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| Gonococcal Infection |
[Jahr’s remarks on the treatment of gonorrhoea are undoubtedly judicious, and the remedies he proposes for the treatment of this disease may be sufficient in a large number of cases. Nevertheless, a few additional remarks may not be out of place.
If the testicles, one or both, should be much swollen and inflamed, it will be found necessary to wear a suspensory bandage for the purpose of alleviating the pain caused by the dragging weight. At the same time the patient should remain in a state of perfect rest until the inflammation is removed.
If a sudden suppression of the discharge, consequent upon exposure to wet, a draught of air, etc., or occasioned by violently astringent injections, should result in violent inflammation of the urethra and neck of the bladder, or the bladder itself-accompanied by excruciating burning pain and an agonizing dysuria or ischuria, violent chills and fever, discharge of blood from the urethra-it will be found necessary to give Aconite, of which, in all such cases, I mix a few drops of the tincture in half a tumbler of water, giving a desert-spoonful of this solution every five or ten minutes until the pain is relieved. Some practitioners, among others Yeldham, in his “Homoeopathy in Venereal Diseases,” propose to alternate Aconite with Cantharides. I prefer giving each remedy by itself: Aconite as long as it is specifically indicated, and, if necessary, follow it up with Cantharides, if this agent seem to be specifically indicated by such symptoms as violent priapism, agonizing chordee, delirium, etc.
I have not the heart to give Copaiva and Cubebs the go-by, as Jahr and other Homoeopathic physicians are in the habit of doing. Any one who will consult the second edition of my Materia Medica, will find that both Copaiva and Cubebs produce a discharge from the urethra, which, in addition to the other symptoms accompanying the discharge, would seem to justify the inference that these agents must be possessed of powerful curative virtues in gonorrhoea. But they must not be given in small doses. Copaiva is evidently adapted to the primary or acute, and Cubebs rather to a chronic form of the disease, or to gleetish discharges with simple burning and a slightly increased desire to void the bladder. If used in the acute stage, Copaiva need not be given in larger doses than ten or twelve drops three or four times a day; when the inflammatory symptoms have subsided with a whitish discharge remains, with more or less burning, urging to urinate, etc., I give larger doses, adapting their size to the tone of the patient’s stomach. This method frequently leads to a cure, and as frequently, perhaps, leaves us in the lurch. In such cases other remedies have to be chosen. If Ricord’s opinion that Copaiva does not act dynamically, but by virtue of a mechanical contact with the urethral lining membrane, is correct-it is evident that Copaiva, if given at all, should be given in large doses. A very convenient mode of administering the balsam is the frequent introduction into the urethra of a bougie smeared with Copaiva.
In the Report of the Medical Statistics of the United States Army Assistant-Surgeon Hammond, in his report on the diseases of Socorro, New Mexico, mentions a new remedy for gonorrhoea, the Exhedra occidentalis, called by the natives popilote. The taste is terebinthinate and astringent, yet agreeable. It is a stimulant diuretic, and does not constipate the bowels. It is prepared for use by macerating two ounces of the branches, cut into small pieces, in a pint of hot water, in a close vessel, for three hours, and then straining. A pint of the infusion may be drunk during the day. It acts with surprising promptness, and is an efficient and valuable medicine. The shrub is an evergreen, and grows in great profusion throughout the country.
In the first volume of the North American Journal of Homoeopathy we find the Nitrate of potash recommended by Dr. J. S. Henry, of Montgomery, Ala., for gonorrhoea. He prescribes one grain three times a day, with a little sugar of milk; sometimes he gives ten grains three times a day. Recent cases yield in a week; old cases in two or three weeks.
Professor Hale, in his work entitled “New Remedies,” has added the following to the list of those that homoeopathic physicians have been in the habit of employing in this disease:
Alnus rubra, or tag alder, recommended by Lee.
