GONORRHOEA. 



flaps and tliancrcs together ; 'but, in our opinion, it 'is moft 

 rational to impute the fovt-s to the application of venereal 

 pus from chancres, together with the gonorrhoeal matter, 

 at the time of coition. We liave no doubt that this aft is 

 often performed, when, between the two parties, both kinds 

 of infetlion are prefent. 



Certainly it feems extraordinary, that if the virus he of 

 the fame nature in both cafes, tiie two Mj&s (liould not always 

 occur in the fame patient. We ought naturally to expedt, 

 that when a gonorrhoea makes its appearance firil, it would 

 always be tlie caufe of a chancre ; and that when a chancre 

 is the firll fymptom, it would invariably be the occafion of 

 ffonorrhcra. We difmifs from prefent confideration the 

 aifertion of fuch writers as defend the identity of the virus, 

 that, in fomc few inftances, one malady docs become the 

 caufe of the other. Mr. Hunter fufpefted, that the irrita- 

 tion of one of the parts, forming the feats of the two dif- 

 eafes, became the prcfervative of the other. He thought, 

 that when the urethra inflames and difcharges matter, the 

 adjacent external parts might, on that very account, be 

 exempt from a difeafe which thty would othtrwife inevitably 

 contraft, by reafon of the effeft of the very virus which, 

 crave rife to the gonorrhoea. The fame celebrated writer 

 alfo »ntertained a fufpicion, that when a chancre attacks 

 the glans, or prepuce, the urethra might become infufccp- 

 tible of the irritation, which, without the external difeale, 

 would certainly' lead to a difcharge from that canal. 



This mode of explanation appears to us fomewhat theore- 

 tical. We are of opinion, alfo, that in arguing in this way, 

 the advocates for the identity of the virus only bring for- 

 ward the (hadow, initead of the fubftancc of reafon. In faft, 

 they fay nothing more than that fuppofed venereal matter 

 cannot make the external parts of the penis ulcerate, becaufc 

 there is an irritatiou in the urethra ; and that the urethra 

 eannot be affedted with gonorrhoea, becaufe a chancre already 

 occupies the external parts. If this reafoning be not hypo- 

 thetical and fanciful, we cannot conceive what arguments 

 can ever be confidered fo. They who talk in this manner, 

 inadvertently fall into difficulties, and make one opinion 

 inconfiftent with another. Thus, they have already told us, 

 that, OGcafionally, a chancre is apt to occur, when patients 

 witli gonorrhoea negleiit to keep the glans and prepuce 

 clean ; yet, according to their principles, a clap renders the 

 external parts infufceptible of infeftion, and, of courfe, 

 there would be no need of cleanlinefs as a prcfervative. We 

 think that the wcaknefs of the argument muft be obvious to 

 the youngeft ftudent, who, on his entrance into any venereal 

 ward of an hofpital, is almoll fure of immediately finding a 

 patient who has at the fame time both chancres and go- 

 Dorrhcca. 



The different treatment required by gonorrho:?a and the 

 venereal difeafe, is another argument againfl the identity of 

 the virus, mercury, being unnecefTary in claps, and the fole 

 fpecific in the other complaint. The partifans of the oppo- 

 ftte opinion endeavour to diminifh the force of this fail, by 

 adverting to the different ways in which the two difeafes 

 nff-ct the parts wiiich are attacked, and by maintaining tJiat 

 BO iull inference can be drawn from the diflerence of treat- 

 ment, while the particular adlion of mercury, on various 

 parts affefted witii the venereal poifon, is not underftood. 

 They alfo contend that, though mercury may have no cflecl 

 in gononhaa, when ufcd in the fame way as for other vene- 

 real affetftion-;, yet, when applied to the urethra itfelf, it 

 fervcs 10 n.od;'rate the fymptoms, and accelerate the cure. 



