Reprinted from the New York Medical Journal 
for April 30, 1893. 
A NEW METHOD OF TREATING 
ACUTE URETHRITIS* 
By B. E. VAUGHAN, M. D., 
ATTENDING SURGEON, NEW YORK DISPENSARY ; 
ASSISTANT ATTENDING SURGEON, NEW YORK CANCER HOSPITAL, ETC. 
When I began the work for this paper I intended to 
speak of my results in treating urethritis at the New York 
Dispensary, where I have had during the past two years 
about two thousand two hundred cases. But in the past 
three months I have been developing what I may call a new 
plan of treatment, which, although not new in all its de- 
tails, is enough so, I think, to warrant such a designation. 
I use the term acute urethritis to include all forms of 
acute inflammations of the anterior urethra, whether specific 
or non-specific-first, because I did not have the time to 
make microscopical examinations, and, second, because the 
same rules of treatment apply, I think, to all acute cases. 
I can not expect that my method of treatment will be 
approved by all, but I hope it may call out full discussion 
and expression of opinion which may tend to throw more 
light on the treatment of a disease which by many is con- 
sidered hardly worse than a cold, but the results and com- 
* Read before the Hospital Graduates' Club. 
Copyright, 1892, by D. Appleton and Company. 28 
A NEW METHOD OF TREATING 
plications of which cause many deaths and so much suf- 
fering. 
In a conversation with Dr. Bangs a few months ago, he 
said, in answer to my question, How he treated acute ure- 
thritis, that he had no routine treatment, but followed sur- 
gical indications, rest, drainage, and soothing applications 
to the mucous membranes. It impressed me as being so 
rational that I made it my basis for work, and have tried to 
follow it out in my treatment of cases. 
Dr. Powers asked me to try dermatol (subgallate of bis- 
muth), an astringent, drying, non-irritating, and non-poison- 
ous drug, which he describes in the Medical Record of Oc- 
tober 17, 1891. I first tried it in suspension, as it is 
insoluble, but the results were negative. Subsequently I 
succeeded in finding a vehicle which has proved satisfac- 
tory. 
I am indebted to Daggett & Ramsdell, of 328 Fifth 
Avenue, for a vehicle which seems to answer every require- 
ment, known under the name of plasment. They have fur- 
nished me the following notes : 
" Plasment consists of the mucilaginous principle ex- 
tracted from Chondrus crispus and Cetraria islandica (Irish 
and Iceland moss) combined with Siam benzoin and gly- 
cerin. The steam heat used in the extraction, together with 
other details of the process, render the preparation aseptic 
and it keeps perfectly. It combines readily with all sub- 
stances used in dermatology, in most instances producing 
preparations which are superior, from a pharmaceutical point 
of view, to ointments. We have used it extensively in the 
prescriptions of several of our leading dermatologists com- 
bined with such remedies as resorcin, salicylic acid, ichthyol, 
sulphur, oils of cade and tar, bismuth, zinc oxide, creasote, 
starch, carbolic acid, potassium iodide, iodine, subiodide of 
bismuth, dermatol, aristol, mercury, boric acid, etc., in all ACUTE URETHRITIS. 
29 
cases giving great satisfaction both to the patients and 
physician." 
Plasment is about of the consistence of vaseline. It is a 
demulcent and soothing to all mucous membranes. It is 
soluble in water, while the oils are. incompatible ; it coats the 
mucous membranes and is readily absorbed in a canal, de- 
positing the medicament on the membrane, and at the same 
time protecting and keeping apart the opposing surfaces. 
With this as a vehicle I use three or five per cent, of der- 
matol. You will readily see how this, through mixture of 
the dermatol with the vehicle, increases its action, if 1 quote 
from the paper of Dr. Powers. 
" Experiments were made regarding its antiseptic proper- 
ties, and it was found that when the dermatol was added to 
a fluid nutrient gelatin, decomposition or bacterial growth 
was hardly hindered. The same occurs with iodoform, 
iodol, bismuth subnitrate, and aristol. The dermatol can 
take effect only when it comes in direct contact with the 
germs and when it is evenly mixed with the nutrient medi- 
cine. This they accomplish in the following manner: Gela- 
tin was warmed in a reagent glass until it was just fluid 
(28° to 30° C.), and with it large amounts of dermatol were 
mixed. This was then mixed with a pure culture shaken 
and poured on cooled trays. As it stiffened in cooling, the 
dermatol was held in a uniform admixture. The anthrax 
bacillus, Staphylococcus pyogenes aureus, Bacillus prodigio- 
sus, bacillus of typhus and pneumonia, were used. In all 
of these the growth was stopped." 
