32S 
PATHOLOGY. 
nal furface of the penis, orraons veneris, aft by fympathy 
in reftraining internal inflammation: lowlivingand keep¬ 
ing the penis tied up towards the belly aft in the fame 
manner. Large quantities of water or tea, and diure¬ 
tics, by diluting the falts of the urine, render them lefs 
irritating, and confequently aft as a fedative on the in¬ 
flamed membrane when this fluid pafles through it. The 
aftion of foda, in neutralizing any free acid in the urine, 
operates alfo in the fame way. Under this plan, the in¬ 
flammatory ftage of Blenorrhoea generally goes off; the 
pain in making water (which is always a fign of inflam¬ 
mation) fubfides; and a mere chronic di(charge, from 
laxity of vefiels, remains. This is curable by the ufe of 
injections, as folutions of fulphate of zinc or alum, and 
by the exhibition internally of copaiba. In very obfti- 
nate cafes the copaiba may be applied locally, by means 
of a bougie. In this ftage the malady is called a gleet , is 
often very troublefome, and requires frequently to have 
a variety of ftimulants tried before any one will fucceed 
in altering the aftion of the fecernents. 
We have before faid, that certain ftimulants applied 
even in the earlieft ftages of Blenorrhcea had the pro¬ 
perty of fo affedting the fecernents as to flop their fecre- 
tion, and confequently the inflammation which arofe out 
of them. Thus fome patients have ufed aftringent in¬ 
jections as foon as the tingling fenfation at the end of the 
penis (the firft fymptom) made its appearance, and with 
fuccefs. This, however, is a very hazardous experiment; 
tor, if the tendency to inflammation be, from conftitu- 
tional or other caufes, very ftrong, orchitis is apt to en- 
fue, and prove a troublefome malady. 
A more foft and efficient ftimulus is the cubeba, a drug 
taken internally in dofes of from one to three drachms 
three times a-day. This medicine fometimes indeed to¬ 
tally fails; but at all events never has appeared injurious, 
and in the majority of cafes cures the Blenorrhcea with¬ 
out leaving behind it any gleet or other unplealant fymp¬ 
tom. If its good effeCts are not apparent in about a 
week, it is proper to leave it off, and commence the an- 
tiphlogiftic plan before laid down. The tinCture of cu- 
bebs, combined with equal parts of the balfam of copaiba, 
is a very excellent medicine in old-ftanding gleets. 
From the above ftatement it very clearly appears, that 
Blenorrhcea is in itfelf a difeafe of no great danger or 
importance, and one which iseafily cured; but it is occa- 
ftonally accompanied by difeafes which are the effeCt of 
an inflammatory character, and are troublefome both to 
the patient and the.practitioner. Thefe are, inflamma¬ 
tion of the tefticle, Ample bubo, cliordee, and ftriCture. 
The inflammation of the tefticle generally comes on 
when the difeharge from the urethra is (topped, and fub¬ 
fides as the latter returns. It is treated in the fame 
manner as Emprefma orchitis in general, which fee, p. 
■2.6 4. The bubo which accompanies Blenorrhcea, does 
not feem, like the true venereal bubo, to depend on the 
abforption of matter, but rather to owe its origin to an 
irritation conveyed along the abforbents. This alfo 
requires the fame treatment as Ample bubo, which fee. 
Cliordee is ufed to exprefs an afteftion in which the pe¬ 
nis is curved downwards at the time of ereftion, the 
under furface of this organ having a hard line running 
along, and being attended with the moft excruciating 
pain. This fymptom arifes from an unufual degree of 
inflammation affefting the corpus fpongiofum of the in¬ 
ferior part of the penis, which confequently is permanently 
contracted, and cannot follow the dilatation of the cor¬ 
pora cavernofa, or fuperior parts. Lee.ches to the penis 
or perinseum are proper, with cold bathing of the affeft- 
ed part when the irritation comes on. If nothing be 
done, the patient, after fullering the moft intolerable tor¬ 
ment for fome days, is relieved by the fpontaneous refo- 
lution of the inflammation, or by a rupture of veflels, 
from which copious bleeding and ultimate relief fol¬ 
low. 
