OBSERVATIONS 
ON THE EFFICACY OF A 
NEW MERCURIAL PREPARATION, 
FOR THE CURE OF THE 
VENEREAL DISEASE, 
IN ITS MOST MALIGNANT STATE; 
And which immediately relieves the Heat of Urine in a 
recent Gonorrhœa, by which Means, a more easy and 
perfect Care is obtained, than by the usual Method of  
Treatment 
WITH 
An Explanation of the Several Symptoms, of Venereal 
Infection, 
BY HENRY WASTELL, SURGEON, 
AND MEMBER OF THE CORPORATION OF SURGEONS, LONDON, 
LONDON: 
PRINTED FOR J. MURRAY, No. 32, FLEET STREET. 
MDCCLXXIX. 
[Price Two Shillings.]



TO THE 
SURGEONS 
OF 
HIS MAJESTY’S NAVY and ARMY. 
GENTLEMEN, 
WHEN the obvious tendency of 
any work is, in its nature, 
salutary to mankind, the private ob- 
ject of the Author, in giving it to 
the public, is a consideration of little 
consequence. 
Encouraged by that intimate know- 
ledge of the excellent qualifications 
of many of those Gentlemen, whose 
patro-

[ii]
patronage he has taken the liberty to 
solicit, which the honour of many 
years service amongst them, has en- 
abled him to acquire, he is induced 
to dedicate to them the following 
Treatise, not doubting, that what- 
ever tends to alleviate the sufferings, 
and restore the health of mankind, 
cannot fail to receive the protection 
and patronage, of so useful, so libe- 
ral, and so respectable a body, as 
the Surgeons of the Army and Navy.
The AUTHOR, 
LONDON, FEB. 11, 1779. 

INTRODUCTION. 
THERE are few complaints, to which 
the human frame is liable, that 
are more deserving of medical attention, 
than the venereal disease; and fewer still, 
perhaps, in which the improvements of 
medical researches have been less adequate 
to the importance of the object, in af- 
fording a safe, speedy, and efficacious cure 
for those persons, labouring under any 
stage of so contagious a malady. 
To attain a perfect cure, even in an early 
period of this complaint, two, three, or 
even six months have sometimes been 
found necessary; during which time,
the patient has unremittedly suffered the 
most


[vi]
most painful sensations; although I am 
now convinced, that from a proper and 
judicious treatment, every species of the 
disorder may be cured in a much less time. 
The venereal gonorrhœa, for instance, in 
its most virulent state, may be effectually 
eradicated in a few weeks; and when it is 
recent, may generally be cured in ten of 
twelve days. 
Experience has fully proved, that the 
fatal consequences of the neglect, or im- 
proper treatment of a gonorrhœa, are ex- 
crescences, cicatrices, and strictures, with 
painful swellings in the urethra, causing 
obstructions of urine, and seminal emis- 
sions, which frequently terminate in a 
confirmed lues or pox. 
Nor does the evil stop even there: up- 
wards of thirty thousand persons are, by 
computation,


[vii]
computation, supposed to be carried off 
every year in this island, by a consumption, 
which disorder is deemed endemial and 
peculiar to this country, and generally 
attributed to the instability and coldness of 
the climate, joined to its moisture; yet 
it is an uncontrovertible truth, that a cons- 
iderable source of so dreadful a mortality 
originates from the various successive degrees 
of venereal infection. For we have too 
many instances, when the venereal poison 
has once infected the circulating fluids, 
that it attacks the glands of the viscera, 
whence a hectical dispoition, nervous 
atrophy, and wasting of the flesh en- 
sue, until at length the body is totally ema- 
ciated, when death closes the scene. 
These are the fatal consequences of a 
GONORRHOEA, unless PERFECTLY and 
TIMELY CURED. 
It

[viii]
It is well known, that no method hi- 
therto offered to the public, can, with 
certainty, remove that painful and disagree- 
able symptom in a recent gonorrhœa, viz. 
the heat of urine, until the original com- 
plaint is nearly subdued. The author, how- 
ever, has fortunately, discovered a prepa- 
ration, which effectually, and without the 
least danger, relieves that acute pain; and 
when it is combined with that active and 
subtile mercurial preparation, which He 
had so particularly recommended in the 
following sheets, radically cures the disease. 
A discovery, which, he flatters himself, will 
not fail of becoming extensively useful, by 
not only co-operating in the prevention of the 
alarming consequences already mentioned, 
but also by procuring that IMMEDIATE 
EASE, which has been fought after for so 
many years, with so little effect. 
CON-


CONTENTS. 
SECTION I. 
Of the venereal infection—page 1 
SECTION II. 
A description of the parts affected, when local—2
SECTION III. 
On the gonorrhœa—17 
SECTION IV. 
Symptoms of a recent venereal infection—26 
Symptoms of the infection being taken into the 
habit—35 
SECTION V. 
On the cure of the recent gonorrhœa—37 
A new method of preparing the mercurial 
ointment—70 
SECTION VI. 
Of the hernia inguinalis and swelled testicle—79 
SECTION VII. 
Of buboes—88 
SECTION VIII. 
Of chancres—102 
SECTION IX. 
Of a gleet—108 




OBSERVATIONS 
ON THE 
VENEREAL DISEASE.           
SECTION I. 
THE Venereal Disease is properly dis- 
tinguished into local and universal. 
In the former, the venereal virus is con-
fined to some particular part of the body. 
In the latter, the infection is carried in- 
to the blood, by means of the absorbent 
vessels, viz. the lymphatics, and circulat- 
ing with it through every part of the body, 
mixes with the several secretions, and in- 
fects the whole habit. 
As it is the former of these we shall first
speak of, I think it not amiss to give a 
brief description of the parts most liable 
to be affected, whilst it remains local, to 
enable the reader (though not a medical 
man) to have a better idea of the subject. 
Being convinced that the successful treat- 
ment of local diseases, chiefly depends on 
B the

[2]
the knowledge of the particular structure 
and use of the parts affected. 
This description is laid down in the 
most simple manner possible, every unne- 
cessary technical term is carefully avoided, 
and the whole calculated to serve the lowest 
capacity, as well as those whose education 
has been more liberal. An attempt, which 
to the author’s knowledge has not yet been 
made, though the extreme necessity of it, 
to those who would judge of the progress 
of the cure, is too manifest to need any 
comments to enhance its propriety. 
SECTION II. 
The Male Organs of Generation. 
The testes or testicles are two glands ap-
propriated to the secretion of the semen 
from the blood. They are suspended in a 
bag called the scrotum, into which they 
descend one or two months previous to the 
birth of the child. 
The blood is carried to the testicles, by 
the two spermatic arteries which arise (most
commonly) from the anterior part of the 
aorta, one on each side, a little below the 
emulgents,

[3]
emulgents, and after the seminal secretion 
is performed, the blood returns back into 
the general mass, by the spermatic veins. 
That on the right side commonly enters 
the trunk of the vena cava, lying on the 
left side of the aorta; and that on the left 
side goes to the left emulgent vein, taking 
the same course, as the left spermatic artery. 
The artery and vein on each side, in their 
course downwards, tend towards the groin, 
not in a direct course, but a little about, 
to avoid being interrupted by the motion 
of the intestines. There is a great variety 
in the manner they arise from the great 
vessels. They are connected to the fixed 
parts, by cellular membrane, and pass un- 
der the peritoneum, through the ring of 
the external oblique muscle into the groin, 
following nearly the sweep of the rim of 
the pelvis: just as they pierce the tendon 
of the oblique muscle, they join the vas 
deferens, and underneath the tendon, the 
spermatic vessels have other parts united 
with them, when the whole takes the 
name of the spermatic chord. 
The spermatic chord consists of artery, 
vein, vas deferens, and cremaster muscle,
with

[4]
with nervous filaments and lymphatic ves- 
sels, and passes down by the superior pro- 
jecting part of the os pubis, just over the 
interior end of Poupart’s ligament, and en- 
ters the testicle at its posterior side, where 
it is connected with the tunica vaginalis. 
The cremaster muscle is made of some of 
the fibres of the obliquus internus, that 
come from the spine of the ilium; it in- 
vests the whole spermatic chord, and goes 
with it through the ring to the testicles. 
This muscle assists in suspending the tes- 
ticles in the scrotum, and spreads its fibres 
over the body of the gland, by its action 
it draws the testicles upwards, towards the 
pubes: the chord has also a thin fascia from 
the outer part of the tendon of the external 
oblique muscle. Old authors say there is 
a sheath proper to the chord and testicles, 
called by them, tunica vaginalis communis, 
but the spermatic chord has no vaginal 
coats, it is connected to the scrotum by 
cellular membrane only. But to the testicle, 
there belongs a bag, or coat, called tunica 
vaginalis propria; this bag is loose from 
the testicles every where, except on its 
posterior part, where it is connected with it 
its

[5]
its whole length. In this bag the water of 
a hydrocele is lodged, and obscures the 
testicle, except at its back part, where 
it may be felt by the finger. 
The tunica vaginalis, is originally peri- 
tonæum, as is evident in the fœtus, where 
it is reflected over the testicle, and forms 
its outer coat called tunica albuginea, so 
that the water of a hydrocele can touch no- 
thing but this membrane. 
The scrotum may be considered as an 
elongation of the skin, and cellular mem- 
brane of the penis, as by inflating the one, 
we inflate the other; on its outside, it has 
a seam, or middle line, called the raphe, 
which is continued from the underside of 
the penis, and internally, this bag is divid- 
ed by a partition, composed of a firm cel- 
lular membrane, called the septum scroti, 
being the duplicature of the internal cel- 
lular coat called dartos, which authors 
have described as a muscle, but without 
any reason, there being nothing like a 
muscular fibre to be seen in it. 
The testicle is an oblong flattish body, 
one end is situated upwards and forwards, 
the other downward and backwards; and,
at 

[6]
at its upper edge, has an appendix called 
epididymis. 
The substance of the testicle is vascular, 
being chiefly formed from the convolutions 
of the spermatic artery, which here secretes 
the semen; it is inclosed in a strong tendi- 
nous coat or covering, called tunica albu- 
ginea, which is closely united with it, 
though a small force will separate them. 
It is owing to the great strength and com- 
pact texture of this membrane, that the in- 
tolerable pain of a bruised testicle arises; 
swellings and injured parts being more or 
less painful in proportion, as they are dis- 
tended with more or less difficulty. Be-
sides the spermatic artery and vein, which 
compose this glandular body, there are se- 
veral lymphatic vessels, and branches of 
nerves, and the semen is secreted through 
a number of small curling threads, called 
vasa efferentia, or tubuli seminiferi, which 
make a surprising number of convolutions, 
and form the epididymis. 
The epididymis which is situated on the 
posterior part of the testicle, and outside of 
the chord, is attached to the testicle by the 
vessels before mentioned, and likewise at 
both

