150 / 868
M
E
D
covered with nutter that anf\Ver! to the
obnruétion.
A·
gaio, (he cardee, excited
by
the ufe of the bougie, is in ·
finitely more painful wherc the obHruélion ¡s. than in
lhe
other pans of lhe peoís.
lt
\lLill,
jt
mua . be owned ,
produce a cardee in a found peois ; but then
jt
extends
through c\'cry pan
oC
¡ti
3ftd is
by
no means
fo
painful
as lhe other.
Ir
lhe fymptóms
oC
the
aflaures,
callous
rc~rs,
caro
uneles and tumou rs of lhe corpus fpongiofulll ureth rre are
errentially different, thoCe
differences
are
nal
fTlentioned
by
any writer; except thal, when lhe urethra
ooly
is
af–
feéll
di fhe
patient, in making water,
VQlds
malter befare
his urine;
bUl
when lhe
pronare glands
or
veficulz
Cemi–
nales ooly are concerned , maner follows lhe lan drop
of urine.
B UI
il frequently happeos lhat ODe is compli.
cared
with
the olher.
The propenies requiure in a bougie
J
are
a
t ufficient
degree of firmneC"
that it may be iDlroduced whh fome
force:
A
fupplenefs aDd tenaclty, tha.t it may conform
to
[he
motions of lhe body Wi lhoUI breaking:
A
lenient
fu ppurative dirporition,
lO
bring on
a
dlfcharge wilhout
paio: A nd,
Jafily, a
rmoothners of furface, that it may
DOt only be introdueed with more
e~fe,
bUI tbat
it
may
Jic cafy io the
palf.getill it begios <o dilfolvc.
That chiefiy made ufe of is as follows ;
~
Emplt¡jJ. COl1mlun. cum pie< B urgllnd.
5ij .
Arg""
vivo
5j .
Anlimon. crudopulv.
5(\.
M .
T he
wlpluJl. como
or diachylon, mufl be made with oil
and a liule Hurguody pitch added tO it, to render it fuf–
ficiently lenacious; [he antimony mufi be 6nely levigated,
that jt may give
a
fmoothoefs aDd good conGfience
t:o
[he
bougie.
The quicHlver, whether it be divided in
balf.lulph.
or hone)' . muH nOl be PUt ioto the plafier till the moment
berore lhe
bou~ies
are made, nor mult Ihe plaUer be boil·
ing hot at thdt time. When the quieklilver
1$
mingled
wilh the rlafler moderately hot, nips of fine rag mull be
ready <o d,p in the compofition. They mulJ be of d,fI'er–
eOl
lengths, from fix tO niDe or ten inehes, and about three
inches broad . R olI them up looldy, and, tak,ng hold of
one eX1rcmity with the
IcCt hand..
Jet
it
fal!
gently on the
furface of
lhe
plaller, and then
draw
it OUt gently,
As
ir is clr;l,wn out,
it
will
unroll, and take
up a quantity of
the plaller upon its furfaee, equa!
tO
the thickners of a
{jI·
ver groat.
It
may be proper tO
amll
[he unrolhng wíth a
fpotula. T he plafler mu(\ be hot enough tO foak through
and difcolour lhe
rag. The
ladlc
in
which
il
is
mel{ed
ou¡!ht tO be broad and
Aat
al lhe botlom; and the planer
murl be kept flirring . tO prt:ferve il in equal confiflence .
T lle bubbles on the rurface of the c10lh may be fmoolhed
with an iron rpatul ... a liHle w<l rmt-d.
One rag
will
make lix hougles of a moderate lize;
they
are
befl
cut
wilh a
knife
2nd
ruler 1 'hey lhould
be
made
taper al the end, by cutting off
íI
nope
auout an ioeh and
a halr long. \ Vhen lhey are ralled up.
jI
mun
be with
that (¡de oUlward
wlllch
is covered
\Vil!.
plan er; ami they
muO.
be
firft
rolled
tlp \\11th
the finger and
lhnmh as clore
as pofJible, befare they are rollt:d uron a board or mu,
ble, In the \Vintt'r
it
\ViII be ploper
10
hold thcm a I¡ule
btrore lhe lire
10
f:t
e.litate l hclr
rullln~.
lhforc
a bougic of any kinu be
imroduc((j
in to lhe ure·
N
E.
