Five cases of inguinal bubo / by G.H. Colt.

  • Colt, G. H.
Date:
[1907]
Catalogue details

Licence: In copyright

Credit: Five cases of inguinal bubo / by G.H. Colt. 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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    of gonorrhoea in any of the cases and no history of painful micturition. There was nothing in the family history of these patients to indicate tuberculosis, and none of them presented any sign of tuberculous infection. The exciting cause of the swelling therefore remains unsolved in all five cases and should indicate one of two things, either that the investigation of the disease is exceptionally diflScult or that the ordinary causes assigned to it are not so common as supposed. Then, again, the patients were admitted consecutively just as they came for treatment, and, though the number of cases is small, one wmuld have expected that not all the swellings present would have been situated on the right side of the body. In Case 5 the patient presented a second swelling on the left side, but apart from this it was always the glands on the right side that were involved. Such a coincidence does not indicate a clear knowledge of the cause of the disease. The chief mass of glands composing these swellings was formed by the glands of Group 1 and these were the first to become enlarged, whereas if the cause had been genital the enlargement should have been noticed first and chiefly in the glands of Group 2. However, the tracing and mapping out of lymphatics has been partly done from clinical rather than from anatomical experience and to apply the last argument would be to argue in a circle. In some cases of bubo occurring in patients on board ship, when there is no jiossible chance of contagion,, often for months at a time, and where the possibility of contagion having occurred is generally freely admitted at once, it is very difficult to discover a source of infection. The cases are as follows :— Cask 1.—The patient, aged 22 years, was admitted on Dec. 23rd, 1904, and discharged to the convalescent home on Jan. 20th, 1905. He was a pale, thin man, and looked worn and ill when he first came to the hospital on Nov. 24th, 1904, complaining of a painful swelling in the right groin. The swelling had been noticed since Nov. 7th. A complete denial of all suspected causes was given and there was no sign of a. possible source of infection over the area mentioned above. The diagnosis made from the clinical ( haracters of the swelling was that of inguinal bubo, and since there were present with the swelling redness, heat, pain, tenderness on pressure with fluctuation at the most prominent part of it nitrous oxide anaesthesia was induced and an oblique incision two inches long was made over the part that yielded fluctuation and about five drachms of pus were evacuated. The relief' of the pain w'as considerable and the patient was instructed to lie in bed at home and have the wound fomented every four hours with boro- glyceride, a teaspoonful to a pint of water. He came to the hospital.