Ulcers however also occurred in the urethra[331] unconnected with tubercular swellings (ἀφανὲς ἕλκος,—invisible ulcer); these not unfrequently occasioned bleeding,[332] and made their presence known by the accompanying pain, while synchronously small irregularly-shaped particles (ἐφελκύδες) were ejected.[333] The appropriate treatment of these ulcers has been described by _Paulus Aegineta_ (loco citato); it consisted in injections of honey and milk (_Aëtius_, IV. 2. 19., and _Actuarius_ also recommended _enemata morsus expertia_,—clysters free from biting acridity), introduction of lotus pounded in a leaden mortar by means of a feather or a twisted piece of lint (λεπτὸν στρεπτὸν,—light material twisted,—an anticipation of the bougie?) along with a mixture of gall-apple, flowers of zinc (oxide of zinc), starch-flour and aloes smeared in equal parts with rose-sap and plantain-sap. Not unfrequently such ulcers give rise to the establishment of _caruncles in the urethra_, particularly _in the neighbourhood of the neck of the bladder_, though they occur[334] also in the ear, nose, as well as in connection with the privates and anus, in the latter case presenting the symptoms of ischuria (retention of urine), interfering as they do with the outflow of the urine. The presence of these caruncles may be diagnosed by the preceding symptoms, as also by the circumstance that the urine is evacuated by the introduction of a _catheter_, that this occasions pain at the seat of ulceration and breaks through the caruncle, causing the urine to pass mixed with blood and the remains of the caruncle. It is necessary to know if a thrombus (blood-clot) or calculus blocks the urethra; but as to whether we pronounce the mischief to be situated in the urethra itself and the cause of the ischuria to be there as well, this is a distinction of no practical or scientific value.[335] For as a rule it was solely as being the excretory duct of the bladder that the urethra had some little attention directed to it; while any signs it exhibited were generally regarded simply as symptoms connected with the urinary bladder and the kidneys. Partial _growing up, or morbid extuberance, in the urethra_ (συσσάρκωσις,—a growing together) following on a previous ulceration is described by _Heliodorus_, as given in Oribasius,[336] occasioning either a narrowing of the urethral passage in one spot or its being filled up over its entire superficies with morbid outgrowths of tissue. Partial narrowing causes dysuria or strangury (difficulty of micturition), the narrowing of the whole canal by morbid outgrowths, ischuria (impossibility of micturition, retention of urine). The outgrowth must be removed by means of a small lancet. The mode of procedure is then as follows. The patient is placed on his back, the penis straight out; then with the fingers of the left hand the operator compresses it behind the spot where the growth is found,