Now comes the question how to best apply such a mixt- 
ure to the mucous membrane that is diseased. 
I had a special soft-rubber catheter made by Tiemann, 
about five inches long, with several small openings near the 
end on all sides. 
As a syringe I use in private cases the compressible 30 
A NEW METHOD OF TREATING 
tube such as paints come in, with a special hard-rubber tip 
screwed on the end, furnished me by Daggett & Ramsdell. 
In this way the substance is kept absolutely clean. 
In my dispensary cases, where 1 make a great many 
injections, I use a hard-rubber syringe, and fill it with a 
spatula after unscrewing and removing the piston. It re- 
quires very little for each injection, and a small quantity 
goes a long way. The catheters are made in two sizes- 
10 and 20 F. scale. I prefer the larger size, if the urethra 
is large enough, as it makes the application more thorough. 
The method of treatment is as follows : 
The patient is first requested to urinate, not only that 
he may wash out the urethra, but that it may be as long as 
possible before it is necessary for him to pass urine again. 
Then the catheter is attached to a fountain syringe (any 
other syringe could be used), about seven feet from the floor, 
filled with warm water of an agreeable temperature to the 
hand (best, one drachm of chloride of sodium to the pint). 
The catheter introduced, the water goes to the bottom of 
the anterior urethra and then flows back around the tube 
and out at the meatus. The catheter should be small 
enough to allow the backward flow. After douching for a 
minute or more, the tip of the syringe is withdrawn from 
the catheter, and the syringe, with dermatol in plasment, is 
applied, and about half a drachm injected as the syringe is 
gradually withdrawn. In this way the whole length of the 
anterior urethra is coated with the medicament. ACUTE URETHRITIS. 
31 
As soon as the catheter is withdrawn, a small piece of 
absorbent cotton is applied over the meatus, and the patient 
is directed to change this frequently. 
Thorough antisepsis of instruments and hands in mak- 
ing application. 
This method of application to the urethra through a 
catheter was suggested by Dr. Fox, about twelve years ago, 
at the meeting of the State Medical Society, and I have a 
glass tube which Dr. Fox used at that time. 
Dr. Vander Poel and Dr. Halsted used iodoform, one 
part, and cold cream, eight parts. 
Dr. Bransford Lewis recommends vaseline and lanolin 
{Med. Rec., Aug. 17, 1889) as a vehicle; boric acid and 
resorcin used as active agents with a catheter four to five 
inches long. 
Dr. Rice {Med. Rec., July 20, 1889), boric acid and gly- 
cerin, three drachms to the ounce. 
Bartholow mentions subnitrate of bismuth and glycerin, 
and Finger lanolin, as a basis for urethral applications. 
You will notice that all these vehicles are emollients, 
while plasment is a demulcent. 
Brunton's definition for emollients is substances which 
soften and relax. Demulcents are substances which protect 
and soothe the parts to which they are applied. 
You will appreciate the difficulty in dispensary practice 
to get patients to return daily for treatment, and also the 
difficulty in keeping them under observation until sure that 
their cures have been permanent. 
I will give you the histories of a few of the average 
cases: 
December J/ih.-Mr. AV. has had gonorrhoea several times; 
last time, two years ago; profuse discharge, with pain on urina- 
tion and balanitis for a week. Dermatol, five per cent, in plas- 32 
A NEW METHOD OF TREATING 
ment. Mist. pot. bicarb., t. i. d. B Potassii bicarb., gr. viij ; 
tinct. hyoscyam., TTLiv; aqufe, 3 j. 
5th.-Pain less; discharge improved. 
Sth.-Discharge very slight; no pain. 
10th.-Discharge very slight; no pain. 
12th.-Discharge very slight; no pain. 
13th.-No discharge. 
The patient was under observation for two weeks; ten days 
under treatment; five visits. Duration of disease, seventeen 
days. 
December 5th.-Mr. B., gonorrhoea several times; last time, 
two years ago. Profuse discharge for a week, with pain on 
urination. Dermatol and plasment. Bicarbonate of potassium, 
as in No 1. 
