On page 175 of the June number of THE THERAPEUTIST, in the case of Dr. E. T. Segur, from the meagre symptoms I should judge we had a case of prostatitis or prostatic catarrh. The leg, knee and feet symptoms indicate obstruction of the rectal circulation, producing an incipient arteriosclerosis. My treatment would be 2 per cent cocaine injections in the urethra, and after waiting to benumb the sensation use a sound from the lowest up (splitting the meatus and if necessary to keep it open put one or two stitches). Let him rest 48 hours and if no urethral chill follows use sounds again and inject fluid extract of phytolacca and Felter's aqueous thuja p. e., with a prostatic curve catheter, gently massaging. Third day treatment on fifth or sixth day. There should be prostatic massage through the rectum and if there is any spasm in the external or internal sphincter massage with as rapid stretching as the patient can tolerate.
The above remedies are the only remedies known to me to remove granulation growths in the urethra or rectum. You will have a good deal of difficulty to remove the warty granulations at the cut off muscle in the perineum and about one inch back of the meatus in the fossa navicularis. Perseverance is the keynote. If your patient is at all corpulent give him internally two to five grains of powdered extract of phytolacca.
L. S. LONG, M. D.
Ellingwood's Therapeutist, Vol. 2, 1908, was edited by Finley Ellingwood M.D.