G O N O R R H CE A. 



Jiquar, and the fccretion which takes place from the hniiig 

 of this canal, and is intended for its lubrication, alfo becomes 

 Icfs tranfparent. At length both thefe fluids, becoming 

 thicker and thicker, gradually affume more and more the 

 qualities of pus. The difcharge often undt-rgoes an altera- 

 tion in its coloiu- and confiftence, a circumllance which Mr. 



but yet it differs alfo'from the latter affeftion in maiijr 

 refpefts. It does not excite any puliatory fenfation ; it 

 caufes little pain, except what arifes from the irritation of 

 the urine and the tenlion of the parts ; and tlie inflammatory 

 irritation feldom extends beyond the aft'efted iurfaces. Tiie 

 rcafonof fo large a quantity of pus being lecreted, in confe- 



Hunter imputed to the difpol'ition of tlie parts by which quence of fo moderate an inflammation, has been attributed 



tfie matter is formed. Sometim.cs it is white, fometimes yellow, '■ '' '- '--■-- -r— '— — "-- <■- - '- -'■- ••■ — 



fometimes of a greenifli colour. Such varieties depend upon 

 the diminution, or increafe of the inflammation, and not upon 

 the poifonous quality of the matter ; for the fan:e appear- 

 ances happen whenever tlie parts are irritated in a certain 

 de-^ree .by any caufe whatfoever, as feveral fadls confirm. 

 Dr. Swediaur injefted into his urethra fome cauftic volatile 

 alkali mixed with water, by way of experiment. The 

 ufual fymptoms of a gonorrhosa enfued, together with a dif- 

 charge which had the fame appearances and alterations of 

 •colour, as the matter of the gonorrhaa virulenta. We ha-,e 



to the parts being fuch as naturally fecrete, fo that they 

 readily alter the natural into a morbid fecretion. 



Although the inflammation of a gonorrhoea is commonly 

 moderate, there are inllanccs in which it is exceedingly 

 fevere, and extends into the reticular textui-e of the fur- 

 rounding corpus fpongiofum urethrx, particularly of that 

 which is near the glans penis. Sometimes the inflammatioii 

 advances further along the corpus fpongiofum, and occafions 

 a fwelling, or extravaiation of coagulating lymph, which is 

 the caufe of chordee. We have already ftated that the in- 

 flammation occafionally gives rife to abfcefles of the glands 



already fl;ated that the fame circumilances mofl: frequently of the urethra, particularly of thofe in the perineum 

 attend the employraent ot bougies. 



In the generality of iiiftances, the difcharge does not 

 pi-oceedfrom any great extent of the urethra, not from more 

 than an inch, or an inch and a half of that part of the paf- 

 fage, which is nearcft the orifice in the glans penis. This 

 diilance Was what Mr. Hunter ufed to name the fpecific ex- 

 tent of the inflammation. Before tiiis celebrated furgeon 

 flouriflied, it wa? commonly fuppofed, that the matter came 

 from the whole of the urethra, and even from Cowper's 

 o-lands, the proftate, and the veficula feminales. Due at- 

 tention to the fymptoms, however, makes this idea feem 

 quite improbable. If, for example, every part of the ure- 

 thra, bevond the bulb, or if the bulb itftlf contributed to 

 the difcliarge, the matter would be propelled out of the 

 palTao-e in th.e fame manner as the fenicn, that is to fay, by 

 ;i fudllen convulfive kind of aftion. It is well known that 

 nolhincr can lodge in the bulb of the urethra, without immc 



It is not decidedly known in what manner the difeafe com- 

 municates itfelf to the uretlira. Seme fuppofe that the in- 

 flammation creeps from the glans penis to the edges of the 

 orifice of the urethra, and thence furtiier into the paffage. 

 Thefe reafoners will not allow the probability of a common 

 opinion, that fdine of the infeftious matter gets into the 

 urethra at the time of coition. At all events it feems clear, 

 that none of the contaminating fluid can get as far as the 

 diieafe extends in ordinary intiances, much kfs in others, 

 where the affection reaches a great way towards the bladder. 

