GONORRHOEA,^* ITS SIGNS.

THE firſt ſymptoms are an agreeable ſenſation in the genital parts in general, and the teſticles have a creeping worm-like motion, which ſtimu⯑lates to venery; next a gradual diſcharge comes on; firſt, a limpid thin humour, which increaſes until it comes a ſharp, ſtinking, purulent matter; the parts inflame, and now great pain is felt in paſſing the urine, like ſo many needles; this in⯑creaſes to ſuch a height, that the patient dreads to make water; and from the pain and fear he does not let it flow, but paſſes it in jerks: his phy⯑ſiognomy [8]at this period is very unfavourable^*. The miſery is now increaſed by a chordee^†, i. e. the penis becomes frequently erect in a diſagreeable manner, curved downwards with exquiſite pain. In thoſe that have long fore⯑ſkins, it inflames, cannot be drawn back, and is called phymoſis^‡; in thoſe that are ſhort, it contracts, and ſwells up behind the nut ſome⯑times to ſuch a degree as to endanger the patient's life, and is named a paraphimoſis^§. From the [9]inflammation, deep corroding ulcers^* now ap⯑pear, called chancres^†.

IN WOMEN.

IT makes its appearance in about three or four days; the patient feels a pleaſing irritation, which ſoon degenerates into pain; a prickling ſhooting [10]ſenſation within the parts, which inflame and ſwell, is ſore and painful; the urine is hot and ſcalding to ſuch a degree, that the patient dreads to make water; ſhe feels a contractive^* and painful ſenſation in the lower part of her body, with a creeping motion within the ſides about the hips, dull pains acroſs the back. The diſcharge is at firſt ſlime; then thin, watery, ſharp, foetid, bloody; and, at length, becomes a deep green.

BUBOES AND SWELLED TESTICLES.

IN this ſtage, will ſometimes ariſe, either from ſudden colds, or the virus being repelled by im⯑proper treatment.

In the firſt, the notice of the patient is attract⯑ed by a pain in the groin, and upon examination [11]he finds a ſmall lump, the ſize of a pea; there is no inflammation externally, but, after handling, the part becomes more painful, and increaſes to the ſize of a nut; the part is more ſenſible, it throbs, the body is inflamed, a ſlight fever comes on, univerſal laſſitude, pains in the limbs, head⯑ach, thirſt, &c. Still increaſing to the ſize of a pigeon's egg, becomes inflamed, matter forms, and it is now at its maturity. The ſecond makes its approach with a painful worm-like motion in one or both teſticles; the running abates, and fre⯑quently ſtops; they ſwell and inflame; dull, hea⯑vy, burthenſome pains come on, with ſudden twinges and ſtitches extending into the loins; they now become a painful load; a fever ſucceeds, and the criſis is at hand, by either ſuppuration, gangrene, or cancer^*.