[7]
both its extremities, by the duplicature of 
the tunica albuginea, which having supplied 
the place of a ligament, afterwards inverts 
it. The posterior extremity of the epidi- 
dymis is incurvated from behind, and 
runs up to form an excretory duct called 
the vas deferens. The tubuli are the se- 
cretory vessels that carry the semen, and 
though we cannot trace them into the vas 
deferens, yet the vas deferens may be traced 
into those tubes. 
The vas deferens is the canal or duct 
which conveys the semen from the testicle 
to the penis. It ascends with the sper- 
matic vessels towards the abdomen, until 
it gets as high as the superior edge of the 
pubis, when it separates from these vessels, 
and passing down with the peritoneum, 
proceeds to the inferior part of the neck 
of the bladder, where it deposits the semen 
in the vesiculæ feminales. It is very thick 
externally without the abdomen, and may 
easily be distinguished in the spermatic 
chord by the finger. If quicksilver is 
poured into it, it descends to the lower 
end of the testicle, which shews that the 
epididymis is a continuation of this tube. 
The

[8]
The vesiculæ seminales are two white 
substances resembling the circumvolutions 
of the intestines of a small bird: they are 
situated between the rectum and lower 
part of the bladder, and are supposed to 
serve as the reservoir of the semen, until it 
is wanted in the act of coition. There 
are two small tubes formed by the extre- 
mities of the vasa deferentia and vesiculæ
seminales, which enter the canal of the 
urethra obliquely on each side. The ve- 
rumontanum, or caput gallinaginis, which 
is a small oblong eminence, supposed to be 
like the head of a woodcock, seems to act 
as a sphincter to these two ducts. These 
tubes or ducts enter the urethra at the basis 
of the prostate gland, which resembles a 
small heart, and is situated close to the 
bladder, between it and the bulb of the 
urethra, having its basis towards the blad- 
der, and the apex or point towards the 
urethra. 
The penis is composed of cellular 
spongy substances, called the corpora ca- 
vernosa penis, and the corpus spongiosum 
urethræ. 
The corpora cavernosa, which constitute 
the

[9]
the greatest part of the penis, form nearly 
two cylindrical tubes, the cavity of which 
is entirely filled up by a strong cavernous 
substance, the cells of which communicate 
with each other. They lie close together 
for the greatest part of their length; but 
behind they separate under the pubis, and 
are fixed, one on each side, to the inferior 
part of the os pubis, making what is called 
the crura penis: at their extremity they 
terminate in a point, where they are co- 
vered by the glans penis. The partition 
betwixt each tube is called the pecten, and 
for near two thirds of its length, nearest 
the glans, it is perforated into interstices 
like a comb, through which these caver- 
nous bodies communicate; but in the other 
third part there are no perceptible interstices 
or perforations. Being united laterally to 
each other for the greatest part of their 
length, two groves are formed, one on the 
upper, the other on the under side. 
In the inferior grove, the corpus spon- 
giosum urethræ lies, which goes down to 
the perinæum, and forms the bulb of the 
urethra; it terminates forward in a consi- 
derable expansion, constituting what is cal-
B  led

[10]
led the glans penis, which is entirely a 
continuation of this spongy substance. The 
cells of the corpus spongiosum urethræ do 
not appear to be similar to the cells in bone 
and other parts, but seem to be made up of 
plexuses of veins. 
The canal by which both the urine and 
seed is conveyed, is called the urethra; it 
runs through the corpus spongiosum from 
the bladder, and terminates at the extre- 
mity of the glans by a narrow oblong ori- 
fice. The cavity of this canal begins 
on the side of the bulb of the urethra, 
is about the size of a goose quill, and is 
larger when the penis is flacid and relaxed, 
than when it is erect; which accounts for 
the difficulty of making water when the 
penis is in an erect state. Just within the 
glans the sides of this canal are depressed; 
which depression is called fossa navicularis. 
The inside of the urethra is lined with a 
fine delicate membrane of exquisite sensi- 
bility, which is perforated by a great num- 
ber of oblong holes called lacunæ. These 
are the orifices of the excretories of several 
small glands dispersed thro’ the substance of 
the urethra; they secrete a glairy fluid, which, 
with


[11]
with a fluid that comes from the prostate
and Cowper’s glands, serves to defend this 
inner membrane from the stimulus of the 
urine. Two of these lacunæ (which are
described by Morgagni) are more consider- 
able than the rest, and are situated near the 
glans penis, the one under the frænum, 
and the other near the fossa navicularis: 
there are other two near the bulb of the 
urethra, which are the openings of the 
excretory ducts from two glands called 
Cowper’s glands: these glands are situated 
under the membranous part of the ure- 
thra within the bulb, one on each side. 
The before-mentioned membrane is con- 
tinued over the glans. 
The muscles of the penis are the erec- 
tores, acceleratores, and transversales. The 
erectores penis arise near to the tuberosity 
of the ischium, and run forwards and up- 
wards, and terminate in the corpora caver- 
nosa. The acceleratores urinæ come down 
obliquely backwards from the crura penis 
on each side, and cover the bulb of the 
urethra, making, where they meet, a ten- 
dinous line along the middle of the bulb. 
The transversales perinæi arise from the 
inside

[12]
inside of the tuberosity of the ischium, and 
go down to the perinæum. 
The perinæum is the space between the 
under part of the penis and scrotum, and 
the anterior edge of the anus. 
The principal arteries are called pudicæ, 
of which one is external, and the other 
internal. The external branches of the 
crural arteries, are distributed to the in- 
teguments of the penis; the internal pu- 
dicæ, which are branches of the iliac or 
hypogastric arteries, run through the center 
of each corpus cavernosum. But the 
course of circulation is different here from 
most parts of the body, as the blood does 
not pass from the extreme arteries imme- 
diately into continuous veins, but is poured 
out into an intermediate cellular texture, 
from which it is afterwards received by the 
extreme veins, and is returned by a large 
vein on the upper part of the penis, which 
runs in a kind of groove formed by the cor- 
pora cavernosa, and is called vena magna, 
or vena ipsius penis. 
On the outside of each artery is a nerve 
distributing its branches to different parts, 
There are a great many lymphatic vessels 
running

[13]
running in all directions, which generally 
accompany the large blood vessels. Their 
coats have arteries and veins for their nou- 
rishment, and are endowed with great sen- 
sibility, as appears from the painful swel- 
lings to which they are subject. They 
therefore have nerves, as well as arteries 
and veins. 
The lymphatic vessels have a great num- 
ber of valves, and convey the lymph to the 
glands in the groin, where they enter on 
one side, and come out at the other, in 
their way to the thoracic duct. 
The glands of the groin may be consi- 
dered as appendages to these lymphatic 
vessels; and being liable to be affected in 
a gonorrhœa, from the discharge being 
prematurely suppressed, or from improper 
treatment of this complaint, it seems ne- 
cessary to take notice of their situation and 
structure. 
A lymphatic gland resembles a kidney 
bean, though in different bodies, and in 
different parts of the same body, a great 
variety in their size and figure is observed. 
Each gland is a congeries of tubes, con- 
siding of arteries, veins, lymphatic vessels,
and

[14]
and nerves, connected by the cellular sub- 
stance. 
The lymphatic glands of the groin are 
six, seven, or eight in number: of these 
some lie in the very angle between the 
thigh and abdomen; and others lie a few 
inches down on the fore part of the thigh. 
It is into these UPPPER glands ALONE, that 
the lymphatic vessels of the genitals enter; 
so that the venereal bubo, which arises in 
consequence of an absorption of matter 
from these organs, is always seated in those 
UPPER glands; and the lower glands are 
never affected, except by the regurgitation 
of the matter, which very seldom happens, 
or from their vicinity to the glands first 
diseased.
As it is the upper glands that are affected 
by absorption of matter from the genitals, 
so it is the lower which are commonly first 
affected by the acrid matter of an ulcer, 
diseased joint, or carious bone, in the parts 
below those glands: a circumstance that 
may assist us in the diagnosis of those two 
kinds of buboes; remembering, that this 
rule may be liable to an exception from 
one of the lymphatic vessels passing the 
lower


[15]
lower glands, and only entering the upper. 
And sometimes a lymphatic vessel will pass 
by all the glands without entering one of 
them, and continue on to the thoracic 
duct. 
This observation may account for the 
venereal poison being sometimes taken into 
the habit, without occasioning a bubo, by in- 
flaming a lymphatic gland in its passage. 
The integuments of the penis are the 
same as in other parts of the body. It has 
cellular membrane, which is here very 
tough, so as to have been called by some a 
tendinous sheath. Where the penis is con- 
nected to the fore part of the symphysis of 
the pubis, the cellular membrane is parti- 
cularly strong, and has been called liga- 
mentum suspensorium; but it is not pro-
perly a ligament, and seems to be only 
common membranous connection. Near 
the glans penis this membrane is reticular, 
not cellular. 
The cuticle, skin and rete mucosum are 
very thin on the penis, and have seldom if 
ever any fat under them, even in the fattest 
bodies. These parts are supplied with 
many small branches of nerves. The præ-
puce, 


[16]
puce, which covers or incloses the glans,
is nothing more than a fold of skin, and 
the skin reflected over the glans makes its 
coat. Underneath it makes a tight band, 
called the frænum, which is fixed to the 
under side of the glans, and draws it down 
in erection. The frænum is sometimes 
originally too tight; in that case, it may 
he divided by incision. 
Near the basis of the glans penis is a 
circular border, called corona glandis: 
round the balls are a number of small 
glands, which secrete a fluid or mucus, 
that is of a fishy smell when it has been 
retained for any time under the præpuce. 
There is a little hole on each side, that 
appears (by the help of a magnifier) to be 
the source of this fluid. 
Here it may not be improper to recom- 
mend frequent washing and bathing of the 
parts, as this fluid, by being retained, be- 
comes acrimonious, and a discharge like a 
clap ensues: and it is very probable, that 
many cutaneous diseases originate from 
want of cleanliness, by which the pores of 
the skin are obstructed. 
The same kind of mucus is secreted from 
the


[17]
the glans clytoridis in women, as from the 
glans penis in men; and women are more 
frequently troubled with this complaint 
than men. It causes an itching all over 
the skin of those parts, and mostly pro- 
ceeds from internal uncleanliness. The 
warm bath, or frequent washing the parts 
affected, generally relieves; if not, a pro- 
per use of the aqua saturnina camphorata 
will seldom fail to accomplish that end. 
SECTION III. 
The gonorrhœa, speaking in general, is 
a preternatural discharge from the urethra; 
and when it is not the effect of venereal 
poison, it is occasioned either by sharp 
juices in the constitution, or sometimes it 
is quite local. 
Some have thought that the discharge 
flowed from the lacunæ; others from the 
prostate gland; and others from the vesi- 
culæ seminales. It is evident, however, 
that the clap affects not only one, but every 
part of the urethra; that is, though at first 
it may affect only one particular part, it 
spreads from one to another, if not timely 
subdued, until it affects the whole canal. 
C It


