90 



SURGERY. 



Chordee may occur, which is an intensely painful erection of the 

 penis, which is bent like a bow, with the convexity upwards : this 

 is owing to the corpus spongiosum being filled with lymph, which 

 prevents its expansion by blood. It is aggravated by the warmth 

 of the bed, and voluptuous dreams. 



The glans may become excoriated ; the prepuce oedematous, in- 

 ducing phymosis ; a sympathetic bubo may form in the groin, or an 

 abscess in the perineum. 



The joints may be pakiful as in rheumatism ; the testicle swell 

 and inflame, constituting orchitis, especially if the patient is impru- 

 dent in exercise, during which the discharge diminishes. As the 

 orchitis declines, the discharge reappears. 



Gonorrhoea is capable of self-cure ; the symptoms gradually sub- 

 siding, and the discharge diminishing, and becoming mucous in its 

 character : it is then a gleet^ which is without pain, redness, &c., but 

 which is readily rekindled into an inflammatory gonorrhoea by im- 

 prudence in diet or exercise. 



Treatment. — In the earliest stage, the ectrotic or abortive plan 

 may be pursued, if the discharge has not reached the suppurative 

 crisis. A strong solution of nitrate of silver, used properly with a 

 glass syringe, may cut short the disease at the outset. It should be 

 used but once or twice, and acts by neutralizing the -virus, as an 

 antiphlogistic, and also coats the urethra with a film which protects 

 the villous surface. This treatment often fails, especially in irritable 

 temperaments, and when not used in the earliest stage ; and if not 

 succeeding, is followed by an aggravation of symptoms. 



In the treatment of gonorrhoea, it is to be remembered that the 

 first attack is generally the most severe ; hence the importance of 

 rest^ which is seldom complied with. Low diet, purging, and tartar 

 emetic as an antiphlogistic and antaphrodisiac; opium and camphor 

 are also useful at night, in preventing painful erections and chordee; 

 a warm bath is most serviceable. Mucilaginous drinks may mitigate 

 the ardor urinse. Leeches and ice to the perineum are sometimes 

 very advantageous. 



The discharge now must not be suddenly arrested, else by metas- 

 tasis the testicle, bladder, or prostate become involved. Strong in- 

 jections are very injurious, although they may temporarily arrest 

 the discharge. As the inflammatory symptoms subside, weak astrin- 

 gent injections may be used with a glass syringe : sulphate of cop- 

 per, zinc, alum, or iron, in the proportion of half a grain to the 

 ounce of water. 



Cubehs and copaiba are remedies which seem to exert a specific 

 influence on the urethra: the latter may be given in almost all 

 stages of the disease ; but the former should be restricted in its ad- 

 ministration to the latter stage. These ^nedicincs often do harm, 

 when persevered in too long, by inducing a chronic disease of the 



