TREATMENT URETHRITIS.
The treatment of urethritis comprises a greater variety of methods and remedies than almost any disease which could be mentioned. This fact is in itself strong circumstantial evidence of the self-limited and—as far as specific medication is concerned—incurable character of the disease. Manifold as are the panaceas and specifics for ure thritis, the fact still remains that no systein of treatment or line of specific medication, when taken alone, has materially diminished the average duration and severity of the disease, excepting those meas ures based upon the principle of its self-limitation and an apprecia tion of the inadvisability and impracticability of attempts to jugulate it. Such measures of treatment have accomplished much; panaceas, nothing but injury on the average. There is scarcely a physician in practice, and probably not one " man about town," but imagines that he has a remedy which is a specific for the " clap," the several remedies varying in position and legitimacy from the fallacious injection Thou• to the more modern application of the bichlori de of mercury by the retro-injection method. The author discredits the statements of those surgeons who claim to cure cases of virulent urethritis in a week or ten days, or perhaps less, quite as much as the statements of the vet eran "rounder" who has a little preparation that "knocks it in three days." It is not to be believed that by any special system of medi cation a virulent urethritis is ever cured in any such time. The author has hunted clown all the wonderful specifics that have ever been called to his attention, and has tried them all faithfully, but has not yet succeeded in finding a remedy which produces the wonderful results claimed by some surgeons and by quite a proportion of patients.
Mr. Milton has well illustrated the fallaciousness of gonorrhoeal specifics in a list, taken from various sources, which comprises sev eral hundred infallible remedies, all of which have been tried and found wanting.
Driving a gonorrhcea to a cure is bad, as well as unsuccessful, practice in general, and much harm may come of it; the best results being apt to follow a "coaxing" method, i.e., mild and persistent treatment and the acceptance of the inevitable for several weeks. There is but one substitute for this line of treatment, and that is one which will be shortly mentioned, involving absolute rest. If a remedy is ever discovered which will cure every case, even in from three to six weeks, the event will be hailed as presaging a surgical millennium. The author would be very well satisfied if
a remedy could be found which would invariably cure gonorrhcea in six weeks or so, meanwhile permitting the patient to go about his business. No matter what system of treatment may be followed, a better average result than this is not often to be hoped for in virulent urethritis. If, however, the surgeon counts his cases of bastard clap and the milder forms of urethritis in with his statistics, he may achieve in a large proportion of instances the wonderful results claimed by many, and this remark is particularly pertinent when we consider the fact that the average surgeon must necessarily treat at least a half-dozen cases of mild urethritis or bastard clap for every virulent case that comes under his observation. It will be found that, with due regard to the self-limitation of the disease and the in tolerance of the urethra for harsh measures of treatment, fewer cases of chronic urethritis will be seen, and fewer strictures and other sequehe will result, than with those systems of treatment which are said to cure within a few days. There are, to be sure, cases which will present themselves to our observation that are likely to shake our faith in this method of management. How often we hear of some self-satisfied voluptuary who some years ago had a gonorrhcea that proved obstinate to the best professional skill for months and mouths, but who finally recovered and now has a prescription which has cured him of from half a dozen to twenty attacks of urethritis ! The surgeon should not let such cases shake his faith in his own pro fessional ability, for these men are constantly deluding themselves. The only virulent urethritis that the patient under consideration ever had was the first attack, from contagion, the subsequent attacks being bastard clap founded upon the damage done by the old-time gonorrhoea. Sooner or later a second attack of violent urethritis—or perhaps a mild case with a tendency to chronicity—is experienced by such patients and not only explodes their faith in the erstwhile panacea, but gives no end of trouble, and necessitates for its cure surgical measures adapted to the removal of the cause of those numerous attacks which the alleged specific so readily subdued.