Some points in practical surgery suggested by the study of the life and work of John Hunter : being the Hunterian lecture delivered before the Hunterian Society of London, February 26, 1902 / by Reginald Harrison.

  • Harrison, Reginald, 1837-1908.
Date:
1902
Catalogue details

Licence: In copyright

Credit: Some points in practical surgery suggested by the study of the life and work of John Hunter : being the Hunterian lecture delivered before the Hunterian Society of London, February 26, 1902 / by Reginald Harrison. 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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    reference to the making of wounds which “ readily heal in spite of urine passing through them,” to use his own words, has an important bearing upon this point, for it will be recognised that their substitution for those which show no tendency to repair, but, on the contrary, to remain patent as suppurating and offensive sores, may often be advantageously utilised. This point has frequently been demonstrated in practice, and proved the quickest and safest way of dealing with certain forms of urethral stricture complicated with one or more urinary fistulas. Thus the secondary proceedings to which Hunter refers, namely, operations on the fistulae themselves, may be obviated as unnecessary when the stricture is entirely freed and the urine so efficiently drained as to be prevented entering unnatural channels. I will take a case in illustration, not because the prin- ciple is unrecognised in practice, but for the reason that there are at least two points which are paramount that I would like to emphasise. The case is that of a man recently under observation, aged 25. His condition is outlined in the diagram, which is introduced for the convenience of description. It will be seen (fig. i) that there is a stricture in the deep urethra, and in addition no less than five fistulae opening externally, and directly or indirectly communicating with the urine passage immediately behind the point of obstruc- tion. One fistula opens on the lowest part of the abdomen in front, another passes through the scrotum, whilst the openings of three will be found in the perineum. Under the act of micturition urine was expelled through all of them in addition to some suppuration, which was con- tinuous. The cause of this trouble was a traumatic stric- ture of the urethra, which supervened upon an injury to this part, and the unhealed abscesses that had arisen out of this.