Venereal Diseases.

The Theory of Gonorrhoea, or How Gonorrhoea is Produced.

The Venereal disease may be divided into eight parts, in which gonorrhoea comes first. Gonorrhoea is a flux or discharge of viscid matter of various colours from the urethra in men and the vagina in women. It commonly proceeds from coition with a person infected with the venereal disease, and is one of the first symptoms by which that disease may be known.

The first symptoms of the disease in men are commonly a sensation at the end of the penis, not unlike a flea bite, with itching and tingling sensations, together with a fulness about the lips of the urethra and some degree of tension in the penis. The urinary canal feels as if tightened, and the urine flows in a small and unequal stream and produces a scalding sensation. A little whitish mucus may also be seen about the orifice of the ureter, and oozing from it when pressed, especially if the pressure is made on the spot where the soreness is most felt. The discharge soon increases in quantity and varies in colour according to the degree of inflammation. The patient feels a sensation of heat and pain in evacuating his urine, particularly at certain spots of the urethra, and above all towards the orifice and from the involuntary erections to which he is subject from the stimulus, particularly when warm in bed, when it occasions a distortion or curvature of the penis and is attended with severe pain. When the inflammation is violent the glands appear tumid and transparent and the tension extends through the whole of the penis. The perinaeum is affected with swelling and redness, and even the loins and buttocks and anus sympathise and cause a very uneasy sensation. Sometimes the prepuse inflames about the ends of the penis and cannot be drawn back, forming what is called a phymosis. At other times, as in the purra phymosis, it remains in an inflamed state below the glands, so that it cannot be drawn forward, and if the stricture and inflammation are violent may terminate in gangrene. Especially when there is a phymosis we may perceive a hard cord extending along the back of the penis. This is an inflamed sympathic and is to be considered as a prelude to a bubo. In mild cases the seat of the disease is in the urethra not far from its orifice, but it frequently happens that the virus insinuates itself much higher up so as to affect corupus glands, the prolate and parts near to the neck of the bladder. In the generality of cases the inflammation goes on increasing for several days, commonly for a week or a fortnight when medicines are taken, after which the symptoms begin to abate, and the running when left to itself gradually lessens in quantity and becomes whiter and thicker till at length it totally stops. The colour of the mucus, however, is by no means a certain guide in these cases, for in many patients it is of a yellowish and sometimes a greenish colour to the very last. But in general it becomes more consistent towards the close of the disease. In women the parts of generation being fewer and more simple the disease is less complicated than in men; sometimes the vagina only is affected, and where this happens the symptoms are very trifling, but in general it comes on with an itching and a sensation of heat as in the other sex, and is attended with inflammation of the nymphae, inside of the tabia clitoris, carmicular myrtiformes, the orifice, and sometimes the whole of the meaius urinanus. Very often the deep-seated glands of the vagina are affected, and it is sometimes very difficult to distinguish the discharge of gonorrhoea from that of a fluor albus.