[18]
It is observed, that the venereal poison 
affects only those parts that are without a 
cuticle, or where it is very thin; which is 
the reason why we find the urethra so 
commonly affected, and not the skin of the 
penis: or if there is any crack in the cu- 
ticle, or little sore about the penis, a 
chancre is the consequence of the applica- 
tion of the venereal poison to that part, 
though there may be a discharge from the 
urethra notwithstanding. 
The morbific matter which produces the 
venereal disease, from its effects, appears to 
be of a specific nature, and different from 
any other infectious matter with which we 
are acquainted. 
The specific nature of the venereal poison 
has been the subject of many fruitless en- 
quiries, and is perhaps unknown. We 
are told by one * of the most eminent 
chymists perhaps in Europe, that it is too 
subtile for chymical analysis, and therefore 
can only be discovered by its effects. 
“ It is observed, that its operation upon 
the human body differs according to the 
* Dr. Saunders, Prof. Chym. and Physician to Guy's 
Hospital.
parts


[19]
parts which are primarily affected, the 
manner in which it has been communi- 
cated, and perhaps according to the degree 
of virulence in the original infection, as 
also the habit of body of the person who 
receives it. In some it unites more readily 
with the fluids, and produces its effects on 
the different secretions; in others, it at- 
tacks the more solid bones, and insinuates 
itself into their very substance. In some 
it causes the most excruciating pains; in 
others, the most virulent and sanious ul- 
cers: in many it lies in the constitution 
dormant and inactive, ready to break out 
in various forms, and with much violence, 
from some occasional cause.” * 
From the effects it produces in the con- 
stitution, it seems reasonable to conclude, 
that it is of a peculiar acrid nature, and it 
probably becomes more or less acrimonious, 
according to the different temperament of 
the patient. The most virulent infection 
in some constitutions, produces a gentle 
disease, whilst, in others, the slightest 
infection gives rise to the most violent 
and obstinate symptoms. As this difference 
* Dr. Saunders. 
may


[20]
may arise from the patient’s blood being 
tainted with a scorbutic or scrophulous 
leaven, is it not reasonable to suppose the 
different degrees of malignity in a great 
measure depends on the constitution of the 
party receiving the infection? 
It has been a matter undetermined, in 
what manner the infection is communi- 
cated, when taken by coition: it seems 
most probable, that the venereal poison 
is imbibed by the lymphatic vessels of the 
glans penis, whose orifices, in consequence 
of a particular organization, are disposed to 
absorb the infected matter. The late in- 
genious Mr. Hewson, in his experimental 
enquiries, observes, that those parts of the 
skin which are intended to have more sen- 
sibility than the rest, have those processes 
called villi most remarkable. This is evi- 
dent from a minute injection, when we 
compare the lips, glans penis, and other 
parts; and whenever absorption is per- 
formed, the blood vessels become turgid, 
and the orifices of the villi stand rigidly 
open; so that those parts being more liable 
to be infected than others, seems much 
to depend on the thinness of the cuticle,
as

[21]
as to their being more disposed to absorp- 
tion, from having more of these processes 
called villi. The great Boerhaave was of 
opinion, that the time of imbibing the 
infection, is when the penis begins to sub- 
side from its turgid state in the venereal 
paroxysm. 
The discharge which appears soon after 
taking the infection, is owing to the sti— 
mulus of the venereal poison, which, by 
irritating the orifices of the excretory ducts, 
causes a greater secretion of mucus from 
the subjacent glands. Thus it is observed, 
that when any sharp acrid matter irritates 
the stomach and intestines, immediately 
the glands in those parts emit a lubricating 
fluid to blunt the irritating spiculæ. It 
must therefore be considered only as an ef- 
fusion of lymph secreted from the different 
glands, which acquires a more viscid con- 
sistence, and becomes of a more acrid na- 
ture, from the inflammatory state of the 
secretory and excretory vessels, and appears 
like pus or matter. 
The quantity of the discharge is differ- 
ent in different people, and in the same 
person at different times, owing to the dif- 
ferent

[22]
ferent state of the parts affected, as well as 
the degree of stimulus that is applied. 
The variety in the colour of the dis- 
charge, seems also to depend on the dif- 
ferent state of the secretory and excretory 
vessels, which appear to possess a power of 
changing the lymph from its natural state, 
into a fluid like pus or matter; and there- 
fore, according to the kind and degree of 
inflammation, the discharge may vary, as 
in weak relaxed habits, the fluid may be 
of a mild nature; so in inflammatory 
cases, where the vessels act strongly, the 
discharge, in consequence of that strong 
action, may acquire a more sanious ap- 
pearance. It has been supposed by some, 
that this variety of colour is owing to the 
adventitious mixture of blood or pus, 
from the venereal virus corroding some 
capillary blood vessel. But Mr. Percival 
Pott observes, that inflammation and ir- 
ritation of the membranous linings of the 
urethra and vagina, will fully account for 
all the appearances in this disease, when 
there is neither ULCER, or ABSCESS. 
The same eminent surgeon also observes.
“ That

[23]
“ That in case of strictures in the male 
urethra, the discharge occasioned by a 
bougie, properly and judiciously used, is a 
discoloured mucus, and not matter, though 
it is generally so called by Daran and o- 
thers. It is from the discharge of this 
mucus, and the dilatation of the passage, 
that the relief is obtained, and not from 
any destruction or division of the parts. 
The bougie which produces TRUE MAT- 
TER, does much more harm than good, 
and makes a sore where there was none, 
and where there ought to be none. 
The inflammation may be of two kinds, 
erysipelatous, or phlegmonic; but we 
have reason to suppose, that it is generally 
the former, or that kind of erysipelas dis- 
tinguished by the name of erythema, where 
the vessels on the surface of the membrane 
in the urethra, communicating with the 
rete mucosum, are affected. We are of 
this opinion, because, though the inflam- 
mation may affect only one particular part, 
the morbid affection is quickly communi- 
cated to the whole extent of the urethra; 
and the erysipelatous inflammation is often 
disposed to spread from one place to ano-
ther 

[24]
ther on the same surface, and in so doing 
to leave the place it had at first occupied. 
That kind of sensation, which is felt as 
if the penis was compressed by the hand, 
seems to be owing to the lymphatic vessels 
being inflamed, which are very susceptible 
of pain in that state, and are affected by the 
distension of the adjoining blood vessels, 
and the cellular spongy parts of the penis. 
The frequent erections during this com- 
plaint are generally involuntary and spas- 
modic, and are effected by the venereal 
stimulus, as we observe a similar effect is 
produced in people advanced in years, and 
also in young children, in a morning, from 
the stimulus of the urine. Ballonius has 
given a very useful hint from this phœ- 
nomenon, viz. “ Let him who is not very 
potent in his generative faculties,” says he, 
“ perform copulation, after much titilla- 
tion, with his urine retained, and having a 
great desire to discharge it.” 
The chordee arising from venereal in- 
fection is of two kinds: the first, which 
is the most common, happens in conse- 
quence of the vessels of the cavernous body 
of the urethra being inflamed; so that the 
penis

(25)
penis in erection is drawn down in a curve. 
The second, is, when the penis seems to 
be tied round with a cord, which is owing 
to a lymphatic vessel being inflamed, which 
runs in that direction. 
In a recent gonorrhœa, the scalding or 
heat of urine is occasioned by the internal 
membrane of the urethra being inflamed 
or excoriated, and the mucus, which is 
destined to lubricate and desend this mem- 
brane, from the saline particles of the 
urine, instead of being a mild emollient 
fluid, is vitiated and depraved, and be- 
comes of a thin acrid nature. This lubri- 
cating fluid is sometimes deficient also in 
quantity, from some of the larger canals 
being obliterated, in consequence of inflam- 
mation, so that the tender membrane is 
left without its proper defence, and the 
urine, as it passes, irritates and causes 
pain. 
This symptom may also arise without 
any venereal disorder, and sometimes hap- 
pens from the great acrimony of the urine, 
owing to its being too long retained in the 
bladder, or not properly secreted, from a 
mal-conformation of the ureters and kidneys.
D The

[26]
The late celebrated Baron Haller ob- 
erves, that the genital organs are both 
sensible and irritable, and are endowed with 
an irritability, peculiar to themselves. And 
that as irritability depends on the mucus, 
the different degrees of irritability are pro- 
portioned to the different consistence of the 
mucus. 
SECTION IV. 
Symptoms of a recent Venereal Infection. 
It is obvious to common sense, that in 
order to perform an effectual cure in vene- 
real complaints, it is necessary to know, 
whether the disorder is local, and in a re- 
cent state, or whether there is reason to 
apprehend that the infection is absorbed, 
and the whole habit infected. We have 
too many instances, where the disorder has 
been treated with medicines that have not 
an antivenereal quality, whereby an illu- 
sory cure was obtained, and though the 
symptoms were suppressed, the cause was 
not eradicated, but reappeared upon exer- 
cise, freer living, or venereal embraces. 
When

[27]
When a person has had connections with 
a woman, if he has received any venereal 
infection, a discharge from the penis is 
observed, which leaves a stain upon the 
linen, like a drop of milk; and if it is 
attentively examined, a small spot of a yel- 
low or green colour, and of a thicker con- 
sistence, is perceived in the middle of it. 
It commonly makes its appearance in two, 
three or four days after the infection has 
been received, if the patient has taken 
any severe exercise, particularly on horse- 
back, or has been living intemperately. If 
he is of a healthy habit of body, and has 
lived temperately, it is frequently longer be- 
fore any symptoms arise, to indicate that he 
has got the infection. Sometimes previous 
to any discharge, there is a kind of tick- 
ling sensation perceived on making water, 
in or near the testicles, which is fre- 
quently attended with a heat or scalding, 
called ardor urinæ, especially when the 
last drops of urine come away. At other 
times, before any discharge is perceived, 
the orifice of the urethra looks red and in- 
flamed; and if the patient uses much ex- 
ercise, a foreness is felt on that part, by 
the

[28]
the rubbing of the shirt, should the glans 
be uncovered. 
When the above symptoms appear a few 
days after having connections with a wo- 
man, the person ought to apply for proper 
relief, as he may be well assured he is in- 
fected, particularly, if a scalding accompa- 
nies the discharge. 
When the running comes on a few hours 
after a connection of this kind, with no 
heat or smarting on making water, and 
is a clear pellucid fluid, it is mostly a 
gleet; but should it be discoloured, and at- 
tended with heat of urine, it is most proba- 
bly an old infection, that has been prema- 
turely stopped. 
Sometimes (though not often) in a recent 
infection, a discharge is perceived behind 
the glans or nut, and from the internal 
part of the præpuce or foreskin, without 
any discharge from the urethra, this symp- 
tom is generally occasioned by a former 
infection, except it is in consequence of 
uncleanliness, and then it is not vene- 
real. These are the common symptoms of 
the mildest species of gonorrhœa, which 
by the use of proper remedies, may be 
cured

