A small, cold enema taken just before retiring, and retained, will often do much to allay local irritation.

[Electricity].—Probably no single agent will accomplish more than this remedy when skillfully applied. It needs to be carefully used, and cannot be trusted in the hands of those not acquainted with the physical properties of the remedy and scientific methods of applying it.

[Internal Applications].—Complete and rapid success greatly depends upon skillful internal treatment, in a large number of cases. We are aware that there is considerable prejudice, in certain quarters, against internal treatment; but having had the opportunity of observing the effects of careful treatment applied in this way, and having put to the test of practical experience this method, we feel justified in recommending that which is approved on both theoretical and practical grounds; for it is rational to suppose that proper treatment applied directly to the seat of disease must be at least equally efficacious with methods less direct.

As heretofore explained, in the more severe cases the urethra is found in a very irritable condition. It is hyper-sensitive, especially in that portion just in front of the bladder, where the ejaculatory ducts open into it. We have also seen how this condition is one of the chief exciting causes of emissions. The remedies described for allaying this irritation are all excellent and indispensable; but there is another method of great value. This consists in the passage of a suitable instrument, a sound or bougie of proper size, two or three times a week. By the aid of this means, the abnormal irritation will often diminish with magical rapidity. The passage of the instrument of course needs to be done with great delicacy, so as to avoid increasing the irritation; hence it should not be attempted by a novice. Lack of skill in catheterism is doubtless the reason why some have seemed to produce injury rather than benefit by this method of treatment, they not recognizing the fact asserted by Prof. Gross in his treatise on surgery, that skillful catheterism is one of the most delicate operations in surgery.

[Use of Electricity].—The use of electricity in connection with that of the sound adds greatly to its utility. By means of the metallic instrument, also, electricity may be applied directly to the point of greatest irritation; and its soothing effect is sometimes really wonderful, as the following case will show:—

The patient, a man of unusual physical development, was suffering from nocturnal emissions and diminished sexual power, the result of early indiscretions and marital excesses. One of his most unpleasant symptoms was severe pain in the portion of the urethra near the openings of the ejaculatory ducts. After he had been suffering more than usual for a few days, we applied the faradaic electric current in the manner indicated above, for about fifteen minutes. At the end of that time the pain was entirely removed, though considerable suffering had been caused by the passage of the instrument, so sensitive was the congested membrane. The pain did not return again for two or three weeks, though treatment was necessarily suspended on account of absence.

In another case, that of a young man, a student, at the beginning of treatment emissions occurred nightly, and sometimes as many as four in a single night, according to his statement, which we had no reason to doubt. Under the influence of these local applications, combined with other measures of treatment and a measurably correct regimen, the number of emissions was in a few weeks reduced to one in two or three weeks.

Numerous other cases nearly as remarkable might be detailed if it were necessary to do so. In quite a considerable number of cases in which we have employed this plan of treatment, the results have been uniformly excellent. A very slight increase of irritation sometimes occurs at first, but this quickly subsides.

The galvanic as well as the faradaic current is to be used under proper circumstances. The application of electricity to the nerve centers by means of central galvanization, and also general and local external faradization, are necessary methods to be employed in electrical treatment.

[Circumcision].—In cases of phimosis, in which irritation is produced by retained secretions, division of the prepuce, or circumcision, is the proper remedy. These cases are not infrequent, but the exciting cause of much of the difficulty is often overlooked. The same remedy is often useful in cases of long prepuce.