GONORRHCEA. 



all occurrence, ho\^-ever, we need hardly remark, is not 

 ;i o cafe. The afFeftion of the urethra in gonorrhoea is not 

 ki-pt up hy the matter, but by tiie fpecitic quality of the 

 uillammation itfelf, wliich, in all probability, can never con- 

 tinue beyond a limited time, fince the fymptom.s at length 

 fpontaneouny fubfide. Had the infetiious matter, which is 

 lornied in the courteof the dii'eafe, the power of protracting 

 the original irritation, the difurder would have no termina- 

 tion. 



In gonorrhoea, as in many other difeafcs, the morbid 

 action of the parts aFFefted cannot go on for a long while in 

 the fame way. After having increafed in violence to a cer- 

 tain degree, it naturally tends to become w;eakcr; and the 

 lymptoms of the diforder which depend upon fucli aclion, 

 at length, entirely ceafe. The time of this o ffation will 

 vary according to circumllances; for if the irritated parts 

 be very fufceptible of the fpecific irritation, the difeafad 

 action muft be more violent and lading; but, in all cafes, 

 this difierence is always owing to fome particularity of con- 

 lUtution, and not to any peculiarity of the virus. 



Tlie reader is aware that Mr. John Hunter regarded the 

 gonorrhoea as one form of the venereal difeafe. It was the 

 opinion of this diillnguifhcd man, that the venereal difeafe 

 was only capable oi a natural celfation, when it occupied a 

 fecreting furface, from which it produced pus. He be- 

 lieved that when the part attacked was not a fecreting one, 

 aad iw. ulcer was formed, the difeafe would of itfelf go on 

 t^)r ever. He referred this difference between gonorrhoea 

 and a chancre, however, more to the difference in the mode 

 of aftion, than to that of the affeded furfaces; f(;r when 

 the venereal virus produces an ulcer upon a fecreting fur- 

 face, as it fometimes does upon the tonfds, and even the 

 urethra itfelf, luch fores are not more diipofed to heal, 

 than if they were fituated any where elfe in the body. 



It is fometimes obferved, in cafes of gonorrhixa, that the 

 parts which were firll irritated get well, while the irrita- 

 tion is communicated to auotlier part of the fame furface, 

 as happens, when it leaves the urethra near the glans, and 

 affecls that part of the canal which is further on towards 

 the bladder. 



Admitting that every gonorrhoea is capable of getting 

 well, without iurgicai aliiltance, it may be doubted wiiether 

 a perfon, who already has a gonorrhoea, is fufceptible of 

 the irritation of frelh gonorrhocal mattei", or that the clap 

 which exills could be augmented by its application. Mr. 

 Hunter extended the fame obfervation to every form of the 

 venereal difeafe ; and he ftates, that the matter of gonor- 

 rhoea, or of a chancre, put on an ulcerated bubo, does not 

 in the leaft retard the cure, although, if venereal matter be 

 applied to a common for^, the venereal irritation will fre- 

 ouently be excited. Such fafts are ftrongly in favour of 

 the opinion, that the matter of gonorrhoea has no etfeft in 

 keeping up the complaint. The urethra is neither irritated 

 by the infectious matter which it fecretes, nor can the irri- 

 tation already exifling lail beyond a certain period. Even 

 were frelli matter applied to the urethra, the complaint 

 wuuld probably get well with equal quicknefs. 



Mr. Hunter extended the idea further, and even con- 

 ceived that a frcfh gonorrhoea could not be contracted, 

 w-re frefli virus applied to the parts affefted, at the period 

 v>hen the cure was juil on the point of being completed. 

 He thuught that, in time, the parts might be lo habituated 

 to the impredjon of the virus, as to become infenhble of it, 

 aiid i.hey muft have regained their natural and original itate, 

 tfe the iufeitiou can again have fuch effcf^ upon them as to 

 r-;>roduee the compliant. 



