We sometimes meet with a more perfectly organised structure in the urethra in the form of polypi. They, however, are by no means common. Rokitansky met with one in the prostatic part of the urethra, in which situa tion they are usually found.
In the Museum of the Royal College of Surgeons there is a preparation (2578 ) of the urethra of an ox, with a large polypus hanging from the verumontanum.
Irritable Urethra.—This condition may be recognised by the following symptoms : there is slight increased vascularity of the canal as indicated by the redness of the meatus : the lips of the meatus are glued together in the morning by mucus, slightly tinged : there is a very trifling discharge, scarcely sufficient to discolour the linen ; this is increased by indul gence in wine ; a sense of uneasiness is per ceived along the canal, and this extends to the testicles and the rectum. The patient has a more frequent desire than natural to pass his water, the stream is diminished, and a scalding sensation is experienced at the extremity of the glans whilst the urine is passing. These symptoms are exacerbated by indulgence in venereal pleasures, and are often associated with increased acidity of the urine ; not unfrequently pain is experienced down the thighs in the course of the nerves, and the patient suffers a slight febrile attack. This state exists, very frequently, altogether independently of gonorrhoea, and appears really to result from a mental cause, the patient being strongly impressed, after a suspicious con nection, with the idea of impending gonorrhoea. Under the use of diluents and the warm bath this disease very generally passes off. The true pathology of this state I believe to con sist in an increased vascularity of the urethra and its follicles, with a similar condition of the glands of Cowper and the prostate, under the influence of nervous irritability.
The prostatic part of the urethra is liable to irritation from long continued masturba tion. The orifices of the ejaculatory ducts are the special sources of this irritation, but the general mucous surface around partakes of the disease.
Areuralgia of the Urethra. — The urethra and neck of the bladder are consentaneously affected in this disease. The periodic and
remittent forms of neuralgia attack the urethra : the periodic disease is characterised by deep shooting pains in the canal extending over the loins and sacrum, and down the thighs, occurring in paroxysms, and generally accompanied by sudden and urgent desire to micturate. The attacks recur at a certain hour, generally night and morning, or every second or third day, and during the intermis sions the patient is altogether free from pain.
The urine is thrown out in jets, and some times stops suddenly, and many of the ordi nary symptoms of stone in the bladder are present, and hence the great importance of the diagnosis, for there is no doubt that, under this condition, many patients have been sub jected needlessly to the operation of litho totny. The sound alone can decide the question. This disease may originate en tirely from the ordinary causes of neuralgic affections, or it may depend on local causes, as the use of stimulating injections, the fre quent use of the catheter, constipated bowels, worms in the rectum : it is often associated with acrid urine, and either leads to, or is ac companied with, hypertrophy of the detrusor urina.* — The female urethra is a short tube by which the urine alone is ex creted. It commences at the neck of the bladder, and terminates at the meatus urin arius. The direction of the urethra in the female is similar to the first or pelvic division of that of the male ; thus it descends slightly, and, passing forwards, in nearly a straight direction, beneath the pubis, it makes a gentle ascent just at its termination : it there fore forms a curve, the concavity of which faces upwards, the convexity downwards, to wards the anterior wall of the vagina, in which it appears imbedded, and to which it is so closely connected, that it is almost impossible to separate one from the other. In its course it perforates the triangular ligament, which is stretched across beneath the arch of the pubis, and is but an imperfect representative of the corresponding part in the male. The urethra thus forms the first and smallest of the three outlets beneath the pubis.