Venereal and urinary diseases / by Temple S. Hoyne.

  • Hoyne, Temple S. (Temple Stroughton), 1841-1899.
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: Venereal and urinary diseases / by Temple S. Hoyne. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    penis greatly enlarged. The inflammatory chancre sometimes follows the too rapid administration of mercury or its compounds. Sometimes gangrene sets in, usually in consequence of the confine- ment of pus under an elongated prepuce, and is always a serious complication. It always follows violent inflammation; and mental emotions, sexual indulgence, alcoholic drinks, want of cleanliness and intestinal disorders are predisposing causes. Gangrene affects usually the upper portion of the prepuce, the slough being limited to the tissues surrounding the ulcer and is always accompanied by phymosis. While affecting by preference the prepuce, it occasionally attacks the penis, or it may spread from one structure to the other, or may attack both simultaneously. The progress of gangrene is more or less rapid, and the destruction of tissue often very great—in bad cases destroying the whole penis. The occurrence of gangrene, which occurs early in the course of the chancre, is announced by a blackish spot, preceded and accompanied by an intense burning pain and increase of the other in- flammatory phenomena. When the chancre is concealed, we recognize it by the swelling, pain and fetid sanious discharge which is always present. There is increased febrile action, with an accelerated and irritable pulse, considerable thirst, loss of appetite, constipation and restless sleep. Gan- grene, as we have already stated, destroys the syphilitic poison. Phagedena is a rare, but the most serious complication of chancre. It is very similar to hospital gangrene and occurs, but not invariably, in those whose constitutions have been ruined by mercury, intemperance, im- proper hygienic surroundings, improper and insufficient food and other debilitating influences. Sailors, prisoners, soldiers and inhabitants of tenement houses are the victims of this terrible affliction. The appli- cation of ointments (greasy) predisposes the patient to this form of chan- cre; so also does cold weather. Phagedena usually attacks the soft variety of chancre, but not invariably. When present, the sore extends rather slowly, but continuously, eating and destroying the parts, both laterally and interiorly. Sometimes its ravages are very rapid, destroying in a few hours a vast amount of tissue. Its favorite sites are the gutter upon the head of the penis and the under surface of the penis at the side of the i'raenum. If by chance the dorsal artery of the penis is in its way and becomes corroded, a serious, if not fatal, hemorrhage takes place. Occa- sionally phagedena occurs as an endemic in crowded hospitals, where the atmosphere is unhealthy and foul. Its duration is always prolonged and is difficult of arrest. It does not lessen the danger of constitutional in ■ fection, as gangrene does, provided that we accept the theory that pri- mary syphilis is merely a local disease. An interesting form of chancre is the serpiginous or erosive, the sore extending about, like a snake, in different directions, usually in circles or half circles and seemingly without limit. Another peculiarity is that