IRRIGATION IN Urethra BY H. S. D. BERRY, M. D., Professor of Gynaecology and Diseases of the Genito-Urinary Organs in the American Medical College, St. Louis, Mo. (REPRINT FROM THE AMERICAN MEDICAL JOURNAL.) COMPLIMENTS OF THE E. HYDE CO., MILWAUKEE, WIS. 8 « 8 ® IN DISEASES OF THE male URETHRA. One of the most important class of diseases we are called upon to treat, and one less understood by the general practitioner, is that of diseases of the male urethra. Nearly all discharges from the urethra are diagnosed as gonorrhoea and treated by injections and stimulating diuretics. We are often told by patients that they have had gonor- rhoea a dozen or more times, and do not mind it more than an ordinary cold; that it is frequently brought on by whites in the opposite sex. Of course we understand these attacks to be due to a badly managed case of gonorrhoea (generally first attack), the sequelae being stricture, either organic or spasmodic, folliculitis, with or without ulceration of mucous membrane lining the urethra, etc. It is a duty we owe our patients to prevent those complications following gonorrhoea. This is not an easy matter to do, owing to the fact that the young man who contracts gonorrhoea for the first time usually has a friend or acquaintance who has had experience, and he tells him that it amounts to nothing, and either gives him a prescription that is a “dead shot” or recommends him to the physician who treated him in the last supposed attack, warning him not to consult the physician who treated him first, whichwas the only time that he had true gonorrhoea. I am, and have been since I began the practice of medicine, a warm advocate of urethral injections for the cure of gonorrhoea, and have been very careful to not use a wash of sufficient strength to cause pain. I do not approve of the abortive treatment, and it is an open question whether gonorrhoea can be aborted during the increasing stage ; but there is no question as to the injury done to the urethra in the attempt to abort the disease, whether it be done by irri- tating injections or stimulating diuretics. I have for the past five months been treating gonorrhoea and urethritis with Lindenschmidt’s Urethral Irrigator, with better results than I had thought possible. I had been using a small Jaques’ catheter for the same purpose for two years. The solution used was forced into the bladder (especially if there was much congestion of urethra anterior to eye of catheter) in several cases, causing irritation of prostate and neck of bladder, the former being bruised by the circular fibers contracting upon it in the effort to expel a few drops remaining in the sinuses. This has not occurred in either of the forty-two casps of urethral diseases treated with Lindenschmidt’s irrigator. My method is as follows : Fill a two-pint fountain syringe with a mild solution of Permanganate of Potash, Bichloride of Mercury, Sulphate of Zinc, or any other solution that I think best adapted to the case ; attach to the irrigator ; suspend syringe about four feet above chair occupied by patient to be operated upon ; allow water to flow while irrigating tube is introduced to prevent air entering urethra, and dilate canal by the force of water as nozzle enters. I usually pass the nozzle back to bulbous portion, never to the membranous. The water is allowed to flow until a pint or quart of the fluid is used, receiving the return flow in a vessel through a large funnel attached to side of operating chair. Of the forty-two cases treated by the irrigator, only four were un- complicated cases of gonorrhoea, all being first attacks : one case run twenty days, one seventeen days, one fifteen days, and one thirteen days. To one of less experi- ence this result may not look flattering, but when I say that four-fifths of the ure- thral discharges that have come under my observation are simple urethritis or some complication of a previous gonorrhoea, and that a large majority of first attacks do not remain with the first physician consulted for the simple reason that he expects to get well in a week, I am giving the verdict of the leading specialists. Keyes (Revision of Van Buron & Keyes) says, page 68: “The duration of gonorrhoea is variable. A well-managed case lasts from three to six weeks, as a rule, but the dis- charge may continue for months or even years.” A first gonorrhoea is the most severe, but it is also the most certain to get perfectly well if carefully managed. In the cases of simple urethritis, two or three irrigations with proper urethral hygiene generally relieves the patient. They pay willingly and are perfectly satisfied. In folliculitis I use the urethral endoscope, make a direct application, and irrigate after- wards. For strictures I usually dilate, and use irrigator on alternate