The patient should also be told to drink alkaline mineral waters, as Vichy, Seltzer, plain soda, etc., and to take an abundance of water between meals, but to drink only one cup of coffee daily. He should avoid alcohol, and be moder ate with tobacco; also abstain strictly from coitus and avoid severe exercise. F. B. Newton (Texas Courier-Rec. of Med., Oct., 1900).
To subdue a very high grade of in flammation the following will be found useful:— 13 Ext. opii aquosi, 16 grains.
Vel morph. sulph., 2 grains.
Liq. plumbi subacetat. dilut., 6 fluidounces.
M. Sig.: Use warm, if possible, four to six times daily.
The pain experienced upon passing urine is most efficiently treated by ren dering the urine slightly alkaline and by diluting it by drinking water very freely. Painful erections or chordee may be so persistent and painful as to demand treatment.
For the relief of this condition the pa tient should be instructed to empty the bladder just before retiring for the night, and to be awakened by an alarm clock at the end of three or four hours for the same purpose. He should sleep upon a hard mattress, with but a light covering over him, and he should avoid lying upon the back.
Of the drugs that are useful, the bro mides may be given in full doses, and in the more severe cases chloral or opium may be necessary. A suppository containing opium, belladonna, and monobromated camphor may be admin istered at bed-time when necessary, but should be employed only for severe pain. If a painful erection occurs, the patient should arise and apply cold locally, al though in rare instances heat gives greater relief. Cold applications to the spine are also efficient in some cases.
Such is the routine treatment during the first few days in the cases presenting very acute inflammatory symptoms. When these subside, or, from the be ginning of the cases of the subacute type, the injections may be made some what stronger, like the following:— E Potass. permang., to 1 grain. Boric acid, 1 to 1 '/, drachms. Aquae lest., 6 fluidounces.
M. Sig.: rse as an injection four times a day after urination.
An injection like the following is use ful in a large proportion of cases at this stage:— Hydrarg. chlor. corros., to grain.
Zinci sulphocarb., 24 to 30 grains.
Ac. carbol., 10 to 12 grains.
Boroglyceride, 2 fluidrachms.
Aq., q. s. ad 6 fluidounces. (White.) This is to be used in the same manner as the previous prescription. It may be diluted at first if its use causes pain. During this period one of the capsules already alluded to should be given.
As the amount of discharge dimin ishes, the injections may be made stronger and more astringent. Any of the following may be employed. Sul phate of zinc, acetate of lead, or alum, 1 to 5 grains to the ounce of water; glycerite of tannic acid, 10 to 30 minims to the ounce; and fluid hydrastis, 5 to 10 minims to the ounce. using the milder strength first, and gradually increasing the proportion. Various combinations of these drugs may be made with advan tage in many cases. When the discharge becomes very scant and watery the treatment may be less active, the injec tions being made less frequently, al though the strength may be cautiously increased. The average duration of a case of gonorrhoea is about six weeks. In some instances it is much less than this, while in others the period is much longer. The last trace of the disease to disappear is a drop of discharge or an undue moisture, observed at the meatus on rising in the morning. When this has been absent for some time, the cure may be considered complete. Shreds of epithelium may, however, continue to be present in the urine for sonic time.
One-and-one-half-per-cent. solution of argonin used, injecting drachms, to be retained for five minutes. Of 12 eases observed, in 9 the gonococci permanently disappeared in from 2 to 0 days. The secretion persisting after the discontinu ance of the drug can be relieved by the use of zinc sulphocarbolate and other remedies. Lewin (Bed. klin. Woch., Feb. 17, '90).
Most satisfaction in treating gonor rhoea obtained by use of permanganate of zinc. Permanent cure noted in 50 cases treated by this drug. It is equally suc cessfully in both acute and chronic cases. After the stage of acute inflammation has subsided injections are made four or five times a day after urination, with an ordinary blunt-pointed hard-rubber syr inge with a capacity of three to four drachms. Beginning with a solution of grain to the ounce of water, one gradually increases to three times that strength. H. S. Hotaling (Med. News., Nov. 7, "06).