A DISSERTATION ON THE Disorders which affect the Neck of the Bladder, the urinary Passage, and the neighbouring Parts, producing Excrescences in the Urethra, attended with the most dangerous Inflammations, and at last, partial, or total Suppressions of Urine, greatly endangering the Patient's Life. SHEWING The different Causes of such Complaints, and the Cure of them made easy, by a Method lately discovered by the Author, of improving the Composition of Daran's Bougies, by which the Cure is sooner performed, without giving Pain, with greater Certainty, and more effectually than with the Bougies of the former Composition. LIKEWISE Hollow Flexible CATHETERS or BOUGIES ARE Made by the Author, being the most commodious and useful In- struments hitherto invented (they giving no Manner of Pain) for injecting the Bladder of those who are troubled with Sand, Gravel, Stone, or Ulcers in that Part. A proper LIQUID for Injection is also prepared by FRANCIS LALLIER, No. 3, RATHBONE-PLACE. Nihil Simul inventum et Perfectum. The FIFTH EDITION with Additions. LONDON: Sold by Mr. NICOLL, St. Paul’s Church-Yard; Mr. AXTELL, No. 1, Finch-Lane, Cornhill; and may be had of all the Booksellers in Great Britain. [Price Six-pence.] INTRODUCTION. IT is not a little surprising, that in a country like England, where the arts and sciences are daily making rapid strides towards perfection, that we should be so long in the dark with respect to some curious inventions of remedies, so essential in preserv- ing the life of man. Such are the medicines called BOUGIES, first in- vented and brought into use by Mr. Daran, at Paris, whose pupil and assistant I was for the space of seven years. When I observe that Bougies were first invented and brought into A2 general iv INTRODUCTION. general use by Monsieur Jacques Daran, Conseiller, Chirurgien ordi- naire du Roy, &c. et maitre en Chi- rurgie de Paris, I would not be un- derstood, that this gentleman was the first inventor of a Bougie, for we find several old authors mention them in their works, particularly in Bar- bett’s Anatom. & Chirurg. Pract. and several others, where they give different receipts for Bougies, but it is to be remarked, that these Bou- gies were to be made use of, merely as sounds, or catheters are at present, to examine the passage of the Ureth- ra and Bladder, which is a momen- tary operation only. Mankind are under the greatest obligations to Mr. Daran, for having by his great ingenuity, long expe- rience, INTRODUCTION. v rience, and labour for many years, brought this probe or sound into the form as well as the specific virtue, properly adapted for curing radical- ly those disorders, for which the Bougies of the ancients were never intended, nor were they ever em- ployed for that purpose, not being composed of proper materials, for cu- ring the complaints we now treat of. Thirty years ago, when I came to England first, by the particular desire of a worthy nobleman, whom I had the honour to know in Paris, I did not find the faculty here, very fond of Mr. Daran’s method of treating the disorders of the Urethra, nor dis- posed to enter into the merits of his practice, notwithstanding the great number of extraordinary cures per- formed vi INTRODUCTION. formed by him on subjects of all nations, who came to him at Paris to implore his assistance, and not- withstanding, the English surgeons had not discovered any other me- thod of relieving and curing such disorders, but their patients were left to take their chance, after being cut and mangled in the old manner, if they had not the good fortune to escape their sufferings by a total sup- pression of urine and a premature death, which, it is too well known, has been the case or many. It is by no means easily accounted for that English surgeons, who in general, are esteemed gentlemen of a more liberal education than the French, and are allowed likewise to be as dexterous in all the manual opera- tions vii INTRODUCTION. tions of surgery, should have such a backwardness and disinclination, to embrace any new method, or im- provement, especially if it has a fo- reigner for its inventor; but an un- willingness to embrace any new re- medy, is, and has been a long time past, much complained of in Eng- land; but this is not all we have to lament, for there is a strange repug- nancy in many to admit any new discovery, however beneficial to mankind; of this the Peruvian Bark is a notorious instance, which made its way into the world with such un- accountable difficulty. I might here mention many other noble medi- cines, which were long opposed by the most learned physicians of Eu- rope, before they were admitted by them viii INTRODUCTION. them into practice. How necessary is it therefore for a practitioner to be void of prejudice, to abound with candour, and to embrace real im- provements with eagerness. Con- ceited authors may rail as much as they please at specific qualities, but it is impossible for them to make any proficiency in the art of healing, without an adequate knowledge of the alterations each drug will pro- duce in the human body, or even in external applications, not by their mechanical action, but by their sin- gular properties, which are only known by experience and not from a knowledge of reasoning a priori. Now since our acquaintance with the virtues of all the Herculean re- medies is the result of experience only, ix INTRODUCTION. only, why should we stop in our en- quiries; or conclude we have already arrived at the ne plus ultra of the Æsculapian art. I have only to add, that soon after I published the first edition of this short dissertation at London, above thirty years since, I had a great number of patients, some of them people of the first fashion, and were known to many of the faculty, whom I had the happiness of curing of the most desperate and inveterate complaints, which had constantly resisted the power of the many dif- ferent remedies, that had been ad- ministered to them for a long series of years. Some time after I had performed the above cures, which B are x INTRODUCTION. are well attested, I had the infinite pleasure and satisfaction of finding many worthy gentlemen of the fa- culty, who were before prejudiced against the use of medicated Bougies in general, now well convinced of their mistake, which they very can- didly acknowledged to me on several occasions. At this present time I believe I may presume to say that there are very few, if any, surgeons of eminence in this metropolis, but are fully convinced of the specific virtue and utility of rightly prepared medicated Bougies for curing Ex- crescences, Carnosities, and, in a word, every other cause of Obstruc- tions in the Urethra or Neck of the Bladder. A DIS- A DISSERTATION, &c. OBSTRUCTIONS in the urinary pas- sage arise from such a variety of different causes, that it would require a much larger work than the present, to give the readers a complete and particular account of them; which, after all, would be of little or no benefit to those who only want to be relieved from their pains and sufferings. Instead, therefore, of entertaining the readers with a long and vain detail of causes and effects, it will be sufficient for them, and more satisfactory, to know, that the most common