lt)0 DISEASES CLASS 1. 2. 3. 24 



Introduce a candle smeared with mercurial ointment. Sponge- 

 tent. Clysters with forty drops of laudanum. Introduce a 

 leathern canula, or gut, and then either a wooden maundrii, or 

 blow it up with air, so as to distend the contracted part as much 

 as the patient can bear. Or spread mercurial plaster on thick 

 soft leather, and roll it up with the plaster outwards to any thick- 

 ness and length, which can be easily introduced and worn; or 

 two or three such pieces may be introduced after each other, 

 The same may be used to compress bleeding internal piles. See 

 Class I. 2. 1. 6. Rub mercurial ointment on the sphincter ani 

 every night for a fortnight. 



May not this disease be cured by lunar caustic applied on the 

 end of a pessary or bougie, in the same manner as used by J. 

 Hunter, and since by Mr. E. Home, in strictures of the urethra; 

 when on introducing the finger, a kind of membranous valve 

 can be distinguished rather than an extensive scirrhus or indura- 

 tion. See the next article. 



24. Scirrhus urethrm. Scirrhus of the urethra. The passage 

 becomes contracted by the thickened membrane, and the urine is 

 forced through with great difficulty, and is thence liable to dis- 

 tend the canal behind the stricture; till at length an aperture is 

 made, and the urine forces its way into the cellular membrane, 

 making large sinuses. This situation sometimes continues many 

 months, or even years, and so much matter is evacuated after 

 making water, or at the same time, by the action of the muscles 

 in the vicinity of the sinuses, that it has been mistaken for an in- 

 creased secretion from the bladder, and has been erroneously 

 termed a catarrh of the bladder. See a paper by Dr. R. W. 

 Darwin in the Medical Memoirs. 



M. M. Distend the part gradually by catgut bougies, which, 

 by their compression, will at the same time diminish the thickness 

 of the membrane, or by bougies of elastic gum, or of horn boil- 

 ed soft. The patient should gain the habit of making water 

 slowly^ which is a matter of the utmost consequence, as it pre- 

 vents the distention and consequent rupture, of that part of the 

 urethra, which is between the stricture and the neck of the 

 bladder. 



When there occurs an external ulcer in the perinaeum, and 

 the urine is in part discharged that way, the disease cannot be 

 mistaken. Otherwise, from the quantity of matter, it is general- 

 ly supposed to come from the bladder, or prostate gland; and 

 the urine, which escapes from the ruptured urethra, mines its 

 way amongst the muscles and membranes, and the patient dies 

 tabid, owing to the want of an external orifice to discharge the 

 matter. See Class II. 1. 4. 11. 