THE CONFIRMED POX, OR SECOND STAGE,^*

Is now uſhered in by venereal excreſcences, or warts, which make their appearances about the private parts; they are neither hard nor ſoft, open, moiſt, or dry; they put on forms like pin⯑heads, or ragged at bottom; ſome is pendent, others like a cock's comb, or mulberries. The firſt ſymptoms the patient feels, is an irregular in⯑termittent fever, pain in the head, arms, legs, knees, great laſſitude and dejection of ſpirits; the pain increaſes, eſpecially at night; and when warm in bed, it is paſt bearing, nor can they get any [13]ſleep till towards the morning^*; the head grows heavy, ſometimes with a dull pain ſixed in one ſpot, like a nail drove in by degrees; ſmall lumps ariſe on the ſcull, arms, legs, and thighs, (nodes) which become painful, and torment the patient alternately; ſcurfy places appear in different parts of the body, face, eye-brows, and forehead; gradually increaſing till it invades the hair, which it incircles, (the crown of Venus); the ears are corroded and filled up with ſcabby ſtinking matter, the eruptions increaſe, the lips become ſore, and crack; the mouth and noſtrils are now infected, and run a thick iſchor; the ſkin becomes rough, [14]and covered with branny ſcales; the eyes are dull, heavy, red, and ſtaring; the face becomes blot⯑ted, the neck ſtiff, the mouth ſore, the cheeks firey, the noſe ſwells, is diſtorted, and ſtuffed with ſcabs, the tongue enlarges, the throat is ſore, the hairy ſcalp is now covered with a cruſt, and loſes its natural colour, the hands ſwell, the nails grow thick and drop off, the voice changes, and the language is unintelligible, the lungs depreſſed, the mouth ſtiff and open, the breath loathſome and foetid, and the mind filled with wretchedneſs and deſpair. To cloſe this horrid ſcene, the burning pains increaſe, a heavy pulſe, univerſal weakneſs, dimneſs of ſight, hiccup, ſtranguary, difficulty of ſpeech and reſpiration, the nodes break open, the ſcaly ſcalp cracks, the noſe and throat is corroded, the teeth drop out, the breath is inſupportable, and the whole fabric is now a maſs of ſtinking carrion; if the malady continues, till limb from limb drops off, the vitals are attacked, and the un⯑happy ſufferer expires, the putrid carcaſe is hur⯑ried to the grave, offenſive to all.

Having thus far given the hiſtory of the diſeaſe, from the beginning to the end, that every one may know how to avoid thoſe who are unfortu⯑nate enough to have any of the above appearances, I ſhall now proceed to give advice to thoſe who labour under its baneful influence.

On the firſt appearance of the diſeaſe, let me injoin you to temperance, ſoberneſs, and chaſtity; three moral virtues here indiſpenſably neceſſary. Your diet^* muſt be moderate, and roaſt meat is preferable to boiled; beef and mutton, to veal or lamb; the former is the more eaſy of digeſtion; but mutton is the eaſieſt of all. Avoid ſpices, or high ſauces; for, as it is in its firſt ſtage a topical inflammation, every thing which increaſes the cir⯑culation of the blood will promote the diſeaſe; conſequently all exceſſive exerciſes muſt be avoid⯑ed, [16]ſuch as riding on horſe-back, leaping, jump⯑ing, &c. You may drink wine; but beware of intoxication, or you will ſuffer the next day ſe⯑verely. Though at this time Venus attracts your thoughts, yet pay no homage at her ſhrine. In ſhort, eat when you are hungry, but ſmall quan⯑tities at a time; let your drink be moderate, and be ſatisfied when your thirſt is quenched. The paſſions of the mind have here great influence; avoid them; they irritate the diſeaſe; and when indulged to exceſs, they have been known to bring on alarming ſymptoms. I muſt lay particular ſtreſs on cleanlineſs^*, eſpecially in the fair ſex; for without this the diſeaſe rapidly increaſes, from the corroding virus lying on the parts, or hid in the folds, by which means the irritation is in⯑creaſed, and conſequently the inflammation will extend, bringing on chancres, buboes, &c. which [17]in many inſtances, by timely care, might have been avoided: and to this end always waſh the parts with a little milk and water two or three times a day; or, what is better, a ſcruple of calomel in two or three ounces of roſe water; and between the folds put a little lint, which change every time. To thoſe who in the firſt ſtage uſe injections, retain them in the parts as long as poſſible; to let it come away immediately is of very little ſervice. By the improper uſe of aſtringent injections^* the running at firſt is frequently ſtopped, and the un⯑happy ſufferer thinks he is cured, till, alas! appear⯑ances too ſoon inform him of his fatal miſtake. On the contrary, injections that are ſerviceable at firſt increaſe the diſcharge; your body ſhould be [18]kept moderate, neither bound nor looſe. If you find a painful ſenſation in your groin, or teſticle, and at this time it is not convenient to apply for advice, ſuſpend the teſticle in a bag, and rub it with a little mercurial ointment mixt with cam⯑phor; the ſame by the buboe; but remember, in the latter, rub rather below the part, that the lym⯑phatis may carry it through the glands; but if they ſtill increaſe, apply a poultice of bread and milk, mixt with the blue mercurial ointment, which, in general, will carry them off^*, or relieve [19]till you can get aſſiſtance^*. If a phimoſis comes on, ſoak the part in milk and water, ſyringe the [20]glands with the calomel injection frequently, after which put up a little lint round the nut with a probe, [21]or ſkewer. The pariphimoſis treat the ſame; but always have your ſurgeon's advice, eſpecially in the latter, as delays here would be injurious. I would always adviſe, as long as any ſcalding con⯑tinues, to drink plentifully of linſeed tea, or to eat gum arabic; theſe mucilaginous ſubſtances will abate the acrimony of the urine. If any hard knot ſhould ariſe, rub them with the ointment before-mentioned. Another ſymptom attending this ſtage, is a chordee; no pleaſant companion; but it is ſoon removed, by rubbing the part with a little ointment, and applying a plaſter of the ſame upon it.