and general causes of stoppages B2 and (ii) and obstructions of urine, which are only to be cured by the proper and well-directed use of BOUGIES, is one or other of the following: First, They may be owing to a natural stricture or straitness of the urinary passage, either in part, or in its whole length, without any previous cause whatso- ever; which may be looked upon as a disorder inherent to the constitution, and which by age always grows worse and worse, as it is well known, that age brings on a contraction of all the fibres of our bodies and diminishes the diameters of all the tubes, &c. This natural or constitutional disorder, has always been looked upon as incurable, and indeed it certainly would be so, but for the invention of Bougies which remove the cause at once; first by acting as a last does on a shoe, enlarging by degrees the diameter of the Urethra, and at the same time occasioning a gentle suppuration from the glands of the thickened coat of it, and by this simple and plain method, reducing the parts affected to a supple and yielding state, so as to allow a large stream of water to pass through without resistance. I have only to observe, that patients in this particular case may expect in some years a return of this disorder, which they can easily prevent by having a supply of Bougies always in their possession, that they may introduce themselves, from time to time, to keep the (iii) the passage wide and flexible, so that the urine may always come off in a full stream, without which, besides many other bad consequences, the gross and terrestrial particles of the urine being retained in the bladder, will without all doubt, produce another still more alarming disorder, which is a stone in the blad- der, so that this disorder though often looked upon as trifling in itself, and though easily cured, yet in its consequences from neglect becomes so terrible as to endanger the person’s life. Secondly, Suppressions of urine often arise from ul- cers, attended with proud fungous flesh in the urinary passage, owing to venereal disorders that have been mismanaged in the cure, either by the surgeon’s or patient’s fault, from astringent injections, or other preposterous methods; which, when of long standing become inveterate and obstinate, producing fistulas in the neighbouring parts, so that the natural channel of the urine being plugged up, the water makes its way through the integuments, forming different hollow urinous sinuses and fœtid ulcers, which are the more terrible as no person ever yet was so happy as to find a cure, but by the use of the right prepared Bougies; and I am sorry to observe, that it is but too true that numbers of persons have lost their lives from being unhappily reduced to the above situation, and this partly from their being ignorant of the happy effects of (iv) of Bougies of the right method of preparing them, and partly from their prejudice to a remedy that is not recommended to them by some practitioner of high reputation. I have only farther to observe, that pati- ents labouring under the last-mentioned case, are as curable as from other causes, for they are restored to their health and vigour by the use of my Antivenereal Bougies. Thirdly, Obstructions in the urinary passage are not unfrequently caused by a disorder which goes under the name of a GLEET, or those sometimes small, sometimes large discharges of a white or yellowish matter from the Urethra, which matter is sometimes infectious and sometimes not: the cure of this most obstinate disorder has been long attempted by loads of astringent and balsamic medicines, pills, drops, cold baths, the bark, and what not; but I can affirm from the practice of others, and also from my own know- ledge, that very few of such unhappy patients receive any real and lasting benefit from the above method. It is well known that before the use of Bougies, Gleets were deemed incurable, even by the best prac- titioners in Europe. But since the use of my improved Bougies I never have found a gleet so obstinate as to resist their efficacy, even when the patient has been reduced to the last extremity, and beyond all hopes of recovery; (v) recovery; of which there are many living and credita- ble witness, both in London and other places, who can attest the truth. As to a species of gleet known by the name of a seminal weakness in either sex, as also a disorder of the bladder, called a diabetes, I have a remedy which has never yet failed in either sex. It was in the year 1759, that I had a patient of great worth and distinction, who had the misfortune to be troubled with a gleet of seven years standing, which by neglect produced a complication of evils, such as a total suppression of urine by the natural course, and having several hard swelling, both inwardly and out- wardly, and all round the neighbouring parts, he was reduced to suffer the most cruel torturiug pains from this his melancholy situation, so that all the urine that came from the bladder insinuated itself through these swellings, and came away insensibly through fistulous ulcers, formed in those parts, which were extremely fœtid and offensive, and threatened a mortification. This patient had been treated however, with Daran’s Bougies before he fell into my hands, but the case was grown so very obstinate as not to admit of a cure by Mr. Daran, though palliated a little in some measure, but upon the whole, the hollow fistulous ulcers in- creasing both in size and malignity, his disorder ad- vanced to a most dangerous state, when I, by the use of my improved Bougies, made a perfect and lasting cure (vi) cure of this gentleman, as I have since that time of many others in the most desperate cases. With submission to the faculty, it is well known that the above disorders have often resisted the utmost endeavours of the most eminent of them; and that there are incredible numbers of persons in this capital, as well as other parts of the kingdom, who have spared no expence to obtain a cure, and yet continued to labour under some of the above complaints, for several years before they heard of the radical cures I have performed by the use of my improved Bougies, which give no pain to the patient. With regard to suppressions of urine, from obstruc- tions formed in the urinary passage, I beg leave to warn my readers of a very great imposition practised of late years upon the too credulous public, namely, that of pretending to cure such obstructions by the means of drops, or other things taken internally; and although the absurdity of such a method must be very obvious to every one who has the least idea of the nature of such disorders, yet a great many unhappy patients have been and are every day artfully drawn in to try the effects of their vain-boasted drops and tinctures, and when too late, are left to repent of their loss of time and money; of which I have seen too many in- stances amongst such as had been thus duped, whom I (vii) I have cured gratis afterwards, they having pleaded hard to be excused payment, since they had laid out their money in vain on such pretended remedies. I shall not take up my reader’s time any more with a farther account of the disorders to which the Ure- thra is subject, but shall finish this