10th.- Discharge improved, but pain worse. 
12th.-Discharge improved; pain less. 
16th.-Only very slight watery discharge; no discomfort. 
17th.-Slight moisture. 
18th.-No discharge. 
19th.-No discharge. 
21st.-No discharge. 
23d.-The patient considered cured. 
From the beginning of treatment to the stopping of discharge, 
thirteen days; five visits. Duration of disease, twenty days. 
November 23d.-Mr. M., no gonorrhoea before; discharge for 
two days profuse, with marked swelling of mucous membrane 
and severe balanitis. No injection given on first day, but bi- 
carbonate of potassium given. 
24th.-Increased discharge and marked pain on urination. 
Dermatol and plasment used. Passing catheter irritated slightly. 
25th.-Condition about the same. 
30th.-Patient not here for five days. Discharge still pro- 
fuse. 
December 1st.-Markedly improved. Pain on urination 
disappeared. 
2d.-Continued improvement; no discomfort. 
5th.-Continued improvement. 
Sth.-Continued improvement. No. 
Name. 
History. 
Nature. 
Treatment. 
Remarks. 
Length of treat- 
ment. 
1 
Mr. C. 
Gonorrhoea 
twice; 1 week. 
Profuse discharge, with 
painful micturition. 
Dermatol, five per cent, 
twice daily; dcrmatol 
and plasment. 
Improved in 3 days. All treatment 
stopped, but in 3 days slight return 
due to beer; cured by one injec- 
tion. 
20 days. 
2 
Mr. Con. 
None before; 
3 weeks. 
Profuse and purulent dis- 
charge, with balanitis. 
Dermatol and plasment. 
Improved after first injection; stopped 
in 3 davs. 
3 days 
3 
Mr. H. 
None before; 
10 weeks. 
Moderate discharge. 
Solution of dermatol, 
five per cent. 
Improved in 2 days. 
3 days. 
4 
Mr. L. 
None before; 
1 week. 
ll Ct 
Il ll ll 
Patient did not return. 
5 
Mr. R. 
None before; 
4 days. 
Ct n 
It ll It 
u ll ll 
6 
Mr. G. 
None before; 
6 weeks. 
Profuse discharge. 
ll ll ll 
Discharged stopped in 7 days. 
10 days. 
7 
Mr. D. 
None before; 
1 month. 
u u 
It ll ll 
Improved in 2 days. 
12 days. 
8 
Mr. B. 
None before; 
5 days. 
Profuse discharge; pain 
on urination. 
Solution of dermatol, 
five per cent., until 12 
days, and then derma- 
tol and plasment. 
3 weeks no discharge; then 2 weeks 
no discharge; then slight return 
after drinking beer. 
7 weeks. 
9 
Mr. S. 
None before; 
4 days. 
Profuse discharge, and 
pain on uiination. 
Solution of dermatol, 
five per cent. 
5 days discharge less, no pain; slight 
showing at meatus for 8 days, and 
then stopped. 
13 days. 
10 
Mr. Z. 
None before; 
3 weeks. 
Profuse discharge; some 
pain. 
Solution of dermatol, 
five per cent.; irregu- 
lar. 
Less pain and discharge the following 
day. In 10 days only slight dis- 
charge ; then no treatment for a 
week. Came back with epididymitis. 
11 
Mr. C. 
Treated for near- 
ly a month with 
copaiba. 
Copious discharge. 
Solution of dermatol, 
five per cent., for 2 
weeks, improvement; 
dermatol and plasment. 
Discharge stopped in 3 weeks. 
3 weeks. 
12 
Mr. S. 
None before; 
1 week. 
Profuse, with pain on 
urination. 
Dermatol, five per cent, 
for 2 weeks ; dermatol 
and plasment. 
Improvement; stopped in 10 days. 
10 days. 
13 
Mr. Gil. 
Gonorrhoea sev- 
eral times; not 
entirely free; 
5 days. 
Profuse and purulent. 
Dermatol and pot. bicarb, 
for 11 days ; dermatol 
and plasment used. 
Improved first ll days; very slight 
discharge continued for 2 weeks 
longer, then stopped. 
25 days. 
14 
Mr. Gar. 
None before; 
5 days ago. 
