ORCHITIS. 95 



nence in the perineum, which opens and discharges, much to the 

 relief of the sufferer. The opening, however, often remains, and 

 through it the urine dribbles. This abscess may be caused by a 

 kick, or urinous infiltration from an internal fistula, produced by a 

 stricture. 



Treatment. — This should be directed to the cause ; if a stricture 

 exist, this should be cured first, and then the fistula, by caustic appli- 

 cation, red-hot wire, or paring the edges. 



ENLARGED PROSTATE. 



The gland is enlarged, from chronic inflammation, brought on by 

 gleet, stricture, horse exercise, &c. ; it is most common in middle 

 life, and disappears upon the removal of the cause. Leeches, rest, 

 counter-irritation, iodide of potash, laxatives, and enemata, are the 

 proper treatment. But the gland is also enlarged in old persons, — a 

 hypertrophy independent of inflammation. This enlargement takes 

 place first in the middle lobe, and the lateral lobes enlarge unequally. 

 The bladder sympathizes, and becomes irritable ; the urine is foetid, 

 mucous, and stains often retained. Catheterism, opiates, laxatives, 

 and regimen are the palliatives. 



INFLAMMATION OF THE BLADDER. 



This is usually a secondary affection, usually resulting from go- 

 norrhoBa, &c. There is pain in the perineum and sacrum ; micturi- 

 tion is frequent, with straining ; the urine is mixed with mucus or 

 pus. 



Treatment. — Bleeding, leeches, hip-bath, opiate enemata, castor 

 oil, &c. 



Chronic Inflammation — Catarrhus Yesicce. — May result from 

 the same causes as the acute form ; and also from over- distension of 

 the bladder : it is attended with great irritability and incontinence of 

 urine. The irritability and incontinence are sometimes the most 

 prominent symptoms ; and for these symptoms the injection of a 

 solution of sulphate of morphia, or nitrate of silver will be found 

 most serviceable. 



ORCHITIS. 



Swelled Testicle is a common accompaniment of mumps. \i is 

 often the result of an injury ; but, oftener, of gonorrhoea and its 

 treatment : exercise, wet, and cold, often induce it. Sometimes it is 

 termed hernia humoralis. 



Symptoms. — There is a great sense of weight, and the swelling 

 constantly increases ; the skin becomes tense, red, glistening ; the 

 pain is intense, often producing fever and vomiting. The cord is 

 often swollen and painful. The epididymis is chiefly aflfected. The 

 urethral discharge diminishes. 



Treatment. — Bleeding, in a plethoric habit, leeches, purgatives, 



