Advice to those who are afflicted with the venereal disease: Containing the symptoms at large, with practical notes, and advice to them while under cure. Also, methods of preventing any future infection, in either sex. By F. B. Spilsbury, ...

ADVICE, &c.

THE Venereal Disease* 1.1 may be obtained three ways, viz. First, By impure connection. Secondly,

By contact of parts* 1.2. And lastly, Hereditary. Be it obtained which way it will, we ascribe it to the French (i. e. the French Pox), they call it the Neapolitan; the Neapolitan, the Spanish; and the Spanish, the Indian. In its first stage it is called the Gonorrhoea, or Clap† 1.3; in the se∣cond, the Confirmed Pox, or Lues Venerea; and that every one may know when they have ob∣tained this horrid disease, and to what stage they have advanced, I shall lay down every symptom as they occur.

GONORRHOEA,* 1.4 ITS SIGNS.

THE first symptoms are an agreeable sensation in the genital parts in general, and the testicles have a creeping worm-like motion, which stimu∣lates to venery; next a gradual discharge comes on; first, a limpid thin humour, which increases until it comes a sharp, stinking, purulent matter; the parts inflame, and now great pain is felt in passing the urine, like so many needles; this in∣creases to such a height, that the patient dreads to make water; and from the pain and fear he does not let it flow, but passes it in jerks: his phy∣siognomy

at this period is very unfavourable* 1.5. The misery is now increased by a chordee† 1.6, i. e. the penis becomes frequently erect in a disagreeable manner, curved downwards with exquisite pain. In those that have long fore∣skins, it inflames, cannot be drawn back, and is called phymosis‡ 1.7; in those that are short, it contracts, and swells up behind the nut some∣times to such a degree as to endanger the patient's life, and is named a paraphimosis§ 1.8. From the

inflammation, deep corroding ulcers* 1.9 now ap∣pear, called chancres† 1.10.

IN WOMEN.

IT makes its appearance in about three or four days; the patient feels a pleasing irritation, which soon degenerates into pain; a prickling shooting

sensation within the parts, which inflame and swell, is sore and painful; the urine is hot and scalding to such a degree, that the patient dreads to make water; she feels a contractive* 1.11 and painful sensation in the lower part of her body, with a creeping motion within the sides about the hips, dull pains across the back. The discharge is at first slime; then thin, watery, sharp, foetid, bloody; and, at length, becomes a deep green.

BUBOES AND SWELLED TESTICLES.

IN this stage, will sometimes arise, either from sudden colds, or the virus being repelled by im∣proper treatment.

In the first, the notice of the patient is attract∣ed by a pain in the groin, and upon examination

he finds a small lump, the size of a pea; there is no inflammation externally, but, after handling, the part becomes more painful, and increases to the size of a nut; the part is more sensible, it throbs, the body is inflamed, a slight fever comes on, universal lassitude, pains in the limbs, head∣ach, thirst, &c. Still increasing to the size of a pigeon's egg, becomes inflamed, matter forms, and it is now at its maturity. The second makes its approach with a painful worm-like motion in one or both testicles; the running abates, and fre∣quently stops; they swell and inflame; dull, hea∣vy, burthensome pains come on, with sudden twinges and stitches extending into the loins; they now become a painful load; a fever succeeds, and the crisis is at hand, by either suppuration, gangrene, or cancer* 1.12.

THE CONFIRMED POX, OR SECOND STAGE,* 1.13

Is now ushered in by venereal excrescences, or warts, which make their appearances about the private parts; they are neither hard nor soft, open, moist, or dry; they put on forms like pin∣heads, or ragged at bottom; some is pendent, others like a cock's comb, or mulberries. The first symptoms the patient feels, is an irregular in∣termittent fever, pain in the head, arms, legs, knees, great lassitude and dejection of spirits; the pain increases, especially at night; and when warm in bed, it is past bearing, nor can they get any

sleep till towards the morning* 1.14; the head grows heavy, sometimes with a dull pain sixed in one spot, like a nail drove in by degrees; small lumps arise on the scull, arms, legs, and thighs, (nodes) which become painful, and torment the patient alternately; scurfy places appear in different parts of the body, face, eye-brows, and forehead; gradually increasing till it invades the hair, which it incircles, (the crown of Venus); the ears are corroded and filled up with scabby stinking matter, the eruptions increase, the lips become sore, and crack; the mouth and nostrils are now infected, and run a thick ischor; the skin becomes rough,