Profuse, and pain on 
urination. 
Solution of dermatol, 
five per cent.; after 3 
weeks, pot. bicarb.; 
dermatol and plasment. 
Discharge stopped in 5 days; 2 weeks 
later, nodule near meatus, which 
burst into urethra. 
6 weeks. 
15 
J. H. 
None before; 
10 days. 
Profuse discharge, pain, 
and frequent micturi- 
tion. 
Sol. of dermatol, five per 
cent.; pot. bicarb.; 
dermatol and plasment. 
Discharge stopped in 5 days ; returned 
in a week, cured by one injection. 
12 days. 
16 
Mr. B. 
None before; 
3 weeks. 
Profuse and purulent 
discharge; pain and 
chordee. 
Solution of dermatol, 
2 weeks; pot. bicarb.; 
dermatol and plasment. 
Discharge stopped; returned 5 days 
later; stopped after 4 days. 
3 weeks. 
17 
Mr. T. 
Several times ; 
1 week. 
Watery discharge; pain 
on urination. 
Solution of dermatol, 
five per cent., 1 week; 
dermatol and plas- 
ment ; pot. bicarb. 
Solution of dermatol, 
pot. bicarb. 
Improvement in 2 days; patient ir- 
regular ; discharge stopped, and did 
not return. 
24 days. 
18 
Mr. H. 
Discharge; 
4 weeks. 
Quite profuse. 
Discharge stopped in 3 days. 
3 days. 
19 
Mr. Har. 
3 days. 
Moderate. 
It ll It 
11 days. 
20 
Mr. B. 
Gonorrhoea 1 yr. 
ago; 1 week. 
Profuse, and pain on 
urination. 
ll ll ll 
5 days, improvement; dermatol and 
plasment given; cured in 4 days. 
Improved; discharge stopped in 2 
days ; patient did not return. 
9 days. 
21 
Mr. J. 
None before; 
5 days. 
Purulent and frequent 
micturition; balanitis; 
phimosis. 
Solution of dermatol, 
pot. bicarb., 1 week; 
dermatol and plasment. 
22 
Mr. M. 
Gonorrhoea 5 yrs. 
ago; 9 days. 
None before; 
2 days. 
Gonorrhoea 1 yr. 
ago; 4 days. 
Profuse; no pain. 
Solution of dermatol, 
pot. bicarb. 
Discharge stopped in 7 days. 
Patient did not 
return. 
23 
Mr. R. 
Chancroid for 1 week; 
discharged; pain. 
Profuse, with pain on 
urination. 
Solution of dermatol, pot. 
bicarb.; then dermatol 
and plasment used. 
Solution of dermatol, pot. 
bicarb., 1 week; der- 
matol and plasment. 
Very little improvement, 8 days; 14 
days, no discharge. 
Stopped in 8 days; slight return at 
intervals for 3 weeks; cured. 
14 days. 
Mr. Coh. 
3 weeks. 
25 
McG. 
None before; 
2 days. 
Thick, white, with pain 
on urination. 
Dermatol and plasment, 
pot. bicarb. 
No discharge after 2 weeks; irregular 
treatment. 
2 weeks. 
26 
McC. 
No gonorrhoea; 
2 days. 
Profuse, with pain on 
urination. 
ll ll Cl 
No discharge on third visit; patient 
irregular; did not return for 8 days. 
Discharge again profuse; improve- 
ment in 4 days. 
15 days. 
27 
McD. 
Gonorrhoea 1 yr. 
ago; 2 days. 
Moderate, with pain on 
urination. 
Sol. of dermatol, 1 week; 
dermatoland plasment, 
pot. bicarb. 
Treated 1 month, although most of 
time no discharge. 
1 month. 
28 
Mr. V. 
No gonorrhoea; 
2 days. 
Profuse, with pain on 
urination. 
ll ll ll 
ll ll ll 
1 month. 
29 
Mr. M. 
No gonorrhoea; 
2 days. 
Profuse, and pain on 
urination. 
Dermatol and plasment, 
pot. bicarb. 
Improvement in 4 days. 
30 
Mr. R. 
No gonorrhoea; 
3 days. 
Ordinary. 
Solution of dermatol, 
five per cent.; pot. 
bicarb.; dermatol and 
plasment. 
