PATHOLOGY. 
Much may be learnt of the precife fituatiop of a ftric- 
ture by means of the bougie. This inftrument parted 
down to the ftridture (hows its (filiation. The impreflion 
it receives from the ftrifture, when it has parted through, 
(hows the fize and form of the latter ; and the refiftance 
it meets with in parting (hows the degree of the ftricture. 
A (tridture is, casteris paribus, more dilatable when the 
body is in a (fate of general relaxation than at other times: 
this arifes from the lofs of contractile power which all the 
contractile fibres undergo; for, though it may be doubted 
■whether a ftrifture dilates or contracts in itfelf, (till it is 
certain, that, when irritated, a fpafmodic refiftance is af¬ 
forded to the partage of an inftrument. But we (hould 
rather refer this circumftance to the fympathetic contrac¬ 
tion of the healthy fibres of the canal. 
From the ftatements we have made concerning the pro¬ 
bable ItruCture and mode of formation of a ftridture, its 
treatment clearly follows. Viewing the mere contraction 
of fome contraCtile fibre as an aCtion which is always an¬ 
tecedent to and coexiftent with that refiftance to the 
dilcliarge of urine which we call ftfiCture, it is obviou's, 
that local and mechanical means of removing that con¬ 
traction mult be put in force, in moft cafes, before a cure 
can be effected. At the fame time, the removal of the 
morbid thickening of the mucous membrane of the ure¬ 
thra by abforption (hould be chiefly attended to. For the 
former purpofe, bougies are generally ufed. Of thefe in- 
ftruments we (hall fpeak prefently. The latter is to be 
effected by conftitutional remedies ; and, when we con- 
fider the very fmall portion of membrane affeCted, and 
the little fympathy this membrane altogether feems 
to hold with the general fyftem, we cannot fail to be 
furprifed at the great benefit thefe remedies afford to the 
malady in queftion. Attention to the bowels, and to 
the ftate of the fecretions in general, with mild diet and 
copious dilution, will often cure recent ftriCtures without 
local application ; and, wdienever it does become necef- 
fary to ufe the latter, their efficacy will be diminirtied or 
increafed in proportion as the general health is deranged 
or the reverfe. Now the advantageous employment of a 
bougie will depend much on the manner of its introduc¬ 
tion. The bougie (hould be of a fufficient diameter to 
refill entanglement in the lacunae of the urethra; and 
the grand principle which fliould direCt its introduction, 
fhould be to pafs it through the ftriCture fo as to dilate 
it, and thereby caufe abforption of its membranous fub- 
ftance; and alfo relaxation of the contraCtile fibre, if indeed 
we can bring our minds to believe that that fibre has any 
thing to do with the continuance of a llriCture once 
formed. If much force be ufed, we (hall (land a chance of 
injuring other parts of the membrane befidesthe ftriClured 
one, and thereby caufe much mifchief. At the fame 
time, much preflure is fometimes required to dilate a 
ftriCture. But on this head we (lull not enlarge. A 
great deal of taCt, and an attention to many minutiae, are 
requifite to the fafe introduction of inftruments through 
the urinary partage; and we (hall defer further notice of 
the parting of bougie, the Ample and cauftic or armed, the 
catheter, &c. till we come to the article Surgery. 
It mult be remembered, that, when the Ample bougie 
has failed, cauftic has been applied to the urethra with 
fuccefs. Ufed as an agent which is to eat through a 
ftriCture, and confequently employed of great ftrength, 
it has no doubt often done harm. Viewed as a local fti- 
mulus which excites the injured part to ulceration and 
abforption, and confequently ufed in weak proportion , 
and infuch a manner as to enfure its exaCt application to 
the ftriClured furface, and to that only, we will venture 
to afiert, that it is a valuable auxiliary to the treatment 
of this troublefome difeafe. 
3. Blenorrhcea chronica, gleet: (limy difcharge from 
the mucous glands of the urethra, without fpecific venom 
or infection; (lightly irritating; chronic. (Gonorrhoea 
mucofa. Cull.) 