Causes.—Many ingenious arguments have of late been advanced to prove that gonorrhoea and lues veneria are different affections originating from two distinct species of virus, and this controversy still perhaps remains to be decided by future facts. (Gonorrhea is caused by gonococcal bacteria, syphilis (lues venerea) is caused by the spirochete Treponema pallidum. -Henriette.) Certain it is that in nineteen out of twenty cases of gonorrhoea no symptoms of syphilis appear, and that the disease readily admits of cure without having recourse to those remedies which are supposed to be universally requisite for combating the contagion of syphilis. It is by no means wonderful that in some cases, both contagions, supposing them to be different, should be communicated at the same time; but, as undeniable proof that the contagion in both cases is precisely the same, it has been alleged by some that the matter of chancre introduced into the urethra will generate a gonorrhoea, and that the discharge from a gonorrhoea will produce chancre, bubo and every other symptom of syphilis. On the other hand, however, it is contended that where experiments of this kind have been conducted with the greatest accuracy, the matter of syphilis uniformly produces syphilis, and that of gonorrhoea, gonorrhoea only. Without pretending to decide as to which of these experiments decides the question, we may only observe that while an almost inconceivably small portion of syphilitic matter applied to the glands penis from connection with an infected female infallibly produces syphilis if it be not removed, the matter of gonorrhoea in every instance of that disease is applied to the whole surface of the glands penis for many days together without producing almost any bad effects whatever from this. Therefore, there are grounds for inferring either that it is not capable of being absorbed or if absorbed it works no harm. But while there have been disputes with regard to the peculiarity of the matter in gonorrhoea, there have also been controversies with respect to the source from whence it is derived. Some suppose it to be principally purulent matter arising from ulcerations, others assert that no such ulceration is ever produced in the urethra by gonorrhoea. They contend that the increased secretion in these cases is exactly similar to what happens in nasal catarrh. But the comparisons will by no means hold good in every particular. In the latter the whole membrane of the nose is equally irritated; whereas in gonorrhoea only particular parts of the urethra seem to be affected. The disease in the generality of cases seldom extends more than an inch and a half along that canal, and in many is confined at least in the beginning to a small spot about an inch from the extremity of the glands. The discharge is produced from that part of the urethra where the pain is felt, and the patient when he micturates feel no smarting till it reaches the inflamed spot. But as the disorder increases the inflammation affects a great number of points just in the sarne manner as a chancre affects different parts of the glands. It might be supposed that dissection would at once clear up this matter and put an end to the dispute, but this is far from being the case. Dr. Simmons has seen several urethrae opened in persons who had a gonorrhoea at the time of their death. In three of them the surface of the urethra, as in the case related by Morgagni, appeared for some way down of a slight red colour, and in all of them was covered with mucus; but without any appearance of ulceration, except in two dissections at Paris, when most of the gentlemen present were convinced that they saw evident marks of it. But Dr. Simmons says that the appearances were to him not sufficiently satisfactory to enable him to decide with certainty on the subject. On the other hand, when we consider that the discharge in a gonorrhoea is sometimes tinged with blood, and that when this happens a little blood vessel is no doubt ruptured, we can have no reason to doubt that an ulceration may, and sometimes does happen in these cases, especially as we often observe an excoriation near the orifice of the urethra. It is certain that wherever there is considerable inflammation there will be danger of ulceration. Besides, from a neglected or badly treated case of gonorrhoea, we often see fistulas in pernico, and other ulcers of the urethra penetrating through its substance and affording a false passage to the urine, and there can be no doubt that slight ulcerations of this canal often occur, and are afterwards perfectly obliterated in a similar manner to what happens in papellae of the tongue, the tonsils, etc. Such an obliteration will the more readily take place in a part like the urethra defended with mucus, and not exposed to the air, which is known to have so little effect in hardening a cicatrix. But whether ulcers take place or not, whether the virus of gonorrhoea is precisely the same kind with that which gives syphilis or not there is reason from the phenomena of the disease to conclude that the matter first acts by mixing with the mucus at the extremity of the urethra, and that from thence it is propagated upwards; particularly where the oozings of mucus are most numerous, and that on the parts to which it is applied it operates as a peculiar irritating cause. The consequence of this irritation will be inflammation and an increased secretion of mucus, and so far the complaint will be local. In ninety-nine cases out of every 100 a local affection of this kind constitutes the whole of the disease; and of this inflammation ulceration within the urethra, stricture and other local affections may be the consequence. Or they may never take place, unless in the case when the contagion of syphilis is communicated with that of gonorrhoea; but this still remains to be determined by future observations and experiments. Nothing can be more variable than the period at which the disease makes its appearance after infection. Perhaps usually we may place it between the third and the fourteenth day, but in some cases it happens in 24 hours and in others not before five or six weeks; neither of these extremities, however, are common. With the view of preventing gonorrhoea, some have advised that the alkali, ether, or caustic state, properly diluted with water, should be injected into the urethra; and there can be no doubt that by this means the contagious matter, when it has entered the urethra, may be removed. A removal may also be effected by an injection of a weak solution of corrosive sublimate. But this injection of corrosive sublimate I would not advise to be used. Neither would I advise the use of alkalies, except it be ordinary soap solution. Corrosive sublimate is one of the worst poisons. It is a preparation of mercury, and produces salivation, rotting of the teeth, falling off of the hair of the body, and produces mercurial sores commonly called syphilitic sores, also mercurial blindness (which is sometimes called syphilitic blindness), and acts not by dissolving the mucus but by producing an augmented secretion. That in some cases the disorder admits of a natural cure there can be no doubt—the increased secretion of mucus carrying off the virus faster than it is formed, till at length the infection is wholly removed—but it is equally certain that in every case by the application of suitable remedies to the inflamed parts we may shorten the duration of the complaint and lessen the sufferings of the patient with the same certainty and safety that we are enabled to remove the effects of an ophthalmia or any other local inflammation by proper topical applications. From the foregoing description of the process of the disease it will easily be perceived that the chief curative indications are to subdue inflammation and remove the virus that occasions them. General remedies, such as occasional giving of a cooling diet, the liberal use of diluting liquor or blood purifiers and mild purges are by all allowed to be useful and even necessary. The utility and even the necessity of a cooling regimen are sufficiently obvious; wines and spirituous liquors, etc., a fish diet, much salted and highly seasoned dishes of every sort will constantly add to the complaint. The patient should eat meat only about twice a week, and that sparingly. He should abstain from hot suppers. Milk, mild vegetables, and fruit should constitute the principal part of diet. While the inflammatory symptoms continue everything that tends to excite venereal imagination should be studiously avoided, for whatever promotes erections of the penis will increase the inflammation, and, of course, add fuel to the disease. For the same reason much walking or riding on horseback will be hurtful, from the inflammation kept up in the perinaeum by such means. Violent exercise of any kind, everything that is liable to increase the heat or momentum of the blood, will of course be improper. The drinking freely of mucilaginous liquors, such as linseed tea, whey, milk, and water, and the like will be extremely useful by diluting the urine, and preventing its salts from irritating the urethra. When heat and pain in making water are very considerable mucilaginous substances are found to have the best effect, particularly gum arabic, liquor made from Marshmallow leaves or root, Nitbone leaves or root, or Slippery Elm. The above is given with a view to lessen the inflammation, the chief action of the above being upon the urinary passages. Nitre, cream of tartar, and the like substances, on account of their irritating diuretic quality, will be found improper to give in such cases, our object being not to promote a preternatural flow of urine—for the virus being insoluble in water cannot be washed away by such means—but to render the urine that is secreted as mild and as little irritating as possible. Gonorrhoea or clap is always the forerunner of syphilis, and also of confirmed lues venera, which means the worst form of the venereal disease.

