A Gonorrhoea signifies a discharge from the mucous membrane of the male or female genitals; generally produced by contagion from a similar discharge during sexual connection.

In the first stage the patient merely notices a little itching at the orifice of the urethra, with a slight serous or thin whitish discharge. If the disease is not checked at once, it passes after a few days into the second, or acutely inflammatory stage. The discharge becomes thick and purulent, and when the disease is at its height is greenish, or tinged with blood. The penis swells; the glans becomes of a peculiar cherry colour, is intensely tender, and often excoriated. In consequence of the swelled state of the passage, the stream of urine is small and forked, and passed with much straining and severe pain and scalding. All the parts in the vicinity of the genitals, the groin, thighs, perinoeum, and testicles ache and feel tender; and the patient's nightly rest is disturbed by long-continued and painful erections, and by chordee,that is, a highly painful and crooked state of the penis during erections. Besides the above symptoms, the following complications may occur in various cases.

There may be severe irritation, or actual inflammation of the urinary organs; sometimes of the deeper portion of the urinary passage, producing great pain in the perinoeum and spasm of the muscles during the act of making water, so as to interrupt the stream of urine, and cause the most exquisite agony, or even sometimes complete retention:-sometimes of the bladder, causing a very frequent desire to make water, and great pain in doing so, which lasts for some time afterwards, together with a white mucous cloud in the urine;-or there may be pain in the loins, scanty urine, tenderness of the abdomen, vomiting, and other signs of severe irritation of the kidneys.

There may be bleeding from the passage from rupture of some of the distended vessels during violent erection. The loss of blood generally gives relief.

Or, inflammation of the glands in the groin; constituting bubo.

The glans may be so swelled that the foreskin cannot be drawn back, or the foreskin may be so swelled that it cannot be drawn forward.

One or both testicles may be inflamed; or there may be Gonorrhoeal rheumatism, pain, swelling, and tenderness of the joints, especially of the knees and ankles, and fever; this generally occurs towards the decline of the complaint, and attacks young people of a delicate, strumous habit. The same persons are also liable to rheumatic inflammation of the eyes.

After a time the inflammatory symptoms abate, and a mucous, purulent discharge is left, which, when obstinate and thin, is called a gleet.

Gonorrhoea varies extremely in its severity. It is almost always severe in first cases, and in patients who are very young, or who possess irritable or scrofulous constitutions. In such cases it may be attended with fever and constitutional disturbance, and may even prove dangerous to life by leading to extensive abscesses in the neighbourhood of the bladder.

There is one form of the disease in which the mucous membrane is red, swollen, and tender, but free from discharge. In the male there are severe pain and scalding in making water, and the lips of the urethra are red and swelled. This form of the disease has the popular name of the dry clap.

Repeated Gonorrhoea may lead to stricture of the urethra.

Inflammation and discharge from the urethra somewhat resembling Gonorrhoea may be produced by other causes, which have occasioned local irritation. They have been brought on by galloping several miles on a horse without a saddle; by immoderate and protracted sexual indulgence; by the introduction of bougies; blows on the perinoeum; violent bending of the penis during erection, and long travel in a jolting vehicle over bad roads. They have occurred as a symptom of rheumatism, and not unfrequently they precede a paroxysm of Gout; or they may be brought on by Piles. A discharge is liable to occur in persons affected with stricture; and to recur in those who have been long habituated to it, upon any neglect of their health, exposure to severe cold, or inordinate fatigue, or excess in food, wine, or venery.

Again, a man may contract a pretty severe discharge from a woman who is perfectly chaste, and has not previously been infected by a third party; as the menstrual fluid is capable of causing inflammation of the urethra with violent scalding and chordee, followed by swelled testicle; and a considerable degree of irritation may be produced by the vaginal secretions just previous to menstruation. Similar consequences sometimes ensue if the female be affected with whites, or with any other discharge of any sort whatever.

Again, a woman may convey the infection from one man to another without ever having it herself. I knew an instance where a girl, having had connection with an infected man, gave Gonorrhoea within a day or two to two others, and never had it herself.

The discharge sometimes makes its appearance soon after connection, but sometimes not till four or five days afterwards.

In women the complaint is much simpler than in men, and much less severe, unless the patient is very young and delicate. The symptoms are much the same. Heat and pain in making water; tenderness and soreness, especially in walking, uneasiness in sitting, and a discharge. On examination the parts are found swelled and red, and, if the case is severe, there may be excoriations or ulcerations.

It must be remembered that young girls from the ages of one or two, up to fourteen or fifteen, are very liable to inflammation of the private parts, and to a discharge much resembling that of Gonorrhoea. This affection has often been mistaken for Gonorrhoea, but it merely arises from heat or irritation in the system, and may be cured with a little cooling physic, and the local application of Black Wash.

Treatment

Many practitioners are fond of employing injections of stimulating lotions to the passage in these cases, but they are very apt to bring on swelled testicle, and had better be avoided. In the first place, in order to prevent inflammatory symptoms, or to check them if they have commenced, the patient should be careful to take as little exercise as possible, and rigidly abstain from all stimulants. He may take the following powders, and continue them till all the inflammatory symptoms have completely subsided.

Powdered Nitre...............................Two Drams.

Bromide of Potash...........................Four Drams.

Powdered Gum Arabic......................Four Drams.

Mix, and divide into twenty-four powders; one to be taken three times a day, in a little water. If the parts are inflamed they may be washed several times a day with Goulard water, or rags dipped in the lotion may be kept constantly on the parts. If there should be any soreness or excoriations the Black Wash may be used instead of the Goulard Water.

Alter the inflammatory symptoms have quite subsided, and nothing but a discharge remains, the patient may take the Balsam of Copaiba, in doses of twenty or thirty drops, three times a day, on a 'little sugar. Or the Copaiba Capsules may be taken, which are less unpleasant. Or he may take the Compound Tincture of Benzoin (Fryar's Balsam) in doses of thirty drops, three times a day. I have known the latter cure a gleet of nine months' standing, in three days.

If the patient is troubled at night, an extra dose of Bromide of Potash, or ten grains of Hydrate of Chloral may be taken at bedtime. If the chordee is troublesome, a little Extract of Belladonna may be smeared along it at bedtime.

In Gonorrhoea in the female the same treatment may be pursued. Pieces of lint, soaked in the Black Wash, may be inserted between the lips; and freshly wetted several times a day; and the passage may be syringed three times a day with a dram of powdered Alum and half a dram of Tannic Acid, dissolved in a pint of milk-warm water. One-fourth of this may be used at a time.