and covered with branny scales; the eyes are dull, heavy, red, and staring; the face becomes blot∣ted, the neck stiff, the mouth sore, the cheeks firey, the nose swells, is distorted, and stuffed with scabs, the tongue enlarges, the throat is sore, the hairy scalp is now covered with a crust, and loses its natural colour, the hands swell, the nails grow thick and drop off, the voice changes, and the language is unintelligible, the lungs depressed, the mouth stiff and open, the breath loathsome and foetid, and the mind filled with wretchedness and despair. To close this horrid scene, the burning pains increase, a heavy pulse, universal weakness, dimness of sight, hiccup, stranguary, difficulty of speech and respiration, the nodes break open, the scaly scalp cracks, the nose and throat is corroded, the teeth drop out, the breath is insupportable, and the whole fabric is now a mass of stinking carrion; if the malady continues, till limb from limb drops off, the vitals are attacked, and the un∣happy sufferer expires, the putrid carcase is hur∣ried to the grave, offensive to all.

Having thus far given the history of the disease, from the beginning to the end, that every one may know how to avoid those who are unfortu∣nate enough to have any of the above appearances, I shall now proceed to give advice to those who labour under its baneful influence.

On the first appearance of the disease, let me injoin you to temperance, soberness, and chastity; three moral virtues here indispensably necessary. Your diet* 1.15 must be moderate, and roast meat is preferable to boiled; beef and mutton, to veal or lamb; the former is the more easy of digestion; but mutton is the easiest of all. Avoid spices, or high sauces; for, as it is in its first stage a topical inflammation, every thing which increases the cir∣culation of the blood will promote the disease; consequently all excessive exercises must be avoid∣ed,

such as riding on horse-back, leaping, jump∣ing, &c. You may drink wine; but beware of intoxication, or you will suffer the next day se∣verely. Though at this time Venus attracts your thoughts, yet pay no homage at her shrine. In short, eat when you are hungry, but small quan∣tities at a time; let your drink be moderate, and be satisfied when your thirst is quenched. The passions of the mind have here great influence; avoid them; they irritate the disease; and when indulged to excess, they have been known to bring on alarming symptoms. I must lay particular stress on cleanliness* 1.16, especially in the fair sex; for without this the disease rapidly increases, from the corroding virus lying on the parts, or hid in the folds, by which means the irritation is in∣creased, and consequently the inflammation will extend, bringing on chancres, buboes, &c. which

in many instances, by timely care, might have been avoided: and to this end always wash the parts with a little milk and water two or three times a day; or, what is better, a scruple of calomel in two or three ounces of rose water; and between the folds put a little lint, which change every time. To those who in the first stage use injections, retain them in the parts as long as possible; to let it come away immediately is of very little service. By the improper use of astringent injections* 1.17 the running at first is frequently stopped, and the un∣happy sufferer thinks he is cured, till, alas! appear∣ances too soon inform him of his fatal mistake. On the contrary, injections that are serviceable at first increase the discharge; your body should be

kept moderate, neither bound nor loose. If you find a painful sensation in your groin, or testicle, and at this time it is not convenient to apply for advice, suspend the testicle in a bag, and rub it with a little mercurial ointment mixt with cam∣phor; the same by the buboe; but remember, in the latter, rub rather below the part, that the lym∣phatis may carry it through the glands; but if they still increase, apply a poultice of bread and milk, mixt with the blue mercurial ointment, which, in general, will carry them off* 1.18, or relieve

till you can get assistance* 1.19. If a phimosis comes on, soak the part in milk and water, syringe the

glands with the calomel injection frequently, after which put up a little lint round the nut with a probe,

or skewer. The pariphimosis treat the same; but always have your surgeon's advice, especially in the latter, as delays here would be injurious. I would always advise, as long as any scalding con∣tinues, to drink plentifully of linseed tea, or to eat gum arabic; these mucilaginous substances will abate the acrimony of the urine. If any hard knot should arise, rub them with the ointment before-mentioned. Another symptom attending this stage, is a chordee; no pleasant companion; but it is soon removed, by rubbing the part with a little ointment, and applying a plaster of the same upon it.

