One of the most popular modern methods of treatment of ure thritis is that by retro-injection of hot water or antiseptic solutions through a soft rubber catheter or some of the various forms of tubes devised specially for this purpose. Many of those who have tried this method are very enthusiastic in its praises, but the author is free to say that these surgeons must either have a knack in the application of the method which he has been unable to acquire, or his patients are characterized by very sensitive urethrae. The method is open to the same objections as the use of soluble bougies, for in the introduction of the tube more or less of the virus is carried into the deeper portions of the canal, and it is questionable whether the injection fluid can be safely given in a strength sufficient to neutralize it. More or less mechanical irritation is induced, and in very acute cases this is likely to be productive of injury. On the other hand, in certain cases which exhibit a tendency to chronicity the irrigation method is decidedly beneficial.
The author has found that a soft, open-ended catheter is as useful as anything for deep irrigation of the urethra. Under ordinary cir cumstances, and always in acute cases, a short nozzle is sufficient. This is to be used without a urethral tube, and has a concave shield to catch the return flow. There are several varieties of injection tubes which are more or less useful.
The latest fad in the treatment of urethritis is what is termed the dry method. This consists in the introduction of dry antiseptic
powders into the canal through a special and patented device. This method is open to the same objections as is the use of solubleiougies and retro-irrigation in acute gonorrhoea. It is apt to be of service, however, in less acute forms of the disease.
Blistering the perineum and penis by means of cantharidal solu tion is a favorable remedy for acute gonorrhoea with some surgeons. Milton, in particular, favors this method of treatment, but applies the blister in the form of cantharidal plaster wrapped about the penis. The author has found that most patients object to fly-blisters, and has compromised by applications of the tincture of iodine along the course of the urethra with apparent benefit. Milton recommends what he terms a " caustic plug" in the treatment of obstinate cases of gonorrhoea. This consists in a strip of linen, saturated in a five grain solution of nitrate of silver, which is inserted into the urethra through a tube similar to an endoscope; the latter is then removed, the cloth being allowed to remain until it comes away with the urine. ' It is not the writer's purpose to present all of the various methods of treatment and specifics that have been recommended for ure thritis. This would be an onerous as well as unprofitable task. The list of specifics recommended runs well into the hundreds. The fore going is intended only as a practical outline of urethral therapeutics.