Having thus far given you cautions, I will now proceed to a more pleaſant ſubject, namely, ſymp⯑toms of an approaching cure; which is, when the ſcalding abates, the diſcharge thickens, the green appearance gradually vaniſhes, yellow ſuc⯑ceeds, till at laſt it is white, and does not ſtain the linen, and may now be called a common gleet, which is removed by balſamic medicines, freſh air, and moderate exerciſe; to which I will add, frequent topical cold bathing^* If from ill treat⯑ment, or neglect, the urethra is filled with carno⯑ſities, or callofities, ſo as to obſtruct the paſſage of urine^†, then bougies become abſolutely neceſ⯑ſary; [23]but always be careful to tie a piece of thread round the top, bind and faſten it gently around the nut.

Though thus far I have treated it as a ſimple inflammation, and ſuppoſed it to be cured on that principle; yet always take ſome alterative medi⯑cine^*, to guard againſt any lurking miſchief; for I am certain too great ſecurity here, or rely⯑ing [24]on the words of boaſting pretenders^*, has, in the end, been the ruin of many; for the diſeaſe lying dormant for a number of years, has after⯑wards broke out in the various forms above-men-mentioned, which, had they taken ſome alterative medicines, would never have happened. Where this is the caſe, alterative medicines are the ſpeedi⯑eſt and ſafeſt cure; they act without injuring the ſyſtem, and, joined with cleanlineſs, never fail in the moſt confirmed pox. The firſt thing to be thought of is frequently cleaning the teeth, and [25]gargling the throat, change of linen, frequently waſhing the body, and beware of catching cold. If any ſcaley eruptions appear, waſh them with bran and water; or warts, clip them off with a pair of ſciſſars, and apply the ointment over them. If your throat, or noſtrils are affected, uſe the fumes of mercury^*, or apply immediately to your ſur⯑geon. If nodes ariſe, rub them every night with the ointment; keep the body temperate; and, in ſome caſes, it is adviſable to wear a flannel jer⯑kin and drawers next the ſkin. When you find all the ſymptoms abate and vaniſh, leave not off your medicines too ſuddenly. After which I would adviſe a courſe of bark, exerciſe, change of air, and cold bathing, to take off the irritability the diſeaſe has cauſed in the ſyſtem.

Before this advice is cloſed, I ſhall give a few hints on the uſe of mercury.