little treatise with an account of a few cases, some of which had been despaired of, selected from a very great number which have been perfectly cured by my Bougies here in London, and also in the different counties of Great Britain and Ireland, who are supplied by me with full directions for their use in all cases of these disor- ders. I apprehend that my candid readers will readily excuse me for not having mentioned the names of any of my patients, this being a tender point I avoided, in order that I might not incur the least reproach from the public; but however, some of my patients of their own accord, have through gratitude for the benefit they received from my Bougies, and for the sake of promoting the same benefit to others, given me leave to mention their names if required; and likewise another privilege I have, which was unsoli- cited by me, viz. that of referring to very eminent physicians in London, who were eye-witness to the many cures performed by me in London, one of whom has received himself, several letters of thanks from the country, from patients of this physician’s C acquaintance (viii) acquaintance who were cured, and to whom my medicines were sent by his recommendation, and who from the goodness of his heart and the many proofs he has known of the lasting and efficacious cures per- formed by my Bougies for these many years pass, continues still to recommend me to patients attacked with all complaints of the Urethra. (9) CASE I. A Young gentleman of twenty-five years of age, had a natural stricture in the Urethra from his birth, so that he was obliged to take 15 or 20 minutes, and sometimes longer in making his water, with much difficulty and pain, the stream being no larger than a common thread. He was to have been married three years before I saw him, to a young lady in the country. He had been treated with common Bougies, by several gentlemen emi- nent in their profession, by which he was able to make his water quicker, and also in a larger stream than usual; but, as the Bougies which had been employed by these gentlemen, had no other virtue, but that of stretching and enlarging the diameter of the Urethra, and that only for a momentary time, after which the part re-contracted, and he reduced again to his old situation; when a friend of his happened to consult me on his case, which I under- took; and, by using my Bougies constantly, he was per- fectly cured of this natural stricture (for he never had had any venereal affection) in two months, when he could make near a pint of water in the course of a minute, and in a large full stream, which he has continued to do, without the least return, to this day. This was in No- vember, in the year 1751, and is mentioned in my first edition of this pamphlet. C2 CASE (10) CASE II. A Foreign minister, who was a man of great quality, had been troubled with a stricture for seven years to- gether, attended with an obstinate and virulent gleet, which, besides the frequent dangerous suppressions of urine, produced great pain and weakness in the parts, as well as of the whole body, and particularly of the back and loins, which made him walk in a bent and crooked manner, not being able to keep himself erect upon his legs; he was greatly emaciated with a loss of appetite, and consequently of his strength. He had been treated for this complaint, for four months in Paris, with Bougies and other medicines, by which he obtained a better state of health; but one year after that, being at London in a public character, his complaint returned as bad as ever; he applied to a physician, who recommended him to the use of my improved Bougies; I undertook the cure, which I performed in three months time. This was in the month of May, 1759; and this nobleman having continued residing in London for the space of five years afterwards, not having had the least return of his former complaint, but recovered a perfect state of health, which the same physician who recommended me this patient, and who is now living, is ready to certify. CASE (11) CASE III. A Foreigner, a favourite servant of the said embas- sador, who had long been troubled with the same com- plaint with his master, but only much worse, for he had two fistulous ulcers, one near the anus and another in the scrotum, through which all his water came, and not a drop by the natural channel, it being choaked up with fungous excrescences, he had also been treated as his mas- ter, in Paris, for the space of four months, but was not cured; probably because he could not stay in that city any longer. I undertook him, and made a perfect cure of his disorder in six months time, which can be authen- ticated by a physician, &c. CASE IV. A Foreign gentleman, aged sixty-seven years, applied to me, who had lived in very great misery for the last ten years, by a continual suppression of urine, occasioned by a stricture of the Urethra, he never could make water but by drops, and in a very painful way, and was obliged to drink but very little, being afraid to endeavour at making water, which he could not do, but by the use of a silver catheter which was introduced several times a-day. He was living in the country, and sent his surgeon to town for my Bougies and my directions, and received a perfect cure (12) cure in three weeks time, by being able to make his water freely and in a full stream; and declared, in his letter of thanks, that he never had made his water so free in the whole course of his life before this period. CASE V. A Person of about forty years of age, having had many very virulent claps of which he was cured, but al- ways with much difficulty, and was several months for each under the surgeon’s care. In about six months after his being cured of his last, he was grievously attacked with a suppression of urine, for which he was advised by his surgeon to make use of Bougies, which gave him some temporary relief, but the disorder returning, he applied to me; on examination I found he had two ulcers with spungy flesh, one near the top, and the other about the middle of the Urethra; he was radically cured in about two months by the use of my Bougies: it is ten years ago, and continues free from obstructions, and enjoys a very good state of health at this present time. CASE VI. A Gentleman from Dublin, came to London for ad- vice in a very bad case, for which he had not been able to find relief in the first mentioned place, for near the space of five years, during which time he was always un- der the hands of the faculty. His Urethra was plugged up with proud flesh or excrescences all the way up to the top, and a fistulous ulcer was formed near the fundament, through (13) through which all his urine came off. I first applied a small bit of Bougie, which I introduced with some diffi- culty into a very small and almost imperceptible orifice at the top of the Urethra, which brought on a suppuration from the part affected; when, by little and little, I pro- ceeded in this manner daily, getting further and further; till at last, in about three months, I got a free passage for a long Bougie into the bladder; soon after this, having dressed the fistulous ulcer above-mentioned, through which the urine came, with proper medicines, the water came by the natural