The inflammation of gonorrhoea is neces sarily of the catarrhal character. At the first onset of the affection there is a slight weeping from the meatus of a transparent fluid, in which mucus particles are floating, probably only the natural secretion of the urethra in excess. This soon gives place to a semi puriform secretion, which glues the edges of the orifice together. It afterwards becomes more distinctly puriform, and at the height of the inflammation, the discharge, which has increased in quantity, puts on a greenish hue, and is of a faint, sickly odour, as the disease subsides. It changes again as to its character in exactly the inverse order of its appearance. It frequently leaves behind it a gleety dis charge. The seat of this discharge in gleet is either the general mucous surface of the urethra, the lacuna', or the anti-prostatic ducts, and in many instances the ducts of the prostate gland are alone affected in long per sistent gleets.
When gonorrhea coexists with chancre, the discharge has usually a greyish or reddish tint, or sanious aspect.
Among the most important consequences of this affection, we may mention simple erosion and cicatrices from ulceration produc ing stricture, and, which is much more com mon, chronic thickening of the urethra giving rise to stricture. if the diseased urethra be examined after death, according to Hunter, the fossa navicularis and its lacunae are found more vascular than usual, and the laciine filled with matter. In more severe cases the membranous part, Cowper's glands, and their ducts, are involved in the disease. Littre found, after examining forty cases, Cowper's glands morbid in one only ; and Morgagni met with only one or two instances of a similar kind. The prostatic part of the ure thra evinces signs of disease in severe attacks of clap.
The glands of Cowper are sometimes in flamed, independent of gonorrhoea, and be come indurated ; or they occasionally suppu rate.
Ulceration of the urethra may arise from common and specific causes. In the latter category, chancres take the first rank ; these can only occur in the anterior part of the canal, and are generally found at the urethral orifice.
Ulceration, independent of specific cause, is sufficiently common : thus, it may arise spontaneously, or as the consequence of stric ture, or foreign bodies in the canal, as calculi, pieces of bone, bougies, &c. Spontaneous ulceration of the urethra is exceedingly rare ; it is not mentioned, usually, by writers on the diseases of the urethra. 1 have met with one
instance of it myself: in this case three suc cessive attacks of ulceration had occurred, which terminated in urinary one an terior to the scrotum, one in the perinmum, and one in the vicinity of the tuber ischii. They were each preceded by rigors, and other signs of fever, and were accompanied by much constitutional disturbance ; no stricture, or other appreciable disease of the urethra what ever, had preceded the ulcerative process.
Ulceration behind a stricture is very com mon ; it depends on inflammation attacking the part as the result of long continued irritation.
A stricture itself sometimes becomes the seat of ulceration, when bougies and catheters are used with violence for its cure. It also happens, though rarely, that spontaneous ulcer ation of the stricture occurs, by which the stricture is cured. Sir Benjamin Brodie re lates an instance of this.
Ulceration consequent on tubercular deposit now and then occurs in the urethra, but only in cases where tuberculosis prevails over the entire urinary apparatus.* An instance of this description occurred to Mr. Robinson of Peckham, in a man who had been the subject of extensive tuberculosis in the urinary and genital organs. The disease appears to attack the follicles.
Cancerous ulceration attacks the male urethra in carcinoma of the glans penis and other parts of the organ.
Sloughing of the urethra, as a consequence of stricture and violent catheterisation, often leads to the destruction of a considerable por tion of the canal.
In severe cases of small pox, pustules are riot unfrequently found in the urethral mem brane.
a consequence of inflam mation, abscesses form in connection with the urethra : they may be acute or chronic : sometimes they communicate with the urethra, but frequently they have no such conimu nication. Abscesses may take place in any part adjacent to the canal: thus, in severe gonorrhceas, suppuration in the spongy body from inflammation of contiguous parts is not very uncommon ; the same also is occasion ally met with in the perinxum, in Cowper's glands, and even in the prostate. Abscesses are not unfrequently met with as the conse quence of injury to the urethra from blows or falls upon the part. In all such cases the abscess communicates with the canal, and frequently, if not generally, is attended with extravasation of urine.