Moftly a fequel of the preceding 3 and ufually accom¬ 
329 
panied wdth ftriCture or enlarged proftate gland. Though 
without fpecific venom, occafionally fo acrimonious, as 
to produce great local inflammation on the perfon coha¬ 
bited with, while the fecreting organ which has un¬ 
dergone the morbid change is torpid, or nearly fo, to its 
virulence. Its treatment has already received due notice 
under the preceding fpecies. 
Genus IV. Spermorrhaa, [from crne^ot, feed, and |e u, 
to flow.] Involuntary emiflion of feminal fluid without 
copulation. There are two fpecies. 
1. Spermorrhoea atonica, (Gonorrhoea libidinofa, Sauv. 
G. laxorum, Cull.) Involuntary emiflion of a dilute and 
nearly-pellucid feminal fluid ; with libidinous propen- 
fity, but without ereCtion. The iaft fymptom is, how¬ 
ever, not always obfervable. 
This difeafe is generally accompanied with much men¬ 
tal difturbance ; lownefs of fpirits, in a remarkable de¬ 
gree, generally attending it. It feems moft commonly to 
owe its origin to the indulgence of folitary vice, and is 
extremely difficult of cure. This may however be ef¬ 
fected, in lefs fevere cafes, by dating to the patient the 
dangerous confequences of his vicious propenfity, and 
cautioning him to refill at all times the fir ft approaches of 
fenfual ideas. In violent cafes it is abfolutely necefiary 
to combat the difpofition for folitude by every kind of 
diflipation; and indeed it may be a queftion whether it 
might not be allowable to lead the fufferer into the 
haunts o( libidinous females rather than fuffer this much 
more dangerous difeafe-to gain ground. The writer of 
this article once attended a young man, over whole 
mental energies this horrible propenfity acquired fo ex¬ 
treme an influence, as to induce, on repeated occafions, 
attempts at fuicide. Advice was thrown away upon one 
in whofe bofom religious feeling was ftrong, and who 
neverthelefs abandoned himfelf to this vice in utter de- 
fpair of overcoming it. Nor could the lefs-excufable 
meafure of inculcating natural fin be ufed with one whofe 
copulative defires failed on the approach of a female. 
Two or three furious attempts at felf-deftruCtion induced 
the writer to adopt bleeding ; and for the bad ftate of the 
bilious fecretion he was obliged to prefcribe calomel. The 
fuccefs of the depletory plan caufed it to be continued 
frequently; and, the calomel being perfiited in, the 
mouth became affeCted with violent ptyalifm. After 
this, the patient returned to his profefllon (the law) 
with renewed health and fpirits, and has never fince 
been afflicted with this malady. The above cafe is nar¬ 
rated as a curious one; but the practice is by no means 
held out to general example. 
When this difeafe is merely local, it probably is in¬ 
flammation of the epididymis. Counter-irritation by blit¬ 
ters to the perineum, with occafional bleeding, generally 
cure it. 
2. Spermorrhoea entonica: involuntary emiflion of 
proper fernen, with erection ; moftly from indulgence of 
libidinous ideas. 
This fpecies is not worthy of particular confideration 5 
it feems rather an effort of nature to relieve glandular ful- 
nefs than a difeafe, and is not of frequent occurrence or 
of dangerous confequence. Indeed a famous phyfiologiit 
has afierted that it is a perfectly natural and falutaty 
procefs. 
Genus V. GalaSlia, [from yu'hx, milk.] Morbid flow 
or deficiency of milk. Five fpecies. 
1. GalaCtia anticipans: efflux of milk during preg¬ 
nancy. A pint and a half has fometimes been poured 
forth daily as early as the fifth month. Sauv. ii. p. 412. 
See alfo Timaeus Caf. p. 220. 
2. GalaCtia impotens: inability to fuckle upon child¬ 
birth. Two varieties. 
a. Atonica; from want of fecretion. 
( 3 . Organica; from imperfeCt nipple, or other organic 
defeat. 
3. GalaCtia 
