The phymosis is such a constriction of the prepuce over the glans, as hinders it from being drawn backwards; the paraphymosis, on the contrary, is such a constriction of the prepuce behind the glans, as hinders it from being brought forward.
The treatment of these symptoms is so nearly the same with that of the virulent gonorrhœa, that we have no occasion to enlarge upon it. In general, bleeding, purging, poultices, and emollient fomentations, are sufficient. Should these, however, fail of removing the stricture, and the parts be threatened with a mortification, twenty or thirty grains of ipecacuana, and one grain of emetic tartar may be given for a vomit, and may be worked off with warm water or thin gruel.
It sometimes happens, that in spite of all endeavours to the contrary, the inflammation goes on, and symptoms of a beginning mortification appear. When this is the case, the prepuce must be scarified with a lancet, and, if necessary, divided, in order to prevent a strangulation, and set the imprisoned glans at liberty. We shall not describe the manner of performing this operation, as it ought always to be done by a surgeon. When a mortification has actually taken place, it will be necessary, besides the above operations, to foment the parts frequently with cloths wrung out of a strong decoction of camomile-flowers and bark, and to give the patient a dram of the bark in powder every two or three hours.
With regard to the priapism, chordee, and other distortions of the penis, their treatment is no way different from that of the gonorrhœa. When they prove very troublesome, the patient may take a few drops of laudanum at night, especially after the operation of a purgative through the day.
OF A CONFIRMED LUES.
We have hitherto treated of those affections in which the venereal poison is supposed to be confined chiefly to the particular part by which it was received, and shall next take a view of the lues in its confirmed state: that is, when the poison is actually received into the blood, and circulating with it through every part of the body, mixes with the several secretions, and renders the whole habit tainted.
The symptoms of a confirmed lues are, buboes in the groin, pains of the head and joints, which are peculiarly troublesome in the night, or when the patient is warm in bed; scabs and scurfs on various parts of the body, especially on the head, of a yellowish colour, resembling a honey-comb; corroding ulcers in various parts of the body, which generally begin about the throat, from whence they creep gradually, by the palate, towards the cartilage of the nose, which they destroy; excrescences or exostoses arise in the middle of the bones, and their spongy ends become brittle and break upon the least accident; at other times they are soft, and bend like wax: the conglobate glands become hard and callous, and form in the neck, arm-pits, groin, and mesentery, hard moveable tumours, like the king’s-evil; tumours of different kinds are likewise formed in the lymphatic vessels, tendons, ligaments, and nerves, as the gummata, ganglia, nodes, tophs, &c.; the eyes are affected with itching, pain, redness, and sometimes with total blindness, and the ears with a singing noise, pain, and deafness, while their internal substance is exulcerated and rendered carious; at length all the animal, vital, and natural functions are depraved; the face becomes pale and livid; the body emaciated and unfit for motion, and the miserable patient falls into an atrophy or wasting consumption.
Women have symptoms peculiar to the sex; as cancers of the breast; a suppression or overflowing of the menses; the whites; hysteric affections; an inflammation, abscess, schirrus, gangrene, cancer, or ulcer of the womb: they are generally either barren or subject to abortion; or if they bring children into the world, they have universal erysipelas, are half rotten, and covered with ulcers.
Such is the catalogue of symptoms attending this dreadful disease in its confirmed state. Indeed, they are seldom all to be met with in the same person, or at the same time; so many of them, however, are generally present as are sufficient to alarm the patient; and if he has reason to suspect the infection is lurking in his body, he ought immediately to set about the expulsion of it, otherwise the most tragical consequence will ensue.
The only certain remedy hitherto known in Europe for the cure of this disease, is mercury, which may be used in a great variety of forms, with nearly the same success. Some time ago it was reckoned impossible to cure a confirmed lues without a salivation. This method is now, however, pretty generally laid aside, and mercury is found to be as efficacious, or rather more so, in expelling the venereal poison, when administered in such a manner as not to run off the salivatory glands.