Having thus far given you cautions, I will now proceed to a more pleasant subject, namely, symp∣toms of an approaching cure; which is, when the scalding abates, the discharge thickens, the green appearance gradually vanishes, yellow suc∣ceeds, till at last it is white, and does not stain the linen, and may now be called a common gleet, which is removed by balsamic medicines, fresh air, and moderate exercise; to which I will add, frequent topical cold bathing* 1.20 If from ill treat∣ment, or neglect, the urethra is filled with carno∣sities, or callofities, so as to obstruct the passage of urine† 1.21, then bougies become absolutely neces∣sary;

but always be careful to tie a piece of thread round the top, bind and fasten it gently around the nut.

Though thus far I have treated it as a simple inflammation, and supposed it to be cured on that principle; yet always take some alterative medi∣cine* 1.22, to guard against any lurking mischief; for I am certain too great security here, or rely∣ing

on the words of boasting pretenders* 1.23, has, in the end, been the ruin of many; for the disease lying dormant for a number of years, has after∣wards broke out in the various forms above-men-mentioned, which, had they taken some alterative medicines, would never have happened. Where this is the case, alterative medicines are the speedi∣est and safest cure; they act without injuring the system, and, joined with cleanliness, never fail in the most confirmed pox. The first thing to be thought of is frequently cleaning the teeth, and

gargling the throat, change of linen, frequently washing the body, and beware of catching cold. If any scaley eruptions appear, wash them with bran and water; or warts, clip them off with a pair of scissars, and apply the ointment over them. If your throat, or nostrils are affected, use the fumes of mercury* 1.24, or apply immediately to your sur∣geon. If nodes arise, rub them every night with the ointment; keep the body temperate; and, in some cases, it is advisable to wear a flannel jer∣kin and drawers next the skin. When you find all the symptoms abate and vanish, leave not off your medicines too suddenly. After which I would advise a course of bark, exercise, change of air, and cold bathing, to take off the irritability the disease has caused in the system.

Before this advice is closed, I shall give a few hints on the use of mercury.

In the first place, I do not agree with salva∣tion, even in the worst of cases. It is from this imprudence that this sacred medicine has been thrown aside; a medicine which, when admini∣stered with caution, is not injurious to the human frame; on the contrary, expel it from the Mate∣ria Medica, how many millions would suffer from the scurvy, gout, rheumatism, yaws, bilious com∣plaints, &c.? It should be given in small doses, with∣out any perceptible action. In this manner, what are its effects? it increases the action of the lympha∣tic system; the consequence is, the glands, before obstructed, have now a free circulation, the offend∣ing virus is absorbed, and thrown off by the pores of the skin, urine, stool, &c. the blood is purified, and the body now restored to health. On the contrary, if too large a quantity is taken, a foul breath, rotten gums, carious teeth, &c. ensues;

the glands are irritated to secretions beyond their power, the appetite is lost, the intestinal canal af∣fected, the head swells, the tongue hangs out of the mouth, and saliva is continually running from it; copious sweats, and universal debility follow; at this period few come near him, from the offen∣sive smell. Suppose he stops here, and the disease is cured, how dearly is it paid for, when so safe a remedy is at hand? He lingers out the rest of his life with a debilitated, irritable constitution.— How many by this are brought to an early grave! From this cause salivation is now justly exploded.

To sum up the whole, I would advise, that in the first stage of a gonorrhoea, or clap, the method of cure shall be to lessen the inflammation and ir∣ritability of the system, to promote gentle perspi∣ration, to correct the acrimony of the fluids, and to protect the body from infection. Injections that will abate the inflammation, that are void of astringency, are preferable; they are applied to the

part diseased, and certainly will cure more speedily than medicines taken by the mouth. With pro∣per injections, where they have applied as soon as they have discovered the injury, I have complete∣ly cured, in a few days, the most virulent gonor∣rhoea. What medicines are taken internally should be anti-inflammatory. After this, when the scalding is abated, the colour gone, a simple gleet only remaining, balsamics are the most pro∣per; but, after all, it is prudent to guard the con∣stitution by a few alterative medicines. In the lues venerea alteratives are what we must depend on; but when joined to balsamics, and others that will promote a gentle perspiration, they are sure of success. By these principles I have always succeeded in the worst of cases; and weak debilitated habits, arising from excesses of any kind whatsoever, by cordial tonic medicines, cold bathing, change of air, and exercise, are sure to meet with relief.

I must here guard youth from that diabolical practice of machinery; so far is it from being a preservative, that numbers have been poxed from too great a security. There is now another fashionable vice, no less injurious in debilitating the system, by forcing nature further than her strength will bear, and bringing on a train of ner∣vous complaints; I mean, whipping. I cannot help wishing, with Dr. Faulk, that fools who lasciviously use this exercise to stir up their lust, might be switched after emission, as they endured it before; which would soon cure them of this diabolical practice.

