GONORRHCEA. 



'<ciitTal fait* have heeirgiven fi'om the idea of their heini- 

 cooling. Some of the profcfrion have cljipfly kept to diu- 

 retics, perhaps with two views ; firll, as evacuants aclirij^ 

 r.echaiiically upon the uri.-inry palTages, fo as to \va(h away 

 the matter ; fecondly, as fi>ecifics. For this purpofc, nitre 

 has been given, a modi<;ine wliieh has always been tliought to 

 i'.ave great effe£l in leiTening inflammation, though Mr. Hun- 

 ter had doubts concerning the truth of the opinion. Under 

 f very mode of treatment the patients always get well, and 

 the cures are afcribed by each practitioner to liis own 

 favourite method. 



Mr. Hunter remarks, tliat " to keep the body open in 

 mott cafes, even wlien the patient is in other refpcfts in 

 health, muft, no doubt, be proper ; but what idea can we 

 form of an irritation, produced all along the intcllinal canal, 

 caring a fpecific inflammation in the urethra ? Yet there are 

 cafes where a brill< purge has been of forvice, and even in 

 fjme has performed a cure. But I fufpeft, that, in fucli 

 cufes, the difcafe had been continued by habit only, and 

 tliat this practice would not liave fucceedcd in the beginning. 

 A gentleman had a gonorrhcca, all the fyniptoms of whicli 

 continued for two months, and by taking at once ten grains- 

 of calomel, wiiich purged him mod violently, h:; was almoil 

 immediately cured. The calomel could not have acled 

 fpscLfically, but by a kind of, derivation, that is, an irrita- 

 tion produced in ojie part, cared, one tliat fubfdlcd in an- 

 uiher ; but even if it fliould be gr.anted,.that in fome con- 

 ilitutioos purges, hrjve the pov.-er of making the folids lefs 

 fufceptible of this irritatioh, it cannot be fuppofed they will 

 have this effeft in every caf^ : in fome conltitutioas, they 

 might debilitate, increafe irritability, and of ccurfe'increafe 

 rhe fymptoms. Thefe contrary effefts muil take place in 

 different conftitutions, in wliich a medicine has no fpecilic 

 ailion. On the fuppofition of the euro being promoted by 

 an evacuation from the blood, v/hat fervice can purging 

 out fome -of the blood, in form of a fecretion from one part, 

 do to an inflammation of another part ? On fuch a fuppofi- 

 tion would not a fweat, or an increafe of faliva, by Cjhcvtfing 

 tobacco, or fl:irBulating the nofe by fnuff", all tend equally to 

 cure a gonorrhoea ? But humours having been confidered as 

 the univerial caufe of every difoafe, efpecially thofe in which 

 pus is fornied', or a difcharge produced, and purging having 

 been fuppofed to be the cure for humours, purgatives were 

 ' f courfe made ufe of in this difeafe ; and as the patients 

 ,ave always been cured, the practice became generally clta- 

 bli.licd. 



" Thofe who recommended mercury in this form of the dif- 

 oafe, did it moll probably from the opinion, that this medi- 

 cine was afpeciiic for the venereal difeafein all its forms. On 

 tins fuppcUtion, we can iee fome realon for their pra&ice, as 

 it would be abforbed from tlie intellines, circulate tlu-ough 

 the inflamed vefi^els of the urethra, and tliereby deftroy the 

 venereal irritation. Here we can only fuppofe it to ac"l 

 by its. fpeciiic virtue ; but I. doubt very much of mercury 

 having any fpeciflc virtue iu' this fpecies of difeafe ; for I 

 find, that it is as fcon cured without meix-ury as with it ; and 

 where- this medicine is.only ufcd as a purge, or purged off the 

 ne>;t day, ?.nd therefore allov.-ed to a6t merely upon the 

 bowels, I cannot conceive that it could have any more effeiil: 

 \ipon the venereal inflammation in the lu'ethra, than an irrita- 

 tion in the bowels arifrng from any other purgative. So little 

 eitetlj indeed, has this medicine upon a gonorrhoea, that I 

 have kinown a gonorrhoia take place while under a courfe of: 

 mercur.y fuiRcient for the cure of a chancre. Wliether the 

 gonorrlicsa arofe from the fame infection that produced the 

 chancre I cannot fay; nor can it be eahly determined ia- 

 Cweh cafes, ivlen Lave alfo been known to contract a. go- 



norrhcea when londtd witli morcuiy for the cure or a hnn 

 venerea ; the gonorrhcca, nevcrthelefs, has been as difficuU 

 of cure as in ordinary ca(c5." P. 72, &c. 



