A. T. Thompson states that in one very obstinate case, which resisted all other remedies, he found decided benefit from pencilling the parts once or twice daily with the following solution: - Argent. Nit. gr. ij., Acid Nit. Dil. my , Aq. fj., M.
335. To Stricture of the Urethra the application of the solid Nitrate has been held in high repute. In some cases, it appears to be beneficial. A sound should be first passed down to the seat of stricture, and subsequently a bougie, or an instrument for the purpose, armed with the caustic, should be passed down and firmly pressed on the stricture. Unless this point is carefully attended to, the caustic will come in contact with the urethra in front of the constricted portion, and cause ulceration. This, however, is not the only danger, as the caustic has, in many recorded cases, become loose, and remained in the passage, an accident likely to be followed by severe consequences. Serious haemorrhage, also, occasionally follows the application, and it is, on the whole, an unsafe mode of treatment; although, in cases where there is some degree of permanent stricture which is exceedingly irritable, a slight touch with a caustic bougie will often afford speedy relief. It should never be employed if the urethra has been damaged by the previous use of the common bougie or catheter; in this case it will produce spasm. Sir B. Brodie§ objects to the use of the caustic bougie on four grounds: - 1st. Although the caustic often relieves the spasm, it also frequently induces it. 2nd. Haemorrhage is a more frequent consequence of the caustic than the common bougie. 3rd. Where there is a disposition to rigors, the caustic is almost certain to produce them. 4th. Unless used with great caution, it may produce inflammation of the parts behind the stricture, terminating in the formation of abscess. It should only be employed after the hot bath, opium, and other remedies, have failed.
* Med. Tune*, March 8, 1850.
On Ulceration of the Uterus, p.
Cyc. Pract. Med. art. Pruritus. § On Diseases of the Urinary Organs, 3rd Ed. p. 61.