The foregoing opinions do not reft altogether uporf ' 

 theory : they are alio founded on experience and obfer>-a^ 

 tion. Men, who have jull had a gonorrhoea, have frequently 

 been known to expofe tiiemfelvcs to be infcfted again with- ' 

 out any recurrence of the complaint taking place, while 

 other iiealthy perfons, who had connexion with the fame 

 woman, have immediately caught the malady. Perhaps, it 

 is on the fame principle, that the firil gonorrhoea is generally 

 the moil violent, and that fuch perfons as are often af- 

 fefted with claps have them m.ore and more mildly, particu- 

 larly when the intervals are fhort. 



In corroboration of thefe fentiments, Mr. Hunter rdatcs 

 feveral cafes, among which is the following : a married 

 man, who, for feveral years, had had no connection uith 

 any woman except his own wife, happened to meet with ati 

 old acquaintance, who gave him a fevcre gonorrhoea, though 

 (lie declared her belief that fhe was quite well. Both 

 adopted fome means of cure ; but continued to cohabit to- 

 gether during the treatment. The man gut well, and it 

 was prefumed that the woman was alfo cured. Thev con-' 

 tinued to live together feveral munlhs, without tlit former 

 experiencing any inconvenience, or having anv reafon to 

 fuppofe that there was ilill any thing the miittcr with the 

 latter. At length they parted, and the woman formed a 

 new attachment. Slie had no fooner made this lall con- 

 nedlion, than ihe gave the new lover a gonorrha-a. She 

 again confulted ^ir. Hunter, whom (he alfured, that (he- 

 had never cohabited with any others, except the preceding 

 two ; and confequently, if this be true, the infection of 

 her lall lover mull have arifen from the very fame ic-' 

 norrhoca, of which (he fuppofed that (he had been for.ncrfy 

 cured. However, (he now uled no remedies, and the ir.ar," 

 after he was well, continued to cohabit with her for fevehil 

 months without receiving any new infection. But her old 

 lover now returning, after a year's abfence, and thinking 

 that, as file was living regularly with tiie fecond, there' 

 could be no danger, ventured to have connection with her ; 

 the coniequence was, that he caugiit another gonorrhoea. 



Before defcribing the treatment, it is prtiper to fay a 

 few words of the difeafe in women. 



The gonorrhoea in females is not fo complicated as in' 

 men, the parts affected being more fimple and fewer in 

 dumber. In women the difeafe is not fo eafy to be afccr- 

 tained, becaufe they are alfo liable to a cojnplaint, called ■ 

 the fluor albus, which Iras fome relemblance. A mere' 

 running from the parts is not fo much a pn^of of the ex- 

 illence of an infectious gonorrhoea in a woman, as a dif- 

 charge without pain in a man ; and in the former the difeafe 

 will often exill, while there is no increafe wh.ttever in the 

 natural fecretion from the parts. Nor can any criterion be 

 deduced from the kind of matter, (ince the difchtirge of 

 tlie fluor albus frequently puts on all the appearaices cf 

 gonorrhaal matter. Neither is pain, nor any peculiarity in 

 t(\e r-nfalions of tlie parts, neceffarily attendant upon the com- 

 plaint in women Mr. Hunter alfo remarks, that the appear- 

 ance of the parts often gives us but little information ; for 

 he frequcutly examined tliem in patients, who complained of 

 all the ufual fymptoms, fuch as an increafed difclargv, p.iin 

 in maicing water, iorenefs, &c. and yet he could perceive no 

 difierence- in the look of the parts and of fuch as are quits' 

 healthy. When the patient was not confcious of any par- 

 ticul.ir fymptoms, or was difpofed to conceal her kT.ow. 

 ledge of them, Mr. Hunter thought that fon-.e judg- 

 ment might be formed from her having had connection 

 with men fuppofed to be ur.four.d, and from her power 

 of communicating the difeafe to others. However, it is 



actcncwledjed, " 



