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AMERICAN MEDICAL TIMES
Being a Weekly Series of the New York Journal of Medicine.
STEP II EN SMITH, M.D.
ELISHA I ARRIS, M.D., AND GEO. F. SIIRADY, M.D
10 JUL 1946
Entered, according to Act of Congress, in the year 1861, by
In the Clerk's Ofice of the District Court of the United States for the Southern District of New York.
CONTRIBUTORS TO THE SECOND
APPLEY, W. L., M.D., of Cochecton, N. J. FETTER, D. F., M.D., of New York.
FINNELL, T. C., M.D., Surgeon to St. Vincent's BARKER, B. Fordyce, M.D., Obstetric Physician
Hospital, N. Y. to Bellevue Hospital, N. Y.
FLINT, Austin, M.D., Professor of Clinical MediBEDFORD, Frederick, M.D., late House Surgeon
cine and Medical Pathology in the New to Bellevue Hospital, N. Y.
Orleans School of Medicine, New Orleans, BENNETT, Ezra P., M.D., of Danbury, Conn.
La. BENNETT, William C., of Danbury, Conn.
FOUNTAIN, E. J., M.D., of Davenport, Iowa. BLACKWELL, E., M.D., of New York.
FRIEND, A., M.D., Boligee Creek, Ala. BRADFORD, G. W., of Homer, N. Y. Brown, John B., M.D., of Boston, Mass. GALT, G. A. D., M.D., of Virginia. BROWNE, Rufus K., M.D., Professor of Physiology GARDNER, A. K., M.D., Professor of Clinical
and Microscopic Anatomy in the New York Midwifery and Diseases of Females in the Medical College, N. Y.
New York Medical College, N. Y.
Hospital, N. Y.
HALLET, Alfred, M.D., Physician to the Long BUTLER, W. H., M.D., of East Saginaw, Mich.
Island College Hospital, Brooklyn, N. Y.
HAMILTON, Frank H., M.D., Professor of MiliCARTWRIGHT, S. S., M.D., of Roxbury, N. Y. tary Surgery and the Diseases and AcciCHISHOLM, J. J., M.D., Professor of Surgery in
dents incident to Bones in the Bellevue the Medical College of South Carolina, Hospital Medical College, N. Y. Charleston, S. C.
HAMMOND, WM. A., M.D., of Baltimore, Md. CHURCH, Wm. Henry, M.D., Surgeon to Belle. Hunt, Jolin W., M.D., late House Surgeon to vue Hospital, N. Y.
Bellevue Hospital, N. Y.
Practice of Medicine in the College of Phy. HUTCHISON, J. C., M.D., Professor of Operative
Surgery and Surgical Anatomy in the Long CLEVELAND, Wm. K., M.D., of New York.
Island College Hospital, Brooklyn, N. Y.
and Surgery in the Medical Department of
Anatomy and Operative Surgery in the Lind
University, Chicago, Ill. Cal. Corson, William C., M.D., Physician to the New JACOBI, A., M.D., Professor of Infantile PathoYork and Eastern Dispensaries, N. Y.
logy and Therapeutics in the New York CUSHMAN, A., Pharmaceutist, N. Y.
Medical College, N. Y.
and Microscopic Anatomy in the College of KNEELAND, Jonathan, M.D., of South Onondaga,
N. Y. DRAKE, Nelson S., M.D., of Brooklyn, N. Y.
LALOR, William, Pharmaceutist, N. Y. ECHEVERRIA, M. Gonzalez, M.D., late Assistant LEE, C. A., M.D., Professor of Materia Medica, Physician to the National Hospital for the
LENTE, Frederic D., M.D., of Cold Spring, N. Y. EDWARDS, F. S., M.D., of New York.
LILLY, H. M., M.D., of Fond du Lac, Wisc. ELLIOT, George T., Jr.
, M.D., Physician to Belle- LITTLE, J. L., M.D., House-Surgeon to the N. Y. vue Hospital and the Lying-in-Asylum, N. Y. Hospital, N. Y.
LIVINGSTON, R. R., M.D., of Plattsmouth, SANBORN, E. K., M.D., Surgeon to first Regiment
Vermont Volunteers, Hort Monroe, Va.
LYMAN, Ilenry M., M.D., Hlouse-Surgeon to SEARLE, A., M.D., of Onondaga Valley, N. Y.
SIMROCK, J., M.D., of New York.
, David P., M.D., of Springfield, Mass.
MAURY, R. B., M.D., of Port Gibson, Miss.
SMITH, S. Hanbury, M.D., of New York.
SPAFFORI), E. W., M.D., Portlandville, N. Y.
SQUIBB, Edward R., M.D., of Brooklyn.
STEWART, P., M.D., of Peekskill, N. Y.
RICHERSON, F. B., M.D., of Cold Spring, N. Y. VEDDER, Maus Rosa, M.D., House Physician to
Bellevue IIospital, New York.
REPORTS FROM THE FOLLOWING IIOSPITALS AND SOCIETIES HAVE APPEARED IN
American Medical Times.
VAN BUREN ON STRICTURE OF THE URETHRA.
Jan. 5, 1861.
ployed for several years, in the enjoyment of very comfortable health, What are the means to be used in such a
case? In the first place you must secure entire control of PUBLISHER'S NOTICE.
