[2]. Take quicksilver one dram, gum-arabic reduced to a mucilage two drams; let the quicksilver be rubbed with the mucilage, in a marble mortar, until the globules of mercury entirely disappear; afterwards and gradually, still continuing the trituration, add half an ounce of balsamic syrup, and eight ounces of simply cinnamon-water. Two table-spoonfuls of this solution may be taken night and morning. Some reckon this the best form in which quicksilver can be exhibited for the cure of gonorrhœa.
It happens very fortunately for those who cannot be brought to take mercury inwardly, and likewise for persons whose bowels are too tender to bear it, that an external application of it will answer equally well, and in some respects better. It must be acknowledged, that mercury, taken inwardly for any length of time, greatly weakens and disorders the bowels; for which reason, when a plentiful use of it becomes necessary, we would prefer rubbing in to the mercurial pills. The common mercurial, or blue ointment, will answer very well. Of that which is made by rubbing together equal quantities of hogslard and quicksilver, about a dram may be used at a time. The best time for rubbing it in is at night, and the most proper place the inner side of the thighs. The patient should sit beside the fire when he rubs, and should wear flannel drawers next his skin at the time he is using the ointment. If ointment of a weaker or stronger kind be used, the quantity must be increased or diminished in proportion.
If, during the use of the ointment, the inflammation of the genital parts, together with the heat and feverishness, should return, or if the mouth should grow sore, the gums tender, and the breath becomes offensive, a dose or two of Glauber’s salts, or some other cooling purge, may be taken, and the rubbing intermitted for a few days. As soon, however, as the signs of spitting are gone off, if the virulency be not quite corrected, the ointment must be repeated, but in smaller quantities, and at longer intervals than before. Whatever way mercury is administered, its use must be persisted in as long as any virulency is suspected to remain.
During this, which may be called the second stage of the disorder, though so strict a regimen is not necessary as in the first or inflammatory state, yet intemperance of every kind ought to be avoided. The food must be light, plain, and of easy digestion; and the greatest indulgence that may be allowed, with respect to drink, is a little wine diluted with a sufficient quantity of water. Spiritous liquors are to be avoided in every shape. I have often known the inflammatory symptoms renewed and heightened, the running increased, and the cure rendered extremely difficult and tedious, by one fit of excessive drinking.
When the above treatment has removed the heat of urine, and soreness of the genital parts; when the quantity of running is lessened, without any pain or swelling in the groin or testicle supervening; when the patient is free from involuntary erections; and lastly, when the running becomes pale, whitish, void of ill smell, and tenacious or ropy; when all or most of these symptoms appear, the gonorrhœa is arrived at its last stage, and we may gradually proceed to treat it as a gleet with astringent and agglutinating medicines.
OF GLEETS.
A gonorrhœa frequently repeated, or improperly treated, often ends in a gleet, which may either proceed from a relaxation, or from some remains of the disease. It is, however, of the greatest importance in the cure of the gleet, to know from which of these causes it proceeds. When the discharge proves very obstinate, and receives little or no check from astringent remedies, there is ground to suspect that it is owing to the latter; but if the drain is constant, and is chiefly observable when the patient is stimulated by lascivious ideas, or upon straining to go to stool, we may reasonably conclude that it is chiefly owing to the former.
In the cure of a gleet proceeding from relaxation, the principal design is to brace and restore a proper degree of tension to the debilitated and relaxed vessels. For this purpose, besides the medicines recommended in the gonorrhœa, the patient may have recourse to stronger and more powerful astringents, as the Peruvian bark,[[3]] alum, vitriol, galls, tormentil, bistort, ballustines, tincture of gum kino, &c. The injections may be rendered more astringent by the addition of a few grains of alum, or increasing the quantity of vitriol as far as the parts are able to bear it.
[3]. The Peruvian bark may be combined with other astringents, and prepared in the following manner:—Take of Peruvian bark bruised six drams, of fresh galls bruised two drams, boil them in a pound and a half of water to a pound; to the strained liquor add three ounces of the simple tincture of the bark. A small tea-cupful of this may be taken three times a day, adding to each cup fifteen or twenty drops of the acid elixir of vitriol.
The last remedy which we shall mention, in this case, is the cold bath, than which there is not a more powerful bracer in the whole compass of medicine. It ought never to be omitted in this species of gleet, unless there be something in the constitution of the patient which renders the use of it unsafe. The chief objections to the use of the cold bath are a full habit, and an unsound state of the viscera. The danger of the former may always be lessened, if not removed, by purging and bleeding; but the latter is an insurmountable obstacle, as the pressure of the water, and the sudden contraction of the external vessels, by throwing the blood with too much force upon the internal parts are apt to occasion ruptures of the vessels, or a flux of humours upon the diseased organs. But where no objections of this kind prevail, the patient ought to plunge over head in water every morning fasting, for three or four weeks together. He should not, however, stay long in the water, and should take care to have his skin dried as soon as he comes out.