channel; and the fistula was cured, and he was perfectly cured, but it took me six months to accom- plish it. This gentleman was no more than twenty-eight years of age. He returned to Dublin soon after, and spoke so well of my remedy, that I have had several sent me by his recommendation, and others to whom I have sent my remedy there. CASE VII. A Knight and Baronet, aged sixty-three, having been at several times for four years past, in imminent danger of his life, by frequent suppressions of urine, and during the last year, the complaint was become so se- rious, that he was obliged to have his water drawn off twice every day by a surgeon, by the help of a catheter, the introduction of which instrument always gave him the most accute pain, and brought away a great deal of blood and matter: this disorder was entirely occasioned by proud flesh and caruncles formed in the Urethra, from frequent venereal infections he had received, which he always (14) always used to stop directly, by what he called his fa- vourite injection; which method he now found, by his sad experience, to be the cause of all his present misery. He put himself under my care, and by the help of my Bougies, and a few other necessary medicines, I per- formed a radical cure in about six weeks. This was in the year 1759, and he now continues to enjoy a more perfect state of health and strength, considering his age, than formerly. CASE VIII. A Young gentleman came to me from Wales, having had several claps, either cured by injections, or by a pre- posterous use of astringent, balsamic medicines, till at last he not only contracted obstructions in the urinary passage, but was at the same time thoroughly poxed, having two deep ulcers, one at the bottom of the penis which commu- nicated with the urinary passage, so that a great part of his water came through this ulcer. The other ulcer was in his thigh, a little below the groin, which was very foul, and appeared to affect the bone, as he was very lame of this limb; a great number of eruptions about the roots of his hair, with nocturnal pains in his head and limbs. On administering my antivenereal remedies, and by the use of my Bougies at the same time, he was perfectly cured in about seven weeks, and returned extremely con- tent and happy, to his own country. This gentleman was about forty years of age at that time, which was in the year 1766, he has done me the honour of correspond- ing with me ever since, and has recommended me many unhappy (15) unhappy patients from Wales, amongst whom is the drover, in the next case. CASE IX. AN honest Welch drover, having been sent to Lon- don, from the last-mentioned patient, to be put under my care; his case was very bad, as it had been neglected for several years; he was however a robust looking man, and had been blest with a good constitution; he had made no water at all by the natural passage for near three years past, but it came off by three different passages it had formed to itself, one close to the scrotum, a second close to the anus, and the third near the groin, where there was a large winding fistulous cavity, this part looked so very bad, that I was apprehensive of a mortification coming on; for some days I applied a very softening poultice to the part, which was often repeated; after which, by that and a few days rest from the fatigue he had suffered in the waggon, (for his sores did not permit him to ride on horse-back) this sore part had a much better appearance; after losing some blood, and taking some gentle physic, I began to make use of the Bougies; but the urinary passage being so entirely stopped up with a fungous that it was a work of five weeks before I could get through this violent obstruction; but having got at last quite into the bladder, in five weeks more I had the pleasure to see the natural course of the urine restored; as also all the other parts well and firmly cicatrized. This was in the year 1767, in the month of May, for D which (16) which I received a letter of thanks from the gentleman by whom he was recommended. CASE X. A Young gentleman of twenty-six years of age, having had claps cured by injections for the space of four or five years; the consequence of this was, that he made water in a very small stream, occasioned by the coat of the Urethra being contracted and fungous; excrescences being also formed in its different parts. This gentleman being troubled also with the gravel, and several small stones with a cake of red sand lodging about the neck of the bladder not being able to come off with the urine from the narrowness of the Urethra; in the course of the cure by the help of my Bougies, I was obliged to push back into the bladder, a great many small stones that were lodged in the entrance of the Urethra, which afterwards were all brought off by the urine when the passage was enlarged sufficiently to permit their passing. After this I injected his bladder with a particular mild decoction of a vulnerary liquid, by the help of my hollow and flexible Bougie, which brought away such an amazing quantity of small stones and gravel at which I was myself much astonished. He was restored by me to an exceeding good state of health. This happened in the year 1768. This gentleman’s case may serve to shew how necessary it is that the urine should come off in a full stream, otherwise many dangerous evils will ensue; such as to lay a founda- tion for the stone and gravel, besides disorders in the part itself, all of the worst consequences. CASE (17) CASE XI. A Youth, but ten years of age, son to a gentleman of great distinction, being at an academy a small distance from London, the master of which having consulted me, and stated the situation of his scholar, which was a natural straitness of the diameter of the uriny passage, which only permitted the water to pass in a size of a small thread; this consequently impeded the gross terrestrial parts of the urine from coming off, and by being daily accumulated, had laid the foundation for the stone in the bladder, which was the case of this youth, as he had all the symptoms of this dangerous disorder, for which he was cut; and though upon cutting he had no hard stone, yet there was brought from him a hard cake of red gravel, which broke in coming out; after which I enlarged the passage by the use of my Bougies, that in three weeks time the stream of urine came off full, and as large as most of his age. CASE XII. IN the month of November, 1768, a person aged fifty- five, was recommended to me by a surgeon of eminence in London. This patient had been clapped a great number of times, for the last fourteen or fifteen years before I saw him: he had likewise gone through the proper course of remedies for the pox, with which he was highly infected, but had been cured at different times by the same gentle- man who recommended him to me; however, he was troubled with a stricture of the Urethra, which obstructed D2 his (18) his making water, which he could do only by drops, and accompanied with great pain, heat, and soreness of the parts, in which he had a continual itching, which was ex- tremely troublesome both night and day. After I had conquered the itching and inflammation by poultices and other calming applications, I set