

GONORRHCEA. 95 



of tannin. One of these was to be dissolved in a half pint of red wine, 

 and the solution was to be used as an injection. If the result was un- 

 satisfactory, the two other powders were to be put into the same quan- 

 tity of wine, and the injection to be continued with this doubly-strong 

 solution. It has repeatedly happened to me that a patient has pulled 

 one of these very powders out of his pocket which I was about to pre- 

 scribe for him, and which he had obtained from a friend, and has asked 

 whether he might try that first. In order that these injections may be 

 of service, we must give them once or twice ourselves, or let a skilled 

 assistant give them. If we neglect this precaution, it often happens 

 that the liquid does not enter the urethra at all, or perhaps is merely 

 thrown under the prepuce, and flows back past the syringe. Gon- 

 orrhoea syringes must be so small that they will not hold more liquid 

 than the urethra is capable of containing. It is then unnecessary to 

 compress the posterior end of the canal. The best plan is to have a sup- 

 ply of suitable syringes at some particular instrument-maker's, and to 

 give them some* unobjectionable name, since many patients, feeling too 

 much embarrassed to ask for a " penis-syringe," get an " ear-syringe," 

 or other unsuitable article instead. I have cut short a large number 

 of recent virulent gonorrhoeas in two or three days by injection of 

 tanrin. Even where the disease is not quite recent, but where the in- 

 flammation is not very violent, I have often used the tannin, and ob- 

 tained excellent results, although the cure was less rapid. I have no 

 idea of claiming especial qualities and merits for tannin ; but I have 

 employed this article much more often than nitrate of silver, sulphate 

 of zinc, sugar of lead, and other astringents. I have never had occa- 

 sion to prescribe the strong solution of nitrate of silver (gr. x xv. to 

 j), for its effects can hardly be better than those obtained from tan- 

 nin, and since even its introducers admit that it sometimes causes 

 severe and even. violent symptoms, such as I have never seen in my 

 treatment. When the inflammation is very severe, it is well to wait 

 for its abatement before resorting to injections. A restricted but not 

 over-restricted diet and a strong cathartic of calomel and jalap aro 

 "~ also advisable in such cases. The customary prescription of milk oi 

 almonds makes the patient unnecessarily conspicuous, without being 

 of the slightest benefit to him. When there is extreme tenderness to 

 pressure along the urethra, but only then, we should apply from ten to 

 fifteen leeches to the perinaeum. Cold applications are also service- 

 able ; but, to do good, they must be kept up continuously. Cold com- 

 presses must be changed industriously, or the patient must be allowed 

 to sit for a long time in a sitz-bath. Compresses which are allowed to 

 remain until they grow warm, and sitz-baths continued for a short 

 period only, merely increase the tendency to erection, and aggravate 



