Manual of surgery / by Alexis Thomson and Alexander Miles.

  • Thomson, Alexis, 1863-1924
Date:
1904
Catalogue details

Licence: Public Domain Mark

Credit: Manual of surgery / by Alexis Thomson and Alexander Miles. Source: Wellcome Collection.

    655/764 (page 635)
    GONORRHEA. 63% erections—chordee—the pain being due to the infiltration and want of elasticity in the corpus spongiosum. The acute symptoms usually last for about ten days, after which they subside, but the purulent discharge from the urethra usually continues for a period of from five to eight weeks from its first appearance. It then becomes thinner and more watery, is perhaps only seen in the morning, until finally it ceases altogether ; or it may persist indefinitely as a mucoid, milky discharge known as gleet. It is difficult to say in what proportion of cases the infection spreads to the posterior urethra. It probably occurs only in the minority, and is sometimes due to unskilful injections made by the patient himself. When the posterior urethra is involved during the acute stage of a gonorrhoea, the discharge often diminishes in amount. There is a feeling of distension and weight in the perineum, increased frequency of micturition, the last few drops of urime cause pain and may be tinged with blood, and erections are distressing. If the urine be passed into two glasses both portions are cloudy and contain shreds of mucus and pus, whereas in urethritis confined to the anterior urethra the second portion is clear. The patient must be warned of the infective character of the discharge, and especially of the danger of carrying the infection to the conjunctiva. All contaminated dressings should at once be destroyed by burning. Treatment.—The patient should keep quiet, and if possible stay in bed during the first week or ten days. If this is not feasible, the scrotum and penis should be supported by a pad of wool held in position by bathing drawers. The bowels should be opened every day by saline laxatives, and the patient should drink as much diluent fluid as he possibly can,—for example, soda water, barley water, etc.,not only to render the urine bland, but mechanically to flush out the urethra. The diet should be as light as possible; red meats, spices, coffee, asparagus, and all forms of alcohol are forbidden. Pain during micturition is relieved if the patient immerse the penis in hot water during the act. Chordee may be prevented by large doses of bromides or trional, and by elevating the foot of the bed. Medicines given by the mouth, with the object of being excreted in the urine and acting on the inflamed urethra, such as sandal- wood oil or cubebs, are of little, if any, value, and they tend to upset the stomach. Local Treatment.—Difference of opinion exists as to whether or not local treatment should be employed at all, and if