PROGRESS OF MEDICAL SCIENCE

WILLIAM OSLER, W. S. THAYER
1904 American Journal of the Medical Sciences  
schrift, 1904, xli., 609) reports a case of gonorrhoeal phlebitis of the posterior saphenous vein and of the pampiniform plexus of veins on the left side coming on four weeks after all urethral symptoms of a rather severe attack of gonorrhoea had subsided. He further reviews 25 cases he has been able to collect from the literature; 20 of the cases were in men, 6 in women, and all bul 2 occurred in the decade from twenty to thirty years of age. In all but 1 case the -complication accompanied the
more » ... ion accompanied the first attack of gonorrhoea. The phlebitis usually occurs in the subacute stage of the urethritis, the average period of incidence in fifteen observations being four and one-half weeks after onset. In 1 case it came on fourteen days after onset, and in 3 others three, sixteen, and eighteen months after, respectively. The original attack of gonorrhoea may run an uncomplicated course, but it is more often severe and associated with complications-prostatitis, urethro¬ cystitis, epididymitis, pleuritis, pyelitis, and erythema nodosum being reported; 15 of the cases were accompanied with arthritis. The veins affected were as follows: the common iliac (side not men¬ tioned), 1; the internal iliac (side not mentioned), 1; the femoral: right, 3; left, 3; the popliteal (side not mentioned), 1; the deep femoral: left, 2; side not mentioned, 1; the internal saphenous: right, 9; left, 6; side not mentioned, 1; superficial abdominal veins (side not mentioned), 3; vaginal veins: left, I; dorsal vein of penis, 1; vein to the corpus cavernosum, 3; prostate and vesical veins, 2; pampiniform plexus: right, 1; humeral vein: right, 3; left, 1; radial and cubital veins: left, 1. In most cases a single venous system is affected; in only 6 cases separate sys¬ tems. Fever was present in 10 cases, in 1 continuous and resembling somewhat a typhoid curve. In 2 cases chills were noted. The out¬ come of the phlebitis is usually a complete restitutio ad integrum; this was the case in 16 cases-62 per cent. The duration in these cases
doi:10.1097/00000441-190412000-00021 fatcat:ikmlpb3qyzcs5ep5x6i5i5edvy