The following conclusions have been reached in regard to largin in gonorrhoea: (1) largin as an antigonorrhceic is at least equivalent to the other silver com pounds; (2) it surpasses the other silver albumin compounds with regard to the power of killing the gonococci: (3) it penetrates more deeply with dead organic substances. Treatment should begin early to prevent immigration of the gono cocci into the deeper parts of the mucous membrane. It may be injected in 1- to solutions several times a day and retained in the urethra for from ten to thirty minutes. Pezzold (Wiener klin. Woch., No. 11, '9S).
The prolonged use of hot-water irriga tions is advised in both acute and chronic gonorrhoea. A soft catheter is passed to within one inch of the prostatic urethra. It is then connected with a "gravity ap paratus," in which the water is gradually heated up to the tolerance-point. The stream flows through the catheter and then back between catheter and mucous membrane, thus flushing out the anterior urethra. Several quarts of warm water are thus pas;ed, some patients having a tolerance-point as high as F. C. S. Murrell (Mass. Med. Jour., vol. xviii, 289-2'32, '98).
In brief, the principles of the treatment for posterior urethritis are: 1. Irrigations with the Janet method in a recent case of gonorrhoea will in many cases prevent posterior urethritis.
2. Irrigations with the recurrent cathe ter with permanganate of potassium, fol lowed by injections of protargol, will cure in a relatively short time a case of sub acute posterior urethritis without com plications.
3. When chronic posterior urethritis lasting for a long time has caused in filtration of the submucous tissues, then the application of a sound with ichthyol salve gives the desired results. A. Ra, vogli (Internat. Jour. Surg., Mar., '99).
A new preparation of argonin is called Argonin-L. The new argonin is easily soluble in cold water and can be kept in solution for several months without decomposing. Also it contains 10 per cent. of silver instead of 4.2 per cent. A 1-per-cent. solution is personally used for cases of both anterior and posterior urethritis. Cases of anterior urethritis were treated by injections thrice daily and retained for five minutes. Posterior urethritis was treated by instillation with Ultzmann's syringe. After disap pearance of the gonococci, astringent in jections of zinc sulphate were used, but the patients had also three injections weekly of the argonin. Frequent exam
inations of the urine were made and the absence of gonococci and threads demon strated. Other patients were treated with the old argonin and results showed the superiority of the new argonin. Jellink (Wiener med. Woch., No. 5, '99).
The results, in the 53 cases of gonor rlura treated by argonin injections, show that argonin is by far the best Clung in the treatment, and if used with judgment will achieve really remarkable results. If a ease is seen within forty eight hours after the appearance of the discharge, argonin alone is a very satis factory treatment, and in a majority of uncomplicated eases will effect a rapid and absolute cure in from four to fifteen days. In one case seen the day the dis charge appeared, and in which the gono coccus was forum, argonin injections alone caused the discharge to disappear on the fifth clay. In this case a 2-per cent. solution was used in 15-cubic centimetre syringe and retained ten minutes, four times a day.
In eases where the urinary symptoms were severe the patient was given the alkaline treatment internally and the injections of argonin for the urethral injections. A 2-per-cent. solution has been the most satisfactory strength, although as high as 5 per cent. may be used in severe eases with excellent re sults.
In vulva-vaginitis permanganate irri gations were very satisfactory, but they were slower than the argonin. The strengths used were 5 per cent. and 10 per cent. for from three to five days. followed by reduction of degrees to 2 per cent.
Much depends on the preparation of the solution. If possible, the surgeon should prepare it personally, and it should be dispensed in dark bottles. The most satisfactory method of pre paring the solution is to first make a paste of the necessary amount of ar gonin powder, using hot water. To this paste enough hot water is added to make the percentage solution required. This solution should be strained. An other very good method is to shake 1 part of argonin in 10 parts of cold water; add sufficient boiling water to make the desired quantity and shake until the argonin is in solution. Then this is strained. W. W. Wilson (Buffalo Med. Jour., Jan., 1901).