To conclude; I shall now lay down the most safe means of preventing this loathsome disease. After intercourse with a suspected person, always wash the parts with a little warm water, or soap; or if not at hand, your own urine. Be careful to wash between the folds, or round the glands; and when you get home, use the following—calomel

1 scruple, rose-water 2 ounces* 1.25, and leave some of it on. Some throw it up the parts with a sy∣ringe, and they are sure of success; even if a slight gonorrhoea has taken place, it will cure without any further application. In women it is the best, easiest, and safest remedy; not only here, but also in the flower albus; it being thrown up the va∣gina 3 times a-day, and the patient taking a little bark to strengthen and brace the system, nothing else is further required. By having this by them, they may at all times keep free from the disease. Some chuse to rub a small quantity of blue mercu∣rial ointment on the groin and parts; this too, like the other, is certainly destroying the infection

in the bud, and advisable when the other cannot be procured; but there is one caution, always to have the calomel pure and mild: what I prepare for the purpose, and for private practice, under∣goes a number of washings in lime water, &c. to take off every minute particle of acid.

THE END.

Notes

• * 1.1

  In ancient records, 1376 and 1398 public stews and brothels were tolerated under certain regulations; and those girls that had the Burning, as it was called, were separated from the rest, and forbid to lie with man while she had it. Falstaff hints at the disease in the Second Part of Henry IV. Act II. Scene IV. —"Fal. If the cook help to make the gluttons, you help to make diseases, Doll; we catch of you, Doll; we catch of you; grant that my poor virtue—grant that—." Also see Leviticus, chap. 13, 15, and 20.
• * 1.2

  Midwives ought to be excessive careful to have no cuts or sores on their fingers, as numbers of cases have occurred, where they have obtained a confirmed lues by the contact of parts.
• † 1.3

  What is commonly called the Dry Clap, is when there is no discharge, with difficulty of making water; from the increase of the swelling and inflammation an ischury, or total suppression of urine, is the conse∣quence.
• * 1.4

  I believe the gonorrhoea to be merely a local com∣plaint; the lues venerea, constitutional. This is proved in the hospitals every day; for if a patient should go through a ptylysmis, or spitting, and contract a go∣norrhoea, during the cure, the constitutional disease would be removed, but the local continue.
• * 1.5

  This is called a dysuria, an inflammable symptom: young people, at the first time, have it worse than others.
• † 1.6

  So called from its similarity to a chorde binding down the penis.
• ‡ 1.7

  There is sometimes vesicles, or bladders, filled with water on the surface.
• § 1.8

  I have known it to swell, and contract, till the in∣flammation increased so as to stop the circulation in the nut, which by this means mortification came on, and they have lost this part.
• * 1.9

  Venereal ulcers are always known by their being jagg'd at the edges, and running in different ways, with a slough-like appearance.
• † 1.10

  The first appearance of a chancre is not unlike the thrush in the mouths of children. Parents cannot be too careful who suckle their children, as they may obtain this disease from a small chancre on the nipple, or on the breast of the nurse; nor can youth be too careful who they salute, as prostitutes frequently have small ulcers on their lips, tongue, &c. Whenever these ap∣pear, even in the slightest manner, we should consider it as the confirmed pox, and treat it under that head.
• * 1.11

  From the inflammable attack of the virus in women, there is a peculiar constriction towards one side or the other in the vagina, which answers to the chordee in men.
• * 1.12

  When the pain and inflammation in the testicle abate, the running returns; if the inflammation runs high, it is then that bleeding plentifully is of ser∣vice; also purging, fomentations, &c. which must be left to the surgeon's care.
• * 1.13

  Women may have the dry or latent pox for a length of time in their habit, as long as their menstrual discharges continue; but the moment these cease, the whole frame falls into confusion.
• * 1.14

  I have observed in the hospitals patients labour∣ing under nocturnal pains from a venereal cause, that when they have had no rest for a month, &c. before they come into the venereal ward, they have not been in the ward above two days, before they have gene∣rally good nights, owing to the minute particles of mercury floating in the atmosphere they breathe.
• * 1.15

  Neither purging nor a low diet are necessary in the cure of the gonorrhoea; drastic purging will in∣crease the inflammation.
• * 1.16

  A species of lues venerea prevails in the west of Scotland, which the natives call Sibbins, or Sivvins, owing to uncleanliness.
• * 1.17