Having feen the calomel injeftion employed in fome hun- 

 dreds of cafes, with lefs benefit than the comntpn vitriolic 

 one, we cannot atfent to the laft obfervat»on. I'he other 



remarks, being bare opinions, may be received or not, as 

 the judgment of the reader may incline Inm ; but, for our 

 own part, we have no hofitation in rcfufing them a place 

 among fuch information as is founded on rational evidence. 

 We fliall now fay a few words, refpefting the time, be- 

 tween the application of the infeftion and the beginning of 

 its effefts. 



In the greater number of difeafes, a certain fpace of time 

 always elapfes betvceen the application of the caufe and tlie- 

 firll ap))earance of the efFeft. The time when a gonorrhoea 

 begins, after contamination, varies confiderably in different 

 cafes. In fome examples, the poifon takes effeft in a few 

 hours, as Mr. Hunter has feen two or three times; while, 

 in other inllances, the complaint does not (hew itfelf till the 

 end of five or fix weeks. There are alfo cafes to be met 

 with, in which the diforder begins at all the intermediate 

 periods. It is calculated, that the moft common time of 

 its origin is in the fpace between the iixth and twelfth day. 

 In one inftance, in which the malady did not commence till 

 the end of fix weeks, it was noticed by Mr. Hunter, that 

 the afFeftion was preceded by various iyniptoms of irrita- 

 tion, and uncommon fenfation, in the parts. Hence, this 

 celebrated autlior concluded, that the virus icldom, or never, 

 remains io long inaftive; but that the inflammatory ftaJe 

 may exiil a good while before fuppuration takes place. 

 The delay in the cosnnieuceinent of the difcharge, however, 

 ntfy be owing to caufe.'i v.hich are not underflood, and this- 

 is very likely to be true, if we confider that fome cafes of 

 gonorrhoea do not begin for five or fix weeks after infeftion, 

 and yet are not preceded by any remarkable fymptom what- 

 ioever. 



The obfervations already made in a preceding part of this 

 article, mull have apprized the reader, that difcharges from 

 the urethra may originate from more caufes than one, and 

 frotn more irritations than that which is produced by one 

 particular kind of virus. There are fometimes fpontaneous 

 difcharges from this pafTage, while no immediate caufe what- 

 ever is affignable. Such inftances as occur independently 

 of a fpecific gonorrhoeal, or, according to the Hunteriaii 

 doftrine, the venereal virus, have been termedjimpli: or lie- 

 vign. Some affert, that thefe cafes may be known by their 

 coming on immediately after coition, and it is violent from the 

 very beginning ; while the virulent gonorrhoea docs not com- 

 mence till after fome days, and grows gradually worfe. 

 However, this criterion is infufficient: fimple genorrhceas 

 are not always owing to coition, nor are they always fudden 

 in their appearance. 



Mr. Hunter has feen the urethra fympathize with the 

 gums in dentition, and all the fymptoms of gonorrhoea affeft 

 the fame infant feveral times. The author of the article 

 Gonci'ihie, in the Encyclopedic Mcthodique, alfo mentions 

 his having feen two female children, v«lio were aflefted 

 during dentition with a difcharge from the pudenda, attend- 

 ed by a certain degree of inflammation, and pain in making 

 water. 



We (hall next introduce a few remarks on the effeft of 

 the difcharge on the parts producing it. 



It was formerly not <*n uncommon opinion, that the dif- 

 charge was a means employed by nature tor carrying off the 

 virus occafioning the- complaint, and thus bringing about a 

 cure. However, it is impoflible for this to be true, v.-itli 

 refpeft to inflammations, which arife from a fpecific virus; 

 for, fnppofmg the fuppuration could wafh away all the 

 poifon, caufing the original irritation, yet, as all the mat- 

 ter afterwards fccreted is equally virulent, no good would 

 be done; the irritation, according to the precednig idea, 

 would Le perpetuated, and, of courfe, the difcharge. This 



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