days, unless inflammation supervenes. In conclusion, will say that in my hands the urethral irrigator has given better results in all urethral discharges than anv other method that I have heretofore tried for the purpose of cleansing or medicating the canal. HYDE IMPROVED REGTAL CASE. DIMENSIONS: Length, 11 inches; Width, inches; Height, inches. Each Case contains 14 Separate Instruments, made of the Best Material. The Most Complete and Painless System of Treatment for the Kadical Cure of all Curahle Diseases of the Rectum, ever offered to the Profession. It does away with the old treatment of cntting and ligating, as given through the regular course of medicine. It will pay largely in the smallest village, and any physician can more than dou- ble his income by adopting this method of treating Rectal Diseases. There is no reason for not being strictly ethical in this practice. The fee from a single patient is frequently more than enough to pay for the entire case of instruments. Address, THE R. HYDE CO., MILWAUKEE, - - WISCONSIN. Sent free of express charges on receipt of price. Cole Brothers’ Throat Specola. The most wonderful instrument for examining and treating the throat ever produced. It is self-adjusting, is a perfect reflector and tongue depressor. ft is made of pure German silver, nickel-plated; made in sets of four sizes, put up in ADDRESS : THE R. HYDE CO., MILWAUKEE, - - WISCONSIN. Sent free of express charges on receipt of price. THE ONE-HANDED HIBBARD CLINICAL ATOMIZER — PATENTED — Can be instantly converted into an Insufflator, a Continuous or Intermitting Syringe. See Insufflator and Syringe. MORE CONVENIENT THAN THE EXPENSIVE AIR COMPRESSORS. A »d a necessary Apparatus for every Physician's Office. A HIGHLY POLISHED DESK HACK, Containing the Hibbard Atomizers and Powder Insufflators complete. greatly adds to its use- fulness Fig. 1. Represents the apparatus as a one- handed atomizer showing the straight, nasal, and post-nasal tips. Fig. 2. Represents the apparatus with at- tachable tongue depressor and attach- ment for making the best continuous spray on the market, with instanta- neous cut off. This style is especially adapted for post-nares and laryngeal applications. Just the apparatus for spraying liquid Albolene, the new preparation of Petroleum. UNIVERSALLY COMMENDED. The bottle for holding the fluid is placed in a bulb of the best shape for obtaining an easy and steady pressure. The bottle can be readily removed for re-filling; and all the parts are simple and easily adjusted. This atomizer can be conveniently carried in the pocket without danger of breakage, leakage or evapor- ation. It requires but one hand to manipulate it, leaving the other free to control the patient. The fluid receptacle is constructed so as to utilize every drop of the fluid. The hard rubber tubes, are manufactured of the best German Rubber, and throw a finely atomized spray. The various atomizing tubes and liquid receptacles can be instantly changed and adjusted, necessitating but one bulb. THE ONE-HANDED HIBBARD POWDER BLOWER. — — Fig. 3, Represents the apparatus with powder tube and adjustable tips. This apparatus works perfectly, and as the powder is contained in a glass bottle, it is always easy to see how much you have in the blower. It is more readily filled than any other, much more economical, and the powder does not absorb the odor of the rubber. The powder does not issue tn matse, but in a nebulous cloud, and is exactly regulated by the pressure used. There is no sucking up of mucus, or caking of powder in the tubes. It is also perfectly adapted for inflating tampons and dilators, when the bottle is emptied Complete Set of Atomizers and Insufflators, - - - - 85 00. With Tongue Depressor, - - - - - - - 5 75. Address, THE R. HYDE CO., MILWAUKEE, WISCONSIN. Sent free of express charges, on receipt of price. BARTLEY’S POCKET URINARY TEST CASE, MANUFACTURED OF HARD RUBBER WITH NICKEL PLATED TOP. CONTAINING ALCOHOL LAMP. DIMENSIONS INCHES. Manufactured orHara Rubber, with Cover containing Alcohol Lamp. THOUSANDS IN USE, The Re-agents (Powders) are prepared from the formulae of Dr. E. H. Hartley, ot the Long Island College Hospital, and chemist to the Board of Health of the city of Brooklyn. The case is designed for the use of physi- cians at the bedside of the patient or for the office. With it a complete ex- amination, for clinical purposes, of the urine can be made. THE CASE contains a scientifically correct nrinometer enclosed in a cloth bag to prevent breakage, a heavy glass test tube serving as an urino- meter jar and test tube, a package of Litmus test papers, a pipette for con- venience' in handling the urine, two vials to contain the test powders and spoon. With these the following points may be determined at the bedside, viz: