A manual of syphilis and the venereal diseases, . Fig. 22.—Urethral speculum (Tiemann). over the latter in displaying larger areas at a time, butthe pressure produced by the sides of the instrumentcauses more or less anaemia of the mucous membrane,and consequently modifies its appearance. CHRONIC URETHRITIS. 419 Illumination is obtained by means of an ordinary mir-ror such as is used in examinations of the larynx. Thismay be fastened to a handle or, better, to a source of light, in order of desirability, may bedirect sunlight, bright diffused daylight, electric or gaslight, or a
A manual of syphilis and the venereal diseases, . Fig. 22.—Urethral speculum (Tiemann). over the latter in displaying larger areas at a time, butthe pressure produced by the sides of the instrumentcauses more or less anaemia of the mucous membrane,and consequently modifies its appearance. CHRONIC URETHRITIS. 419 Illumination is obtained by means of an ordinary mir-ror such as is used in examinations of the larynx. Thismay be fastened to a handle or, better, to a source of light, in order of desirability, may bedirect sunlight, bright diffused daylight, electric or gaslight, or a kerosene lamp. If an artificial light is used,it should be mounted on a freely movable and adjusta-ble bracket. The addition of a condenser will improvethe illumination. An excellent apparatus is that devisedby Dr. F. Tilden Brown (Fig. 23).. Fig. 23.—Browns method of illuminating the urethra. In another type of endoscope the tube is directly con-nected with an electric illuminating apparatus. TheLeiter electro-endoscope, used and recommended byFinger, has been modified by several operators in Otis electro-urethroscope (Fig. 24) is probably asserviceable as any endoscope of this type. It has thegreat advantage of being but one-sixth as heavy asLeiters instrument. By far the most satisfactory endoscope, and thesimplest to use, is one recently produced by the Electro- 420 SYPHILIS AND THE VENEREAL DISEASES. surgical Instrument Company of Rochester, N. Y. (Fig#25). The light is a minute incandescent lamp, which,
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