In spite of what has been said regarding the parasitic or microbic origin of virulent urethritis, the author fails to see any practical re sults in the way of improved methods of treatment—not that this is in any sense an argument against the microbic character of the disease, but it certainly signifies its self-limitation. The investigations of bacteriologists who unhesitatingly accept the gonococcus of Neisser have shown that the poison of the disease infects the'entire thickness of the mucous membrane and the submucous cellular tissue so com pletely that repair cannot take place in well-pronounced cases until the layers of affected cells have been replaced by new and insuscep tible connective-tissue cells from beneath. This condition of affairs proves positively that nothing short of caustic applications capable of destroying the entire thickness of the mucous membrane can by any possibility abort a virulent urethritis when once it is thoroughly established. As a corollary, it is obvious that attempts at the abor tion of a virulent urethritis should be made only in the very incipiency of the disease, before, in fact, it is possible to determine whether or not we have to deal with a simple or virulent case of inflammation; for inasmuch as the different grades of urethritis often begin in pre cisely the same manlier, it is impossible to tell for a few hours, or perhaps several days, whether or not we have to do with a virulent type of the affection or with the simpler and more curable variety.
Any form of treatment the efficacy of which is supposed to depend upon the action of antiseptics on the specific germs of the disease must, in order to shorten the duration of the affection, be applied within a few hours of its inception. Thus the disease can be aborted—if the term abortion is proper as applied to something which does not already exist; the poison begins to produce irritation of the epithelium of the urethral mucous membrane very scion after its introduction into the canal, and if the virus be destroyed in loco, the disease not hav ing yet fairly begun, it may be said to have been prevented rather than aborted.
The two methods of treatment applicable to urethritis may for the purpose of discussion be divided into the jugulative or abortive and the methodical or rational systems.