cure, but even to relieve sperma- torrhoea and Mr. Curling, in a communi- cation he favoured me with, says, “ Cauteri- zation is not an infallible remedy. Some cases are too aggravated or too well esta- blished readily to admit of cure by any treatment. Many circumstances tend to connteract the beneficial effects of the caustic, such as want of self-control to check bad habits and the thouglits dwelling on impure subjects, occupations and modes of living detrimental to health,” &c. But again he says, “ cauterization has rarely failed to give more or less relief.” Of its safety there can be no doubt when it is properly employed. LaUemand used it for twenty years, and even cauterized the lower part of the bladder, without any unto- ward result; and Mr. Acton, commenting upon this statement, says he can fully bear it out. Mr. Curling says, “ in no instance has any harm resulted from the application of the caustic aud Mr. Phillips, in one of his answers to me, says it has ne^er produced injurious results in his hands, though his experience extends over many hundred cases. We might suppose that some part of this was owing tq the excellent surgery of those who employed it. M. LaUemand does not aUow the ckustic to remain an instant longer in contact than is absolute necessary. “ I cannot,” he says, “protest too strongly against those who give a fixed period (une duree quelconque) for the action of the caustic, and measure it off by the watch. Even to look at the dial takes too long a time” And Mr. Curling attributes the ab- sence of severe symptoms in the cases where he has used it to his having applied it stiU more gently. But Mr. Phillips, though he has seen some discomfort caused by it, has rarely heard of any complaint on the pa- tient’s part; the pain on passing urine is “ very bearable,” although he uses the caustic very freely. “ I have never appUed,” he says, “ too much caustic, but I have more than once faded by using too little.” Had any severe symptoms occurred, Mr. Phillips, would, we may rest assured, neither have overlooked nor suppressed the mention of them. All that is left us is frankly to admit that iu his cases no harm resulted from the application of the caustic. M. LaUemand, however, has seen severe reten- tion of urine, hajinorrhagc, intense pains, which only yielded after a long time, and it seems that stricture has also foUowed, I have myself seen cases where intense and long-continued suffering ensued withou any amendment in the patient’s condition. Questionable Utility of LaUemand's Caus- tic-holder.—The more I see of this com- plaint, the more does the conviction grow upon me, that' the use of caustic upon Lal- Icmand’s plan is, in a great number of in- stances, quite uncalled for ; and that it very often, perhaps in the majority of instances, fads to effect a lasting cure of the disease. I am wed aware that this view is totaUy opposed, not only to the opinions, but also to the experience of many able snrgeons ; that the treatment by caustic was matured and tested in a most extensive practice for many years; that its inventor with unex- ampled success, dved to see his treatment universally adopted as the great panacea for a disease, which, from the time of Hunter till his day, was almost totally neglected, and, as a consequence, only treated in the rudest and most empirical manner. StiU, I cannot help thinking that it is a bye-path, and that under the shadow of a great name much has been said that wiU hardly stand the test of criticism. I have now seen so many cases where caustic had been- appUed without success— in fact, without producing any amendment whatever, that I no longer have any doubts upon the point. More than one-half the spermatorrhoea cases which have come under my care had, where treatment had been em- ployed, been cauterized without any ben^- cial result, in others a temporary improve- ment had taken place, followed by a relapse. Several surgeons have also told me that they had been' consulted by so many patients who had been cauterized in vain, and that they had themselves employed the caustic with so little result, that they had almost given up using it. Now these were not patients who had been handled by bunglers in the art—by men who had employed the caustic unskilfully and rashly ; on the contrary, they had been under the care of the first-class surgeons in this speciality, both in this country and in France aud Germany—even of M. LaUemand himself. Some of them, after having bid their surgeons good-bye, the cure being in the opinion of both com- plete, had endured the mortification of seeing the worst symptoms return. Beyond all question some part qf this may be attributed to the total want of a system- atic course of treatment by medicine. Even granting the value of caustic in some in- stances, it seems most desirable, in order not to lose any part of its effect, first of all, as