[29]
cured in a few days—hence appears the ad- 
vantage of applying early for relief. 
When proper methods of treatment are 
not pursued, as the disorder advances, the 
venereal virus acquires a greater degree of 
acrimony, the inflamation becomes more 
general, and frequently affects the parts 
near the neck of the bladder, a more co- 
pious discharge from the urethra ensues, 
which is of a thicker confidence, and of a 
yellow, green, or bloody colour; often a 
throbbing and heat in the perinæum is 
perceived, with a frequent desire to make 
water, and often a strangury; the erec- 
tions are more frequent and painful, and 
the penis is in a manner incurvated, or 
bent double, particularly when the patient 
is warm in bed. This pain, in erection, 
is called a chordee. When these last 
symptoms appear, it is presumed that the 
seminal vessels, prostate gland, and the 
parts adjacent to the bladder, are affected, 
which require a more judicious treatment 
than is generally met with in this metropo- 
lis. Under these circumstances, should the 
discharge be suppressed, before the venereal 
poison is entirely subdued, a bubo, or swel- 
led


[30]
led testicle will most probably be the 
consequence. 
A bubo seldom appears soon after the in- 
fection is received, but in consequence of 
neglect, mismanagement in the treatment, 
or from some error committed by the 
patient himself. When this swelling in 
the groin happens in a recent gonorrhœa, 
a slight pain and stiffness is felt in the part, 
a day or two before the tumor or swelling 
is perceived; and in plethoric habits the 
gland is painful and the part looks inflam- 
ed. But, if it arises in consequence of the 
mass of fluids being infected, there is fel- 
dom any stiffness or pain perceived at first, 
nor any remarkable heat, tension, or pul- 
sation, in the part affected, but the tumor 
has a soft œdematous feel, and there is no 
discolouration of the skin. Therefore, 
an a bubo which is owing to a recent in- 
fection, the venereal poison, which occa- 
sions the tumor, is conveyed by the lym- 
phatics of the penis to the inguinal glands, 
where most commonly it remains for some 
time, and it is attended with less danger to 
the constitution, than when it arises with- 
out any manifest cause, as it then proceeds 
from a venereal taint in the constitution.
It

[31]
It has been generally supposed, as the 
lymphatic vessels of the penis pass through 
the inguinal glands in their way to the 
thoracic duct, and as the venereal infec- 
tion is carried into the habit by these ves- 
sels, that previous to the venereal virus 
being taken into the general mass of fluids 
and producing a pox, the lymphatic glands 
in the groin should always be infected, and 
consequently inflamed, and occasion a bu- 
bo, putting the practitioner timely on his 
guard to pursue such methods as may be 
most likely to prevent the habit from re- 
ceiving any venereal taint. But since the 
lymphatic system has been so minutely 
traced by diffection, and accurately describ- 
ed by my late worthy friend Mr. Hewson, 
we find that the lymphatic vessels do not 
always pass through the glands; it may 
therefore happen that the venereal poison 
may, upon being absorbed, pass into the 
circulating mass of fluids, by one of the 
lateral branches, without entering a lympha-
tic gland, or inflaming it. That this is 
probable will evidently appear by examin- 
ing the third plate in Mr. Hewson’s ex- 
perimental enquiries, of the lymhpatic 
system.

[32]
system, where the mercury (in making 
the preparation) appears to have passed 
from the groin, the whole length of the 
trunk of the body, without entering a lym- 
phatic gland. From which fact may be 
understood how the venereal poison some- 
times enters the habit, and produces a pox, 
without occasioning a bubo. Instances of 
which every careful observer must have 
remarked. 
The variolous matter introduced by in- 
noculation, although it frequently produ- 
ces inflammation and swelling of the 
glands in the axilla, or arm pit, yet is not 
always attended with those symptoms. 
Another reason why these poisons do not 
constantly affect the lymphatic glands in 
their way into the body, may be the dimi- 
nished sensibility of these glands, in some 
particular cases: whence the same poison 
which at one time would have produced the 
worst effects, may at another pass through 
these glands without inflaming them. 
The lymphatic vessels conveying the 
poison which inflames them, may be tra- 
ced particularly when the infection is re- 
ceived by the hand, as sometimes it hap-
pens.

[33]
pens in dissecting dead bodies infected with 
the venereal disease, if there be any cut or 
crack in the cuticle. A small red streak 
may be observed, which is the inflamed 
lymphatic vessel running along the sore 
arm, disappearing at the bend of the joint, 
and appearing above passing into the axil- 
lary gland under the arm, where a bubo is 
formed. 
Most elegant preparations of the lym- 
phatic vessels, made by Mr. Cruikshanks, 
are shewn at Dr. Hunter’s anatomical lec- 
tures.
Cancerous ulcers, commonly called 
chancres, may happen either with or 
without a discharge from the urethra; and 
though they are sometimes merely local, 
in consequence of the venereal poison hav- 
ing been deposited on the glans, yet they 
are more frequently symptoms of a general 
taint. 
When they appear soon after the infec- 
tion is received, they are commonly near 
the orifice of the urethra, or on the glans, 
often affecting the frænum, and sometimes 
underneath the præpuce. In this situation, 
they are attended with great pain and in- 
E flammation,


[34]
flammation, and frequently occasion a 
phymosis. 
But when they arise in consequence of 
an infected habit, they are not so painful, 
and are generally accompanied with some 
other symptom of a confirmed pox, such 
as ulcers in the throat, nocturnal pains, 
scurfy eruptions about the roots of the 
hair, and eruptions in other parts of the 
body, which commonly are sufficient symp- 
toms to distinguish them by. But by at- 
tending to the nature of the discharge, for 
a few days, the difference is obvious. In 
the latter case, it is more sanious and acrid;
so much so, that it destroys the part, and 
is not so easily checked by topical appli- 
cations; whereas in chancres arising from 
recent infection, the discharge is not of so 
acrid a nature, though the pain and in- 
flammation is greater. 
The phymosis is such a constriction of 
the præpuce or foreskin over the glans, as 
prevents it from being drawn backwards. 
The paraphymosis is such a constriction 
behind the glans, as hinders it from being 
drawn forwards. 
These symptoms are not always the ef- 
fect


[35]
fect of a venereal cause, though, in gene- 
ral, they are occasioned by chancres, or a 
defluxion excited by the acrimony of the 
venereal poison. 
Therefore, when we find that local 
symptoms, such as chancres, bubos, &c. 
though owing at first to recent infection, 
do not give way to the usual treatment, 
or break out again, after having been ap- 
parently cured, without a fresh infection, 
we may with great probability conclude, 
that the venereal poison has gained admis- 
sion into the blood, and tainted the gene- 
ral mass of fluids. But if, at the same 
time, we find ulcers in the throat, dry 
scabby eruptions on the skin, or appearing 
amongst the hair, we may be assured, that 
it is a confirmed lues or pox. Other sure 
signs are those deep seated pains, which 
are felt chiefly in the night, on the shin 
bones, arms, head, and sometimes on the 
shoulder blades; also those hard indolent 
swellings, as nodes in the periosteum, and 
exostosis upon the bones, which, when 
they are painful, may be supposed to pro- 
ceed from a venereal cause. 
These are the most manifest signs of a 
confirmed

[36]
confirmed lues; there are others, which 
are merely equivocal, and except they are 
attended with other symptoms, cannot be 
deemed certain signs of the venereal disease, 
such as violent inflammations of the eyes, 
obstinate headachs, wandering and obsti- 
nate pains in different parts of the body; 
none of which can be known to be vene- 
real, except they coincide with some or 
other of the more certain signs. 
It ought therefore to be remembered, 
that a confirmed pox, however slight the 
symptoms may be, which give the first 
notice of it, is a very serious disorder; 
since if it is improperly treated, or ne- 
glected in the beginning, it hardly ever 
fails, sooner or later, to introduce a train 
of symptoms, which not only render the 
patient miserable to himself, but, under
some circumstances, a nuisance to society. 
SEC-

[37]
SECTION V. 
On the Cure of the RECENT GONORRHOEA. 
From what has been said concerning the 
nature and effects of a virulent gonorrhœa, 
it plainly appears to be the consequence of 
a preternatural irritation in some one, and 
sometimes in all the parts, which have 
been shewn to be the seat of the disorder. 
Now since this irritation is undoubtedly 
produced by the stimulus of the venereal 
virus, the plain, and obvious indication of 
cure, must be, to remove the irritating 
cause; that is, to subdue and destroy the 
venereal poison, by such methods as are 
most likely to answer this purpose. 
To enumerate the several ancient authors 
who have wrtiten on this subject, would 
be an arduous and endless talk; and to 
mention the several methods they pro- 
posed for the cure of a recent gonorrhœa, 
would be productive of no useful purpose. 
Let us then enquire into the general 
practice of authors of a more modern
date.

[38]
date. We are told in a late publication, 
that the generality of authors are agreed, 
that purging is the remedy for the gonor- 
rhœa, as is salivation for a confirmed pox; 
and for the scalding in making water, 
(called ardor urinæ) that bleeding is the 
sovereign remedy. 
A most eminent surgeon * has made the 
following just observation, “ That the 
merely curing diseases, is not all that is re- 
quired; that was done, sooner or later, 
while surgery and anatomy were in their 
most imperfect state, and while every 
branch of medicine laboured under many 
inconveniences, which are now happily 
removed; but the different methods, in 
which chirurgical disorders are treated, or 
their cures attempted, will make so consi- 
derable a difference in the confinement and 
sufferings of the patient, as to be very well 
worth attending to.” 
In plethoric habits, if the inflammation 
be very great, bleeding and gentle purga- 
tives may sometimes be necessary, as auxil- 
liaries, we allow; but they become useful. 
* Mr. Percival Pott.
more

[39]
more on account of the bad habit of body 
occasioned, too frequently, by various 
kinds of excess, than from the nature of 
the disease itself. When the pain is be- 
come great, from whatever cause, there 
will be an extraordinary flow of blood and 
humours to the vessels in the parts affect- 
ed, which, by distending the canals, and 
cellular substance, will increase the in- 
flammation: therefore, diminishing the 
quantity of circulating fluids, removes the 
plethora, or too great fulness of the ves- 
sels, diminishes the tone of the moving 
fibres, and tends to prevent the occurrence 
of a topical determination of the blood, to 
the part affected: but where the constitu- 
tion is debilitated, or scorbutic, or the pa- 
tient advanced in years, these evacuations 
are not required; therefore, though bleed- 
ing and purgatives may sometimes be neces- 
sary, they are undoubtedly often employed 
without the least shadow of necessity. 
When the general habit is disordered, it 
will often make a very material difference 
in the treatment of venereal complaints. 
As to strong drastic purges daily repeat- 
ed, though they have the sanction of those 
illustrious