about curing the obstruc- tions in the urinary passage, in which I found, as I pro- ceeded, that there were three different parts affected, one near the neck of the bladder, the second about the middle, and the third in those glands called the great Lacunœ, near the top of the yard. I made a perfect cure of this patient in about three weeks, when he had the pleasure to find that he made water as free and in as full a stream as if he had been a school-boy again. CASE XIII. A Gentleman aged fifty-two, was recommended to me by his apothecary, in the year 1770; his case was very inveterate and of a long standing, having had a virulent running for eleven years past, his urinary passage greatly obstructed, and could only make water a little at a time, and that little with the greatest difficulty, and the most painful strainings: his life was thought to be in great dan- ger, and as he himself expressed, was a burthen to him. He had taken many medicines, was at Bristol and Buxton for the use of the waters of those places; besides, he had made use of different Bougies from different people, with- out any solid relief: he was very much emaciated in his face, as also in his legs and arms, but his belly was always very (19) very much swelled and pitted pretty deep; I was afraid he would have occasion to be tapped, for he had a con- firmed dropsy which would soon have carried him off, had he not met with relief from me, for by the assistance of my Bougies and other purgative remedies, he was freed from all his dropsical symptoms, from his virulent running which was owing to deep fungous ulcers in different parts of the Urethra, in the space of ten weeks after he began to use my medicines. CASE XIV. AN Italian gentleman, aged thirty-nine, came to me with a letter from an English gentleman at Naples, who had been an old patient of mine, and had been cured by me of the very same disorder with which this Italian gen- tleman was afflicted. He had, after many venereal infec- tions, some of which were neglected, others badly cured, a very large swelling near the anus which extended to the testicles, this had been opened at Paris two years before he came to London; however, after this tumour was opened, there appeared different sinuses through which the urine, as well as matter, came off, the wound was suffered to fill up, but still the urine made its way through many different fistulous-openings; and a hard swelling of the prostrate gland by the root of the yard, grew at length to such a bigness, that not a drop of urine came by the na- tural channel. Being still in Paris, he put himself under Daran’s hands, in which he remained near six months without being cured. His mercantile business calling him to (20) to London, I undertook him, and cured him of his very bad complaint in less than four months; and am very certain that had I had this patient at the first, he would have been cured much sooner. CASE XV. The following cure, whether considered from the patient’s great age, or from the greatness of the disorder, his life being despaired of by the faculty, must make my medicines appear in a more advantageous light to the public than any case I have ever before had the satisfac- tion of curing. IT was on the first day of October 1771, that a surgeon of eminence applied to me for a patient of his, aged eighty years, who was at death’s door with a violent suppression of urine; the surgeon was not able to Introduce one of the smallest of his Bougies. This unhappy patient being so far spent with continual agonies of pain for near three weeks, that his surgeon did not expect that he could hold out three days longer. I told him, that since I followed my profession, not one patient had ever died in my hands, and I begged to be excused from seeing a patient in such a desperate case, as it might affect my character: in the mean time, I was so strongly solicited by the surgeon and apothecary of the patient, to examine his case, that I was at last prevailed upon to visit him. I found a large hard ulcer situated near the neck of the bladder, which totally prevented the patient’s making water. In my first day’s application I gave him some relief, but his irrita- tions, (21) tions, though not increased, still existing, and his weak- ness increasing, I must own, that I, from his bad symptoms, dreaded the consequence; but, on the next day his wife informed me he was sleeping, having the preceding night voided half a chamber-pot, which she shewed me, of a very bad corrupted urine mixed with blood and matter. I continued my applications of Bougies and other medi- cines every day for three weeks, at the end of which I was so happy as to make a perfect cure of him, notwith- standing every one about him, as well as myself, despaired of it. He is now quite well, and is ready to give his testi- mony of the truth, as are also his surgeon and apothecary, who may be applied to, and shall be informed by me of their names and places of residence in London. CASE XVI. A Tradesman of the city of London, having applied to me, in the month of July 1771, being recommended by an apothecary, who knew a gentleman whom I had cured of an ulcer in the neck of his bladder some years before. At first when I saw this patient, I found him in a very melancholy and desponding situation, saying to me, that unless I could give him speedy relief, he was certain he could not live a week longer. I found by what he said, that he had contracted a clap about three years since, for which he applied to a surgeon, who, in appear- ance had cured him; but in a fortnight after, a shanker made its appearance on the glans penis, which in in a short time grew so malignant that this part swelled to a monstrous (22) monstrous size, and though he in this dangerous situatlon applied to a surgeon of known skill in his profession, yet he was not cured without the loss of the whole penis; this loss he could have born with patience and resignatlon, but another dreadful disorder came upon him afterwards, viz. obstructions in the remaining part of the Urethra which pre- vented him from making water, but by using great efforts and straining, &c. He was advised to make use of Bougies he got from some person, which he did with little or no effect as he could not get them introduced to the bladder. At last, having heard of an apothecary who fells drops which he boasts of being proper for such complaints; and having taken them for two months together, did not find that he was the least relieved from his terrible complaint. Being tired with living in such misery, he was resolved to let nature take its course, finding himself grow worse and worse, he took several internal medicines from different people, however he received no relief, nor indeed should it be expected that internal medicines can help a local complaint of the Urethra. After this I was called to his assistance, and found the urinary passage quite obstructed, it not being possible to introduce one of my strongest Bou- gies above one inch. At the root of the yard, there was a hard swelling and a fistula, through which most part of his urine was discharged, his scrotum was likewise hard, and swelled ready to break into different fistulas, &c. These local complaints had brought him