The quantity of urine passed, the color, transparency, reaction, specific gravity, total solids passed and the presence or absence of sugar and albumen. Each Bottle contains sufficient I’owders for some 50 Tests. A small hand-book containing instructions, formulae for the powders, and valuable information obtained by recent investigations of Dr. Bartley and others, accompanies the case. Price, 82.00. Address, THE R. HYDE CO., Milwaukee, Wis. Sent free of express charges on receipt of price. A. M. LESLIE SURGICAL INSTRUMENT CO., 915 OLIVE ST., - - ST. LOUIS, MO. 1VJ. XL, ■}.' $*&'■> ' TT A Q t ?y T > 'v-> ;. (PATENT PENDING.) THE BEST FOR THE USE OF VASELINE OR „ ALBOLINE CATARRH, COUGHS, COLDS, Etc. CHEAPER, STRONGER AND MORE DURABLE THAN ANY OTHER. The treatment of inflammations of nose and throat with vaseline or alboline as a menstruum is now universally established and is generally regarded as the best me- thod in these complaints thus far. This Atomizer is also an efficient means for mak- ing local mercurial applications to throat and nasal cavity in syphilitic treatment. We have several monographs by competent authority explanatory of the above me- thods of treatment which we shall be happy to send to any address on application. TO PHYSICIANS, $1.00. RETAIL PRICE, $1.25. Physicians and the Trade also supplied by . , :es_ htde co., Cor. THIRD and PRAIRIE STS., Sent free of express charges, on receipt of price. MdlWllllkCG j WlSCOHSlll. IE20SS, dz CO., 868 MAIN STREET, BUFFALO, N. Y., — MANUFACTURED — The “Ross” Hypodermic Syringe and Case. [Patented April 2d, 1869.] The Latest and Best in the Market. POINTS OF EXCELLENCE. THE SYRINGE, (Fig. 1,) Is beautiful in design, style and finish. The Piston (A) is Hollow its entire length, forming a receptacle for tablets. The Piston Cap (B) removes easily. Tablets can be quickly obtained. By removing screw Cap (C) on Needle end of Syringe, tablet can readily be dropped in barrel for solution. No bottle or spoon required. Strictly first-class and Standard Form of needles used. Being hermetically sealed, when in the case, tiie piston is always moist and ready for use. THE CASE, (Fig. 2 and 3,) Is very attractive, being new, novel and very elegant. Made of polished hard rubber. It is very convenient in size and shape for the pocket. The Reserve end (Fig. 3, holds three nickeled bottle (D,) for extra tablets (atropia apomorphia, etc.,) also an extra needle. A moment’s study of the above cuts will give a clear understanding of this MODEL of COMPACTNESS and CONVENIENCE. F3RIOE $3.00. PHYSICIANS AND THE TRADE ALSO SUPPLIED BY * The R. Hyde Co., - NEEDLES SUPPLIED IN ANY QUANTITY. Sent free of exeress ch?r°,es on receict of orice. The “Roberts & Allison” Operating Chair. Simple in construction. No complicated machinery to get out of order. Easily and quickly adjusted to any position required. Noiseless in its movements. Substantial, perfectly adjusted, artistic in design, well proportioned. It combines strength, beauty, simplicity and convenience. It is absolutely first-class in every re- spect. Is sold at a reasonable price, and on easy terms. The “Roberts & Allison” Surgeons' Table. This is the most complete and practical table ever offered to the profession. It can be tilted sideways, and the head lowered at the same time, giving it a perfect Sims’ posi- tion. The back can* be raised to a reclining position. It is noiseless in its movements. The cross bar pinion, (patented) enables the operator, with the slightest effort, to place the heaviest patient in any position he desires. There is nothing in the market to com- pare with it. Ulustrated'catalogue of operating chairs and tables, with prices and terms, sent free on application. ROBERTS & ALLISON, MANUFACTURERS, INDIANAPOLIS, - - - INDIANA. o t ->&=—:■ THE -J— R. HYDE CO., MILWAUKEE, WISCONSIN. Third and Prairie Streets. Urethral Irrigator and Irrigating Dilator WITHIN REACH OF EVERY PHYSICIAN. OYER 1000 SOLO IX TEX WEEKS. The only Instrument with which you can obtain thorough Antiseptic I: iga- tion of the Male Urethra and of the Uterine Cavity. COMPLETE SET ONLY K5.00. -a.2d:dis:ess: THE R. HYDE CO., - MILWAUKEE, WIS. :2S~ SENT FREE OF EXPRESS CHARGES ON RECEIPT OF PRICE. “©fi f»A.:o rniM..... .s, TT -p _7 Jr-pOIF LINDENSCHMIDJ& URETHRAL IRRIGATOR AND IRRIGATING DILATOR when connected for treating both Acute and Chronic Diseases of the Urethra, Prostate and the Bladder. This Instrument can be obtained from all the leading dealers in the U. S. and Europe, also direct from the manufacturers, The R. Hyde Co., who will forward the same to any address free of express charges on receipt of 85.00. Corrosive Sublimate and Potassium Permanganate Tablets sold in any quantity. Complete Instructions for connecting the Instrument enclosed in every case.