Some attention is necessary to the dressing of the penis. One of the most pernicious practices that can be adopted is to bind ab sorbent cotton or other material over the meatus, a plan which is fre quently followed by patients with a long prepuce, in the orifice of which absorbent cotton or lint may be packed with great facility. Common sense should teach the surgeon that, inasmuch as the in flammation of the urethra is due to the inoculation of successive areas of the mucous membrane with the virulent products of inflammation, the process extending gradually from the anterior to the deeper por tions of the urethra, any dressing which dams back the discharge must necessarily feed the pathological process and enhance the dan ger of its extension into the deeper portions of the canal. Improper dressing is frequently the cause of serious complications. A very simple plan is for the patient to roll the shirt up in front out of harm's way and to pin upon the tail of that garment a soft white hand kerchief or napkin, which is drawn through beneath the perineum and up over the penis in such a manner that one corner of the nap kin may be tucked down each leg of .the pantaloons, with numerous folds of the soft cloth resting in the crotch of that garment in such a way that the penis rests therein, the meatus at the same time being unobstructed. Another very excellent plan is to pin the toe of a stocking upon the drawers or pantaloons in such a manner that the penis may hang therein without the meatus coming in contact with the improvised bag. In the bottom of this receptacle a little absorb ent cotton may be placed and frequently changed. There are several cloth gonorrhoea bags upon the market which answer the same pur pose. The penis should never be dressed and allowed to remain in the upright position. By attention to these little details cleanli ness may be secured, and at the same time free drainage of the affected membrane facilitated. Rubber protectives should never be
used.
Inasmuch as it is impossible for us to abort the inflammation when it has already frankly begun, it is obvious that we must content ourselves with a not too officious management of the case until the normal process of repair begins.
One of the best measures for facilitating resolution of inflammation is the application of heat, and it is nowhere more efficacious, if prop erly applied, than in inflammations about the sexual apparatus. It will be found that heat applied by means of the sitz-bath of from one-half to one hour's duration several times daily will materially assist in the successful management of the urethritis, particularly if there exists any irritation about the prostate or neck of the bladder. When the patient will consent to keep perfectly quiet, it is the most valuable auxiliary method of treatment at our command. The value of the hot sitz-bath has been questioned, but the author is convinced of its efficacy.
In lieu of the more general application of heat by means of the bath, prolonged soaking of the penis in hot water will be found to be beneficial. When urination is very painful, relief may be obtained by passing the urine while the organ is immersed in a vessel of hot water.
The use of remedies, both internal and local, should be guided, not only by a knowledge of the natural course of the disease, but by the conditions present at various stages of the affection in each in dividual patient. It would be absurd, as well as pernicious, to treat a case complicated in the stationary stage by inflammation of the bladder or prostate in the routine fashion prescribed for the aver age uncomplicated case at the same period of the disease.