[40]
illustrious names, Boerhaave and Syden- 
ham, to recommend them; yet it is now 
well known, from the immoderate and 
unseasonable use of strong purgatives, that 
they frequently act a contrary part, and, 
instead of curing the disease, assist it to 
overcome the constitution. For it is very 
obvious, from the degeneracy of the con- 
stitutional vigour of mankind, that the 
present race are less able than our ances- 
tors, to bear the repeated operations of 
bleeding and purging. And it will hardly 
be denied, that obstinate gleets as fre- 
quently are the effects of strong purges, as 
they are easily and certainly prevented, by the 
use of tonic medicines; such as Peruvian 
bark, steel, &c. &c. where the venereal 
virus has been previously subdued.
Others have been equally unsuccessful 
in their method of treating venereal cases, 
from attempting to discover the nature of 
the morbid fluid. Astruc says, it is of an 
inflammatory, coagulating, fixed, and pro- 
bably of an acid, or salso-acid nature. 
Cockburne endeavours to prove an acid,
by chymical experiments; others have de- 
clared

[41]
clared this poison to partake of a volatile 
alkali. 
All this is systematical, and does very 
well to read, but if the physician, or sur- 
geon, should set about the cure of his pa- 
tient, by ordering acids, or alkalies, or 
absorbents, or such things as he imagines 
will conquer the predominant species of 
acrimony, he will prescribe to very little 
purpose. 
We know that the venereal disease arises 
from some peculiar subtile matter, which 
we find, by experience, produces its par- 
ticular symptoms; but the quality of this 
poison, we cannot possibly describe, nor 
determine; therefore, let us be under no 
concern, whether we know, or do not 
know, what its particular qualities are, 
provided we can tell, when it is present, 
what things will correct or subdue it. For- 
tunately, experience has furnished us with 
medicines that scarcely ever fail, if applied in 
time, and prepared with care and attention. 
Upon the whole, we apprehend, that 
the frequent ill success, in curing the recent 
gonorrhœa, has been occasioned by at- 
tending chiefly to the general inflammatory
F state 

[42]
state of the system, and neglecting the local 
or venereal inflammation, by which means 
the venereal poison is absorbed into the 
habit, and the gonorrhœa often terminates 
in a confirmed lues; or from the notion, 
that the discharge proceeded from ulcers 
in the urethra, improper modes of cure has
been adopted by different people, with a 
view of deterging, incarning, and cica- 
trizing these imaginary ulcerations of the 
parts. 
We observe, in regard to the absorp- 
tion of acrid matter, that frequently it 
is not immediately absorbed, but remains 
for some time in a wound, before it en- 
ters the vascular system: which fact is evi- 
dent on introducing the variolous matter 
by inoculation; also in the poisonous bite 
of mad animals; which poisons are ob- 
served to remain inactive, until a topical 
inflammation arises on the place of their 
insertion. May we not therefore con- 
clude, that it is more owing to the inacti- 
vity of the poison, than the efficacy of any 
medicine hitherto known, that so few per- 
sons die from the effects of the bite of a 
mad animal; and it is too true, that the 
only


[43]
only method to be depended on, is to 
render the poison inactive, by immediately 
burning the part, or, what is certainly 
preferable, to extirpate the poison before 
absorption has taken place. 
Therefore, in a recent gonorrhœa, it 
cannot be too strongly recommended, to 
destroy, or render inactive, the venereal 
virus, by suitable topical applications, as 
soon as possible; since it seems to be the 
most rational and efficacious method of pre- 
venting the future ill consequences of such 
an injury, and preserving the constitution 
from the infection. 
In a late publication on this subject, a 
gentleman * of eminence in the profession, 
gives the following satisfactory reasons, 
why the method of curing this disorder 
by injection, has not been more univer- 
sally practised. 
First, “ The patient’s fear of not obtain- 
ing a perfect cure without the purging 
method.” 
Secondly, “ Because many people used 
injections improperly, in cases for which 
* Dr. Leake. 
they

[44]
they never were calculated; or directed 
such as were pernicious in quality, to the 
great injury of the patient. But this was 
not at all the fault of the remedy, but of 
those who wanted skill to apply it. Hence, 
by abuse, injections were brought into dis- 
credit, which was no more than what had 
happened to the most valuable medicines 
ages ago. Has not the use of Peruvian bark, 
mercury, and opium, been decried, as de- 
structive to the constitution; yet how much 
would the power of physic be weakened, 
were those salutary medicines taken away?” 
Dr. Duncan, in his observations on the 
operation and use of mercury in the vene- 
real disease, observes, “ That mercury, 
when properly administered, is a certain 
antidote to the venereal virus; and that in 
whatever way it be introduced into the 
system, it must come in contact with the 
venereal poison in those parts in which it 
is lodged, previous to its producing a cure.” 
And therefore he concludes, that mercury 
cures the venereal disease, from its power, 
as an antidote, in consequence of its being 
topically applied to the venereal matter. 
He also observes, “ That when the mat- 
ter

[45]
ter ocasioning the infection, is still in a state 
of topical application only, as happens in 
the case of a gonorrhœa, the introduction 
of mercury into the system is totally unne- 
cessary; and a cure may be effected by 
other means, not only with greater ease 
and safety, but likewise with more expe- 
dition. 
Dr. Saunders, in his supplement to Mr. 
Plenck’s treatise on mercury, speaking of 
the cure of the venereal gonorrhœa, says, 
“ It must be allowed, that there are many 
local affections, independent of any disease 
in the habit, which can only be cured by 
external applications to the diseased parts; 
and as the neglect of topical applications in 
such cases, has been productive of infinite 
mischief, by conveying fresh infection into 
the constitution, an early and a judicious 
use of external applications to a part recently 
and primarily affected, while an attention 
is still paid to the general habit, often les- 
sens the quantity of infection introduced.” 
Besides, that mercury topically applied sub- 
dues or renders inactive the venereal poi- 
son, appears clearly, not only in those 
ulcers to which dressings can be applied, but 
in


[46]
in others more out of reach, where its ap- 
plication can only be temporary. The 
advantages obtained in some cases, by ap- 
plying mercury to venereal ulcers in the 
mouth and throat, whether in the form 
of vapour or gargle, sufficiently shew the 
truth of this assertion: So that the cure pro- 
duced by these methods, is unquestionably 
to be referred to an immediate action upon 
the part.” Therefore, that injections may 
with propriety be used, none will deny, 
except such as have wanted opportunities 
of observing their good effects; since re- 
peated experience, which is the most cer- 
tain test of propriety in medical practice, 
has clearly shewn, that when they are 
suited in strength and quality, to the nature 
of the infection, the time of its duration, 
and the tenderness of the part to which they 
are applied, they afford the most rational 
means of curing a fresh venereal contraction. 
Hinc medicamenta externa in hoc morbo 
primis profutura cencendum est, materiam 
morbosam efficacius corrigere et mutare va- 
leant, quam remedia interna vulgo adhibita, 
quæ per longas vasorum ambages, debili- 
tata ad loca adfecta tandem feruntur. 
MONRO on the Lymphatics. 
Notwith-


[47]
Notwithstanding what has been said of the 
advantages obtained from proper injections, 
it is of the highest importance to avoid, or 
at least use with great caution, those of an 
astringent nature. I believe I am not sin-
gular in my opinion, when I assert, that 
more poxes are occasioned by the impro- 
per and unseasonable use or abuse of astrin- 
gent injections and balsamic medicines, 
than from any other cause. And it seems 
most probable, that the frequent disorders 
in the urethra are generally from an inju- 
dicious treatment, by astringent injections. 
Dr. Storck, in his Annus Medicus, 
justly observes, in the venereal disease: 
“ Effientiæ, tincturæ, et remedia balsamica 
“ ac adstringentia hic raro profuerunt. In- 
“ jectiones adstringentes, consolidantes et 
“ præfertim saturninæ summa cum Cau- 
“ tela evitanda sunt, hæ enim pessima 
“ symptomata producunt. Etenim testiculi 
“ inde fæpius intument, fiunt schirrosi; 
“ oriuntur bubones inguinales. Vidi a 
“ gonorrhœa, hac ratione suppressa, exul- 
“ ceratum esse umbilicum, et eandem ibi 
“ prodiisse materiam, quæ antea per ure- 
“ thram exstillavit.” 
The

[48]
The fatal consequences that will inevi- 
tably ensue from the use of astringent in- 
jections before the venereal virus is entire- 
ly subdued, must be obvious. If at any 
time they are required, it is for a tedious 
gleet, occasioned by neglect or improper 
treatment at the beginning of the disorder, 
and even then, they should be of the mild- 
est kind: but by using injections on the 
first appearance of the discharge in a viru- 
lent gonorrhœa, which do not possess any 
antivenereal quality, an apparent cure is 
frequently only obtained; for though the 
running may disappear, yet the cause is 
not entirely eradicated, and a reflux of the 
infected fluids into the blood is occasion- 
ed. 
Another objection has been made to 
the use of injections, that when the dis- 
order seems to be seated in some of the 
parts adjacent to the bladder, there ap- 
pears no possibility of conveying the pre- 
paration to the parts affected. With the 
common syringe, indeed, it seldom can be 
thrown up high enough, to produce any 
salutary effect; but by using the hollow 
flexible bougie, with an elastic syringe, it 
may

[49]
may be done with the greatest ease and 
safety. 
Therefore if the mode of treatment, by 
injections, has not always been attended 
with good effects, our censure ought to fall, 
not on the method itself, but on the mis- 
application of it, by injudicious people. 
The cure of a recent gonorrhœa, or 
fresh contracted infection, is very easily 
accomplished in a few days, without 
bleeding or purging; and provided the pa- 
tient is in good health, the use of me- 
dicines internally is not necessary. 
But when the disorder has been of a longer 
continuance, and the patient is of a bad habit 
of body, it will often make a material dif- 
ference in the method of treatment, as 
well as in the time required to accomplish 
a radical cure. 
It is therefore always necessary to make 
proper enquiry, in regard to the time when 
the infection was taken, and also to be in- 
formed, of the particular parts which are 
affected, being convinced, that injections 
have frequently failed, for want of this pre- 
vious knowledge. For so long as the dis- 
order affects only the penis, proper injec- 
G tions,

[50]
tions, judiciously applied, will always subdue 
the venereal poison, and produce a radical 
cure, in less time, with equal certainty, and 
less trouble to the patient, than it is possible 
to do by any other means, without them. 
Therefore, when the disease is recent, 
and attended with no pain, or smarting, 
near the root of the penis, we may conclude 
the infection has not extended far, and has 
only excoriated the lacunæ near the glans; 
in this case, a proper injection with a com- 
mon syringe will be sufficient to effect a 
cure; but where there is great pain or throb- 
bing in the perinæum, with considerable 
smarting after making water, near the blad- 
der, and frequent calls to discharge the u- 
rine, we may suspect the prostate and Cowpers
glands, and the parts adjacent to the blad- 
der, are affected; therefore a radical cure 
cannot be expected by injecting with the 
common syringe, as it is out of the reach of 
preparations injected by them. Under 
these circumstances, the introduction of 
mercury into the system, either by inunc- 
tion, or given internally, is generally pro- 
per, as the infection may have got into the 
habit, without affecting the inguinal 
glands.

