BOUGIE. In the French language it signifies a wax candle, and is applied to a machine which (as the wax candle formerly was) is introduced into the urethra for removing obstructions there. Mons. Daran, a French surgeon, lately boasted of his introducing them as an improvement in his art, and acquired considerable profit by making and selling them. Scultetus, about the middle of the 17th century, used bougies in diseases of the urethra, and Mons. Daran probably took the hint from him. Different compositions have been used, and generally mercury was a part of them. Riverius made
made a plaster as follows: R. ol. oliv. lb. iv. cere. ci-
trin. lb. ii. minii & ceruss. aa. lb. iis. tereb. venet. & rez.
alb. aa. 3 iii. m. Whether the bougies are made up of
this or any other composition, they must be of different
sizes, from the bigness of a knitting needle, to that of
a goose quill. They are made of linen rags, spread
with a proper matter, and then rolled up as follows.
Having spread any quantity of the linen rag with the
composition that is chosen for the purpose, cut it into
slips from six to ten inches long, and from half an inch
to an inch broad: then dextrously roll them on a glazed
tile into the form of a wax candle; and, as the end of
the bougie that is to be entered first into the urethra
should be somewhat smaller than the rest, it would be
as well to cut the slips a little tapering. It should also
be observed, that when the bougies are rolled up, that
side must be outward on which the plaster is spread.
Monf. Daran, and some others, attributed the action
of their bougies to the composition they made use of in
forming them. Mr Sharp apprehended, that as much
of their efficacy was owing to the compression they
made on the affected part, as to any other principle;
and Mr Aiken very justly says, As it is evident that
bougies of very different compositions succeed equally
well in curing the same disorders in the urethra, it is
plain that they do not act by means of any peculiar
qualities in their composition, but by means of some
property common to them all. This must be their me-
chanical form and texture, therefore their mode of ac-
tion must be simple compression. The efficacy of mere
compression in many cases of constriction is well known,
from the use of sponge tents for widening parts that are
straitened by cicatrices; and admitting obstructions in
the urethra to be from a constriction formed by cicatr-
ized ulcers, or a projection of the spongy substance
of the urethra into the canal, we may easily conceive,
that a gentle continued elastic compression will in time
overcome the disease. We may also readily account
for the inferior efficacy of metallic and whalebone bou-
gies, from their not having the property of swelling
with moisture, and therefore not making so equal a com-
pression. As to bougies procuring a discharge of mat-
ter, there is no doubt but the mechanical stimulus of a
foreign body in such a tender part, though free from
disease, must produce it in some degree; and that this
will be varied according to the chemically irritating
quality of the composition, and the irritable state of the
urethra: but it seems an absurdity to apply a topic,
made uniform throughout, to the whole length of a can-
al, with a view of producing extraordinary effects upon
a particular part of it, by means of some powerful qual-
ity in the ingredients. As to that part of the bougie
which was in contact with the diseased part, being par-
ticularly covered with matter; this circumstance is prob-
ably owing to the greater irritation of that part of the
urethra where the disorder is, than any other.