If there is much hyperwmia, secretion and pain, cold applications, cold injections, and even the introduction of ice into the vagina is the next best thing to a narcotic. Scanzoni's advice to apply a few leeches to the part of the anterior vaginal wall corresponding to the urethra has received little attention from recent authorities, and has probably rightly been displaced by cold and local treatment of the affected mucous membrane. Hourmann accomplishes this latter object by first emptying the bladder, and then filling the urethra with a tampon of cotton 5 lines long, and the thickness of an ordinary catheter. By the repeated use of this method, he claims to have effected a cure in fourteen days. But Bois de Loury found that this procedure did no good at all in 10 cases, and that it was very troublesome, since it had to be renewed at least thrice daily. Streu bel cauterized the mucosa, rolling the point of a waxen bougie in pul verized sulphate of copper, then dipping it in oil, introducing it inches into the urethra, and leaving it there for a few minutes.
Injections are less useful in the female than in the male, from the short nesi of their canal, and their inability to retain the fluid.
To quickly cure marked hyperxmias or acute or chronic urethral gon orrhceas in women, our best remedy is the solid stick or the lapis miti gatus. It should correspond in size to the urethra, be rounded off in front, and should be drawn through the whole length of the canal two or three times. It is true it is very painful. In 3, 4 to 6 days the slough is
cast off, and the process is to be repeated. Knoblauch saw a vesical hemorrhage follow this treatment which lasted 4 days, and was accom panied by ischuria; but no one else mentions any drawback. In very sensitive individuals bougies of mucilage, of tragacanth or butyrum c,acao, containing iodoform or chinoidin, with astringents such as alum, zinc, and sulphate of copper (1:40-20), may be used. C. A. Martin recommends the application of a solution of nitrate of silver in an equal amount of water to the urethra by means of Clerc's caustic holder. Many authors, as Costilhes and Cullerier, use cubebs and copaiba internally, as well as external remedies. Huet uses colophonium soap. Colophon ium has also been given dissolved in boiling soda, and made with some caicined mag nesia in 3 grain pills, 15 to 30 to be taken daily. But I think we can usually do without any internal treatment. Besides a bland diet, tonics and quinine and iron for weakly individuals is all that is necessary.
If an abscess forms in the urethral wall, it should be incised from the vagina as soon as fluctuation is perceptible.
We have already mentioned inflammation of the lacunae. Pawlik's case (Wien. Med. Wochensch- 1883, No. 25, 26) belongs here also.