by length of suffering pain, to the lowest ebb, but I had the satisfaction in four months time, with my Bougies and other proper medicines, to make a perfect cure of this patient. Sur- geons and Apothecaries who knew this, as well as the patient (23) patient who is but twenty-five years of age, are ready to testify the truth of what is here related. I beg leave here to observe to my readers, that since the year 1772, to the year 1780, I have cured above five- hundred persons of different denominations, many of whom would have died, and most part of the others would have lived a life of misery, and unfit to propagate their own species; therefore it would be easy for me to give them many more examples of cases exceedingly bad, when the life of the patient was in the utmost danger, and must have died had they not applied to me in time, all which can be well authenticated. It is presumed that the cures here published are sufficient to confirm the practice, and more would have exceeded the bounds of this short treatise. They will, however, serve to shew to such as are un- happily afflicted with such cases, the terrible consequences of neglecting to apply for a cure, which they should not despair of, however bad they may be; as I declare, I never lost one single patient in my life, out of the great number I have treated, nor have they ever missed of a cure. Such may be perfectly assured, that my Bougies are the only medicines capable of producing a speedy and lasting cure of the different disorders with which the urinary passage is liable to be affected; whether gleets, ex- erescences, ulcers, fistulas, or any other thing that forms ail obstruction to the free passage of the urine, by what name soever called. A great number of surgeons and apothecaries in different parts of Great-Britain and Ireland, are supplied by me with my Bougies, with proper directions for their use, E cure (24) cure their patients who are afflicted with the above com- plaints, as well as I could, had they been under my care; from whom, as well as from the patients themselves, I have received many compliments, and letters of thanks for several years past. I likewise send them to the persons themselves, who do not chuse to divulge their case to their neighbouring surgeons, who treat themselves by my direction, and without difficulty obtain a cure; for the application and treatment is quite easy, the grand secret lies in the composition of these remedies. I likewise compose hollow flexible Bougies of a very soft and healing nature, made with the same ingredients as my ordinary Bougies. Their use is for injecting the bladder with a liquid of a vulnerary and healing nature, for curing ulcers in that part, as also for bringing off, and cleansing the bladder of mucus, gravel, sand, or small stones, which, if not brought away in time, would in- fallibly produce large hard stones of an indissoluble nature. This operation may be performed by the patients them- selves, they being provided with my flexible hollow Bou- gies, without any pain or difficulty. I supply my patients at the same time with the vulnerary and healing liquid for the injection, and also with syringes proper to throw it up with. These medicines and instruments are of more utility than can at first be well conceived by any one who has not had opportunities of seeing their surprising good effects in all the disorders of the bladder, whether occasioned by the stone, gravel or ulcers, producing great pain and inflam- mation in that part. Though I do not pretend that my vulnerary (25) vulnerary liquid injected into the bladder will dissolve a stone that may be contained in it; yet I must assure mv readers, that I give them a present relief from their torturing and most excruciating pains, by the effect of this medicine, which heals the ulcers which had been produced by the stone or gravel fretting and wounding the tender coats of the bladder, after which, the patient will remain free from pain in that part for several months together, until the stone or gritty matter shall have made fresh wounds, when, recurring to the injection again, will meet with immediate relief. The following is the substance of a letter in the Gazetteer of August 29, 1765, signed Edward Nihill, apothecary in the Hay-market, who at that time sold Daran’s Bou- gies, prepared by Mr. Lallier. “Mr. Daran accuses me in a pamphlet lately published by him, of hanging out at my shop-windows in the Hay- market, these words, Daran's original Bougies, and while he denies having supplied me with any, he declares he will not be answerable for the bad consequences that may attend the use of them. To this Mr. Daran received for answer at that time, that it would have been more candid and more liberal to have entered into a personal explanation on this subject with me, whom he had visited several times, than to have arraigned me to the public, as if I had imposed on it by a counterfeit medicine. But the truth was, that I never pretended to have the Bougies in question from Mr. Daran himself, and had only used the above words in the like sense as Daffy's Elixir, Friar's Balsam, &c. as many other nostrums are every day made E2 and (26) and dispensed, under the names of the inventors of them nor was I ever apprised till the coming out of Mr, Daran’s pamphlet, of his having made a nostrum of his invention. But what authority I had, will appear still more clearly from the following account of the way by which I came by these remedies, Mr. Lallier, whom I knew had lived as assistant with Mr. Daran seven years, or thereabouts, and who had been wholly employed in the making his Bougies, and at that time had all the opportunities re- quisite for obtaining a thorough knowledge of all the in- gredients without reserve, and the application of them in their different states; for we find Mr. Daran acknowledges himself, in his pamphlet, page 12,” That the compo- sition of his Bougies was not so strict as not to admit of proper alterations according to the exigency of each case. “Mr. Lallier then came to London, and set up a practice here of what he had learned under Mr. Daran at Paris. On his arrival he published a short treatise on the disorders of the Urethra, with directions concerning the use of the Bougies; the genuineness of the preparation of which could not be better proved, than by his great and repeated success in curing the above disorders, and of this he has numerous testimonles; and from my own experience, having been constantly supplied by Mr. Lallier, having this to say for Mr. Daran’s satisfaction, that they by no means dishonour his name thus put to them, so that he need not have any apprehensions on this score; the real and indisputable truth being, that they have had surprising good effects, in the cure of many obstinate (and by other surgeons imagined) incurable disorders: they have fully answered (27) answered the recommendation of the remedies coming im- mediately from himself, being in fact essentially accord- ing to his own form of composition, and to all intents and purposes of cure, the very kind of Bougies he him- self dispenses. As to the words ignorant people, and empiric, of which Mr. Daran makes use in the same paragraph, I have the less reason to