Excerpt from Pamphlets, Homoeop. Surgery, 1898, Vol. 1

Looking over the subject in a superficial way we see that it is usually the result of a badly managed acute clap which has become chronic, several factors being responsible. The urethra in advance of the compressor urethra and surrounding the bulb is abun dantly supplied with glands and follicles, a favorite site for the inroads of gonococci and other pyogenic oaganisms. Urinary conditions subject to changes resulting from dietetic errors also predispose to irritate an already congested canal. The tissue changes will perhaps be better understood by quoting Finger, of Vienna. The Opinions advanced are the results of ante and post-mortem findings, both macroscopical and microscopical. Hyperaemia, serous swelling and infiltration are revealed by urethroscopy. The epithelium rarely suffers to the extent of erosions, although in some superficial areas are observed. Marked thickenings and whitish discolorations exist. Circumscribed spots on the surface of the sub-epithelial tissue present uneven nodules, which by microscopical examinations prove to be granulations. The openings of the lacuna-3 of Morgagni are enlarged in some, andin others replaced by milky-white nodules imbedded in the mucosa. Occasionally erosions and papillomata obstruct the field. The most interesting observations, however, are disclosed by microscopic research. The upper layer of the cylindrical cells of the epithelium in most cases undergo mucoid degeneration. The trans ition cells occupy a larger area than usual. Pavement epithelium predominates. In the sub-epithelial con nective tissue the inflammatory process produces most important changes, consisting of an infiltration of the connective tissue resulting in retracting tissue. In new cases this infiltrate occupies the upper layers of the sub-epithelial connective tissue. Sometimes the cavernous body is involved in other cases the cellular infiltrate contains hew bloodvessels, both of which give the sub-epithelial connective tissue that papillomatous aspect termed granulation tissue. These granulations are flattened by retraction and a callosity results. The lacuna-3 exhibit changes similar to those found in the mucous membrane, producing in some dilation of their lumen in others, if retraction occurs, atrophy results. Where the corpus cavernosum is involved, Littre s glands are the seat of changes amounting sometimes to destruction. The corpus cavernosum is frequently attacked (although in some cases remaining intact) in two ways: first by the chronic infiltration remaining superficial, entering along the excretory duct and around the bodies of Littré's glands second, where the chronic infiltration occupies the entire thickness of sub-epithelial periurethral tissue, penetrating the corpus cavernosum, it remains either superficial or occupies its entire width. Where the circumscribed infiltration has undergone retraction, the mucosa and corpus cavernosum are converted into a firm retracting callosity. These deep-spreadingcallosities are the cause of stricture. To recapitulate Granulating tissue is the result of long residence of the virus of gonorrhoea in certain areas of the urethra, and by its conversion into cicatricial tissue stricture is formed. Practically, how can we prevent this The problem logically rests upon the treatment of chronic urethritis, its prevention, and, when established, its eradication. Let us briefly mention some methods employed for its prevention. In March, 1896, i had the honor of reading a paper before the Homoeopathic Medical Society of the County of Philadelphia on the treatment of Acute Specific Urethritis, entering a plea for its abortive treatment. The methods therein advised are now followed by those connected with the genito-urinary department of the Hahnemann Hospital Dispensary. Several important measures have since been added. The well-selected internal remedy is assigned its proper place. Par