13!
thra, il will be neceIT.try to fi net\r it \Vilh rwect oí) tha r
it. Olay go in eafi) y, aod nOl rlirnulate tOO much at'
rirJL
T he patient may either lland or lie down in Ihe poHure
of lJeing. cut fo r the (lone; lhen Ihe furgeon muU gr.•fl'
the penls near lhe glans, and extenrl it gen tl y, thía lhe
urethra may not be.:: wrink len, and then il
\ViII
meet
\v¡llt
no impediment but what is oceafioned by lhe difeafe .
lt
oflen happeos al lhe beginning, thal the bougie can.
nOl be too fm all ; and then the end murl be round, that
it
may
re~dil y
flip over the plie:r
pf
the urethra ; it is airo
exceedingly deGrable that it enter wil hin the ollrlruélion.
Howevc:r,
it
is nece(fdry tO deGrl from puOling it \Vhen
once it beg;ns
tO
bend. \ Vhen it meets \Vith
any
reGIl .
ance, to avoid the bending, turn il round \Vilh your
fln–
ger and Ihumb reveral limes, and,
3S
you turn
tt,
pre{s
i~
a I¡ttle forwards ,
If
by this ruethod
it
ad\'ances, con.
tlnue tO do the {ame thil:g till lt !lops . •
BUI
il murl
be
owned lhltt the üperator in lhis cafe m.,y be e.tfily deceivcd .
T he buugie mufl be confined in lhe penis by fome
kind of bandage, or rather \Ve
m~y
keep
Jt
Jjxed in the
uTethra by
a
cotto n Oriog ticd aboul its cxtrcmity, and
Ihen pa{fed round the penis
j
no other thread ís r.cceITary.
When the patlent
IS
timoTl/us. or lhe pan tender, it
may
be left. in two or üHee hours
in
a day only al
firn-~
but ot herwlfe fix or fevtn, \ Vhen the pallent finds
he
cannot.bear it, il ma}' be dircon tinued two or three days,
accordlOg to the n.nure of the fYOlptoms.
There are innanees of
ItS
havlng firrl c;J red , and then
brought
00
a f,c:Ol Clrangury
In
this cale. forlJear ils ure
for l WO or lhree days, and lhe lIrangury
wiJJ
ccare.
Sorne have been able tO wear
it
n¡ght and day wuhout
iotermiffion ; and as they wi:hdrl!w one, imrodueed ano·
lher. Aod lhis is
a
prudent tlep
j
for the more fuppu–
ratíon is procured , and the longer lhe urethra is kcpt
di·
({eoded, the cure is Ojore iLkely 'o be radi ..al, When
this cannot be done, t,.he day is beuer ror jlS u{e th an lhe
night, beeaufe
in
Ihct night it is mOre fubjetl lO ereélions.
T w6
bougies io a day generally an{\Ver the purpofe;
one in lhe morning, and one in lhe tvclling, as more fui t–
able to the patient's a90cation
j
though fome edn walk a–
boul with them.
Jf
<he tellicles fhould,infl ar.'lo, or .ny fcverilh diforder
come on, they may be kept in OlD hour, or half 3n hou r
i?
a day, to prcvent the· urethra from contraél ing again
tlll
the CymE,tom is removed
j
tO prevent lhe{e ditorders,
the
paticnt fh ould obfcrve
a
cool1Og regimen
during
the
treatment.
Sorne are rclieved by the bougic io
a
few \\'ccks, fome
nOl til lomany mooths . G encr.tlly
dIe
cure may be per·
form cd
10
feven, eiglll, n¡ne or len wc.'eks . T his i!'i known
by
the removOl) of c\'ery fymptom of the difCJrdcr
i
for
fume <legree of running will
gen~r2lJy
COnt inllc as long
as
the bougie is employed .
When the patienl j \ldges
himrt rr
wcll, jt will be befl
to
uefill
gradually, wcarinp. it at
(j (fl
only
30
hou r or
t\Ve
in
a
u:ty,
and ¡hen
t WO
(Ir
dll ee times
a
wl ('k, :dlcr which
it may
be entirely
left
off.
Ir
any
gkct lIill
rcmai n,
or
any obflrué\ion Ihrcatcns to rC1u nl, it
wil!
IJc ncccJla ly
tO ufc the bougie {our Or
fi ve
wCl'ks
Junga.
1n fllpprdllnns of urin,;: ít \ViiI he al\\'ays advi ffahJc
10
introoul'e the calh etu if r offi blcJ ilno indccu 10
kCl p
it
;n