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Phlegmone

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Causes.

vances ra

Treatment.

Gen. II. B Strangulans.

The prepuce retracted and Spec. VI.

Strangulating phimosis. strangling the glans. phimotica. Phimotic The FIRST VARIETY alone is denominated phimosis by phlegmon.

some writers, the SECOND being distinguished by the Paraphimosis, what. term paraphimosis, or circumligatura. But the inflam

mation is one and the same, and the same specific name should express it; for the difference is a mere accident.

This inflammation, like the last, though often produced by common causes, and hence perfectly simple, is

often, also, the result of a specific virus, as in lues and Often ad- blenorrhoea. It arises frequently with great rapidity; pidly.

the prepuce is prodigiously distended with effused serum, and the mucous glands of the internal surface secrete an enormous quantity of pus before there is any ulceration or breach of surface. If the prepuce be retracted violently, and the glans strangulated, and cold applications, and topical bleedings prove ineffectual, it is often necessary to divide the prepuce to set the glans at liberty. And occasionally it is also necessary to perform the same operation when the glans is imprisoned by a protraction of the prepuce: for ulceration is apt to take place under these circumstances in either case, and the matter soon becomes erosive from communicating with the air: as much of it as possible, however, should be washed out by a syringe used several times a-day, and an astringent solution be afterwards injected, consisting of alum dissolved in water in the proportion of about a scruple to a quarter of a pint.

The imprisoning phimosis is said to occur not unfrequently from laborious exertion in a very narrow vagina*. I have not met with this result, but often with a lacerated prepuce. In many instances of both kinds relief has been easily obtained by grasping the penis with a very cold hand, and dextrously urging the prepuce forward or drawing it backward according to the nature Gen. II.

* Essich, in Ziegenhagen Anweisung alle venerische Krankheiten -- zu behandeln. A.D.B. xcv. 421.

Spec. VI. of the case *

Phlegmone When the inflammation is very violent, whether in phimotica. the strangulated or retracted variety, and surgical at

Phimotic tention has been neglected, gangrene will readily ensue, Treatment. and an amputation of a smaller or larger portion of the Sometimes

followed by penis may be absolutely necessary. In an instance of an

gangrene. amputation of this kind, recorded by Mr. Jamieson of Kelso, in the Edinburgh Medical Essays, the whole of the glans penis was restored by a process of pullulation: the Mortified. new shoots having at first been mistaken for fungus, and

Busy and regermiattempted to be destroyed by escarotics. The fresh nated. glans was well shaped and proportioned t.

has

• Andree, on the Gonorrhæa-Heckeer, Von Venerischen Krankheiten, &c.

† Vol. v. Art. xxxvi.

GENUS III.

PHYMA.

Tuber.

IMPERFECTLY SUPPURATIVE, CUTANEOUS, OR SUBCUTA

NEOUS TUMOR; THE ABSCESS THICKENNED, AND IN-
DURATED AT THE EDGE; OFTEN WITH A CORE IN THE
MIDDLE.

Gen. III. Phyma, a Greek term importing a tuber, tubercle or Import of

small swelling, from pów, “ produco, erumpo", was used the term: formerly

among the Greek and Roman physicians with great lavery loose titude and no small want of precision: sometimes, as by and confused.

Hippocrates and Paulus of Ægina, being applied to scrofulous and other imperfectly suppurative tumours; sometimes, as by Celsus and Galen, to tumours perfectly and rapidly suppurative, larger than a boil, but less painful and inflammatory, and without a core or ventricle: and sometimes by other writers, as Celsus also informs us, to fleshy excrescences or warts on the glans penis, which it was then the custom to destroy by caustics. And in consequence of this vague sense of the term, and the latitude of its original meaning, the great body of the Galenists, as Sauvages observes, applied it

to protuberances of every kind. Its exact Modern writers have, hence, been at a loss in what meaning

exact signification phyma should be employed. Linexcited dis- néus and Cullen have rejected it. Sauvages and Sagar cussion.

have used it as the name of a distinct and separate order. Vogel, following the example of Hippocrates and Paulus, has reduced it to a genus of imperfectly suppurative and glandular tumours; and, as a genus, it thus occurs in Dr. Willan's table of arrangement, including boils, carbuncles, and similar inflammations as its species.

has hence

Tuber.

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character.

This seems to be the most accurate sense; and as such Gen. III. it is adopted in the present system, and made to include the stye, boil, sycosis, and carbuncle; in all which we find Most a some degree of imperfection in the suppurative or the rate import. ulcerative process of these small abscesses, or in both Common conjointly; and hence the pus is foul and sanious, or the walls or edges of the abscess are thick and indurated, or the dead matter is not completely carried off, and remains behind in the shape of a core or a fungus, sometimes black and spongy, and sometimes excrescent and granulating.

The following, therefore, are the species included under it:1. PHYMA HORDEOLUM.

STY. 2. --- FURUNCULUS.

BOIL. 3. — sycosis.

FICOUS PHYMA.

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TUMOUR SEATED ON THE VERGE OF THE EYE-LID ; GRA

NULAR: HARD; REDDISH; SORE TO THE TOUCH;
SUPPURATION CONFINED TO THE POINT.

Spen

The vernacular term sty, or as it is sometimes written Gen. III. stian, is to be met with in the earlier writers, who ob

Origin of tained it from the Saxon, in which stihan (rrigan) sig- the vernanifies “a rising, springing up, or ascent"; and hence in cular name. Bede's Bible, Mar. iv. 7. stigon da þornar (stihon tha thornas), “up spring the thorns.” Wickliffe spells the

Sty.

Gen. III. old English derivation stigh, but Spenser, who uses the
Spec. I.
P. Hor

word frequently, drops both the last letters of Wickliffe, deolum. as in the following couplet :

To climb aloft and others to excel,

That was ambition, and desire to sty. Sometimes. From the hardness of the margin of the tumour, and hard drink the imperfection of the suppurative process, Sauvages

compares it to a small boil: and asserts that it is often the result of a morbid state of the stomach; adding that he knew a man who uniformly had a sty after drinking ardent spirits. The inflammation, though often very troublesome while it lasts, for the most part readily subsides upon the breaking of the minute abscess, or puncturing it at its apex when mature.

ing.

SPECIES II.

PHYMA FURUNCULUS.

Boil.

TUMOUR COMMON TO THE SURFACE ; DEEP-RED; HARD;

CIRCUMSCRIBED; ACUTELY TENDER TO THE TOUCH;
SUPPURATING WITH A CENTRAL CORE.

Character.

Gen. III. The boil is a push with a central core; and like the push
SPEC. II.

is found in persons of an entonic or phlogotic habit, with
a peculiar susceptibility of irritation : on which account
it often makes its appearance successively in different
parts of the body, and sometimes synchronously, so that
we meet with a crop at a time. This tumour is therefore
chiefly found in persons of high health and in the vigour

of youth. Core. The existence of a core offers a singularity in this af

fection that is well worth attending to, and shows that from some cause or other the ulcerative part of the pro

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