By attending to these symptoms, the gonorrhœa may be generally distinguished from any other disease. There are, however, some few disorders for which it may be mistaken, as an ulcer of the kidneys or bladder, the fluor albus, or whites in women, &c. But in the former of these, the matter comes away only with the urine, or when the sphincter of the bladder is open; whereas in a gonorrhœa the discharge is constant. The latter is more difficult to distinguish, and must be known chiefly from its effects; as pain, communicating the infection, &c.
Regimen.—When a person has reason to suspect that he has caught the venereal infection, he ought most strictly to observe a cooling regimen, to avoid everything of a heating nature, as wines, spiritous liquors, rich sauces, spices, salted, high seasoned, and smoke dried provisions, particularly salt itself in every shape; as also all aromatic and stimulating vegetables, as onions, garlic, shalot, nutmeg, mustard, cinnamon, mace, ginger, and such like. His food ought chiefly to consist of mild vegetables, milk, broths, light puddings, panado, gruels, &c. His drink may be barley-water, milk and water, decoctions of marshmallows and liquorice, linseed tea, or clear whey. Of these he ought to drink plentifully. Violent exercise of all kinds, especially riding on horseback, and venereal pleasures, are to be avoided. The patient must beware of cold, and when the inflammation is violent, he ought to keep his bed.
Medicine.—A virulent gonorrhœa can rarely be cured speedily and effectually at the same time. The patient ought, therefore, not to expect nor the physician to promise it. It will often continue for two or three weeks, and sometimes for five or six, even where the treatment has been very proper.
Sometimes, indeed, a slight infection may be carried off in a few days, by bathing the parts in warm milk and water, and injecting frequently up the urethra a little sweet oil, or linseed tea, about the warmth of new milk. Should these not succeed in carrying off the infection, they will at least have a tendency to lessen its virulence.
To effect a cure, however, astringent injections will generally be found necessary. There may be various ways prepared, but I think those made with the white vitriol are both more safe and efficacious. They can be made stronger or weaker as circumstances may require; but it is best to begin with the more gentle, and increase their power if necessary. I generally ordered a dram of white vitriol to be dissolved in eight or nine ounces of common or rose-water, and an ordinary syringe full of it to be thrown up three or four times a day. If this quantity does not perform a cure, it may be repeated, and the dose increased.
Whether injections be used or not, cooling purges are always proper in the gonorrhœa. They ought not, however, to be of the strong or drastic kind. Whatever raises a violent commotion in the body increases the danger, and tends to drive the disease deeper into the habit. Procuring two or three stools every second or third day for the first fortnight, and the same number every fourth or fifth day for the second, will generally be sufficient to remove the inflammatory symptoms, to diminish the running, and to change its colour and consistence. It gradually becomes more white and ropy as the virulence abates.[[1]]
[1]. If the patient can swallow a solution of salts and manna, he may take six drams; or, if his constitution requires it, an ounce of the former, with half an ounce of the latter. These may be dissolved in an English pint of boiling water, whey, or thin water-gruel, and taken early in the morning. If an infusion of senna and tamarinds be more agreeable, two drams of the former, and an ounce of the latter, may be infused all night in an English pint of boiling water. The infusion may be strained next morning, and half an ounce of Glauber’s salts dissolved in it. A tea-cupful of this infusion may be taken every half hour till it operates. Should the patient prefer an electuary, the following will be found to answer very well. Take of the lenitive electuary, four ounces, cream of tartar two ounces, jalap in powder two drams, rhubarb one dram, and as much of the syrup Of pale roses as will serve to make up the whole into a soft electuary. Two or three tea-spoonfuls of this may be taken over night, and about the same quantity next morning, every day that the patient chooses to take a purge. The doses of the above medicines may be increased or diminished, according as the patient finds it necessary. We have ordered the salts to be dissolved in a large quantity of water, because, it renders their operation more mild.
When the inflammatory symptoms run high, bleeding is always necessary at the beginning. This operation, as in other topical inflammations, must be repeated according to the strength and constitution of the patient, and the vehemence and urgency of the symptoms.
Medicines which promote the secretion of urine are likewise proper in this stage of the disorder. For this purpose an ounce of nitre and two ounces of gum-arabic, pounded together, may be divided into twenty-four doses, one of which may be taken frequently in a cup of the patient’s drink. If these should make him pass his urine so often as to become troublesome to him, he may either take them less frequently, or leave out the nitre altogether, and take equal parts of gum-arabic and cream of tartar. These may be pounded together, and a tea-spoonful taken in a cup of the patient’s drink four or five times a day. I have generally found this answer extremely well, both as a diuretic, and for keeping the body gently open.
When the pain and inflammation are seated high, towards the neck of the bladder, it will be proper frequently to throw up an emollient clyster, which, besides the benefit of procuring stools will serve as a fomentation to the inflamed parts.