apply it to myself, for that he cannot well have forgot my title to a less un- favourable designation, he himself knew me surgeon to the houshold of the Marshal de Contades, when a cir- cumstance happened in which Mr. Daran was concerned, and which afforded him an opportunity of considering me in another light, and indeed I have so great an esteem for him, that I should be sorry to see him fall into the same abuse with which he taxes some in his 4th page, that of depreciating the merits of others.” I am yours, &c. EDWARD NIHILL. Hay-market, 24th August, 1765. There is nothing better known, or can be better at- tested, than my having lived for the space of seven years with Mr. Daran in Paris, as his assistant, both in dressing his numerous patients as well as my own, and preparing his Bou- gies, the composition of which I knew as well as himself; nor can I say that he ever appeared to conceal any thing of their composition from my knowledge. I have long ago informed the public, that I not only possess the same kind of Bougies as Mr. Daran prepares himself, but also that I have made a considerable improvement in the com- position of this medicine. It was in the year 1759, I had a patient of an exceeding bad habit of body, whose case was (28) was so very complicated with hard fistulous ulcers in pærineo, scrotum, &c. his case in short was so obstinate, and of so many years standing, that it had baffled the skill of Mr. Daran himself, whose patient he had been, as well as all others, by whom he had been attended for a course of years. I was very unhappy at finding this gentleman’s case so remarkably obstinate, and finding that I gained no ground even by the most active sort of my Bougies, but after many alterations in their composition, at last I made such am improvement in them that I was so happy to accomplish his cure, which gave me great pleasure, as it certainly did to my patient. This improved Bougie, I find from constant experience far exceeds Mr. Daran’s, being milder in its effects, and of a much more balsamic and healing quality. I not only use this improved Bougie in similar cases as the above mentioned, but in all cases in general in obstructions of the Urethra, whether attended with very bad symptoms or not, as the cure is greatly shortened and facilitated by their use. Near seven years after I had improved Mr. Daran’s Bougies, as above related, we find Mr. Daran, in his last pamphlet published in the year 1766, has followed my ex- ample; for in it he complains of the bad success some of his correspondents have had (and no doubt himself also) in curing several of their patients, and therefore he de- clares that he had luckily, very lately discovered a me- thod of improving his Bougies, which he now could cure the most obstinate disorders in a shorter time than for- merly, &c. Mr. (29) Mr. Daran’s words in page 15, of the above pamphlet, are the following: “Je suis d’autant plus sondé à faire ces offres, que par mon travail affidu, j’ai été assez heureux pour faire des améliorations dans la composition de mes remedes, tendant à abréger le traitement des maladies de l’Urethre, surtout dans les cas les plus difficiles.” In English thus: “I am enabled to make these offers with the more con- fidence, as by my great labour and affiduity I have been so lucky, as to improve the composition of my Bougies lately, so as to shorten the cure of the disorders of the Urethra, especially in the most difficult cases.” N. B. Mr. Daran’s making use of the word luckily in his declaration, of his discovery of improving his Bougies seven years after I had, by much labour and study im- proved this medicine, one would be led to believe that he luckily met with some person who pretended to discover to him the improvement I had already made; I have more reasons than one for believing this to be the true state of the case, and yet I positively declare that I never made a confidence of it to any one. I beg leave to lay before the readers of this Dissertation the three following cases, which I have had the liberty of doing from the patients themselves, to whom any person any person doubtful of the truth of what I have advanced with respect to the superior efficacy of my improved Bou- gies may be referred, they having been perfectly cured by me, after having spent a great deal of money and time in attending Mr. Daran, both in Paris and whilst he was in London, without receiving any advantage. This being (30) being a flattering circumstance to me, as it gives to the public a convincing proof of the superiority of my im- proved Bougies, both in respect to their not giving that sensation of pain, like those of Mr. Daran’s, as also of their performing lasting cures in a much shorter space of time than any other whatsoever. I may add to this, that these three patients are men of very respectable characters, two of them being gentlemen of rank and of independent fortunes, and the other an officer of his majesty’s navy. CASE XVII. P. A. Esq; aged about forty years, having had a severe, tedious, and obstinate gleet for several years, from the effects of a bad cured gonorrhoea, at last was attacked with obstructions of the Urethra, which produced many disagreeable symptoms, such as acute pains in the parts affected, with frequent suppressions of urine, on which, as he was then in France and hearing of the great cures performed by Mr. Daran, he applied to that gentleman, who agreed for a large sum of money to cure him; he was relieved by this gentleman in some measure though his gleet still continued, but Mr. Daran having assured him of his being cured, and that he should travel to a warmer cli- mate to restore his health, he being at that time looked upon to be visibly in a decline; on which he went to Portugal and Spain, but sometime after he came to Eng- land, though not cured of his very troublesome complaint, and applied to Mr. Francis Lallier who in a few months made a perfect cure, which happened some years since, and he is and has remained perfectly well without the least return (31) return of his old disorder, and he declares that Mr. Daran’s Bougies always produced great pain in using, but that he never felt the least pain or inconveniency from the use of those of Mr. Lallier. CASE XVIII. E. T. Esq. aged near forty, after a great number of ill cured claps, had the misfortune to be reduced to the most deplorable situation imaginable, the many obstructions formed, at last produced a total suppression of urine by the natural way, the passage in its whole length being quite plugged up with carnosities; which caused the urine to make its way through integuments of the museles of the pærineum and scrotum, and at length brought on a putrid urinous fever, and the parts affected swelled and inflamed to a most enormous size and threatened with a mortifica- tion, all the urine making its way through chinks and hollow corroding ulcers, at length produced two large fistu- lous passages, through which his urine came off involun- tarily for several years, in which distressed situation he was unable to walk, or even to sit in any other way but upon a close-stool or chair made in that form. He was visited for several years by most of the eminent physicians and sur- geons in London, but