-JAHR Georg Heinrich Gottlieb
As we have a venereal, contagious blennorrhoea, superinduced by venereal infection, and another form of blennorrhoea which is non-contagious, and may have been induced by irritating stimuli, so we have a so-called balanorrhoea or external gonorrhoea. The noncontagious form, which frequently befalls individuals who do not keep themselves clean, or where prepuce is very long and narrow and covers the whole glans, is a simple affection, that may occur in young as well as old people, and may even be occasioned by the friction in sexual intercourse. As in gonorrhoea the matter is discharged from the urethra, so in balanorrhoea it is secreted between the prepuce and glans, sometimes attended with swelling of the prepuce, increased redness of the glans, and partial excoriations, which, however, are merely superficial, and, in a few days, heal of themselves. Venereal balanorrhoea acts in a similar manner, with this difference, that it never gets well of itself, and that the erosions, which, in simple non-contagious balanorrhoea, scarcely look like redness such as may be produced by simple irritating stimuli, in the syphilitic form, which always results from an infection by the chancre-virus, are more or less ulcerated and characterized by the diagnostic signs of other syphilitic products. What distinguishes the contagious from the non-contagious balanorrhoea, are the complications that either exist or may occur in the course of the disease, such as chancre, buboes, figwarts, mucous tubercles, etc. Regarding its origin, it may exist as a secondary disease, consequent upon constitutional syphilis, or as a primary disease induced by an immediate, direct or primary infection by the chancre-virus. In this case it commences exactly like simple balanorrhoea, the patient experiencing at first, under the prepuce, a simple titilation, burning and unusual itching; the under surface of the prepuce and glans looks red and swollen; an increased secretion arises between the prepuce and glans at first of a sero-mucous character, and afterwards, as the inflammation increases, assuming an increased degree of thickness, and finally changing to gonorrhoeal matter. If the inflammation is violent, it may induce a true inflammation of the vein along the dorsum of the penis, and even a severely constricting phimosis, in which case the pus, instead of running off, remains behind the glans, and the whole of the integuments of the penis become involved in the inflammation. In such a case, the above mentioned erosions, pustules or chancre arise at a later period, whereas, in the secondary form of syphilitic balanorrhoea, these phenomena generally precede that effection for a certain period of time.