[51]
glands. Should there be any considerable 
degree of defluxion, or should the inflam- 
mation have affected the seminal vessels, or 
prostate gland, if it is not quickly remov- 
ed, a tedious gleet frequently ensues from 
the erosion or relaxation of the excretory 
ducts of these parts; in these cases, should 
any astringent injection be used, or the 
discharge be stopped by any other means, 
before the venereal virus is subdued, a bu- 
bo, swelled testicle, or abscess in perinæo, 
generally are the consequences, which 
frequently terminate in a pox; therefore, 
the sooner the inflammation is removed 
from the parts affected, the less injury they 
are likely to sustain, and there will be less 
danger of the venereal poison being carried 
into the general mass of fluids. 
As the ardor urinæ, or scalding in mak- 
ing water, is one of the most distressing 
symptoms in a recent gonorrhœa, and 
whilst it is violent, from the tenderness of 
the parts affected, surgeons have been hi- 
therto prevented from using mercury, by 
way of injection, as it has generally been 
supposed to encrease the inflammation; it 
is therefore obvious, that the immediate 
removal


[52]
removal of the heat of urine, must be at- 
tended with material benefit, in expedit- 
ing the cure, as well as relieving the pa- 
tient of his sufferings, by permitting the li- 
beral and immediate use of mercurial injec- 
tions, without giving the least pain. 
To accomplish this purpose, the usual 
method of treatment, is to dilute with large 
quantities of small liquors, wherein nitre 
has been dissolved, or emollient drinks, 
such as lintseed tea, barley water, with 
gum arabic and such like: at the same time 
soaking the parts in warm milk and water, 
throwing up emollient injections, with 
sometimes an opiate joined to them; and 
where feverish symptoms accompany the 
heat of urine, to bleed plentifully, and give 
frequent purges. 
It is well known to every patient who 
has had a severe scalding, that none of these 
methods will remove this symptom, until 
they have been pursued many days, nay, 
sometimes weeks, and in some cases, the 
ardor urinæ has continued during the whole 
time of cure. When the feverish symp- 
toms are high, bleeding, with an antiphlo- 
gistic regimen, is certainly required; but 
it

[53]
it becomes necessary, more on account of 
the general inflammatory state of the pa- 
tient, than to remove this particular local 
affection. 
As for nitre and diuretics in general, 
with large quantities of diluting liquors, 
they seldom are wanted in a recent com- 
plaint; as by causing so great a flow of 
urine, they serve to multiply the patient’s 
sufferings, without abating his pain. 
As this symptom in a recent gonorrhœa, 
is merely a local complaint, topical appli- 
cations to the affected parts, are found 
to be mod effectual to remove it; but 
the inefficacy of any preparation hitherto 
in use, has induced most practitioners, as 
well as their patients, to wish for some 
medicine, or some method, which would 
answer this desirable purpose, with greater 
certainty and expedition. The Author 
will therefore give some account of a pre- 
paration, he has used, and the methods he 
has pursued with uncommon success, which 
has been found to remove immediately this 
troublesome complaint, without danger, or 
giving the least pain to the patient; and which 
when combined, or used along with a proper
mercurial 


[54]
mercurial injection, effectually cures a RE-
CENT gonorrhœa in a few days; as many 
gentlemen at this time in London have ex- 
perienced. 
I will not attempt to explain how it acts 
so immediately upon the parts affected, but 
shall give some cases to elucidate its effects 
in the various symptoms of this disdorder. 
At the same time, the Author wishes to 
have it understood, that what he has to 
advance on the efficacy of the preparation, 
in IMMEDIATELY relieving the ardor uri- 
næ, is meant in recent gonorrhœas, and 
not in old cases. 
A young man, twenty-two years of age, 
of a very delicate, though healthy habit 
of body, applied to me on the 17th of July 
1777, for a recent clap, which was attend- 
ed with great scalding on making water; 
the discharge was moderate. He began to 
use the preparation for the ardor urinæ, 
which immediately took away the heat of 
urine, and by injecting it night and morn- 
ing, combined with a mild solution of 
mercury, he was perfectly cured, in ten 
days, without the use of any other me- 
dicine whatever, and continued perfectly 
well for ten months, when he contracted 
another

[55]
another gonorrhœa, and was cured by the 
same method of treatment. 
It may not be improper to observe, that 
in every stage of this disorder, keeping the 
parts affected clean, by washing with milk 
and water of a moderate degree of heat, is 
very conducive to a speedy cure, as well as 
comfortable to the patient. Where a costive 
habit indicated the use of laxatives, I have 
always found the gentlest, the most effica- 
cious: such as two drams of cathartic salt 
in an infusion of sena, or, what I have found 
preferable, in water impregnated with fixed 
air, and occasionally repeated. 
In December 1777, a lady seven months 
gone with child, came to ask my advice 
for a disagreeable smarting, with difficulty 
in making water, attended with a discharge 
from the urethra. As her husband had been 
my patient some months before, I con- 
cluded it was venereal, without mention- 
ing my suspicions to her. The vagina and 
vestibulum uteri were free from inflamma- 
tion, but the orifice of the urethra looked 
red, and internally was so susceptible of 
pain, as not to permit the introduction of 
the smallest bougie. By the daily use of 
water

[56]
water impregnated with fixed air, to each 
pint of which was added half a dram of 
the native fossile alkali, (nitrum vel natron 
antiquorum) the inflammation was abated, 
so as to suffer the use of mercurial injecti- 
ons per uretbram, which took away her 
complaints in a few days, and they have not 
returned. 
As we very frequently have patients, 
who have a virulent gonorrhœa that is not 
recent, it would be imprudent to trust to 
injections alone; and when attended with 
other symptoms of venereal infection, as 
chancres, bubo, &c. it then becomes ne- 
cesary, at least prudent, to introduce a 
proper quantity of mercury into the system; 
but as it would be absurd to suppose, there 
can be one invariable method of using this 
powerful corrector of the venereal poison, 
it is necessary, that such measures should 
be pursued, as are best suited to the strength, 
age, sex and constitution of the patient, as 
well as to the state of the symptoms. 
In a virulent gonorrhœa of long stand- 
ing, unattended with any other local 
symptom of venereal infection. I have 
found mercury given internally, answer 
every

[57]
every purpose I could wish; but where 
a virulent discharge, is accompanied with 
a bubo, or swelled testicle from a venereal 
cause, greater benefit may be obtained from 
applying it externally in the form of uncti- 
on, with proper mercurial injections. 
In strong plethoric habits, where mercury 
is designed to enter the circulating system; 
previous to its use in any form, taking away 
a proper quantity of blood, is not only ne- 
cessary, but will generally be found to make 
its operation more safe and effectual, and 
admit of this valuable specific being used 
with greater freedom; and where a costive 
habit prevails, or laxatives are required on 
any other account, two or three spoonfuls of 
the following mixture, given occasionally 
at bed time, I have found answer better 
than any other medicine. 
ꝶ ol. ricini ℥iss 
Vitell. ovi parum. 
Probe contritis in mortario, adde sensim 
Aq. menth. simp. 
—Cinnam. simp. an. ℥ii 
Syrup, rosar. solutiv. ℥ss. mis. 
H Where

[58]
Where oily mixtures are disagreeable, the 
cathartic salt or soluble tartar in an infusion 
of sena may be given. But laxative me- 
dicines are very seldom required, where 
mercury is used internally, except the sali- 
vary glands should be much affected, 
which may generally be prevented by pro- 
per care. 
In weak relaxed constitutions, where 
the fluids are in a more dissolved state, all 
evacuations previous to the use of mercury 
are not only unnecessary, but improper; 
in these cases, I have found it generally 
requisite to give the bark, and water im- 
pregnated with fixed air for common 
drink. 
In whatever form mercury is used to 
subdue the venereal disease, whether taken 
inwardly, or externally applied, it must 
pass either through the lacteal, or the ab- 
sorbent vessels on the surface of the body, 
before it can be received into the blood; 
and though we find many preparations of 
this specific, may, under proper manage- 
ment, be successfully employed in the cure 
of this disease, yet as some are better ad- 
dapted to the various symptoms that occur,
than

[59]
than others, it is therefore of great import- 
tance to attend to the separate effects and 
operations of particular preparations, in or- 
der to answer the different intentions of 
cure. 
Among the various preparations of mer- 
cury, I have found none so safe or effec- 
tual in the cure of the venereal disease, 
as a solution of mercury, I have made, in 
which the crude quicksilver is suspended. 
Though it has proved singularly beneficial 
in the cure of this disorder, under its va- 
rious forms and appearances, when exhi- 
bited internally, as well as when used by 
injection, yet I do not suppose or expect it 
infallible, and that in all patients, it will 
produce salutary effects, and never frustrate 
the hopes of the prescriber. Experience and 
observation has convinced me to the con- 
trary; but evident proofs of its supe- 
rior efficacy, in safely and radically sub- 
duing this disease, have induced me to pre- 
fer it, in most cases, to any other prepa- 
ration. Its superior efficacy, may probably 
be owing to the perfect solution of the 
quicksilver, and the prodigious smallness 
of its mercurial parts, and in consequence
to

[60]
to its subtilty, whereby it penetrates the 
most minute vessels of the body, and dif- 
fuses itself through the whole system, cir- 
culating readily with the fluids. It may 
be given with the greatest safety in the 
most tender habits, so that those of 
delicate constitutions, need not be afraid 
of a salivation, or the pernicious effects 
so often produced by other preparations of 
mercury. 
In very obstinate cases, when the vene- 
real poison has been long in the habit, it 
has proved most efficacious, and has suc- 
ceeded in the cure, after large quantities 
of mercury had been introduced into the 
system by inunction, without any material 
benefit; particularly where the venereal 
disease is attended with cutaneous erupti- 
ons, commonly called scorbutic, but 
which ought carefully to be distinguished 
from real scorbutic blotches. 
March 18th 1777, E. G. about forty years 
of age, was recommended to my care, by a 
gentleman in town, for a painful inflammato- 
ry swelling, which reached from her knee to 
her ancle, with two deep sanious ulcers near 
the calf of her leg; on the other leg, there 
was

[61]
was a node on the shin bone, and a large 
swelling under the ham, with scabby erup- 
tions on the head, among the roots of the 
hair; her pains were so great she could get 
little or no rest, had a continual headach, 
and sickness at her stomach. She had been 
ill two years, during which time, she was 
salivated in St. George’s hospital, and af- 
terwards, in the Westminster Infirmary. 
The preparation for the ardor urinæ was 
applied to the ulcers in her legs, which re- 
lieved her of the violent pain, and by tak- 
ing a diet drink with the solution of mer- 
cury, she got well in six weeks, and re- 
mains well at this time. 
I shall add an instance of the different 
effects of this medicine and mercurial unc- 
tions, after the latter had been used with- 
out any benefit, in an obstinate venereal case. 
August 24th, 1778, I was desired to visit 
a gentlewoman in Westminster, near forty 
years of age, who had been ill five or six 
years of a venereal complaint, and was 
much emaciated; she had various ulcers 
on her forehead, lower jaw and shoulder, 
with a rigidity of her elbow, which was 
swelled and very painful, and her ham was 
so


