The Boston Medical and Surgical Journal, Vol. 36

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Excerpt from The Boston Medical and Surgical Journal, Vol. 36: February to August, 1847 What, then, is to be done with those cases in which the urine will only pass guttatim, and in which there is great difficulty in passing the small est bougie? They are either to be incised (a practice, we are sorry to say, that is freely pursued in this city), or caustic is to be used and here it must he confessed there is roonr for some difference of opinion, and a great chance for quackery to attack the regular practitioner, for, be it known, that like the Thomsonian and his anti-mineral cry, they raise their voices against us for using it, and constantly abuse it themselves in the most fearful manner. We have had several cases of caustic strictures made by these gentry, which from the description of the instruments used, and the severe burning that followed their application, leaves no doubt on my mind, that caustic was the origin of all the trouble. All strictures that exist at the curved part of the urethra, or beyond the scrotum, should be treat ed with hollow bougies, admitting a stiff wire to within a quarter of an inch of the point and the surgeon will find them pass with increased fa cility, if his patient stands before him and he places the left hand under the urethra, making gentle pressure thereon so as to support the instrument and occasionally tilt up its point, whilst the hand holding the bougie can make pressure in the opposite direction, and thus depress the point, all the while making gentle pressure towards the stricture, and as it were humoring the urethra. 'indeed, it is always best not to alarm this delicate membrane, for it often is ready primed to oppose your efforts with spasm, act, then, like a wily politician, and conceal your real intention till you have effected your purpose. In some of these spasmodic cases, bella donna may be used with the caustic by an instrument we shall describe presently. About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully, any imperfections that remain are intentionally left to preserve the state of such historical works.