Modern surgery, general and operative . s in at night, and in a con-siderable proportion of cases the symptoms rapidly grow worse and worseimtil, at the end of a few days, the patient sinks into a semicomatose conditionfrom which he seldom rallies. Postmortem there are all the signs of recentacute cystitis and pyelonephritis. The mucous membrane lining the pelvis 1 Lancet, Sept. 10, 1898. 1370 Diseases and Injuries of the Genito-urinary Organs and calices of the kidney, the ureters, and the bladder is swollen and stainedby old and recent hemorrhages, and here and there a thin layer of pus is a
Modern surgery, general and operative . s in at night, and in a con-siderable proportion of cases the symptoms rapidly grow worse and worseimtil, at the end of a few days, the patient sinks into a semicomatose conditionfrom which he seldom rallies. Postmortem there are all the signs of recentacute cystitis and pyelonephritis. The mucous membrane lining the pelvis 1 Lancet, Sept. 10, 1898. 1370 Diseases and Injuries of the Genito-urinary Organs and calices of the kidney, the ureters, and the bladder is swollen and stainedby old and recent hemorrhages, and here and there a thin layer of pus is ad-herent to it. The pelvis and the ureters are dilated, the apices of the pyramidsare eaten away, the cortex is shrunken and hard, the capsule is adherent, andin places between the tubules are minute collections of pus differing in shape andoutline according to the anatomical arrangement. Treatment.—Aseptic catheterization is necessary if we would avoid urin-ary fever; and as the iirethra contains some of the causative organisms, the. Fig. 920.—Symes grooved staff. prepuce, glans, and meatus should be washed with soap and water and irri-gated with boric acid or permanganate of potassiiun solution, and the urethrabe irrigated with boric acid solution or permanganate of potassium before thesterile catheter is introduced to draw the urine. If urinary fever arises, it may be possible to control it by frequently irri-gating the bladder with warm normal salt solution, solution of nitrate ofsilver (i : 8000) or boric acid solution, and by administering stimulants, Fig. 921.—Wheelhouses staff. diuretics, diaphoretics, saline cathartics, urotropin, salol or boric acid, qui-nin, and nutritious food. In severe cases perform suprapubic cystostomy fordrainage. Perineal section is external perineal urethrotomy. There are threemethods—the operation of Syme, of Wheelhouse, and of Cock. Symes Operation.—This operation is employed if a stricture is verycontractile, if dilatation fails
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Keywords: ., bookcentury1900, bookdecade1910, bookpublishe, booksubjectsurgery
