To effect a cure, however, astringent injections will generally be found necessary. These may be various ways prepared, but I think those made with the white vitriol are both most 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 order a drachm 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[[164]].
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[[165]].
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.
Soft poultices, when they can conveniently be applied to the parts, are of great service. They may be made of the flour of linseed, or of wheat-bread and milk, softened with fresh butter or sweet oil. When poultices cannot be conveniently used, cloths wrung out of warm water, or bladders filled with warm milk and water, may be applied. I have often known the most excruciating pains, during the inflammatory state of the gonorrhœa, relieved by one or other of these applications.
Few things tend more to keep off inflammation in the spermatic vessels, than a proper truss for the scrotum. It ought to be so contrived as to support the testicles, and should be worn from the first appearance of the disease till it has ceased some weeks.
The above treatment will sometimes remove the gonorrhœa so quickly, that the person will be in doubt whether he really laboured under that disease. This, however, is too favourable a turn to be often expected. It more frequently happens, that we are able only to procure an abatement or remission of the inflammatory symptoms, so far as to make it safe to have recourse to the great antidote mercury.
Many people, on the first appearance of a gonorrhœa, fly to the use of mercury. This is a bad plan. Mercury is often not at all necessary in a gonorrhœa; and when taken too early, it does mischief. It may be necessary to complete the cure, but can never be proper at the commencement of it.
When bleeding, purging, fomentations, and the other things recommended above, have eased the pain, softened the pulse, relieved the heat of urine, and rendered the involuntary erections less frequent, the patient may begin to use mercury in any form that is least disagreeable to him.