the different forms of gonorrhoea :idea of gonorrhoea :

-JAHR Georg Heinrich Gottlieb

Of gonorrhoea generally

Gonorrheal discharg

FROM what we have said it is evident that we do not understand by the term gonorrhoea, as so many continue to do, every imaginable mucous discharge from the urethra, but only an infectious inflammatory blennorrhoea, and that we regard it as a great calamity in the domain of science that recent practitioners, even medical authors, should ignore the meaning of a term which had been consecrated by the common vernacular, and should designate as gonorrhoea every kind of discharge from the urethra, admitting not only venereal and syphilitic, but likewise arthritic, hæmorrhoidal, catarrhal, and Heaven knows what other kinds of gonorrhoea. We cannot wonder, in the presence of such a horrible confusion of terms, that some physicians should pretend having cured gonorrhoea with remedies that will never remove a genuine gonorrhoea, and that others should still advance the doctrine that a gonorrhoea may not only be caused by any acrid, though otherwise perfectly innocuous leucorrhoea, but even by the menstrual blood. True, discharges from the urethra may be occasioned by such causes, as well as by irritating bougies or other foreign bodies such as gravel, stone in the bladder, urethral calculi, worms in the rectum, hæmorrhoids, medicinal substances, etc. What distinguishes this form of blennorrhoea from a genuine, infectious gonorrhoea is, (1) that the former is not contagious; (2) that it does not pass through a definite inflammatory stage, no matter how violent the inflammatory irritation may have been; and, (3) that after the removal of the irritating matter the blenorrhoea ceases of itself in a few days. Where these three diagnostic marks exist, there is, according to our definition of the term elsewhere as well as in the present work, no gonorrhoea, but simply an innocuous discharge. Where these signs do not exist; where the discharge runs through definite stages, from the incipient, scarcely perceptible oozing of a serous fluid to that of a greenish yellow purulent matter, attended with constantly increasing symptoms of inflammation, after which the discharge decreases in quantity while it continues to increase in thickness; in all such cases we do not diagnose a simple discharge, but a genuine contagious gonorrhoea, and it is our positive conviction that, in all such cases, the female who had infected the patient, was not merely afflicted with a corrosive leucorrhoea, or had a too acrid menstrual blood an infectious gonorrhoea, and even other troubles which she was anxious to conceal. Nothing produces nothing; where an infectious disease is contracted, it must have been derived from an infectious contagium. Hence we cannot call to mind a more foolish illusion than the belief which is not only entertained by many lamen, but even by physicians, that a gonorrhoea may be communicated during a heated sexual embrace even by a woman in perfect health; a discharge may indeed be occasioned, which, however, will cease again in a few days provided the woman was really sound, but in no case an infectious gonorrhoea like that which constitutes the burden of our remarks.