GONORRHOEA. 97 



ss., bals. copaibae 3 ij, cera alba q. s. u. f. pil. 120. About three 

 boxes of such pills will be required; ten of the pills to 'be taken at 

 first three times a day, and afterward four times a day. The gelatine 

 capsules, containing extract of cubebs and balsam of copaiba in com- 

 bination, are also to be recommended. If there should be a diarrhoea, 

 with severe scalding pain about the anus, or if an eruption spots of 

 roseola appear upon the face and body (which is not uncommon), the 

 use of the medicine must be suspended. 



The results of treatment in a recent gonorrhoea are most satisfac- 

 tory ; that of an old inveterate gleet, however, is quite the reverse, 

 and the longer it has lasted so much the worse will the prognosis be. 

 Before all else, we must satisfy ourselves, by the introduction of a 

 catheter, as to the existence or non-existence of an urethral stricture. 

 When there is such a stricture, the inflammation often lurks just be- 

 hind it, and no benefit is to be expected from the use of injections 

 which cannot well reach the affected point, until the stricture has been 

 relieved by the use of bougies. Where there is no stricture, or where 

 the existing stricture has been dilated, we should inject a strong solu- 

 tion of tannin or of nitrate of silver, and, when this fails, should intro- 

 duce a sound, smeared with an ointment of lunar caustic, into the ure- 

 thra. Guthrie's unguent, opthalmicum magicum may also be employed 

 (arg. nit. gr. ij g. x, ung. cetacei 3 j, liq. plumb, gtt. xv.) 



The haemorrhage which sometimes occurs during gonorrhoea scarcely 

 ever requires particular attention. If it be exceptionally profuse, we 

 may apply cold, or endeavor to stanch the bleeding by compression 

 of the point whence it proceeds. In order to prevent the painful erec- 

 tions which occur chiefly during the night, the patient should eat but 

 very little food toward evening, and, above all, should avoid drinking. 

 If, nevertheless, his rest be disturbed, and if the customary popular 

 remedies fail of effect (such as walking barefoot about the room or 

 jumping from a chair), we may give a Dover's powder in the evening. 

 I have no personal experience of the effect of lupuline, which has also 

 been recommended. If chordee develop, apply leeches (but rather to 

 the perinaeum than to the penis), and give an opiate at night. Ab 

 scesses forming in the urethra require poultices, and the prompt punc- 

 ture of any fluctuating point. Upon the first signs of inflammation of 

 the prostate, apply a large number of leeches to the perinaeum, and, 

 after the leeches have fallen off, encourage the bites to bleed, by the 

 application of hot stupes. Sometimes the leeching has to be repeated. 

 Internally give calomel with opium, in divided doses. Whether this 

 last prescription really be of service I do not venture to say. The 

 catheter is never to be applied without the utmost caution, and in 

 some cases it must be laid aside altogether for a while. If the 



