On stricture of the male urethra : its radical cure / by Fessenden N. Otis.

  • Otis, Fessenden N. (Fessenden Nott), 1825-1900.
Date:
1875
Catalogue details

Licence: Public Domain Mark

Credit: On stricture of the male urethra : its radical cure / by Fessenden N. Otis. 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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    tion was resorted to ; and besides, that the results of the divulsion and division were of a more permanent character. These claims were stoutly resisted by the advocates of a gradual dilatation, and all the possible benefits and advantages accruing from every other mode of treatment were asserted to be possessed, in superior de- gree, by their more conservative proceedings. Besides this contest between the advocates of gradual dilatation and immediate opera- tion, we now have this latter class divided into those who believe that all strictures are best treated by divulsion, and those who claim that the best results are produced only by division of stric- ture, with some one or other of the various urethrotomes in use. Each party, however, accepting the necessity of keeping up the re- sults of their operations, by the systematic use of dilating sounds or bougies, for the remaining lifetime of the patient so operated on. It would, therefore, seem to be not so very much matter after all, in the very great majority of cases, whether the little risks, and much trouble and expense, of the patient, in gradual dilatation, were a little less or a little greater in the aggregate, than by one de- cisive blow, to reach the No. 12 of the English scale, and then start out with it for the lifetime journey. To this complexion do all ap- pear to come at last, the ultimate necessity for continuance of instrumental measures, throughout the lifetime of the patient. In this respect, then, whether the plan of treatment for stricture be that of gradual dilatation, rapid distension, divulsion, or simple urethrotomy, the patient (whatever the surgeon may say) is never cured. By each one of these modes life may be saved and much suffering averted. Thousands, to-day, live in comparative comfort, who, but for the intelligent surgical aid afforded by these instrumental procedures for the relief of urethral stricture, would be in their graves. Yet the opprohrium medicorum rests upon the treatment of stricture, and why ? Because after the patient is pronounced cured by his surgeon, he is obliged to continue the systematic use (always re- pulsive, and often hazardous), of a sound or flexible bougie, for the rest of his life.* Far be it from me to undervalue the skill, the study, and the experience which have brought relief to those under the very shadow of death, nor the teachings that have enabled the least practised surgeon to operate, with fair assurance of a successful issue, out of difficulties, which, twenty years ago * Wade on Stricture of the Urethra. London, 1860, p. 352.