3°2 Mr. H. Earle on the re-establishment of a portion 
time he obeyed the calls of nature. This, coupled with the 
distressing excoriation attendant on the scattering of the 
urine, made him anxious to submit to any plan of treatment 
which afforded a possibility of relief, and I determined on 
pursuing the following one. 
The integuments on the right side had suffered less ex- 
tensively than those on the left, so that when a catheter was 
introduced, that portion which passed across the cicatrix 
could be about half covered by drawing the skin and cicatrix 
from the right towards the opposite side. My first attempt, 
therefore, was to encourage this disposition in the integu- 
ments to fold over; and as some delay was requisite in 
order to dilate the anterior part of the urethra with bougies, 
he was directed to remain in bed with his knees tied together 
over a pillow, and a truss was so applied as constantly to 
press the integuments from the right to the left side.* To 
this plan the ultimate cure of the patient is in some measure 
referable. 
After some weeks, the urethra being sufficiently dilated to 
admit a moderate sized catheter, I determined to attempt the 
following operation. The smooth cicatrized surface having 
become insensible to the irritation of the urine, I resolved to 
employ it in the formation of a canal, and to endeavour to 
connect by it the two portions of the urethra : for, as many 
# I constructed a similar truss some years before, for the relief of a female suf- 
fering under incontinence of urine, and have since successfully employed it in three 
cases. It consisted in a spring which passed round the front of the body above the 
pubes, and fastened with a strap behind. From the centre of the truss a fine 
spring descended, taking the necessary curve to pass under the arch of the pubes, 
and terminating in an oval pad covered with oil silk, about an inch in length, and 
half an inch wide. 