Asclepias incarnata, or swamp milkweed. Dr. Hauser recommends it strongly for gonorrhoea and syphilis. He gives a table-spoonful of the tincture three times a day, before breakfast, dinner, and supper. [See Tilden’s Journal of Materia Medica, Vol. 1. page 41. ]
Asclepias syriaca, Silkweed. It has long been in use among the Negroes of the South for gleet, gonorrhoea, scrofula, etc. The most usual mode of administration is in powder or infusion, the latter made with water and whiskey. Old cases of gleet, of many years’ standing, have been reported cured, after other medicines had failed, by taking a wine-glassful of an infusion of the fresh root, three times a day, before meals.
Chimaphila, pipsissewa, and Caulophyllum, blue cohosh; our experience in the use of these agents is limited.
Erigeron canadense, Canada flea-bane. Recommended by Coe. “It allays the scalding of the urine, and assists materially in cutting short the disease.”
Eryngium aquaticum, button snakeroot. “Two ounces of the pulverized root, in doses of two or three grains, have effected cures in obstinate cases of gonorrhoea and gleet.”
Gelsemium sempervirens, yellow jessamine. A case of cure is reported at page 448 of Hale’s “New Remedies.”
Hydrastis canadensis, golden seal. Dr. Brown cured a case of gonorrhoea with five-drop doses of a saturated tincture three times a day. It is also used as an injection.
Phosphorus, Dr. Meyer of Leipzic reports a case of secondary gonorrhoea, complicated with hypertrophy of the prostate gland, which was cured by the persistent use of this agent in the space of seventy-one days. Both the discharge and the hypertrophy yielded perfectly to the treatment instituted.
Aloes. Dr. Gamberine, of Bologna, treats gonorrhoea very successfully with injections of dilated tincture of aloes. His formula is as follows:
Aloes, 4 drachms;
Water, 4 ounces.
He injects the urethra three times a day.
In the twenty-third volume of the British Journal two new remedies are recommended for gonorrhoea by Dr. Thomas B. Henderson; one of them is obtained from the wood of the tree, Sirium myrtifolium. Dr. O’Shaughnessy writes: “Sandal wood, in powder, is given by the native physicians in ardent remitting fevers. With milk it is also prescribed in gonorrhoea.” The other remedy is the Gurjun or Gurgina balsam, or wood oil. It is the product of the Dipterocorpus turbinatus, an immense tree growing in different parts of India. Thomas recommends both medicines very highly. [See British Journal.]
Regarding injections, it may be said that opinions among homoeopathic practitioners are divided. Some reject the use of injections entirely, others resort to them even to the extent of adopting the French “abortive plan.” I have known this plan to succeed to the perfect satisfaction of both the physician and the patient. Sometimes the gonorrhoeal inflammation is cured upon the principle of Trousseau’s method of substitution; the nitrate of silver inflammation being substituted in place of the gonorrhoeal inflammation. The former, running a definite course, carries off the disease, leaving at most a weakness of the urethral lining membrane, which is afterwards removed by the use of tonic astringents, such as tannin, a solution of quinine, the sulphate of zinc, the sub-acetate of lead, hydrastis canadensis, etc. An excellent agent to inject is the sulphate of hydrastin, which may, at the same time, be administered internally. In all cases where a gleetish discharge remains, more especially in debilitated and cachectic individuals, mild astringent injections, like those mentioned, may be of great use. Even cold water injections may prove expedient and beneficial. The injection-syringe should be provided with a long nozzle that should be well inserted in the urethra. The liquid injected has to be retained in the urethra for several minutes. For this purpose the penis has to be held in a horizontal position, and, at the same time, compressed between the thumb and index finger of the left hand, while the syringe is drawn out with the right. Injections, if they prove suitable and beneficial, may be repeated three or four times in the twenty-four hours.
The muriate of iron is likewise useful in this stage, both in the form of an injection and by the mouth. Internally I give ten to twelve drops in water three times a day, and when used as an injection, mix fifteen to twenty drops to an ounce of water.
