See Chorda. It is a painful involuntary erection of the penis, happening at all times, but more commonly when the patient is warm in bed: under which circumstance, the penis is not only hard and painful to the touch, but generally bent downwards in a considerable degree. It sometimes remains after the heat of urine and other symptoms of gonorrhoea have disappeared; but is usually more severe during the continuance of the inflammation, and becomes more or less violent according to the greater or less degree of that symptom.
Astruc distinguishes two species; when the whole body of the penis is regularly drawn downwards in the form of a semicircle, from inflammation, an ulcer in the membrane of the urethra, or in its corpus cavernosum; or when the glans only is drawn down by inflammation of the fraenum. He also observes, that, besides the chordee, there are other distortions of the penis. If the suspensory ligament that connects the penis to the os pubis is inflamed, or if only one of its cavernous bodies is injured, the penis will either be bent upwards or to one side; and these are relieved in the same manner as the chordee.
Dr. Rutherford, in his Clinical Lectures, supposes that inflammation and swelling in the corpus cavernosum urethrae is the cause of the chordee; and Mr. Bell, that the irritation is communicated to the contiguous muscles, producing unequal degrees of contraction over the whole substance of the penis which universally takes place in this disease. Neither explanation is, however, satisfactory; nor can we attribute it to any cause but a spasm in the cells of the corpora cavernosa, and an irregular distribution of the blood. It has not, however, yet been shown that these cellular parts are muscular.
If the patient is costive, gentle laxatives should be administered; and in full habits, bleeding is essentially necessary. A cold solution of acctated litharge, or the camphorated oil, applied to the part, and sleeping in tight drawers, have been recommended. Rubbing the parts with tincture of opium, or a strong solution of it in water, or pledgets immersed in either, kept upon the parts, have been found useful. Emollient injections, impregnated with opium, are exceedingly efficacious in lessening the violence of this complaint: but taking-thirty or forty drops of tincture of opium at bed time is the remedy mostly to be depended upon, as it seldom fails to prevent or remove the affection: and this is considered as one of the most effectual remedies in every stage of this symptom, particularly where it has been of long continuance. If opium fails, the hyoscya-raus niger may be tried, beginning with one grain of the extract, and gradually increasing the dose, according to its effects. Though, in slight degrees of chor-dec, blood letting is never necessary; still, whenever, it is severe, particularly if the habit is plethoric, and the pulse strong and full, it should never be omitted; and, perhaps, the best mode is by the application of leeches to the part affected; particularly as it prevents the chor-dce remaining after every other symptom of gonorrhoea has disappeared, which is sometimes the case. Frictions, with mercurial ointment, have been strongly recommended; but they are generally unnecessary, and often useless.
See Astruc, Foot, Hunter, Bell, and Swediaur, on the Venereal Disease.