 There are fcjme fafts which tend to prove that the fimple 

 application of the infedtious matter to the end of the penis 

 may give rife to a gonorrhixa. A cafe related by Mr. 

 Hunter in his treatife on the venereal difeafe, feems to con- 

 firm the truth of what we have mentioned. 



As wc have already obferved, the complaint feldom extends 

 further along the urethra, than abota an inch and a half, or 



diately putting that part of the canal into aftion, particularly two inches. Mr. Hunter t'lought, that this part of the ca- 

 when in a (late of irritation and inflammation. A drop of nal appeared 



urine is not allowed to remain there, and if fimple warm 

 ■water be injefted thus far, it is inftantly forced out by the 

 adion of tlie accelcratores urinte mufcles. Therefore it 

 Seems rational to conclude, that if the membranous and 

 bulbous parts of the urethra, Cowper's glands, the proftate, 

 and the veficuls feminales, all had a (hare in forming the 

 matter, no Iconer would a certain quantity have collected in 

 the bulb, than an immediate expulfion would be occafioncd 



to be mod fufceptible of the particular kind of 

 inflammation brought on by the iiifed'tion, and it conftitutcd, 

 what he ufed to term, the fpecinc diihince of the diforuer. 

 However, neither the fcnfations of which the patient com- 

 plains, nor the irritation of the parte, are confined to the real 

 feat of the difeafe. The neighbouring parts are often affected 

 with a variety of fymptoms, of a nature more or lei's fevere, 

 fuch as uneafinefs, and even pains every wliere about the pubcs, 

 fcrotum, perinasum, anus, and hips. It is often necefl'ary 



by the mufcles of the part. No fymptom of this kind, to fufpend the tefticles, which become fo irritable, that tlie 



however, is ufually obferved, although it occafionally hap 

 pens, that the accelcratores urinx are afl^eCled with fpal.modic 

 contraftions, which are particularly difpofed to occur juft 

 "after the patient has been making water, and do not feem to 

 have any dependance on the difcharge. 



Mr. Hunter has taken notice tiiat when the inflammation 

 J6 violent, I'ome of the vcflels of the uvc-thra often give way, 

 l-fence a hemorrhage arifes, which is molt profufe, juft sfter 

 the patient makes water, though it alfo continues at ether 

 times. Sometimes the blood is inconfidernble in quantity, 

 andonly jull fufficient to give a red colour to the matter. 

 The eredtions, which are ib frcq^^£nt in thii complaint, are 

 iipt tooccafionan extravafation ufulood, a fymptom which 

 is always attended with an increafe of the,^paiii felt at the 



p. leaft accident, or exertion, which, in other circumflances, 

 would have no effeft, makes them fwcll. It frequently hap- 

 pens that the glands in the groin nif fympathctically aileCl- 

 ed ; they fwell and inflame, though thcy du not commonly 

 fuppurate. Cafes alfo occur in wliicli the irritation extendi 

 to the buttocks, thighs, and abdominal mufcle.';, occafion- 

 ing acute pain, fwelling, and extreme forvnefs of the parts, 

 and putting the patient under the nceeflltv of always con- 

 tinuing in an horizontal pofture. Thefe fymptoms, how- 

 ever, are not ftriClly intiammatory : if the patic-nt be bled, 

 his blood does not exhibit the inflammatory cruft, and the 

 ConlHtution is little or not at all afFettcd. 



M'hen the *cafe, independently of the affedtions ariung 

 from fympathy, b not mprc violent than wliat has been 



time of making water ; but the bleeding' ahvays in the end deftribed, it is called a common gonoiThoea ; but the vio- 



leftens the inflammation, and tcnda to the relipf of the leoce of the efTentiai fymptoms of the difeafe will be moifl 



•patient. _ . °'' ^^^^ confiderable, according as the patient is more or lef» 



. The inflammation, accompanying a gonorrhcca, is attended fufceptible of fuch t-omplaints as de]!cnd upon irritation, 



with feveral of the charnfters of common inflammation ; Thu?, in particular liabits, the inflammation does not con^ 



JlilC 