In the ninth volume of the North American Journal of Homoeopathy, the late Dr. J. C. Peterson, of St. John’s N. B. publishes an interesting article on gonorrhoea, where he recommends the following injections of the chloride of zinc during the initial stage of the disease: Three drops of the liquor chloride-zinc to eight ounces of water. Before the patient uses the injection he is directed to void his urine, after which half a drachm of solution is thrown up the urethra, and retained until it produces a smarting sensation; the liquid is then allowed to escape, and is followed in a few minutes with an injection of cold water. In the third stage, when all inflammatory action has ceased, he uses injection of the nitrate of silver, chloride of zinc, or the acid nitrate of mercury. In the fourth stage, or that of gleet, he uses injections of rose water and port wine, and of the iodide of iron; four ounces of the wine to two ounces of water; and two grains of the iodide of iron to six ounces of distilled water.
Peterson’s injection of chloride of zinc was first mentioned by Gaudriot. His formula is:
Liquid chloride of zinc, 24 to 36 drops.
Distilled water, 4 ounces.
Two injections a day, for two or three days, will generally suffice for a radical cure of gonorrhoea; the first injections are almost always followed by more or less swelling of the glans pains, but this does not contra indicate their continued use.
For gonorrhoea in females suppositories may be used composed of.
Liquid chloride of zinc, 5 drops,
Sulphate of morph., 1/2 grain,
Mix with 3 drachm of paste made
of mucilage of gum-tragacanth, 6 parts,
Starch powder, 9 parts,
Powdered sugar. 6 parts,
Make into vaginal suppositories, one suppository every day, or every third day. Four or six in all will effect a cure; the first suppository generally causes a swelling, with more or less heat of the vulva, which soon subsides.
Thomas Evans, of London, uses very frequent and every weak injections of the sulphate of zinc, one grain to the ounces, to be still further reduced if pain is felt. They are simple but efficacious. He repeats them every half hour during the day. Slight cases are cured in twenty-four hours, severe cases in three or four days.
Velpeau prefers nitrate of silver to sulphate of zinc, one grain to the ounce; in old-standing cases two grains may be used.
Carmichæl prefers a quarter of a grain to one ounce of water; he seldom increases to one grain. He recommends three or four-injections a day.
Alum injections are used by Dr. H. Collins exclusively in all stages of gonorrhoea. In the most acute form the patient is directed to pour a small jug of cold water on the organ; and immediately inject a syringeful of alum solution one-half of a grain to an ounce of water. The first day the injection is to be repeated every half hour; at night as often as the patient wakes. In old cases the injection may be increased to one drachm of alum in eight ounces of water, three or four times a day. [See British Journal, vol. xxiv. page 183. ]
Injections of Merc. corr. and Arg. nitr. are used by some French physicians in quantities equivalent to our first or second centesimal attenuation. Many cases are reported by them as having been cured by these injections without the aid of any other remedial agents.
Gonorrhoeal ophthalmia, when resulting from metastasis, may have to be treated like any other severe inflammation of the eyes, with Aconite, Belladonna, Bryonia, Pulsatilla, etc., the specific treatment for gonorrhoea being continued all the while, if the gonorrhoeal discharge is not suppressed. For an interesting cure of such a case I refer the reader to page 275 and further, in the tenth volume of the British Journal of Homoeopathy.
An interesting cure of gonorrhoeal rheumatism is reported at page 23 of the fifteenth volume of the British Journal. It occurred in consequence of a gonorrhoeal discharge having been suppressed in three weeks by means of copaiva [? Ed.]. Soon afterwards he experienced a tearing pain in the left knee, with swelling and stiffness of the joint. The patient took the Schlangenbad, one of the Teplitz baths. The rheumatism left him entirely after the discharge had reappeared; it gradually ceased entirely.
Beside the sequelæ of gonorrhoea, mentioned by Jahr, we have “irritable bladder,” a most annoying symptom. In a case of irritable bladder, of several years standing, which had remained after a gonorrhoea treated allopathically with caustic injections, and where the patient was troubled with painful urging to urinate, the urine dribbling off in drops; and where quantities of mucus were discharged with the urine, and the patient complained of debility, loss of appetite, etc., we effected perfect relief by the persistent use of Copaiva and the tincture of Cinchona. Owing to circumstances, the patient mixed both ingredients in one bottle, in the proportion of one ounce of Copaiva to two ounces of Cinchona, of which preparation he took a teaspoonful three times a day. After using it for a week he considered himself cured.