296

adoption of this plan, for theradical cure of such affections.

--

In the cure of stricture, I con-sider much also depends on thenature of the instrument used;it has been my practice to usethose of a ’metallic nature inpreference to common bougies,as on account of the equalityand solidity of their pressure,they are more effectual. in pro-moting absorption, and dilatingthe urethra.

I am, Sir,Your constant reader,ROBERT RbWLEY, jun.

83, St. Margarets-Hill South-wark, Feb. 26, 1824. ,

ROBERT ROWLEY, jun.

Case of permanent Strictures andretention of urine, successfully

treated by ROBERT ROWLEY,JUN. Esq. of Southwark, Mem-ber of the Royal College of

Surgeons, London.. J. B.. The subject of the fol-lowing case, a practitioner inthe country, some years ago re-ceived a fall from his horse, whilevisiting- a patient, at which pe-riod the most excruciating painwas felt in the perineum. This,in the course of two monthsafter the accident, was followedby: a slight discharge from theurethra, with some degree ofpain, and ’ scalding, in voiding-his urine. These symptoms con-tinued, and gradually increased,until. -the most complete stric-tures had formed in the urethra,accotmpanied with great efforts tovoid urine, together with inex-pressible pain, and irritation, atthe neck of the bladder. On the23d Dec. last, a total retention of"urine took place. About. thirty-six hours had elapsed without-

being able to evacuate a drop ofwater. During this pe,riod, foursurgeons were called‘ in ; but

only the last of whom, Mr.ROWLEY, having previously ab-stracted 36 ounces of blood fromthe arm, and administered alarge dose of tincture of opium,was able to succeed in introduc-

ing the catheter into the bladder,which he accomplished, how-ever, after passing five stric-’tures, when about five pints ofurine were evacuated. A dozenleeches -were soon afterwards

applied to the perineum, and re-peated daily. ,

Fomentations of cammomile.-flowers and spirits of wine werealso frequently applied over theregion of the abdomen with thegreatest advantage, and largedoses of opium exhibited to,

allay irritability, and here it.may be worth observing thatthe effects of opium not only inthis, but almost in every othercase of extreme irritability is at-tended with astonishing benefit,more particularly where thequantity be duly proportionedto the state of the nervous -ex-citability. By a steady perse-verance in the application- ofthe above number of leeches onthe perineum, every second orthird day, with the occasional.introduction of the catheter; orsound, a perfect cure of these

, strictures has been effected.,

The writer of this. paper begsto observe that he considers him-self highly - indebted to’ Mr.ROWLEY, insomuch that he ne-ver saw or heard of stricturesbeing thus treated, until his com-munication with that gentleman.

London, Feb. 15, 1824.

297

_

We have the satisfaction of

stating that our Report of theHUNTERIAN ORATION has been

admitted, by the best authority,to have been given with the

most scrupulous fidelity. A se-

cond edition of the -last num-ber of THE LANCET which

contains it, was published onThursday.

HOSPITAL REPORTS.

GUY’S HOSPITAL.’

February 24th.A boy of twelve years of age

was operated on this day by Mr.KEY, for stone. The stone was

of the mulberry kind, and rathersmall. It was extracted with

the most perfect ease in a minuteand a half. The staff intro-duced into the bladder was

straight, excepting towards thepoint, where, it was slightlycurved ; the external incision

and division of the prostatewere effected by the same knife.We will defer giving a moreminute account of the instru-

ments used, and the operation,till we review Mr. KEY’S workon his new method of perform-, ing theoperation of Lithotomy,which we °understand will bepublished in a few days.

A child with ’a hare lip,, and a man with fistula inano, were operated on by SirASTLEY ’C*oop-ER. That gen-tleman also divided the sphinc-ter ani towards the os coccygis,in a person who had an ulcer atthe lower part of the rectum.

Amputation at the Hip Joint,continued from p. 258. ,

This man has been consider-ably better this week, and onThursday (Feb. 26th) sat up bythe fir6 for an hour. The woundis nearly healed ; but there is aslight discharge of matter fromopposite to the acetabulum.

Feb. 28. The boy operatedon by Mr. KEY for stone has hadno unfavourable symptom sincethe operation.

’

’

ST. THOMAS’S HOSPITAL.FEBRUARY 27th.

,

Enlargement of the Purotid,Continued from page 255.The woman with this affec-

tion, the history of which casewe gave in our last number, hadintended leaving the hospitalthis week, as she was informedthat no operation would be per-formed on her,’for the removalof the tuniour; but as the useof iodine has been suggested,the patient is going to remaina- little longer to ’try its ef-fect.—We will give the result ofthis plan of treatment, butwe confess that we expect littleadvantage from it ’in this case.

For several reasons we think an

operation‘ _has been prudentlydeclined. The patient has sevenchildren dependent on her ownexertions, and it would place asurgeon in- -a very responsiblesituation if he performed an oper-ation in this instance, should ithappen to cost the patient herlife.

’

A man was brought into thehospital this day with an injury