If he takes the common mercurial pill, two at night and one in the morning will be a sufficient dose at first. Should they affect the mouth too much, the dose must be lessened; if not at all, it may be gradually increased to five or six pills in the day. If calomel be thought preferable, two or three grains of it, formed into a bolus with a little of the conserve of hips, may be taken at bed-time, and the dose gradually increased to eight or ten grains. One of the most common preparations of mercury now in use is the corrosive sublimate. This may be taken in the manner afterwards recommended under the confirmed lues or pox. I have always found it one of the most safe and efficacious medicines when properly used.
The above medicines may either be taken every day or every other day, as the patient is able to bear them. They ought never to be taken in such quantity as to raise a salivation, unless in a very slight degree. The disease may be more safely, and as certainly, cured without a salivation as with it. When the mercury runs off by the mouth, it is not so successful in carrying off the disease, as when it continues longer in the body, and is discharged gradually.
Should the patient be purged or griped in the night by the mercury, he must take an infusion of senna, or some other purgative, and drink freely of water-gruel to prevent bloody stools, which are very apt to happen should the patient catch cold, or if the mercury has not been duly prepared. When the bowels are weak and the mercury is apt to gripe or purge, these disagreeable consequences may be prevented by taking, with the above pills or bolus, half a drachm or two scruples of diascordium, or of the Japonic confection.
To prevent the disagreeable circumstance of the mercury’s affecting the mouth too much, or bringing on a salivation, it may be combined with purgatives. With this view the laxative mercurial pill has been contrived, the usual dose of which is half a drachm, or three pills, night and morning, to be repeated every other day; but the safer way is for the patient to begin with two, or even with one pill, gradually increasing the dose.
To such persons as can neither swallow a bolus nor a pill, mercury may be given in a liquid form, as it can be suspended even in a watery vehicle, by means of gum-arabic; which not only serves this purpose, but likewise prevents the mercury from affecting the mouth, and renders it in many respects a better medicine[[166]].
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 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 hog’s lard and quicksilver, about a drachm may be used at a time. The best time for rubbing it on is at night, and the most proper place the inner side of the thighs. The patient should stand before 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 become 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 must 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. Spirituous 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 considerably 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, thick, 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.