As already stated, the Venereal disease is divided into several different forms, namely, gonorrhoea, hard chancres, soft chancres, uterine chancres, bubos and gleet, syphilis, or secondary and confirmed lues. We can safely say that in the treatment of any of the above different forms of the disease where no poisonous remedy is used, but a pure botanic non-poisonous remedy, no bad effects can afterwards take place.

Treatment for All Forms of Venereal Disease with Non-Poisonous Herbal Remedies.—(Do note that this advice is from 1922. Modern medicine has better remedies. It is also very important to find the person who gave you any given VD, and tell them to get treatment. -Henriette.) The internal treatment in all cases of the venereal disease, no matter what form they may take or symptoms shown, will be a blood purifying remedy made from herbs, and used as per directions with them, together with two cayenne pills taken after each meal. As an outward application, in a case of gonorrhoea or a discharge known as "clap," use warm water to keep the parts clean. In case of hard chancre, or where hard chancre is produced a wash made with liquor from Marshmallows will cause them to fall off; in case of soft chancre or uterine chancre a wash with a liquor made from Purple Loosestrife, and a little Chickweed Ointment afterwards applied will eventually cure the soft chancre. In cases where phymosis is formed the same treatment as above will also remove phymosis, also paria phymosis in cases where it has run to sores or rose rash anywhere on the body. The internal treatment above recommended, together with a wash of the parts affected, will answer all purposes—that is, Marshmallows, Purple Loosestrife, and Chickweed. The blood purifying will answer the purpose internally, but warm baths must be used twice a week in pigmentary syphilis; the same treatment will answer every purpose in serpigenious syphilide. On no account use injections in male cases, but in female cases injections may be used from the same preparation as advised for outward application or as mentioned for gleet and gonorrhoea in the article on Marsh Gentian.

Notes of a Lecture by R. L. Hool on "Gonorrhoea and Syphilis."

By treatment with such remedies as aqua fortis or dilute nitric acid, blue pills, corrosive sublimate, and mercury, aggravated forms of the disease are produced, increasing the syphilitic sores all over the body, followed by loosening of the teeth, falling-off of the hair all over the body, defective sight, and blindness. The same symptoms also occur from the use of bella donna, henbane, aconite, and other drugs of a similar nature; and even such substances as poke root, exchinacea, balsam of copabia, dragon's blood, etc., are better not used. Although these may stop the discharge outwardly, they re-direct it into the system, and in after time it breaks out again in secondaries; and if still neglected or still wrongly treated will end in confirmed lues or in a form of leprosy. Even without such treatment as above mentioned, it may, through neglect and uncleanliness, drink and debauchery, produce all the above-mentioned symptoms, with the exception of mercurial blindness and salivation. I have seen nearly all the worst forms of syphilitic disease that anyone could possibly suffer from and treated hundreds of cases, but always with non-poisonous remedies. Whenever the disease is contracted the treatment should always be with non-poisonous remedies, such as a wash for outward application with liquor in which Common Dock, Marshmallow leaves or roots, Comfrey (Nit-bone) root or leaves had been boiled. As an internal treatment blood purifying herbs-should be freely used, and if the case is a very bad one at least one half-pint made from these herbs should be taken three or four times per day before meals. In mild cases half a teacupful three to four times per day before meals will be found sufficient. Also take one cayenne pill after each meal, and keep the bowels open with doses of aperient mixture made from Constipation Herbs. If this treatment be persevered with it will entirely eradicate the disease, and no after-results or bad effects will ever show themselves either in themselves, their wives, or children, and it will leave no mark or blemish behind.

Blood Purifying Mixture.

Red Jamaica Sarsaparilla Root (cut and split), 1 oz.
Turkey Rhubarb (crushed), 1 oz.
Burdock Root (do.), 1 oz.
Yellow Dock Root (do.), 2 ozs.
Lump Ginger (do.), 2 ozs.
Fumitory Herb (cut), 1 oz.
Clivers Herb (cut), 1 oz.
Best Block Juice, 2 ozs.

Boil the whole in 5 quarts of water down to 3 quarts, strain through sieve, and when cold it will be fit for use.

Dose: Half a teacupful 3 or 4 times a day before meals.

Common Plants and their Uses in Medicine was written by Richard Lawrence Hool, F.N.A.M.H., in 1922.