Three demonstrations on malformations of the hind end of the body / by Arthur Keith.

  • Keith, Arthur, Sir, 1866-1955.
Date:
1908
Catalogue details

Licence: In copyright

Credit: Three demonstrations on malformations of the hind end of the body / by Arthur Keith. 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 proximal side of the bulb, prevents the reflux of its contents towards the bladder. Hunter regarded the bulb and its musculature as an apparatus for the forcible emission of semen; the transformation which is seen to take place in the perineum of the male fetus during the second and third months is connected with the adaptation of the urogenital sinus to serve as an ejaculating and con- ducting apparatus in place of the cloaca, as in the tortoise. An atrophy of the bulb, of its musculature, or an arrest of development may be regarded as due to the absence or the imperfection of the genital glands. Group B.—Minor Conditions of Hypospadias. In my opening demonstration I remarked we should discover both the merits and defects of the museum, and here we reach a very considerable blank, for there is only one preparation in the museum to show the minor degrees of hypospadias, apparently every one supposing that such a common condition must he already amply represented. In the museums of the metropolitan medical schools I saw only two specimens, and yet in a recent paper Dr. Edington'® was able to give an account of 28 cases. Thanks to the courtesy of the staff of the London Hos- pital, I had opportunities of seeing many cases and of forming a first-hand opinion as to the nature of the defects. Minor degrees of hypospadias may be grouped in the three stages shown in Fig. 12; A, stags 1 of that Fig 12.—Three types of hypospadias—(A) in which the groove in the glans (phallic groove) is open, and urine passes by the urogenital orifice; (B) in which the floor of the phallic groove is formed, but the urogenital orifice is unclosed; (C) in which the phallic groove is unformed or obliterated and the urogenital orifice serves as a meatus. (Drawn by W. Finerty.) 1, Urogenital orifice ; 2, frenum praeputii; 3, phallic groove and canal; 4, permanent meatus. figure, shows a condition recalling the tortoise form—the part of the urethra formed by the union of the lips of the glans (phallic groove) remains open, thus forming a furrow which terminates behind at the opening of the urogenital sinus. The orifice of this sinus serves as a meatus ; it is bounded by two lateral folds, which are continued forwards into the glans and frenum of the prepuce, while behind the orifice they unite in a sharp, thin falciform margin, which undoubtedly represents the fourchette of the female vulva, and therefore may be