Discharge stopped after a week; re- 
turned again in 4 days. Injection 
given of dermatol and plasment; 2 
days better, but slight moisture in 
the mornings for 2 weeks. 
1 month 
(no return). 
31 
Mr. Hein. 
Discharge; 
3 weeks. 
Slight, and pain on uri- 
nation. 
Dermatol and plasment, 
pot. bicarb. 
Discharge stopped in 24 hours, with- 
out perceptible return. 
2 days. No. 
Name. 
History. 
Nature. 
Treatment. 
Remarks. 
Length of treat- 
ment. 
32 
McC. 
Gonorrhoea and 
stricture before; 
3 days. 
Profuse discharge, and 
pain on urination. 
Dermatol and plasm ent, 
pot. bicarb. 
In 2 days the discharge disappeared; 
but with very slight returns, with- 
out any pain or irritation, for 1 mo. 
Discharge improved after three visits; 
did not return for 10 days, and with 
another trouble; no discharge since 
visit. 
5 weeks. 
33 
Mr. St. 
2 weeks. 
Profuse discharge, and 
pain on urination. 
For 2 weeks patient was 
treated by AgN03 (1 
to 3,000), no improve- 
ment ; dermatol and 
plasment, pot. bicarb. 
3 days. 
34 
Mr. D. 
Gonorrhoea 2 yrs. 
2 days. 
Profuse discharge; bala- 
nitis. 
Dermatol and plasment, 
irregularly; pot. bi- 
carb. ; thirteen visits 
in a month. 
Discharge stopped in 3 weeks, but re- 
turned and continued slightly for 
1 week. 
5 weeks. 
35 
Mr. M. 
No gonorrhoea; 
2 days. 
Profuse; balanitis; small 
meatus. 
Dermatol and plasment, 
pot. bicarb. 
Stopped entirely in 5 weeks; meatus 
was irritated by catheter. 
5 weeks. 
36 
Mr. S. 
No gonorrhoea; 
3 weeks. 
Profuse. 
G G 
G 
Following day very much improved; 
second injection given. 
Patient did not 
return. 
37 
Lewis. 
No gonorrhoea; 
3 weeks. 
Considerable discharge, 
with pain. 
G G 
G 
No discharge on second and third 
visits; then very slight for 10 days. 
No discharge at 3 weeks; patient re- 
turned 2 weeks later with discharge 
following use of beer. 
12 days. 
38 
Mr. B. 
Gonorrhoea 3 yrs. 
ago; 3 days. 
Profuse, with pain. 
G G 
G 
5 weeks. 
39 
Mr. G. 
Gonorrhoea 2 
years; 1 day. 
Gonorrhoea sev- 
eral times; 1 wk. 
Quite profuse. 
G G 
G 
Patient very irregular; cured after 5 
weeks, only 6 visits. 
3 weeks (not 
satisfactory). 
40 
Mr. W. 
Discharge; pain and 
balanitis. 
G G 
G 
No discharge in 11 days. 
11 days. 
41 
McG. 
Several times; 
2 weeks. 
Ordinary. 
G G 
G 
Discharge stopped in 1 week; re- 
turned twice later due to excessive 
indulgence. 
1 week; under 
observation for 
4 weeks. 
42 
Mr. B. 
Several times; 
1 week. 
g 
G 
Discharge stopped temporarily in 13 
days; in 16 days stopped and did 
not return. 
16 days. 
43 
Gross. 
2 months. 
g 
G G 
G 
4 days, stopped; but returned in 1 
week slightly after beer in excess; 
stopped by one injection. 
12 days. 
44 
Mr. J. 
1 week. 
Small meatus; profuse 
discharge. 
G G 
G 
No discharge in 19 days. 
19 days. 
45 
Mr. G. 
No gonorrhoea; 
1 week. 
Profuse discharge; swell- 
ing of glands and oede- 
ma of prepuce. 
G G 
G 
Stopped in 12 days; slight return at 
intervals for 2 weeks longer. 
1 month. 
46 
Mr. F. 
No gonorrhoea; 
1 week. 
Profuse discharge; chan- 
cre and balanitis. 
G G 
G 
Discharge stopped in 6 days. 
6 days. 
47 
Mr. H. 
2 days. 
Profuse. 
G G 
G 
G G G 
Patient did not 
return. 
48 
Mr. C. 