[62]
so contracted, that she could not walk across 
the room without some assistance. She 
had also a violent cough attended with a 
shortness of breath. 
August the 26th she begun the use of a 
diet drink, with the mercurial solution. 
and had proper medicines ordered for 
her cough, and asthmatic complaints; 
she applied the steam or vapour of a mix- 
ture of vinegar and honey to her elbow, 
and flexor tendons of the leg, with an 
embrocation prepared with the yolk of a 
raw egg, beat up with two ounces of water, 
which she used twice a day. 
The ulcers discharged a fœtid acrid mat- 
ter, to which was applied, the mercurial 
solution diluted with water impregnated 
with fixed air. 
September 5th, she walked near half a 
mile to my house, and was better in every 
respect. The same method of treatment 
was continued until the 29th, when she 
left off taking any medicines, the ulcers 
were completely healed, only the skin in 
the forehead remained a little tender; her 
ham and elbow perfectly recovered their 
flexibility, and, except her asthmatic com- 
plaints, she was perfectly well. 
Several

[63]
Several surgeons who happened to be 
with me, saw these two Patients, when they 
came to be dressed; and though both of 
them were unable to walk without support 
for upwards of twelve months, they now 
can walk perfectly well. The neighbours,
as also the patients, will certify these cases 
to any person who may with to be further 
informed. 
Previous to my attending the above pa- 
tient, she had rubbed in large quantities of 
mercurial ointment at different times, and 
had also applied it to the ulcers, as I 
found on the dressings, when I first visited 
her. 
I could give several cases to shew the effi- 
cacy of this preparation, where it was admi- 
nistered by other gentlemen of the profession, 
but at present, it is unnecessary, as the above 
sufficently prove its salutary effects, in sub- 
duing some of the most inveterate symp- 
toms of the venereal disease; and as it acts 
in the most gentle manner, it may be safely 
given, without occasioning the least incon- 
venience, to the most delicate patients, or 
requiring any alteration from the usual way 
of living, so as to give any one the least
suspicion

[64]
suspicion of the nature of their complaint. 
It is therefore presumed, that on further 
trials, it will be found one of the most safe 
and efficacious mercurial preparations, hi- 
therto discovered, and from its active and 
penetrating properties, equally applicable 
to eradicate this pernicious poison, either 
used by injection for a gonorrhœa, or when 
given internally, where the infection has 
got admittance into the general mass of 
fluids, and the whole habit is affected. 
But the nature of this mineral is such, 
that the greatest care and circumspection is 
required, in whatever form it is used, par- 
ticularly when administered to persons of 
weak lungs, or of a scorbutic habit of body, 
for should it be too liberally used, or too 
suddenly thrown into the habit, disagreeable 
consequences will often ensue, as it is well 
known, that the most powerful remedies pro- 
duce the most fatal effects, when used impro- 
perly: and though it is a melancholy truth, 
yet it is too often experienced, that the pa- 
tient suffers more from its imprudent use, 
than from the violence of the disease it was 
designed to remove. Therefore, as every 
powerful remedy is by the abuse of it, con- 
vertible


[65]
vertible into the most powerful poison, it is 
not in the least surprising, that so many 
persons of tender and delicate conditu- 
tions, suffer from the usual mode of treat- 
ing this disease, when it is considered, 
that one general plan is indiscriminately, 
or at least with very little variation, pur- 
sued, in the treatment of people of all ages 
and constitutions. The most common, as 
well as the most fatal of these pernicious 
effects, are an affection of the lungs or con- 
sumption, and violent headachs. But 
such must be the fatal consequences, attend- 
ing the practice, whenever the disease is 
prescribed to, and not the patient. 
In June 1777, a young gentleman having 
got a slight venereal infection in the coun- 
try, put himself under the care of an apo- 
thecary who had pursued this general plan 
of treatment, and gave him mercurial me- 
dicines at night, and a purge next morn- 
ing, constantly for five weeks. Finding 
himself no better, but much reduced in 
his strength, he came to town for farther 
advice. 
In July, when he applied to me, he bad 
a great discharge from the urethra, which
I did

[66]
did not shew much signs of venereal infec- 
tion, except the being accompanied with 
a little heat of urine, for which he used 
proper injections. 
His general health seemed to claim the 
greatest attention; he had a continual fever 
attended with a short dry cough, which 
generally increased after eating, with a 
flushing in his cheeks. The rest of his 
face was thin, and of a dirty sallow hue, 
with his eyes sunk in their sockets; his 
pulse was quick, particularly in the evenings, 
when it was also hard; he had a constant 
thirst; he frequently complained of a par- 
ticular kind of heat and dryness in the 
palms of his hands and soles of his feet; 
he slept badly, and towards morning a cold 
clammy sweat broke out. In the day 
time he had frequent shiverings, sometimes 
succeeded by a hot lit, with other hectic 
symptoms, which seldom terminated in 
a sweat. This appeared to me, to be 
truly an incipient phthisis mercurialis, or 
mercurial consumption, induced by impro- 
per treatment of his venereal complaint. 
As the disease was not far advanced, his 
appetite and digestion were pretty good, 
and

[67]
and since he had left off taking mercurial 
medicines, a diarrhœa, which had been 
perpetual, was much abated, I hoped from 
a well regulated diet and temperance, to 
afford him more relief than I expected 
from medicines. 
His diet was directed to be chiefly milk 
and strawberries, and such ripe fruits as 
were then in season, abstaining entirely from 
animal food, wine and malt liquors. Morn- 
ing and evening he drank water impregnated 
with fixed air, to which, one third part of 
milk, warm from the cow, was added. To 
abate the heat and thirst, which in the be- 
ginning were great, he took three times a 
day a scruple of purified nitre in a cup of 
coltsfoot-tea or barley-water sweetened with 
honey; in less than a fortnight his night 
sweats left him, his cough became trifling, 
and his pulse much slower and fuller, and 
not the least appearance of any venereal in- 
fection. Finding himself so much better, 
he inadvertently stayed out late one even- 
ing, and next day his cough returned with 
a pain in his side, for which a moderate 
quantity of blood was taken from his arm.
He now persevered steadily in the use of 
milk

[68]
milk and strawberries, with other ripe fruits, 
as his sole diet; using for drink water im- 
pregnated with fixed air, to which was 
added the fossile alkali, in the proportion 
of a dram and a half to two quarts of the 
water. By continuing this regimen and 
diet for near six weeks, he recovered his 
health and colour, so as to be able to go 
into the country, where he took constant 
exercise on horseback; and when I saw 
him about five months ago, he had no re- 
turns of his complaint, and was in perfect 
health. 
As the use of the solution of mercury, has 
hitherto been confined to my own patients, 
and exhibited only by those gentlemen of 
the profession, to whom I had given it to 
ascertain its effects by tryal, I shall beg 
leave to offer some observations on those 
preparations of mercury in general use. 
In obstinate venereal cases, where a large 
quantity of mercury is necessary to be in- 
troduced into the habit, the practice by 
unction has been considered, as the most 
useful and efficacious method of cure. 
Many advantages may be derived from its 
use in this form, if properly managed; par-
ticularly 

[69]
ticularly by this mode of using it, we avoid 
the disagreeable effects so frequently pro- 
duced by its internal use, on the stomach 
and intestines. 
The only inconvenience which I have 
observed from the use of the mercurial 
ointments, (as usually prepared) arises from 
the acrid nature of the substances with 
which the mercury is triturated. Every 
person I presume, who has been much con- 
versant in venereal practice, must have re- 
marked the disagreeable consequences which 
are frequently occasioned by the turpentine, 
with which the mercury is divided; from its 
acrid and irritating nature, it generally 
produces an erysipilatous inflammation, ap- 
pearing in little angry pustles, on those 
parts where the ointment is applied; be- 
sides, from the viscid and clammy nature of 
the turpentine and balsam of sulphur, they 
seem ill adapted to penetrate the pores of 
the skin, and to be taken up by the absorb- 
ent vessels. 
The mucilage of gum arabic seems also 
improper for dividing the mercurial glo- 
bules, when intended for external use. 
Sometimes it is prepared with lard alone, 
which certainly is a more eligible method,
but

[70]
but from the great difficulty in perfectly 
extinguishing the mercury, it is liable to 
great uncertainty in its effects, as its acti- 
vity will depend on the degree of triture 
employed in preparing it. 
To obviate these objections to the un- 
guent. cærul. fort. (as it is usually made) 
I take the liberty to recommend a method 
of preparing it, which I have found from 
experience, to be mild, penetrating, and effi- 
cacious; and as the substance employed in 
the place of the turpentine, divides the 
mercury with very little trouble, and in 
much less time, I hope the following form 
will merit the attention of those gentle- 
men, who may have occasion to use this 
valuable, though untractable mineral, by 
way of inunction. 
ꝶ Hydrargyri ℥i 
Axung. porcin. ℥vi 
Adipis anseris purificat ℥ii 
Adeps cum hydrargyro intimè teratur. 
Dein adde axung. porcin. et bene mis- 
ceantur. 
Where

[71]
Where mercury is to be exhibited inter- 
nally, I have found no preparation more 
efficacious, than the precipitate of calomel, 
as directed by Dr. Saunders. But as it is 
with some difficulty suspended in a fluid, 
it may in most cases answer better if given 
in a pill. 
As I have always remarked, that the ve- 
nereal disorder is cured with the greatest 
certainty, and in the least time, where the 
mercury occasions no apparent increase of 
evacuation by the intestinal tube, and 
where a gentle moisture on the skin is pro- 
duced, I have generally given this prepara- 
tion with the pill è styrace and camphor. 
But in some constitutions, mercurials, how 
much soever the complaints may seem to 
demand them, are found to produce very 
disagreeable effects when internally exhibi- 
ted; these circumstances, which cannot 
always be foreseen, ought carefully to be 
attended to, for in such cases, if we obsti- 
nately persist in their internal use; we 
shall be so far from relieving the patient, 
that we shall not only render the disease 
worse, but materially injure the constitu- 
tion. 
Where

[72]
Where mercury occasions unusual spas- 
modic affections in the stomach and intes- 
tines, and its internal use is deemed neces- 
sary, if it be combined with opium and 
ipecacuanha, these disageeable consequences 
will be prevented, without diminishing 
its efficacy. 
In scrophulous, as well as scorbutic ha- 
bits, the general health of the patient must 
be particularly attended to. As the for- 
mer disease, perhaps, originates more from 
a faulty absorption, than from any consti- 
tutional or hereditary taint in the blood, as 
is generally supposed, we must not there- 
fore think to rectify this remote cause 
(which may in some cases be attributed to 
a malconformation of the solids) by purg- 
ing and evacuating these imaginary gross 
humours, by which treatment we weaken 
the patient, who is already in too relaxed a 
state; but endeavour to assist nature, in en- 
abling her to perform the due secretions, 
by strengthening the general habit, with 
tonic medicines, good air, and moderate 
exercise, at the same time that we destroy 
or render inactive the venereal poison, by 
mild mercurial preparations.
There-

