Gonorrhoea of the male: symptoms :

-JAHR Georg Heinrich Gottlieb

Gonorrhoeal Discharge

So far we have shown with sufficient clearness that we understand by the term gonorrhoea a urethral discharge that have been caused by the action of some specific infectious virus; not any discharge occasioned and contained by the action of some internal or external irritation of the urethra. A gonorrhoeal infection that may not only result from impure coit, but likewise from the use of instruments which the gonorrhoeal virus had remained adhering, generally becomes apparent after the lapse of four to seven days, or even two or three weeks after the infection had taken place. At first it may betray its existence by a slight titillation in the urethra which is not disagreeable and excites erections and a desire for sexual intercourse. This titillation is soon after succeeded, and very frequently accompanied by a scarcely perceptible-secretion from the urethra (gonorrhoea-incipients), which closes more or less the slightly reddened and, but in a few cases, somewhat swollen orifice of the urethra, and leaves very small, slight stains on the linen. Almost always, as I have noticed in many cases, this appearance is preceded the day previous by a feeling of malaise, which either remains unnoticed or is attributed by the patient to some other cause. This feeling of malaise is in a very few cases attended with slight febrile shiverings, but is almost always accompanied by a feeling of goneness or weakness in the præcordial region, and excites in the patient a desire to take something stimulating. Very frequently we notice already at this period of the precursory symptoms a scattering of the stream, which is probably owing to the partial agglutination of the urethra caused by the as yet imperceptible secretion in this organ. This scattering of the stream disappears, together with the other precursory symptoms, in order to reappear again with much more violence after the lapse of a few days. In a few days, probably two or three, the above-mentioned voluptuous titillation changes to a more or less troublesome sensation of smarting or tension, while the erections become even now somewhat painful. At the same time the orifice of the urethra appears more or less swollen, pouting, and a clear serous discharge sets in; the inflammation at the same time increases and is attended with a frequent urging to urinate; urination itself is likewise beginning to become painful. Generally these phenomena increase within a short time, but sometimes only in the second week. At this stage of the disease (gonorrhoea inflammatoria) the glans swells up and assumes a dark or yellowish-red color; the discharge keeps increasing in quantity, sometimes to an incredible degree, acquiring a yellow or greenish tint, and in appearance and consistence resembling a thin pus, and leaving yellowish stains on the linen which always have a gray sharply-circumscribed border (of which the stains occasioned by the non-contagious leucorrhoea of females are always destitute). The swelling from the meatus urinarius to the glans communicates itself to the prepuce and body of the penis (with more or less phimosis or paraphimosis); the urging to urinate increases, becomes very troublesome, and is attended with violent erections, which sometimes become so painful, especially at night, that they deprive the patient of all sleep. These inflammatory symptoms, if the disease is left to itself, generally increase to the 15th, 25th or 30th day, after which they gradually decrease, simultaneously with the discharge, which loses its greenish color, becomes yellow and afterwards whitish, more consistent and viscid and finally disappears more or less rapidly, according as the constitution of the patient and the employment of proper hygienic and dietetic rules and more or less suitable remedial agents may influence the course of the disease. Left to itself, a gonorrhoea scarcely ever terminates before the 30th or 40th day, but, if mismanaged by improper treatment, or interfered with by a wrong diet, may continue for months, or even years, in the shape of gleet.