4 weeks. 
Profuse; treated 4 wks. 
by copaiba. 
G G 
G 
Stopped in 3 days. 
3 days. 
49 
Mr. S. 
Gonorrhoea 
twice; 2 weeks. 
No gonorrhoea 
before; 2 weeks. 
Ordinary. 
G G 
G 
In 2 days discharge disappeared; in 
10 days cured. 
10 days. 
50 
Mr. K. 
g 
G G 
G 
Stopped in 13 days; returned slight 
on 17th ; cured in 20 davs. 
20 days. 
51 
Mr. S. 
No gonorrhoea; 
2 days. 
Profuse, and pain on 
urination. 
G G 
G 
After 5 days only slight moisture at 
meatus; stopped entirely in 15 days. 
15 days. 
52 
Mr. D. 
Gonorrhoea 4 
months; 1 wk. 
Profuse; copaiba, 3 days. 
G G 
G 
Practically stopped after one injec- 
tion ; cured in 10 days. 
10 days. 
53 
Mr. H. 
Gonorrhoea 8 yrs. 
ago; 1 week. 
Ordinary. 
G G 
G 
Second visit practically no discharge. 
Stopped in 6 days; no discharge for 
10. Indulgence in beer brought 
back discharge for 3 days. 
21 days. 
54 
Mr. C. 
No gonorrhoea; 
1 day. 
Profuse, with pain. 
G G 
G 
Four injections; much improvement. 
Patient did not 
return. 
55 
Mr. M. 
Gonorrhoea 
three times; 
last time 2 years 
ago; 1 day. 
g g 
G G 
G 
3 days, no discharge; slight return in 
3 days, then no discharge for 5 days. 
Slight return, frequent urination, 
and pain. Discharge stopped in 13 
days; pain on urination disappeared 
after 5 days. 
13 days. 
56 
Mr. W. 
No gonorrhoea; 
2 days. 
g g 
G G 
G 
Improvement for 21 days. 
Patient did not 
return. 
57 
Mr. L. 
2 years ago; 
2 days. 
Profuse, with pain ; bala- 
nitis. 
G G 
G 
Gradual improvement; no discharge 
after 13 days. 
13 days. 
58 
Mr. G. 
No gonorrhoea; 
3 days. 
Profuse, with pain. 
G G 
G 
Patient on third visit had no discharge, 
and it has only been very slight with 
no discomfort since. 
Still under 
treatment. 
59 
Mr. L. 
No gonorrhoea; 
4 days. 
G G 
G G 
G 
Discharge stopped in 4 days, did not 
return ; saw patient 10 days later. 
Discharge stopped by one injection. 
8 days. 
60 
Mr. Lewis. 
No gonorrhoea; 
4 weeks. 
Ordinary. 
G G 
G 
2 days. 
61 
Mr. F. 
Gonorrhoea once 
before; 1 week. 
Quite profuse. 
G G 
G 
After 3 injections discharge stopped; 
patient returned 10 days later for 
another trouble. 
1 week. 
62 
Mr. H. 
Gonorrhoea 2 yrs. 
ago; 1 week. 
Gonorrhoea 
twice before; 
3 weeks. 
G G 
G G 
G 
Improved; very slight watery dis- 
charge only; 16 davs. 
Under treat- 
ment. 
63 
Mr. R. 
Ordinary. 
G G 
G 
No discharge in 3 days, but returned 
8 days later; again stopped after 
two injections ; four injections. 
12 days. 
64 
65 
66 
Mr. A. 
Fifteen cast 
Twenty-five 
No gonorrhoea 
before; 4 days. 
;s under treatmer 
cases could not 
Profuse; purulent, with 
pain on urination and 
oedema about penis. 
it less than 10 days ; all d 
ittend regularly; treatmen 
G G 
fing well, 
t not given. 
G 
Improved after first injection; still 
under treatment, but discharge prac- 
tically cured. 
Still under treat- 
ment; 12 days. ACUTE URETHRITIS. 
33 
10th.-Continued improvement. 
11th.-Continued improvement. 
16th.-Continued improvement. Patient came regularly 
discharge growing less. On the 30th it entirely ceased and did 
not return. Discharge lasting in all five weeks, but course and 
symptoms mild after first week. 
