ntity by
the meatus. In others, the stricture is rendered wholly imperforate, and
the canal either contracted or nearly obliterated anteriorly through
disuse. Of these two conditions, the first is that in which catheterism
may be tried with any reasonable hope of passing the instrument into the
bladder. In the latter state, catheterism is useless, and the only means
whereby the urethra may be rendered pervious in the proper direction is
that of incising the stricture from the perinaeum, and after passing a
catheter across the divided part into the bladder, to retain the
instrument in this situation till the wound and the fistulae heal and
close under the treatment proper for this end. (Mr. Syme.)

[Illustration]
Plate 57.--Figure 15.

Fig. 1, Plate 58.--In this figure the urethra appears communicating with
a sac like a scrotum. A bougie is represented entering by the meatus,
traversing the upper part of the sac, and passing into the membranous
part of the urethra beyond. This case which was owing to a congenital
malformation of the urethra, exhibits a dilatation of the canal such as
might be produced behind a stricture wherever situated. The urine
impelled forcibly by the whole action of the abdominal muscles against
the obstructing part dilates the urethra behind the stricture, and by a
repetition of such force the part gradually yields more and more, till
it attains a very large size, and protrudes at the perinaeum as a
distinct fluctuating tumour, every time that an effort is made to void
the bladder. If the stricture in such a case happen to cause a complete
retention of urine, and that a catheter cannot be passed into the
bladder, the tumour should be punctured prior to taking measures for the
removal of the stricture. (Sir B. Brodie.)

[Illustration]
Plate 58.--Figure 1.

Fig. 2, Plate 58, represents two close strictures of the urethra, one of
which is situated at the bulb, and the other at the adjoining membranous
part. These are the two situations in which strictures of the organic
kind are said most frequently to occur, (Hunter, Home, Cooper, Brodie,
Phillips, Velpeau.) False passages likewise are mentioned as more liable
to be made in these places than elsewhere in the urethral canal. These
occurrences--the disease and the accident--would seem to follow each
other closely, like cause and consequence. The frequency with which
false passages occur in this situation appears to me to be chiefly owing