There are considerable discrepancies of opinion amongst the highest medical author ities regarding the treatment of this disease. Various quack medicines, in the form of prophylactic washes, to be employed after exposure to possible contagion, are daily advertised iu certain cheap and disreputable journals; but as Dr. Druitt quaintly but very truly remarks: "The only prophylactic to be relied on is chastity; next to this, soap and water, followed by an alum wash." To these directions he might have added, that the urine should be discharged as soon as possible afterwards, so as to wash out the urethral passage. If the patient apply on the first suspicion of the disease, before any acute inflammatory symptoms have set in, and if he can devote his whole time to his cure, he should keep a constantly recumbent position, should live on a farinaceous diet, avoiding meat, wine, and beer, and the abortire treatment should be tried. This consists in the injection into the urethra, every four or six hours, by means of a glass syringe, of a solution of two grains of nitrate of silver in eight oz of distilled water. By about the second clay, the discharge will begin to lessen, and the use of the injection must be stopped; and if any tinge of blood has appeared in the discharge, the •remedy must at once be discontinued. If the diminution extend in a few days to a total disappearance of the discharge, the patient is cured; if a slight discharge continue, a weak solution of sulphate of zinc (one gr to the oz.) may be injected two or three times daily for a few days. During this treatment, the bowels should be kept freely open by an antimonial saline mixture, and the patient should drink freely of barley-water, lin seed-tea, and similar mucilaginous fluids. If this treatment be adopted at the very first, we can usually cut short, in a week, an affection that might possibly be troublesome for months; if it be tried after inflammation has fairly established, it is very apt to give rise to stricture. If a patient does not seek advice till the acute stage has set in, perfect rest in the recumbent position should be insisted on; but if, as is too often the case, the patient is unable to carry out this important regulation, all exercise must be avoided as far as possible, and the parts affected should he properly supported by a bandage, specially sold for that purpose, and termed a suspensory bandage. A very low, unstimulating diet must be insisted on, and all stimulating drinks strictly prohibited. while he should partake freely of mucilaginous diluents; and as a medicine, an alkaline saline diuretic be prescribed, such as a combination of a scruple of acetate or bicarbonate of potash, half a dram of tincture of henbane, and twenty minims of nitrous ether, with a little tartar emetic in urgent cases, administered in a small tumbler of water, contain ing a little gum in solution, or of barley-water, three times a day. As an outward local application, nothing is better or more soothing than water as hot as the patient can bear it. When, under thek menus, the scalding pain in micturition and the local swelling subside—but not till then—certain medicines which exert a special influence on inflamed mucous membranes—viz., copaiva and cubebs—should be administered. Copaiva may be administered in half-dram doses three or four times daily; and after a few days, the dose may be increased, if necessary, to double that amount. Under no conditions
can it be made an agreeable medicine. Some practitioners combine it into an emulsion with yolk of egg, liquor potassee, or gum-arabic; others recommend that it should be taken floating on a wine-glassful of water to which a little tincture of oraiige-peel has been added. If the gelatine capsules of copaiva can be depended on as being genuine, they afford an easy mode of taking this medicine. In whatever form it is taken, it is liable to produce an, eruption of the skin, consisting of small red pakehes somewhat resembling nettle-rash, Although the rash is perfectly harmless, and speedily disappears on the discontinuance of the medicine, and the administration of one or two saline pur gatives, it often causes great alarm to a patient who has not been duly warned of its possible occurrence. Cubebs is a less unpleasant medicine' than copaiva. To be of service, at least a dram of the powder should be taken three times a day suspended in milk. A confection formed by mixing powdered cubebs with balsam of copaiva, which may be swallowed as a bolus with an envelope of moistened rice-paper, is an efficacious form of prescribing these medicines. In the third stage. when the urgent symptoms are abating, the patient should continue the use of copaiva and cubebs, and should begin to use injections, commencing with one composed of a scruple of bismuth and half a grain of acetate of morphia in an oz. of water containing sufficient mucilage to keep the bismuth in suspension, to be. used thrice daily. After a few days it may be replaced by one of sulphate of zinc (one gr. to an oz. of water), which may be increased in strength if necessary. If a gleet remains, it must be treated with tonic medicine, especially tincture of iron, exercise in the open air, sea-bathing, good diet, etc.; and the under-side of the urethra may be painted with tincture of iodine, or in very obstinate cases, treated with a slip of blistering tissue. A well-marked case of gonorrhea, when left entirely to itself, rarely runs a shorter course than from three to four months. Various forms and complications of gonorrhea occur, into which it is unnecessary for us to enter in this work.
As has been mentioned in the article OPHTHALMIA, the purulent discharge of gowon rhea, if brought in contact with the conjunctiva, may occasion destructive disease of the eye. There is also a troublesome affection, accompanied by pain, swelling, and tenderness of the joints, with feverishness, which is apt to supervene towards the decline of the discharge, which is known as gonorrheal rheumatism.
From what has been stated regarding the so-called abortive treatment, it is obvious that, by applying for medical aid on the earliest suspicion of contagion, the patient may save himself from a long and troublesome disease, which, if neglected or badly treated, may give rise to a serious local affection—namely, stricture of the urethra. As patients with diseases of these organs are apt to entertain remarkable and altogether erroneous views as to their constitutions being irretrievably ruined, and to the possible outbreak of secondary and tertiary symptoms, it is the duty of the practitioner always to impress upon them that, as a general rule, gonorrhea is merely a local affection, and cannot give rise to any subsequent constitutional symptoms.