I will also give the result of its use in two private cases, 
where I had acute exacerbation of chronic urethritis: 
1. Young man under treatment by deep injections of nitrate 
of silver for chronic posterior urethritis. 
After free indulgence in beer and connection with a prosti- 
tute, he came to my office with a profuse discharge. Pain and 
swelling of the whole penis. One application relieved all the 
acute symptoms and the discharge entirely stopped. 
2. While patient's wife was abroad he contracted gonorrhoea. 
The discharge had stopped after six weeks' treatment by copaiba 
and injections of nitrate of silver. Two weeks after this, his 
wife having returned, there developed an acute urethritis fol- 
lowing first intercourse. The discharge was profuse; the whole 
mucous membrane of urethra was swollen, painful, and tender 
to the touch. After the first injection of the dermatol and plas- 
ment all acute symptoms subsided. 
The acccompanying tables give histories of sixty-four 
cases: 34 
A NEW METHOD OF TREATING 
Treatment. 
Duration. 
Treatment. 
Duration. 
Weeks. 
Days. 
Weeks. 
Days. 
Weeks. 
Days. 
Weeks. 
Days. 
2 
6 
3 
6 
5 
Irreg., 
5 
2 
3 
3 
3 
beer. 
1 
7 
1 
5 
4 
5 
2 
4 
5 
Irreg. 
5 
3 
1 
5 
5 
5 
5 
u 
5 
1 
7 
Irreg. 
- 7 
5 
1 
4 
3 
4 
1 
6 
2 
3 
2 
2 
3 
2 
1 
3 
4 
3 
1 
3 
3 
7 
1 
5 
9 
5 
1 
3 
4 
1 
2 
5 
3 
5 
6 
6 
5 
3 
6 
1 
5 
3 
1 
2 
3 
3 
3 
4 
5 
3 
4 
3 
6 
1 
6 
1 
4 
2 
6 
1 
1 
1 
2 
2 
2 
3 
4 
3 
5 
1 
1 
3 
3 
3 
1 
2 
2 
2 
6 
4 
6 
2 
2 
2 
2 
1 
2 
3 
3 
3 
4 
1 
3 
2 
3 
2 
2 
2 
1 
4 
2 
1 
9 
3 
1 
6 
2 
4 
4 
2 
1 
6 
2 
1 
4 
4 
2 
1 
1 
1 
5 
1 
2 
2 
4 
2 
1 
5 
4 
5 
4 
4 
3 
8 did not return. 
2 
3 
2 
3 under treatment. 
5 
Irreg. 
5 
2 
3 
2 
3 
5 
Irreg. 
5 
2 
Treatment. Duration. 
1 week or less . . 
12 
1 
2 weeks, 
more than 1. . . . 
20 
7 
3 " 
u 
2.... 
R 
10 
4 " 
u 
3. . . . 
4 
10 
5 " 
u 
4. . . . 
14 
6 " 
] 
8 
7 " 
] 
2 
9 " 
1 
Total...... 
or 
53 AGUE URETHRITIS. 
35 
Although the results of treatment do not make a brill- 
iant showing in these tables, yet I think you will all admit 
that it is far above the average results. 
I do not allege that urethritis is aborted by this treat- 
ment, but that, when regularly applied, it allays the inflam- 
matory symptoms and makes the patient much more com- 
fortable, shortening the course and preventing complica- 
tions. 
In all these cases there has developed only one case of 
epididymitis, and in that the patient had absented himself 
a week from treatment. 
Other complications-such as cystitis and balanitis- 
have been absent, unless present at beginning of treat- 
ment. 
Conclusions.-1. That in the treatment of acute urethri- 
tis soothing applications rather than irritants should be 
used. 
2. That the passage of the soft-rubber catheter recom- 
mended does not, as a rule, irritate the urethra; that if it 
does it should not be used. 
3. That plasment is an excellent vehicle for urethral 
medicaments. 
4. That dermatol in plasment is the most efficacious 
drug I have used in urethritis, although I have used no 
other drug with plasment. 
5. That treatment by the above-described method has 
produced a milder course and fewer complications than that 
with other remedies that I have used. 
Note.-Since the foregoing was written, six of the patients reported 
as cured have returned with a discharge. In all these cases there was 
a history of previous attacks, and examination showed evidences of 
chronic urethritis. 
209 West Fifty-fifth Street.