G :0 N 11 R H CE A. 



acknawlcdgcd, that as this lad cii«umftance is derived from 

 the tcltinioii}- of another pcrfoii, thciv arc obvious rcafoiis 

 why it ihoulj not always be ti-ultcd. 



When a woman contradls.a gonorrlioca, the vagina muft he 

 firft ivttacked, a part which is not endued with confiderable 

 fenlibihty. Frequently, however, the complaint extends 

 much furtlier, producin^j difagreeable fenfations and fore- 

 ncfs of the inhde of the labia, nymphjc,, clitori?, carunculae 

 myrtiforracs, and meatus urinarius. The parts arc fome- 

 times fo fore that the patient cannot bear them to be touch- 

 ed ; flte can hardly walk ; and a great deal of pain is ex- 

 perienced when the urine comes into contaft with the fore 

 furfaees, as it muft unavoidably do as often as the bladder 

 is emptied. 



Wlien the difeafe extends to parts which are more fenfi- 

 ble than the vagina, and more fufceptible of inflammation, 

 women have nearly the fame fymptoms as men; a fulnefs 

 about the parts, a difcharge from the urethra, violent pain 

 in making water, and great uiieafmefs from the preffnre 

 on the parts in fitting. Sometimes tlie bladder is alfo 

 aifeilcd. 



The inflammation frequently extends to feme depth, run- 

 ning along the dufts of the glands, and afl'edting the glands 

 them.felves, fo as to occafion hard fwellings under tlie fur- 

 fiice of the infide of the labia. Thefe tumours often fuj)- 

 purate, and burll near the oritice of the vagina. They re- 

 tciuble the abfcefl^.'S in the glands of the urethra in men. 

 . The time in vihich a gonorrhoea may be cured is ex- 

 ceedingly variable, fome cafes terminating in a week, while 

 others continue for months under the fame treatment. 



According to Mr. Hunter, the objeft in the cure is to 

 dellroy the difpofition and fpeeifie mode of aftion in the 

 fijhds of the parts, and, as foon as that change is accom- 

 pliflied, the poifonous quality of tlie matter produced will 

 alfo be deftroyed. Thus the difeafe may be cured though 

 not always its confcquences. 



A gonorrhcca is not capable of being continued beyond 

 a ceVtain time in any conllitution, and when the com- 

 plaint is violent and lails a long while, it is owing to the 

 parts being very fufceptible of fuch irritation, and readily 

 retaining it. 



Since there is no fpeeifie medicine for the gonorrhcea, 

 it is very fortunate, as Mr. Hunter obferves, that time 

 alone will eiFeft a cure. This celebrated furgeon was in- 

 clined to think, that, in cafes of gonorrhoea, medicines 

 were fcldom of fervice, perhaps not more frequently 

 than once in ten inftances. With the idea, that every go- 

 norrhoea cures itfelf, he gave certaii. patients pills of bread, 

 which were taken with great regularity. Thefe perfons all 

 got well ; but Mr. Hunter thought that fome of them 

 were not cured quite fo ioon as they would have been, had 

 artificial means been employed. 



Tlie furgical methods of cure confift of internal remedies 

 and local applications; but in putting any plan of treatment 

 in execution, more attention Ihould always be paid to the 

 nature of "the confliitution, or to any attending difeafe in 

 the parts themlelves, or parts conncfted with them, than to 

 the riuming itftlf. 



The nature of the conllitution is principally to be judged 

 of from the local eiredls of the difeafe. Thefe are fo dif- 

 ferent in di.fercnt people as to require a great variety of 

 treatment, a circumllance, fays Mr. Hunter, which has 

 been too little attended to, every one endeavouring to at- 

 tack the immediate fymptoms, as if he had a fpeeifie for a 

 g.onorrhoea. 



Wearefirll to confider, whether the inflammation is vio- 



lent or mild, commoai or irritable. When the fymptoms 

 are violent, but of the common inflammatory kind, which 

 u to be j\idged of from the attending circumllances, and 

 particularly from the extent of the inflammation not ex- 

 ceeding the fpeeifie difl:ance, the local iipphcations may be 

 either of the irritating or foothing kind. In this ex- 

 ample, irritating applications may be lets dangerous, tljan 

 when die inflammation is of the irritable fort, and may have 

 the elfeA of altering the fpeeifie aclion, the parts after- 

 wards recovering of themfelves, as from any other com- 

 mon inflammation. Mr. Hunter, however, exprefii;s his 

 belief, that the foothing plan is the bett at the be- 

 ginning. 



When the inflammation is great, and of the irritable kind, 

 no violence -i to be ufed'in the treatment, as the fyihptems 

 would thus only be increafed. Mr. Hunter thought, indeed, 

 that there were fome cafes, which are exceptions to the lat- 

 ter remark, the great degree of inflammation ari/ing entirely 

 from a fufceptibility of this irritation, and not from any ge- 

 neral irritability in the conllitution. He confefles, how- 

 c\Tr, that fuch examples can feldom be difcriminated. 



When the fymptoms run very high, nothing fliould be 

 done to Hop the difcharge, as, were it to be checi^:ed, the 

 inflammation would ilill contuuie, and no good be cfFefted. 



Mr. Hunter recommends us to alter the confl:itution, if 

 poflible, by remedies adapted to each difpofition, with a 

 view to alter the aftions of the parts arifing from fuch dif- 

 pofitions, and reduce the difeafe to its fimple form. If the 

 confl:itution cannot be altered, we can only allow the adtion 

 to wear itfelf out. 



Wlien the inflammation has confidcrably abated, and the 

 difeafe only remains in a mild form, its cure may be at- 

 tempted either by internal remedies, or local applications. 

 If local means are ufcd, violence is ftill to be avoided, be- 

 caule it may bring back the irritation. At this period (con- 

 tinues Mr. Hunter% gentle afl;ringents may be applied witli 

 a profpedl of fuccefs ; or, if the difeafe has begun mildly, 

 and there are no figns of an inflammatory difpofition, either 

 of the common, or irritable kind, an irritating injcftion may 

 be ufed, in order to get rid of the fpeeifie mode of adlion 

 quickly. Such application will increafe the fymptoms for 

 a time ; but, when it is left off, they will frequently abate, 

 or wholly difappear. In fuch a ftate of parts, afliringents 

 may be ufcd : for the only thing to be done, is to procure 

 a ceffation of the difcharge, which is now the principal 

 fymptom. 



\Vhen the itching, pain, &c., are felt for fome time before 

 the dilcharge appears, Mr. Hunter rather prefers the foothing 

 to the irritating plan of treatment. He fufpefted, that thus 

 the coming out of the difcharge would be promoted, which 

 occurrence he conceived was the firft ftep towards a re- 

 folution of the irritation. He believed that, at all events, 

 in this cafe, the employment of aftriiigents would be 

 bad praflice, as, by preventing the difcharge from taking 

 place, they might prolong the inflammation, and protraft 

 the cure. Alf'), in cales of ftrlftures, and of difeafed tef. 

 ■ tides, he is adverfe to the ufe of aftriiigents; for, fays he, 

 while the difchai'ge lafts, both the other complaints are re- 

 lieved. 



The interna! remedies commonly recommended in a gonor- 

 rhcca, may be divided into evacuants and aftringents. The 

 evacuant.s (fays Mr. Hunter), are principally of the purga- 

 tive, or diuretic kind, and tliefe are not confined to any par- 

 licular ntedicines, every practitioner fujipofing that he is in 

 ]w..ll'effion of the heft. Sonje life mereurial evacuants ; 

 \s hilll others carefully avoid mercury in evej-y form. Tlie 



neutral 



