on the perinseum by two wide fistulse. Several of the prostatic
ducts are dilated. The bladder is so much contracted,
that there is not room in its cavity for two ounces of fluid :
the coats are thickened, but not in a corresponding degree.
—Prof. Kirby.
F. b. 314. Frightful specimen of the effects of a neglected
stricture. There appear to have been originally two contractions,
one at the glans, the other anterior to the bulb, but
the former of these alone remains. The entire urethra, from
an inch behind the orifice to within a short distance of the
neck of the bladder, forms a hideous mass of disease;
in fact, strictly speaking, the urethra proper does not exist;
the original mucous membrane has for the most part disappeared,
and a new canal or rather elongated sac has been
formed by dilatation and destruction of the surrounding erectile
tissue. Its parietes are rough, floceulent, and excavated
by numerous burrowing ulcers into foramina and depressions
of various depths; some of these open into an abscess which
exists beneath the skin of the penis, and others pass directly
to the surface, forming fistulse. The membranous portion is
the only situation in which the lining membrane remains; it
is thickened, ulcerated, coated with lymph or calcareous matter,
and distended into pouches, one of which contained a
small stone. The bladder is of moderate size and thickness ;
its interior is columnar; the surface is remarkably rugous,
and is slightly coated with earthy deposit. The ureters are
but little dilated.—J. W. Cusaclc, Esq.
F. b. 315. Extremely narrow stricture, three quarters of an
inch long, situated a short way anterior to the bulb ; a bristle
has been with some difficulty passed through it. The membranous
part of the urethra is dilated into a pouch capable of
containing a small egg, the surface of which has a pasty coating
of calcareous matter. In front of the stricture the canal
is contracted for its whole extent. Two perinseal abscesses
exist in the vicinity of the stricture, one of which communicates
with the urethra immediately anterior to it by a diminutive
opening; they possess distinct cysts of a yellowish colour.
The bladder is enlarged, and the lining membrane is
thickened, indurated, and granular on the surface.—Professor
Kirby.
F. b. 316. Stricture of the urethra, three inches from the
orifice. The membranous portion is dilated and ulcerated
a large ragged opening exists in the inferior wall, which communicated
with a urinary abscess : a second opening situated
nearer the prostate, leads into the rectum, three inches
from the anus. There is an abscess in the lateral lobes of the
prostate. The bladder appears but little affected. The ureters
are dilated. This patient, when he proceeded to make water,
was always obliged to use two vessels, as a greater or less
quantity of urine invariably escaped through the anus.—Prof.
Colles.
F. b.. 317. Stricture of the urethra in front of the bulb,
accompanied with perinseal fistula and thickened bladder.—
J. W. Cusack, Esq.
F. b. 318. Narrow stricture of the urethra, commencing
in the membranous portion, and passing forward through the
bulb for the distance of two inches ; its termination is very
abrupt, the canal resuming at once its normal condition:
a false passage runs a short way along the right side of it.
The contraction appears to be produced by the existence of a
firm, lymphy deposit, both in the sub-mucous tissue and the
substance of the membrane itself. The bladder presents the
appearances usual in such cases. The left ureter is dilated
into a small sac close to the bladder, immediately above
which it ceases to be pervious, The subject of this case was
an old soldier, the disease had been going on for forty years;
during which time no remedial means whatever had been employed
: it does not appear that it contributed much to
shorten life.—J. Stokes, Esq.