  Astringent injections are such as the vitriol, alum, and the preparations of lead. About 10 or 15 drops of the extract of lead, in four ounces of soft water, are sometimes necessary to wash the parts when a pariphi∣mosis takes place; it acts as a seditive, and will abate the inflammation; but ought to be sparingly used.
• * 1.18

  There certainly is no occasion to bring the buboe to suppuration, giving the patient unnecessary pain and trouble; I do, and always think it advisable to sup∣press them, especially at the beginning, as they fre∣quently arise from irritation, which causes inflamma∣tion in the glands, and hence obstructions. I must here ask the gentlemen of the faculty, if abating the inflammation, lessening the irritation, and by any means removing the obstructions, can pox the patient? On the contrary, I think letting it proceed to suppura∣tion, and exposing a surface to the air, is the most like∣ly means in the world. [I knew a worthy practitioner in the country so bigotted to the idea of a suppurated buboe curing the diseafe, that after he has applied his caustic, he seldom took any further notice of it.] But if the patient applies too late, and suppuration is at its height, I seldom open them in men—in women, never. If an opening is required, I guage the lancet between my finger and thumb, and by drawing the same across the buboe, from left to right (and vice versa, as occasion may require) open it with ease and safety; by this means the patient is not frightened with the knife, nor tortured with the caustic. The dressing cannot be too slight; and for the first day or two apply a poultice of white bread and milk mixt, with a little mercurial ointment over all; this takes off the callous edges, so much complained of when the knife is used.
• * 1.19

  Buboes sometimes, by ill treatment, or a bad ha∣bit of body, become phagedenic, i. e. when the lips of the wound are hard, loose, and for the space of an inch does not adhere to the surface of the ulcer; under∣neath this a probe may be passed; all round there is a livid appearance, discharges a thin fluid very different from the true pus. Some practitioners have been in∣duced to give mercury at this time, while suppuration is going on, and likewise after matter has been evacu∣ated, which will irritate, inflame, and produce a truly phagedenic sore; when this is the case, I would recom∣mend the bark and sarsaparilla; the patient at the same time should have a milk and vegetable diet, with coun∣try air. There is no medicine that so speedily re∣moves the effects of mercury, as sarsaparilla given in powder or decoction, and bark will strengthen the sys∣tem. After this treatment has been used for some time, and the sore brought into a good state, it will be apt to spread, and break out again, from being af∣fected by the venereal matter returning, when mercu∣ry must be had recourse to, but with a great deal of caution. If the sore should again have phagedenic appearances, mercury must be desisted from, and the bark and sarsaparilla as before; and when at a favour∣able state, the mercury again continued. These kind of ulcers are the most difficult to cure in all surgery; outward applications should be mild; the best is a white bread poultice.
• * 1.20

  The parts are always, after a gonorrhoea, relaxed, or lame; and nothing is more conducive to restore the tone of the fibres than topical cold bathing: what I mean by this is, to pour a bottle of cold water on the parts as soon as you rise in the morning; this some call cabbaging.
• † 1.21

  Where there are strictures in the urethra, the urine is always divided into two streams; and there is always matter on the bougie where the stricture or ulcer is. A bougie will sometimes cause a chordee in an healthy person; but, as above, it is the most painful at the part affected.
• * 1.22

  Mercurials, in small doses, are the best alterative medicines; and during their course I always give the following diet drink—Take of sassafras chips 4 oz. sarsaparilla 2 oz. guaiacum shavings 3 oz. mezerian root 2 drams; pour on this three quarts of boiling water, and when cold, it is fit for use; a gill four or five times a day.
• * 1.23

  It is become the fashion, in modern quackery, to advertise to cure without taking a single grain of mer∣cury. True; so I am satisfied it is frequently done; but if there be one out of five that have any virus left in the constitution, it ought to induce all to take a few small doses. I am certain it is from this our hos∣pitals are so crouded—from this lurking mischief breaking at a distant period in various forms, well de∣serving the name of Hydra.
• * 1.24

  The best method of applying mercury in fumes, is to put ten or fifteen grains of cinnabar on a hot iron, drawing the smoak into the throat, or up the nose, twice a day, through a funnel.
• * 1.25

  I cannot speak too highly of this preparation; it is the most safe and efficacious application to old ulcers and cancers of every kind, it producing good matter in a few dressings; and when the ears are affected, and discharge a foetid matter, they should be syringed with it three or four times a day.