Imágenes de páginas
PDF
EPUB

bodily faculties. Gleet, in fact, is gonorrhoea changed from the acute to the chronic stage, and appears to arise from a morbid deficiency of the absorption of the mucous membrane of the urethra, continuing to flow from the influence of habit. The affect of the duration of the virus of gonorrhoea in one constitution is more permanent than in another; and the result as to the duration of gleet is governed more by the peculiarities of the patient than by the virulence or malignity of the virus imbibed. Where Gleet begins and Gonorrhoea ends it is practically immaterial to determine; the phenomena accompanying this derangement vary very widely in different persons, according to the circumstances that produce it and the constitution acted upon; the appearance of the matter also in gleet is very various, in respect to the difference of its quantity, quality and colour; it may in fact be justly considered as symptomatic of other affections of the urethra, and when its copious effusion is long continued, it induces a most alarming debility, not alone of the genital system, but of all the bodily and constitutional energies.

INFLAMMATORY DISEASE and ENLARGEMENT of the PROSTATE GLAND, may be enumerated as among the sequela of severe gonorrhæa. Its effects are of no transient character, impeding the action of the bladder, producing an amount of pain and suffering that is scarcely for a moment absent, disturbing every enjoyment, and inflicting such misery on the hapless sufferer, which, if not cautiously studied with a view to its amelioration, frequently runs coeval with every remaining year of his ill-fated existence.

CHAPTER V.

ON THE SYMPTOMS AND TREATMENT OF THE VENEREAL DISEASE, IN ITS LOCAL AND CONSTITUTIONAL FORMS AND ON THE USE AND ABUSE OF MERCURY.

THE virus or animal poison engendering syphilis or pox terminates in the destruction of the surfaces where it falls, and being absorbed into the general current of the circulating blood, contamination is diffused throughout the entire extent of the human body. The poison producing syphilis is then essentially different from that producing gonorrhoea, and even among syphilitic diseases it is an axiom established by concurrent observation, that there are varieties even in this; inasmuch as some are more frightfully rapid, others more manageable, and ending in less severe disorganization of the structures that are successively attacked. The matter secreted by the local sores of a female labouring under this disease, produce by direct inoculation similar sores from impure contact. These ulcers or sores, generally single, but occasionally numerous, and affecting mostly the external genitals have received the denomination of CHANcre, which forms in the male chiefly on the foreskin and glans, or nut of the penis, of an irritated and red appearance, gradually spreading, and if not speedily arrested ending in the total destruction of the penis. An indefinite period of time elapses before these ulcerations, after unhealthy coition, make their appearance. First an inflamed spot

K

is perceptible, then a small watery pimple is seen, which, discharging its contents, displays a rapidly enlarging ulcerated sore. In its centre an excavation is seen, extending beneath the skin, excessively painful and sensitive; a blush of dark fiery redness is seen around the ulcer, and the skin becomes unusually thickened and firm. The diseased surface is yellow, its edges are hard and ragged, its outline irregular, and there is a feeling of solidity to the touch. The thickened base is one of the most obvious peculiarities of the true syphilitic chancre. As to the seat of these primary sores, they are not limited to the genitals alone, but may be found on any other part of the body if that part be invested with a mucous membrane, as, for instance, the lips or nostrils. If a chancre be limited to the external surface, its progress is slow, but if its destructive ravages have extended deeply beneath the skin, mortification may be expected.

The most remarkable forms of venereal chancre that are met with in practice are the following :—

First, that characterized by its circular form, its excavated surface, covered by a layer of tenacious and adherent matter, and its hard cartilagenous base and margin.

Second, another form of chancre, unaccompanied by induration, but with a very high margin, appearing often on the outside of the foreskin, and seldom existing alone, called from the preceding description "the superficial CHANCRE with raised edges." These kinds of ulcers are occasionally very serious, neither getting better nor worse, but resisting almost every plan of treatment, generally adopted by the profession for their removal. We have known instances where they have existed for several months.

Third, the phagedenic, or malignant chancre, a corroding ulcer without granulations, and distinguished by its circumference, being of a livid red colour. Cases have occurred where, from injudicious treatment, or the misapplication of mercury, the whole of the penis has been removed by ulceration.

Fourth, a most formidable kind of chancre, denominated the sloughing ulcer. It first appears as a black spot, which spreads and becomes detached, leaving a deepened and unhealthy looking surface, which has evidently no disposition to heal. This sore is very painful, and encircled with a dark purple inflammatory ring. If neglected, or improperly treated, the process of mortification goes on until all the parts of generation are destroyed.

The venereal poison from any of the above-mentioned sores, is usually taken by absorption from the chancre to the glands of the groin, and in its course through those bodies, produces inflammatory and painful enlargement, mostly terminating in a deep and extensive abscess bursting the skin; and to this state, either previous to suppuration or subsequently, the term venereal bubo is correctly applicable. As a venereal sore or ulcer may assume from the commencement an irritable or malignant appearance, rapidly destroying the penis by mortification, so a bubo may assume the same character; and in this way even life may be endangered, unless timely aid be afforded.

It appears, then, that the mode in which the venereal disease becomes constitutional, is by the absorption and transmission of a poisonous virus, first from the primary ulcer to the groin, and thence throughout the whole system of blood vessels. In this way, having reached

the circulating fluid, it affects and contaminates the various solid structures of the body in succession. First, the lining membrane of the throat and nose; next the skin or surface of the body; and, lastly, the membrane which invests the bones, as well as the firm and unyielding structures of the bones themselves. When, even long after the original cause of the mischief has healed, the syphilitic action is set up in the soft and delicate membrane that lines the throat; it becomes red and inflamed, a pimple forms upon it, which, when it breaks, lays bare a ragged surface, bedewed with whitish matter; or, if it be seated over a bony structure, the exposed bone is thrown off, and so very rapidly an unnatural communication is established between the mouth and nose, that fluids return through the nostrils, and the voice becoming nasal, proclaims but too surely the character of the malady that has produced such disorganization.

This affection of the throat is a white slimy looking ulceration, and there is a most offensive discharge, with a fœtid breath, the soft palate being not unfrequently entirely removed, or hanging in ragged portions. In fact, the upper and back part of the throat presents one vast ulcerated cavity, covered with viscid matter; and not only is the voice thick and indistinct, but swallowing the softest food becomes difficult if not severely painful. The lining membrane of the nose is liable likewise to be similarly affected. Ulceration in this part very speedily affects the bones and cartilages, an incrustation forms on the surface, and on this being accidentally removed by the finger, a quantity of bloody fluid mixed with matter is seen on the exposed part. The progress of disease is frequently such as to disfigure the face most horribly,

« AnteriorContinuar »