Stritture of the urethra is the moft ferious diforder 
which is liable to attend on Blenorrhoea. It come3 on, 
however, from other irritation befides clap; but is treated 
in the fame way, whatever may have been its firft caufe. 
There is fome difficulty in explaining what a ftrifture is. 
It has been generally luppofed to be a contraction of 
certain mufcular fibres furrounding the mucous mem¬ 
brane ol the urethra. Mr. Shaw, in a paper in the tenth 
volume of the Medico Chirurgical TranfaCtions, has 
(hown, however, that the mufcular ftruCture of the ure¬ 
thra cannot be demonftrated in man or in the larger ani¬ 
mals. Yet we cannot infer that contraCtile fibres do not 
exift becaufe red mufcular fibres are not found ; neither 
can we allow, that, becaufe they are fo diminutive, they 
mu ft have no power, when we confider the favourable 
polition in which circular mufcles aft. Moreover it feems 
to us, that the complete expulfion of both femen and 
of urine indicates a contraftile power in the urethra 5 
and it feems alfo, that no other afl'umption explains the 
form of a ftrifture; for if, as Mr. Shaw feems to infer, it 
is merely an inflammatory procefs of the mucous mem¬ 
brane, we ihould naturally expeft to find the morbid 
thickening on one fide, and a fomewhat extended furface 
of the membrane, and not in this peculiar round form. 
As far, however, as practical fafts are concerned, we are 
quite ready to agree, that our treatment (hould never be 
direfted to the dilatation of a contracted mufcle, for 
that no ftrifture can arife from this caufe alone. It 
feems probable that the irritation which exifts in the 
mucous membrane of the urethra calls forth a fpafmodic 
contraction of fome filament of contraftile fibre. It 
muft be granted, indeed, that at firft this contraction will 
not, on account of the weaknefs of the fibre concerned, 
impede the flow of urine. It feems to us, that this latter 
effeft will not take place till inflammation and thicken¬ 
ing of the mucous membrane enfue; this inflammation 
being viewed as a confequence of the contraction of the 
contraftile fibre on the one hand, and the irritation the 
contracted portion is fubjefted to by the dilating force 
of the urine on the other. This thickening of the mu¬ 
cous membrane will of courfe be liable to fome varia¬ 
tions; it may undergo fpafmodic aftion, in confequence 
of a contraction of the arteries which enter in the com- 
pofition of the thickened ftruCture ; but it is in that part 
of the urinary canal (viz. the neck of the bladder) which 
is evidently furnifhed with mufcle, that fpafmodic ftric- 
ture is moft commonly found. The precife nature of the 
irritation that brings on ftriCture is not very apparent. 
Stricture is certainly more common in hot climates, and 
with intemperate perfons, than under other circumftan- 
ces. It is alfo more frequently a confequence of clap 
than of any other kind of urinary ftimulus ; but it does 
not feem to have any proportion to the violence of the 
clap. Strictures are often produced by the incautious 
ufe of injections, and are aggravated by copulation. A 
ftrifture of the urethra often produces other difeafes, as 
a paraphimofis, or a fwelled tefticle. 
The fymptoms of a ftrifture are rather obfeure. There 
is a flight diminution in the fize of the flow of urine, oftep 
with a degree of twifting or bifurcation of it; and on 
fome occafions the ftream is fcattered in various direc¬ 
tions ; on others it is completely flopped, or at lead with 
the exception of a little dribbling. A difeharge of thin 
mucus alfo attends, which is liable to be miftaken for a 
gleet. The impediment to making water is always in- 
creafed by the patient’s catching cold, or indulging in a 
debauch. A pain at the end of the glans penis is often 
found in ftriftured perfons; and in old cafes a variety of 
dilorders are engendered. Thefe are at firft merely irri¬ 
tative difeafes, as unufual irritability of the bladder, noc¬ 
turnal emiffions, pricking and (hooting fenfations about 
the fundament, &c. but in fome cafes aftual inflamma¬ 
tion of the bladder and its inverting peritoneum has 
come on. In almolt all cafes, the refiftance caufed by a 
long-ftanding ftrifture caufes the bladder to acquire a 
great increafe of thicknefs and mufcular power. 
1 Much 
