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tula, or fome otlifr ii.ftniincnt. The plafter, liowcvi-r, muil 

 be warm enoujjh to foak throiigli, and difcolour tlif rag, 

 othtrwifc it will not make To guud a bougie. 



If the tlotli be txaftly ttiice inches broad, it will make 

 fix bougies of a moderate fize ; but their fi/e may be fuited 

 to the occafion. It is generally advifeable that the bougie 

 (hoidd be I'malier at t!ie end which is introduced through the 

 ftrie^urcs, than at that which is left out at the penis. For 

 this purpofe many cut off a part of the oblong fquare 

 before mentioned, in fuch a maniicr as to reduce it almoft 

 iuto the (hape of a long right-angled triangle ; but as this 

 way of cutting it weakens the bougie exceedingly, and as it 

 is not at all necelTary that the bougie Ihould be taper from 

 one extremity to the other, it is much better to cut oil a 

 little Hope of about an inch and a half long from the end 

 that is to be palfed into the urethra, which will lelTtn it 

 where it is Hectiniry to be Imall, and leave it Urong in the 

 other part, where the diminution is not ntceffary. 



The plafter taken up by the cloth, when dipped, will have 

 little bubbles upon its furface, and nut be fo fmooth as if it 

 had been fprcad : therefore an iron fpatula, a little warmed, 

 may be paiTcd over the plaller before it be cut iito bougies, 

 which will render it more compatt and even. It is a much 

 more exad and fpeedy method to cut the bougies off with a 

 knife and ruler than with fcilTars. When they are rolled up, 

 it muft. be with that fide outward which is covered with 

 plafUr ; and they mull firll be rolled by hand as clofe as 

 poflible, before they are rolled upon a board or marble ; for 

 upon this circumllance the neatnefs of the bougie depends. 



It feldom happens that a bougie is required to be more 

 than a quarter of an inch in diameter, or three quarters in 

 circumference ; but the gencraUty of praftitioners are apt 

 to err in ufnig them of too fmall a fize to produce any per- 

 manent advantage in overcoming the (Irifture. There is 

 undoubtedly a great difference iu the calibre of the urethra 

 of different perfons, and we have known the plaller conipo- 

 fition to have been forced oil the linen by a patient having 

 uftd the bougie too large, fo as to collect the plafttr in a 

 mafs w^thin the urinary canal; but we llill lay it down as a 

 general rule to employ the inftrnment as large as can be 

 conveniently introduced, and again withdrawn from the 

 urethra, although by no means fo large as to hazard the ac- 

 cident here alluded to. 



Some furgeons have very highly extolled the utility of 

 bougies made of catgut, btcaufe of the property they pof- 

 fefs of becoming dilated by the moifture of the urethra, and 

 thus enlarging the contradled part of the canal. We have, 

 however, been much difappointed in our expeftations from 

 catgut bougies ; as they did not dilate with fufEcient force 

 upon the exaft fpot in which th.- difeafe exillcd, and there- 

 fore fwelled generally without advantage : nav, it even hap- 

 pens that the catgut, if it be large, will not come away 

 without difficulty and pain, iince it dilates equally beyond 

 the flriAure itl'elf, as well as on tlie contraifled part ; and if 

 It be not fufEciently large, its fuftnefs renders it of no utility 

 whatever. As there is no polTible mode in which the cat- 

 gut can do any gotij, but by mechanically extending the 

 flriclure, and as this can only happen for a few moments 

 while the mllrument remains firm, it mull be obvious to 

 every reHedling perfon that ttiis kind of bougie is likely to 

 be even Icfs ufeful than ihofe made of plaller or cere- 

 cloth ; and this is precifely what we have obferved as the 

 refult of our own experience. 