In the firſt place, I do not agree with ſalva⯑tion, even in the worſt of caſes. It is from this imprudence that this ſacred medicine has been thrown aſide; a medicine which, when admini⯑ſtered with caution, is not injurious to the human frame; on the contrary, expel it from the Mate⯑ria Medica, how many millions would ſuffer from the ſcurvy, gout, rheumatiſm, yaws, bilious com⯑plaints, &c.? It ſhould be given in ſmall doſes, with⯑out any perceptible action. In this manner, what are its effects? it increaſes the action of the lympha⯑tic ſyſtem; the conſequence is, the glands, before obſtructed, have now a free circulation, the offend⯑ing virus is abſorbed, and thrown off by the pores of the ſkin, urine, ſtool, &c. the blood is purified, and the body now reſtored to health. On the contrary, if too large a quantity is taken, a foul breath, rotten gums, carious teeth, &c. enſues; [27]the glands are irritated to ſecretions beyond their power, the appetite is loſt, the inteſtinal canal af⯑fected, the head ſwells, the tongue hangs out of the mouth, and ſaliva is continually running from it; copious ſweats, and univerſal debility follow; at this period few come near him, from the offen⯑ſive ſmell. Suppoſe he ſtops here, and the diſeaſe is cured, how dearly is it paid for, when ſo ſafe a remedy is at hand? He lingers out the reſt of his life with a debilitated, irritable conſtitution.— How many by this are brought to an early grave! From this cauſe ſalivation is now juſtly exploded.

To ſum up the whole, I would adviſe, that in the firſt ſtage of a gonorrhoea, or clap, the method of cure ſhall be to leſſen the inflammation and ir⯑ritability of the ſyſtem, to promote gentle perſpi⯑ration, to correct the acrimony of the fluids, and to protect the body from infection. Injections that will abate the inflammation, that are void of aſtringency, are preferable; they are applied to the [28]part diſeaſed, and certainly will cure more ſpeedily than medicines taken by the mouth. With pro⯑per injections, where they have applied as ſoon as they have diſcovered the injury, I have complete⯑ly cured, in a few days, the moſt virulent gonor⯑rhoea. What medicines are taken internally ſhould be anti-inflammatory. After this, when the ſcalding is abated, the colour gone, a ſimple gleet only remaining, balſamics are the moſt pro⯑per; but, after all, it is prudent to guard the con⯑ſtitution by a few alterative medicines. In the lues venerea alteratives are what we muſt depend on; but when joined to balſamics, and others that will promote a gentle perſpiration, they are ſure of ſucceſs. By theſe principles I have always ſucceeded in the worſt of caſes; and weak debilitated habits, ariſing from exceſſes of any kind whatſoever, by cordial tonic medicines, cold bathing, change of air, and exerciſe, are ſure to meet with relief.

I muſt here guard youth from that diabolical practice of machinery; ſo far is it from being a preſervative, that numbers have been poxed from too great a ſecurity. There is now another faſhionable vice, no leſs injurious in debilitating the ſyſtem, by forcing nature further than her ſtrength will bear, and bringing on a train of ner⯑vous complaints; I mean, whipping. I cannot help wiſhing, with Dr. Faulk, that fools who laſciviouſly uſe this exerciſe to ſtir up their luſt, might be ſwitched after emiſſion, as they endured it before; which would ſoon cure them of this diabolical practice.

To conclude; I ſhall now lay down the moſt ſafe means of preventing this loathſome diſeaſe. After intercourſe with a ſuſpected perſon, always waſh the parts with a little warm water, or ſoap; or if not at hand, your own urine. Be careful to waſh between the folds, or round the glands; and when you get home, uſe the following—calomel [30]1 ſcruple, roſe-water 2 ounces^*, and leave ſome of it on. Some throw it up the parts with a ſy⯑ringe, and they are ſure of ſucceſs; even if a ſlight gonorrhoea has taken place, it will cure without any further application. In women it is the beſt, eaſieſt, and ſafeſt remedy; not only here, but alſo in the flower albus; it being thrown up the va⯑gina 3 times a-day, and the patient taking a little bark to ſtrengthen and brace the ſyſtem, nothing elſe is further required. By having this by them, they may at all times keep free from the diſeaſe. Some chuſe to rub a ſmall quantity of blue mercu⯑rial ointment on the groin and parts; this too, like the other, is certainly deſtroying the infection [31]in the bud, and adviſable when the other cannot be procured; but there is one caution, always to have the calomel pure and mild: what I prepare for the purpoſe, and for private practice, under⯑goes a number of waſhings in lime water, &c. to take off every minute particle of acid.