[Reprinted from the Journal of Cutaneous and Genito-Urinary Diseases 
for June, 1896.] 
FORMALIN IN GONORRHCEA. 
By GEORGE T. HOWLAND, M. D., 
Washington, D. C. 
SOME time ago my attention was called to the use of formalin as 
an antiseptic of the first class. Seeing a number of cases of 
gonorrhoea, I made up my mind to give it a test. With this end 
in view I append six cases. These are not selected cases, but just as 
they came to my office. 
I started with a five-per-cent solution, but I found it too strong; 
it was almost caustic in its action. I immediately injected a pint of 
normal saline solution, hot, 100° F., and in the rest of the irrigations 
I used only one-half-per-cent solutions. Unfortunately, all the cases 
were acute anterior gonorrhoea. In all the cases the secretions were 
examined daily for the gonococci, careful tests being made with the 
Gram-Roux method. In each case the gonococci were found. The 
method I used was the following: Introduced Stein's urethral irri- 
gators as far as the bulb. Then passed a soft rubber catheter within 
the irrigator and connected it with the tubing of Dr. H. Holbrook 
Curtis's heating apparatus. Never allowed the temperature to go 
above 100° F. 
For the first two or three days irrigations of one quart of the hot 
formalin solution were given twice daily ; afterward once daily until 
discharge ceased to contain the gonococci. 
No internal treatment was given except regulating the bow'els. I 
used the compound cathartic pills-two pills twice a week. 
All highly seasoned food, alcohol, tea, and coffee were prohibited. 
Advised the ingestion of from two to four quarts of pure water in 
the twenty-four hours. Most of the patients used Poland Spring 
water. 
There was one peculiar characteristic that was noticed in regard to 
the action of the irrigating fluid on the gonococci. They " shriveled 
up " and lost their form. Especially was this marked if they were 
free in the pus, not within the cell. 
Copyright, 1896, by D. Appleton and COJH'ANYfJ 
SliRfirnw nc 2 
Original Communications. 
Case I.-February 15, 1896. J. W. W., aged twenty-five. First 
attack. Microscopical examination revealed the gonococci. 
Decolorized by Gram-Roux. 
One quart of one-half-per-cent formalin solution was used twice 
daily for three days. 
Then only one quart was used daily until February 28,1896, when 
discharge had ceased. 
He returned as requested on March 4th, but reported no return of 
discharge. 
Case II.-W. McC., aged twenty-nine. Second attack. First, 
four years ago. Irrigations were commenced on February 22,1896, and 
continued until March 6, 1896, when they were stopped, as no secre- 
tion wras present. Patient has disappeared ; have not seen him since. 
Case III.-P. G. (colored), aged twenty-six. Second attack. First 
attack eight or nine years ago. Irrigation commenced on February 
29, 1896. March 13th, ceased treatment, as discharge had ceased. 
Saw him since; reports no renewing of discharge. 
Case IV.-W. L., aged twenty-one. First attack. Irrigation 
commenced on March 7, 1896. Discharged him March 22, 1896. 
Secretion disappeared on March 21, 1896, but continued irrigation one 
day longer. Returned on March 25th ; reported no discharge. Is to 
be married shortly, and was afraid he was not cured. Gave him two 
drachms of bichloride, two per cent, a hand syringe to throw the solu- 
tion in his urethra on retiring, and also to drink a couple of bottles of 
beer, and to report at the first appearance of pus. Forty-eight hours 
after, reported no discharge. Saw him on April 16, 1896, but has had 
no return of the disease. 
Case V.-T. W. B., aged thirty-eight years. Third attack. Com- 
menced irrigation March 10, 1896. Discharged him April 7, 1896. 
Saw him on April 15th ; reports no discharge in the interval.