Praclitioners, being in fome refpeiSs diffatislied with the 

 bougies commonly uftd, have introduced pieces of fmooth 

 whalebone, or long Hips of leall.er, for the fame purpofe : 

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but we think, upon the whole, they are liable, at leaft, to 

 as tlrong objections as any we have already mentioned ; and 

 the trials made with theni, by fcveral furgeons, have not at 

 all produced a conviAion of their luperiority. At prefent, 

 indeed, they feem to be entirely laid afide. 



Another fpccies of bougie, which deftrves much more 

 attention, is compofcd of catgut internally, and covered by 

 a thin layer of diffolved elallic gum, or caoutchouc. The 

 manufadlure of this elaflic vegetable fubftance is confined 

 to a very few hands. We believe it was firft applied in a 

 Hate of folution to the purpofes of furgery, either by Mr. 

 Theden, a Pruffian furgeon, or by M. Bernard, of Paris ; 

 but bougies of this kind are alfo made in other countries, 

 efpecially in Sv. eden and Germany, and lately by Mr. Walfh, 

 of London. The mode of diffolving and dr^'ing the caout- 

 chouc is kept as a fecret. It is faid, however, to be foluble 

 in a:ther and in linfeed oil : it may likewife be rendered fluid 

 by cutting the fubftance into flips, and burning them ; but 

 the great difficulty is in refloring it to a ftate of folidity 

 and drynefs, fo as to render the bougies ufeful after they are 

 fabricated and covered with caoutchouc. Thefe bougies, 

 when properly made, arc not only very flexible and fmooth, 

 but may remain a confiderable time in the urethra without 

 being greatly injured. When they crack, or become rough 

 on their furface by repeated ufe, they are unfit for our pur- 

 pofe, and fliould be exchanged for new ones. See the arti- 

 cles Catheter and Caoutchouc. 



It has formerly been the piaftice of fome furgeons, in 

 ufing any of the feveral kinds if bougies already defcribed, 

 to daub their furface over with diilerent llimulating un- 

 guents, &c. And it has been imagined that the puriforni 

 difcharge thus produced from the urethra, had a tendency 

 to diffolve the callofity of the ilriAure or caruncle, which 

 they fuppofed to be the occafion of the obllrufted urine. 

 Now this is an entire fallacy, founded on a falfe theory ; for 

 neither is there any proof of the exiftence of fuch caruncles 

 and callofities in the urethra, nor (if they really did exill) 

 could the fuppuration produced by fuch means afford mate- 

 rial advantage. Any llimulating fubllance introduced into 

 the urethra, for example a common plaller bougie, may pro- 

 duce a difcharge of matter, efpecially in very irritable pa- 

 tients ; but this difcharge arifes from the whole internal 

 furface of the canal to which the bougie has been applied, 

 and not exclufively, or perhaps, not at all, from the ob- 

 ftrufted part where the llrifture exills : and this fuppuration 

 is no more than the common refL;lt of the application of a 

 mechanical Itimulus, or foreign body, to a delicate fecreting 

 membrane. If that portion of the bougie which came into 

 contaft with the difeafed part be more covered with mucus 

 or pus than any other, this circumftance is probably owing 

 to a greater irritation or increafe of aftion in the fecreting 

 arteries of that part, in confequence of its preternatural irri- 

 tability ; but, by introducing a bougie compofed of aftive 

 ingredients, or fmearing its furface over with acrid materials, 

 we excite an unhealthy aftion not only in the morbid part 

 of the urinary pafi^ge, but alfo along the whole extent of 

 the found furface. The reafoning here employed againll fo 

 ablurd a praAice, will apply likewife againll the uje of what 

 have been called " Medicated bougies," which have been 

 ignoiantly fuppofed to pofTefs fome healing or medicinal 

 quality. 



The only remaining bougies we intend to notice in the 

 prefent article, are thofe which Mr. Smyth, an apothecary 

 of London, has recently fabricated, of a flexible metallic 

 compofition. Although he has not publifhed his invention, 

 (if indeed it be a nciv compound of the metals,) we think 



the 