Confine him to his room, in warm air, and if necessary, to his bed. Insist upon regular, unirritating
diet, and if possible, cut off all alcoholic stimulants. MoNo. 1 of the present volume of the derate local inflammation by the application of leeches to
the perineum, the use of warm baths, and dilute mustard AMERICAN MEDICAL Times being out poultices to the hypogastrium nightly.' Give diluents freely
in the shape of flaxseed tea, or other mucilaginous drinks, of print,—the publishers have re
and administer from Dj. to 3 ss. of bi-carbonate of potass
three times in twenty-four hours, unless a microscopical printed the following Lecture of
Lecture of examination of the urine should indicate other and more
appropriate medication. And here let me remark that the Dr. W. H. Van Buren, which ap- voided, may be alkaline; it frequently possesses its normal
use of alkalies is not contra-indicated because the urine, as peared in that Number, in order acidity, as transmitted from the kidneys to the bladder, but
is rendered alkaline by altered mucus of an inflamed blad
der. So much for medicinal means, and they will facilitate that the series of Lectures shall greatly the success of your instrumental manipulations.
These should be employed at judiciously selected intervals, be complete. The remainder of every two or three days, or longer, according to the degree
to be the number, or pages 3 to 18 of the selected for the treatment of such a case let me recommend
very fine French flexible bougies with a tapering volume, will be found wanting. point, from No. 1, of the ordinary scale, downwards. In
ject the urethra with warm olive oil before introducing them, and give a spiral twist, as recommended by Leroy d'Etiolles, or an in-shaped bend, to the extremity of the bougie, so that by rotating it between the fingers as you repeatedly and perseveringly withdraw and re-apply it to the face of the stricture, its point will be more likely to enter the opening through which the urine escapes. Be
very careful, especially at first, not to prolong your attempts LECTURES ON
injudiciously; and if unsuccessful, finish by passing a steel
sound of good size down to the stricture, and pressing its STRICTURE OF TIIE URETIIRA, point very gently against it for a few seconds. If the
tapering point of the bougie should enter the stricture and
be grasped by it, leave it there for five minutes, and consiCLINICAL COURSE ON DISEASE OF TIIE GENITO
der that you have gained enough for one visit; at the next
you will probably recognise the advantage thus secured. URINARY ORGANS.
Should your patient be very irritable it may be advisable DELIVERED AT THE UNIVERSITY MEDICAL COLLEGE.
to insert an opium suppository into the rectum, and this should consist of from one to three grains of the watery
PRELIMINARY TO THE
extract, with butter of cacao. W. H. VAN BUREN, M.D.,
The principal danger to be anticipated, whilst pursuing
this plan of treatment, is the liability of bringing on an LECTURE VI.
attack of retention of urine before you have secured the
power of introducing an instrument at will ; and you canIf a case of stricture shculd present itself, in which, in not be too careful to avoid this by extreme gentleness and consequence of the existence of false passages, or temporary circumspection, otherwise the necessity of an immediate aggravation from inflammation, or extreme contraction, in resort to operation by cutting instruments may be precipiduration, or tortuosity, you are unable to introduce an tated. Of the measures to be employed in case of reteninstrument into the bladder, what course is then to be pur
tion, and of some other devices to be brought to bear upon sued? Is treatment by dilatation to be attempted here ? an obstinate stricture, I shall speak hereafter. Meanwhile, I would answer, yes; as long as the patient can empty his let me commend to your considerate judgment the means bladder without assistance it is your duty to attempt dila -both medicinal and surgical--which I have just enumetation. The case is one of increased difficulty and danger, rated; by their deliberate and judicious employment you and success may not ultimately crown your efforts; but by have it in your power to effect a cure in strictures of the bringing to bear upon it all the resources of your art, and most serious character, and they are applicable to the great by the employment of the requisite amount of tact, gentle- | majority of cases you will meet in practice. Above all, do ness, and intelligent perseverance, in the great majority of not permit your patient to undervalue the gravity of his cases you will succeed. Keep in view the idea that wliere symptoms, and do not commence systematic treatment urine can escape, an instrument ought also to pass, and, without fair control over him, otherwise you place yourself sooner or later, in all probability, it will. Some years ago in a false position, and risk disappointment, and loss of I assumed the responsibility of the case of a gentleman, reputation. past middle age, who had been under treatment for ten In cases of stricture in which much difficulty and delay years by various surgeons, with impassable stricture, and have been experienced in getting an instrument into the liable to frequent attacks of retention of urine, and who had bladder, and where there is doubt as to the possibility of positively refused to submit to an operation. For a period its re-introduction without additional delay, it is proper, of six months I persevered regularly and steadily before I unless contra-indications exist, to leave the instrument in succeeded in introducing an instrument into his bladder, the bladder, and follow out the plan, as already described, but in six weeks after attaining this success my patient was of so-called vital dilatation. In most cases the urine will able to introduce for himself Nos. 11 and 12 steel sounds pass readily beside a fine bougie thus left in the bladder; with very slight difficulty, and these he subsequently em and probably in a few days a catheter may be substituted
AM. MED. TIMES, VOL. II., No. 1,
PROFESSOR OF ANATOMY, ETU.