without any hopes of being cured; in this dismal situation I was applied to, and he continued under my care for several months, when he was in a fair way of getting the better of his complaint, as the freedom of the natural passage of the urine was re-established in part by the use of my medicines, though indeed, some part of his urine would come off, through the fistulous cavities of the pærineum, which was not yet cicatrized, and only F required (32) required a longer time, he however was so much better that he could walk about and even go in his carriage, nei- ther of which he had been able to do for a long time be- fore. At this time (about the year 1766) Mr. Daran hap- pening to be in London, when Mr. T. asked me if I did not think it would be right for him to have a consultation with him about his complaint, my answer was that I had no objection to his seeing Mr. Daran, he replied that it would be a satisfaction to him to hear what he would say, &c. Mr. Daran advised him to apply fomentations to the parts, and being soon to return to Paris he advised Mr. T. to follow him there, where he would make a perfect cure of him. Mr. T. accordingly did so, where Mr. Daran first of all made an agreement with him for a round sum of money, half of which sum was to be paid down immedi- ately, and his note given when the cure was accomplished. Mr. Daran kept him in Paris several months, where he suffered much pain and torture from his applications, but as soon as he could travel (for he was reduced to a most weak and emaciated state) he went to the waters of Barrege in the Pyrennean mountains, which he drank and bathed in for some months, and recovered his health and strength to a tolerable degree; but in other respects his original disorder was far from being cured. When he returned to England, he told me he heartily repented of his weakness in letting himself be persuaded by Daran to go to France, where he had drained him both of his blood and money pretty handsomely. Mr. T. then put himself into my hands again, and has often assured me and others that Mr. Daran’s Bougies always gave him intense pain, but that mine never gave him the least uneasiness, which he is always (33) always ready and willing to declare, and also that he owes his cure entirely to the use of my improved Bougies; he has been for some years past, as he at this present time is, hearty and well. CASE XIX. SIR, I Have for upwards of twelve years past laboured under a most dreadful pain in the neck of the bladder and uri- nary passage, often producing a total stoppage of urine, and always a great pain and difficulty in making water, being obliged to strain with the utmost violence and could only then discharge my urine by drops, and at best in a small stream about the size of a thread, in short I was abso- lutely tired of my life, despairing of ever being any better, having tried many of the faculty without the least success, and particularly Mr. Daran, surgeon to the King of France, under whose care I was for upwards of five months, in the year 1766, (Mr. Daran being then in Lon- don) at which time I was obliged to leave England, much better I must confess, but very far from being cured, as the disorder returned in the course of three months, and I was as bad as ever, and continued so very bad as to make me quite unable to go about any kind of business, till about four or five months since happening to hear of the many extraordinary cures performed by your improved medi- cated Bougies, I put myself under your care, and have reason to be thankful to God and you, for my being hap- pily cured of my desperate disorder: and conformable to F2 truth, (34) truth, I have to add, that I never found the least pain in wearing your Bougies, which was far from being the case with all the other Bougies I made use of, without effect: I therefore in justice to your skill, and for the benefit of mankind, desire you will publish this extraordinary case. I am, SIR, Your much obliged, And most obedient humble servant, EDWARD CROUTH. Late mate of his Majesty’s ship the Egmont. Since the receipt of the above letter, Mr. Crouth has made affidavit of the contents, before one of his majesty’s justices of the peace, which, with the original letter, may be seen at Mr. Lallier’s. FINIS. ADVERTISEMENT. MR. LALLIER begs leaves to inform the public, that he has no connection or con- cern whatever with any of those people who advertise Bougies to be sold. This caution is so much the more necessary, as he has been often informed, that some of them have sold Bougies to their customers, pretending that they were the genuine Bougies of Mr. Daran, or Mr. Lallier’s improved mild Bougies, which is not true. AS Mr. Lallier did live seven years with Mr. Daran, in Paris, as his Assistant, he had an opportunity of being constantly employed in making and composing his Bougies, and also ADVERTISEMENT. also in attending his numerous patients; since which time he has for thirty years past prac- tised his art in London, where he has had the satisfaction of curing great numbers of most inveterate and desperate cases, the truth of which is well vouched and authenticated; he being the only person in England who has constantly attached himself to that particular, but most important branch of surgery, viz. the healing all disorders which affect the neck of the bladder, urinary passage, and neighbour- ing parts, producing gleets, fistulas in perinæo, spongy ulcers, and other excrescences, with painful obstructions and dangerous suppressions of urine, which last, unavoidably, without speedy relief, occasions certain death. Such local painful disorders, it is well known to the faculty, cannot be relieved, much less cured, by any internal medicines whatsoever, nor yet by any other means than by the use of proper Bougies, and it is now well known to the pub- lic, that those composed by Mr. Lallier are much superior to all others, because they are milder and more efficacious, never having yet failed in producing a radical and complete cure ADVERTISEMENT. cure, and at the same time without giving the least painful sensation to the most tender pati- ent; which is far from being the case of all other Bougies, which inflame and irritate the parts so much, that the patient is tired out and disgusted without being cured. Mr. LALLIER attends to give his advice in all the above disorders, every day from twelve to two o'clock, and from seven till nine, at his house, No. 3, Rathbone-place, the third door from Oxford street, opposite Soho-square; where his Bougies, with proper directions are sold, and no where else. Gentlemen who reside at any distance from the capital, either in Great Britain, France, or Ireland, by stating their case, in a letter post- paid, the medicines may he sent them, with proper directions, by which they may cure themselves. N. B. AS there is a considerable demand for Bougies in all the British Colonies, as well as in the East and West Indies, the inhabitants of which places, being very subject ADVERTISEMENT. subject to such disorders, for which Mr. LALLIER’S well-known improved Bougies are the only specific remedy; Merchants and Captains of Ships, may be supplied with any quantity to sell again with a handsome allowance.