Sir E. Home was the first who recommended cauterizing the urethra as a means of arresting involuntary spermatic discharges. It was subsequently introduced into France, and adopted by Lallemand, who strongly advocates the practice as the most certain and efficacious. In England it has also met with an able advcate in Dr. Ranking of Norwich.* There can be no doubt, however, that, used injudiciously, it is capable of doing much mischief. In obstinate cases of Prosta-torrha, Prof. Gross considers that cauterization once a week may be beneficial.
Immediately after the first appearance of a chancre, the caustic should be applied in substance freely to the whole surface, so as totally to destroy its character. It is believed that, by adopting this practice in the earliest stage of the sore, the venereal poison is decomposed, and its absorption into the system prevented. If the chancre has existed some days, and the poison has become absorbed, the application of the caustic can be of little value. To indolent bubos the Nitrate is sometimes used locally, with the view of stimulating the pails and hastening the process of absorption.
McDonnell advises injecting into the bladder a solution of the Nitrate of Silver (gr. ij. - v., Aq. Dest. fj.). He directs the bladder to be first washed out with warm water, the solution to be then injected and allowed to be retained for a few seconds, never above a minute. Should the urine be rendered bloody or shreddy, fomentations and anodynes should be employed. In all cases (in one the patient was seventy-two years old) the cure was permanent. The quantity of injection used at one time should never exceed fiv.
Spasmodic Diseases. 339. In Chorea, much benefit occasionally results from a prolonged course of the Nitrate of Silver. It has been successfully employed by Drs. Unwins, Prion,§ Frank -lin,|| Crampton, and others. It should be commenced in small doses, which may be gradually increased. The great objection to its use is the danger of its discolouring the skin.
* Lancet, Oct. 14, 1843.
Ranking's Half-Yearly Obs. vol. x. p. 89.
Ed. Med. and Surg Journ. vol. viii. p. 408.
§ Med. and Phys. Journal, vol. lii. p. 262.
|| Ibid vol. xxxii. p. 272.
"Wilson, Sims, M. Baillie, Roget, Lombard, Copland, and Carron. Its efficacy, however, is less uniform than the Salts of Zinc and Copper, and the danger of "turning blue" from a long persistence in the remedy has tended to bring it into comparative disuse.
341. In Hooping Cough, after the acute stage is passed, the Nitrate is strongly advised by M. Trousseau. He uses the subjoined formula: - Argent. Nit, gr. 1/3, Syr. Simp, fss., Aq. Dest. fj., M. The dose for a child of one year old is a tea-spoonful. It is also spoken of in high terms by Berger.* Dr. E. Watson relates several cases cured by the application of a solution of the Nitrate (gr. xv., Aq. fj.) to the glottis in the manner advised in Croup.
342. In Spasmodic Asthma, the Nitrate of Silver given in the intermissions, in doses of a grain daily, will be found in many cases to reduce the force and frequency of the paroxysms. I have thus employed it with decided benefit. In Angina Pectoris it is also favourably spoken of by Dr. Copland.