KING'S COLLEGE HOSPITAL
Fergusson
1854
The Lancet
Upon a post-mortem examination, a piece of intestine was found tightly strangulated by a fold of the mesentery, and much inflamed above and below the strictured part. In the above case death evidently arose from strangulation of intestine, and yet all the usual symptoms of this affection were so masked as to escape detection. The pulse, the relief on pressure, the freedom from fever, and the total absence of vomiting, were directly contrary to what usually occurs; and, moreover, the malady
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... d fatal very speedily, the patient being in apparently good health twenty-four hours previous to dissolution. Now that stricture of the urethra forms an important subject in the surgical calendar, it may not be uninteresting to the reader of this subject to introduce the following case of intermittent lameness in the right foot resulting from aggravated permanent stricture of the urethra. In November, 1850, a young man about twenty-six years of age, applied to me with a peculiar urgent pain in the perinseum, which, although very varying, had annoyed him for some years. On making an ordinary examination, I discovered, at about six inches and a half from the meatus, a yielding stricture of about an inch. On further inquiry, I was told of a very particular (indescribable rheumatic, as the patient called it) grinding pain extending down the femoral region, from the sacral plexus, by the great ischiatic, popliteal, tibial, and plantar nerves, to the flexor brevis digitorum muscle and its parietes, which, becoming more or less affected and preternaturally contracted, reduced the lameness. In the ordinary course of inquiry, I found that this gentleman had not dispensed with the ideas so common to his class, the carrying out of which incurred the instigation of the above penalty; although, in his case, a cogent reason was, that in his hurry to be freed from his unenviable acquisition, he had applied to a quack, who ordered a strong and very forcible injection of sulphate of zinc, thereby injuring the delicate membrane of the prostatic urethra to an alarming extent, making the remedy worse than the malady. I treated him by dilatation and the warm bath with success. _ Bridport-place, Hoxton.
doi:10.1016/s0140-6736(02)40458-8
fatcat:leovly2r7zhylle5pibanfynxm