Witli refpedt to diuretics, confidered as evacuants, Mr. 

 Hunter obfervcs, tliat they may have the fame general re- 

 marks made on them as iia-vc been offered in regard to pur- 

 gatives. It is poffiblc, fays he, tliat fpecittc medicines, 

 taken into the conititution (if we liad fuch), ami pafling off 

 by tlse urine, might aCt upon the uretln-a in their paffagc- 

 through it. The balfams and turpentines paf» ofF in this 

 way, and become fpecifics for many irritations in the urinary 

 paifagcs ; but how far medicines wliicli have the power of 

 affe£ting particular parts when found, or when under difeafe* 

 peculiar to thofe parts, have alfo the powers of affecting a' 

 Ipcciiic irritation in them, Mr. Hunter was uncertain. H» 

 conceived, however, that they mii.;ht be capable of rcmoN-ing 

 any attending irritation, though not the fpecific one. He 

 thought, tliat diuretics did good inafmuch :is they increafcd 

 the quantity of urine ; but he believed limple 'water \va6 

 bell fortius purpofe, or water joined with fuch things as en- 

 cinuage the patient to drink a good deal, as with ten, capil- 

 lairc, orgeate, <xc. 



Alh-ingeuts have frequently been prefcribed, though \vith^ 

 out the approbation of the generality of regular i)ractiti- 

 oners. It was Mr. Hunter's opinion, that fuch mcdiciaw 

 did not leffen the inflammation, but that they oflen leffened 

 die difcharge. 



With regard to local applications, they may be either in- 

 ternal to the urethra, or external to the penis. In many' 

 cafes both kinds are proper. One would f.ippofc, that what 

 is ajjplied to the urethra, muft be the moll likely to eflect 

 a cure, by coming immediately into contaft with thedifeafed 

 parts. 



Local apphcations to the urethra may be cilh.er in a folid 

 or fluid form, each of which has its advantages and difadvan- 

 tages. A fluid, (fiiys Mr. Hunter) is only a teniporarj- ap- 

 plication, and that of very (hort duration. 



The folid applications may remiiin a long time, and. in 

 tlds refped, would fecm to be better than fltrid ones; but 

 in general they create irritation. They mull: be ufed in the 

 form of a bougie, which Mr. Hunter imagined vres com- 

 monly injurious, when the parts were in an inflamed llatc, 

 though he confeffep, that lie never faw anv harm from it it) 

 any cale, when employed with caution. 



Fluid applications to the infide of the uretljra are i:fval)y 

 called injcttions, and, like the internal remedies, are without 

 number. However, as the inflammation is fivquently re- 

 moved under the ufe of injections of various kinds, irtvr 

 we not, (as Mr. Hunter notices) a ibrong' cf rrcborstingcir- 

 cumihuicc in favour of an opinion, that ewry fuch complaint 

 will in time cure itfelf? This eminent furgeoii thought, 

 however, that praftice evinced, that sn inje^'rion often has 

 almoil an immediate effeft upon the fymptoms, and, therefore, 

 that it muit: have fome powere, tiiough the injeilion, which 

 v.ould have the greatcif fpecific effe(5f, he believed, was not. 

 yet known. If an injeftion has no fpecilic powers, it muft 

 be very uncertain in its effefts, and can only be of fcrrice as' 

 far as it may be adapted to a pecuharit)' of conlHtution, or 

 parts. As injections are only temporary applicrifion!!, it bp» 

 comes nccelfary to ufe them often, efpecially in cufcs where 

 they are found to be of fervice. They Oiou'd therefore be 

 applied as often as convenient, perhaps every honr, orcTen' 

 oftener; but Mr. Hunter adds, tirat this rnwll br rrguhted 

 i:i fome mcafure by the kind of njec'tion ; for, if it br irri- 

 tating, it will not'he proper to uf* it f* oft^,- as it maybe 

 productive of bad conf.-quenees-. 



The fame aatliar obferves, tliat- nwny iajeft'.ot* rcmo-»e- 

 4 the 



