This section of the book is from "The Complete Herbalist" by Dr. O. Phelps Brown. Also available from Amazon: The Complete Herbalist: The People Their Own Physicians By The Use Of Nature's Remedies.
This is a diminution or contracted condition of the tube, and may be either spasmodic or permanent. Spasmodic-stricture depends on spasm of the muscles of the perinaeum, or upon contraction of the muscular portion of the urethra. Exposure to cold and indulgence in drink favor an attack, which usually occurs after dinner. It generally occurs in persons with permanent obstruction. The urine is suddenly retained, the desire to urinate causes incessant straining, the bladder becomes distended, the countenance anxious, the pulse quick, the skin hot, and at last the urine dribble, or the bladder may burst, and extravasation occurs into the peritonaeum or perinaeum. There is another variety of this affection, termed inflammatory stricture, caused by abuse of injections, exposure, or intemperance during acute gonorrhoea.
Permanent stricture is a contraction from permanent inflammation, plastic deposit having taken place in the tissue beneath the mucous membrane. The occasion of this inflammation may be gonorrhoea, venery, kicks or blows, riding on horseback, acrid urine, drinking, etc. It is situated most frequently in the membranous portion of the urethra, usually a few inches from the meatus. The extent and degree of contraction vary. Sometimes the stricture is very tight, but limited, as if a thread had been tied around the urethra; most frequently it is of greater extent, containing from a quarter of an inch to several inches. Several strictures may exist at once. Permanent stricture comes on gradually, occurring mostly in middle-aged men. Urination is frequent, tedious, and painful; the stream is thin, twisted, or forked; and a few drops pass after urination, which had collected behind the stricture. There is pain in the perinaeum, thighs, and loins; erection is often painful; chill and fever constantly occuring as in ague; the testicles, rectum, and bowels sympathize, and the general health is greatly impaired. It is a disease that causes extreme annoyance, pain, and disorder, and should receive early and competent treatment.
TREATMENT. -- The indication in spasmodic stricture is to overcome the spasm, and relieve the bladder. This is usually effected by warm hip baths, Dover's powder, laudanum enemata, and cold water upon the genitals. A favorable mental impression is made by pouring water from a can, in a small stream, from some height, into a vessel containing water, in imitation of urination. A few sniffs of ether will usually relax the spasm, but if these means fail, the urine should be drawn off by a catheter.
In permanent stricture dilatation by means of a flexible bougies is the usual method of cure. Great caution is necessary in the use of these. Some use caustic applications, and in some cases puncturation is resorted to. In some cases opening the urethra may be necessary, as the stricture is so extensive and complete that no other means are available.
These surgical means may at times be necessary, but I have cured very many cases by purely medicinal treatment, and it is very seldom that I employ bougies, but compel absorption of the deposit by alterative treatment. In some cases, however, I frequently combine dilatation with medication. Those desiring consultation are referred to page 390.