[73]
Therefore, where scrophulous complaints 
are known, from glandular swellings 
in the neck or other parts, mercury 
should be used with the greatest circum- 
spection, as by its imprudent exhibition, 
we should not only be disappointed in cur- 
ing the venereal complaint, but be liable 
to render the original disease more certainly 
destructive. 
When the glands are painful and inflamed, 
no preparation of mercury should on any ac- 
count be used, but what is very mild; at the 
same time the swellings should be carefully 
defended from the cold air; the bowels 
should be render’d laxative, and the pores 
kept open by mild, diluting nitrous drinks. 
In habits, tainted with a real scorbutic 
leaven, as where the gums are putrid, 
with blue or black spots, and eruptions 
on the body, which generally first appear 
on the outside of the arms, from the wrist 
to the shoulders, or sometimes on the legs 
and thighs, mercury should be cautious- 
ly administered, as it is observed, that a 
very small quantity will induce a dange- 
rous salivation in scorbutic patients, and is 
often followed by a diarrhœa or dysentery,
K which

[74]
which being stopped, the salivation returns.
May not this, in some degree, be attributed 
to the bibulous disposition of the lacteals 
and lymphatic vessels, and perhaps from 
some peculiarity in the texture of the 
glands? 
In these cases, where a true scorbutic 
diathesis exists, previous to a mercurial 
course, vegetable acids, with proper re- 
gimen, and keeping up the secretion by 
the skin and urinary passage, will generally 
be requisite. Therefore the liberal and con- 
stant use of oranges, lemons, and other 
fruits, with whey made by acescent juices 
or crem. of tartar, and a vegetable diet, 
must be rigidly adhered to, if we expect to 
derive any benefit from mercury, in the cure 
of venereal complaints, complicated with 
the scurvy. Where I found such manifest 
signs of a putrid habit, joined with a vene- 
real complaint, after a proper vegetable diet 
had been pursued, I had the most convin- 
cing proofs of the superior efficacy of the 
mercurial solution, particularly when given 
with a decoction or infusion of the peru- 
vian bark, which I thought, in these cases, 
improved its salutary effects, by being 
power-

[75]
powerfully antiseptic, and preventing that 
putrid disposition which mercury generally 
occasions. 
It may not be unnecessary to observe, 
that the morbid matter or fault in the 
blood which produces the true scurvy, is 
different from that kind of humour, 
which is commonly, though improper- 
ly, called scorbutic; and which, when 
thrown out on the skin, appears in the 
form of tetters and scurfy eruptions. 
Although the true scurvy is most fre- 
quently observed to attack those who have 
been long at sea, and soldiers encamped 
in low marshy places, yet there are few 
constitutions in England, entirely free 
from some degree of scorbutic taint, as 
appears from their spongy gums and other 
complaints; I shall therefore beg leave to 
relate a method of treatment, which by 
varying as symptoms may require, I have 
found very successful in a great number 
of patients, afflicted with this native en- 
demial disorder, together with a venereal 
complaint. 
In July 1777, J. C. applied to me for 
a venereal disorder, which he had con- 
tracted

[76]
tracted about seven weeks before; he never 
had any discharge from the urethra, nor 
heat of urine, or any other symptom, to 
induce him to imagine he had got the in- 
fection, until about a week before he ap- 
plied to me, when he felt a soreness, 
at the end of the penis, where there 
was a little ulcer, with a swelling in the 
groin. 
On examination, I found the ingui- 
nal gland swelled, and a chancre at the 
superior part of the orifice of the urethra, 
with the glans in that part very hard. 
He was a stout young man, but had that 
pasty complexion which denotes the gene- 
ral health to be affected. Perceiving his 
breath very offensive, I suspected he had 
been taking mercury, which he denied. 
On looking into his mouth, I observed his 
gums spongy, of a dark livid colour, 
and bleeding on the slightest touch. 
His arms were covered with small pur-
ple spots, like flea bites, which he said 
itched much in cold weather; his hams, 
wrists, and the spaces betwixt his 
fingers, were quite clean and no ways 
affected. He had a pain across his breast,
was 


[77]
was often out of breath when he walked 
fast, and had pains in his legs and thighs, 
with great latitude; he was also very low 
and dejected. 
As he had caught a violent cold, attend- 
ed with acute pain in his breast, and a 
cough, I took away a few ounces of blood, 
which was in a very dissolved state, and 
the serum like thick whey, which afforded 
him no relief. 
As no doubt remained of a scorbutic 
added to his venereal disorder, he was 
ordered a vegetable diet; to abstain from 
all animal food, and spirituous liquors, and 
to take milk for his principal support; to 
drink whey made with the juices of sorrel 
and Seville oranges, and when costive, to 
add from ℈ii to ʒi of sal. polycrest, to each 
pint of whey. This addition was seldom 
required, as his body was kept sufficiently 
lax, by the whey and vegetable diet; and 
at the same time, a gentle perspiration was 
kept up, by a little wine added to the whey 
at bed time, and a flannel waistcoat wore 
next his skin. 
He washed his mouth frequently with an 
astringent and antiseptic gargle, which took 
off

[78]
off the soreness, and restored the gums to a 
found state in a few days. By using a pro- 
per injection, a discharge from the ure- 
thra came on, which continued about a 
week. 
This antiscorbutic plan being regularly 
persevered in for a fortnight, and proper 
applications used to the chancre, it healed, 
the glans became soft, and the bubo re- 
mained about the same size, as when he be- 
gan. He was got much better as to his 
general health, and the itching on his arms 
was gone. 
He then entered on a course of diet 
drink with the solution of mercury, to 
every quart of which, was added eight oun- 
ces of a strong decoction of Peruvian bark, 
still continuing his former regimen; by 
which means the bubo was dispersed, and he 
got well in less than three weeks, and re- 
mains free at this time of his scorbutic, as 
well as his venereal complaints. 
Another patient, whose scorbutic symp- 
toms were nearly similar to the above, but 
whose venereal complaints were of a much 
longer standing, attended with a great dis- 
charge, was cured by following the same 
anti-

[79]
antiscorbutic method of treatment, with 
proper mercurial injections, and the use of 
the following pills, prepared by rubbing 
the precipitate of calomel in distilled vine- 
gar till perfectly united, to which was ad- 
ded manna, and the whole rubbed on a 
marble slab, and passed through a sieve to 
separate the impurities of the manna; to 
each ounce of the above mass, was added. 
Ext. cort. peruv. moll 
pulv. myrrhæ, an ʒii 
It was then formed into pills of a mode- 
rate size, to be given as the symptoms of 
the disease, and constitution of the patient 
required. 
SECTION VI. 
Of the Hernia humoralis and swelled testicle. 
A swelling or enlargement of the tes- 
ticles, may arise from various causes. When 
it is occasioned by a venereal infection, or 
takes place in consequence of a critical 
termination of some disease in the habit, 
it is called hernia humoralis. 
When this disease happens in a virulent 
gonorrhœa, it is an inflammatory defluxion 
produced by a preternatural irritation on
the 

[80]
the mucous membrance of the urethra, in 
those parts adjacent to the bladder, where 
the vesiculæ seminales terminate. 
This species of swelling is particularly 
painful, owing to the great sensibility of 
the part chiefly affected, viz. the tunica 
albuginea; from the firm compact texture 
of this membrane, and its close adhesion 
to the body of the testicle, it is with great 
difficulty distended, which occasions into- 
lerable pain. 
Sometimes, the swelling arises from a la- 
tent venereal taint in the habit, indepen- 
dent of a gonorrhœa, or any disease in the 
urethra; in this case, the distension is more 
gradual, consequently not so painful, and 
the tumour feels hard and indolent. 
It may also happen, either from the 
use of bougies, improperly used, or 
from the escharotic ingredients, with 
which they are made, irritating the parts 
near the neck of the bladder. 
Sometimes it is occasioned by strong 
drastic purges; also from cold, the effects 
of hard drinking or violent exercise; but 
most frequently it happens by the im- 
proper treatment of a gonorrhœa. 
It


[81]
It is also liable to swell from external in- 
juries, as a blow or bruise, and other 
causes, where there is no venereal infection; 
but all these, may easily be distinguished 
by a careful examination. 
The different occasional causes must de- 
termine, what method of treatment is pro- 
per to pursue. 
When it proceeds from the effects of a 
virulent gonorrhœa, the antiphlogistic me- 
thod is generally necessary; if it originates 
from an old latent venereal taint, evacua- 
tions, &c. only become necessary, as parti- 
cular symptoms may indicate. 
When it arises from an inflammatory 
defluxion, it is immediately necessary to 
suspend the scrotum in a proper suspensory 
truss, and where no particular symptoms 
forbid it, to take away as much blood, at 
first, as the patient can conveniently bear; 
which often renders a repetition unneces- 
sary. To empty the intestinal tube, by 
emollient laxative glysters, and soment the 
groin and scrotum with a warm anodyne 
fotus, covering the whole with a large 
poultice. If the pain still continues violent, 
L an

(82)
an anodyne glyster will generally afford 
relief. 
After sufficient evacuations, I have found 
no method, which affords such speedy 
and permanent relief, as giving antimo- 
nials joined with opiates, so as to promote 
a plentiful perspiration, which should 
be kept up at least twenty four hours, 
by drinking plentifully of warm diluting 
liquors; if the perspiration is likely to 
flag, the saline draughts may occasionally 
be given. 
A young gentleman, from the country, off 
a strong athletic make and good constitu- 
tion, applied to me in May 1776, for a 
swelling in his left testicle, with an acute 
pain darting down from his groin. He 
told me he had contracted a gonorrhœa 
about three months before, attended with 
a copious discharge, which had been stop- 
ped by injections of aq. saturnina, and some 
few doses of calomel had been given;
after that time, he perceived no symp- 
toms of venereal infection, until his 
testicle swelled, which was now so pain- 
ful, as to admit of a very slight examina- 
tion. However, as no external injury 
had


[83]
had befallen the part, nor any febrile disor- 
der preceded the complaint, I had no doubt 
of its being venereal; particularly, from 
the method of treatment that had been 
pursued, in the preceding gonorrhœa. 
I took away twenty ounces of blood, and 
applied a saspentory truss; as he came to 
reside at my house during the cure, he lay 
down upon the bed for about an hour, 
when a violent sickness and vomiting came 
on, which was encouraged by drinking 
warm chamomile tea. The swelling of the 
testicle increased, the pain became more 
severe, and extended up to the groin. An 
emollient laxative glyster was administered, 
which was repeated in an hour, and as it 
had no effect, after waiting some time, a 
few grains of calomel were given, with a 
draught prepared with castor oil, which 
produced the desired effect. The scrotum 
and groin were somented with an anodyne de- 
coction, and the whole covered with a large 
poultice of lintseed meal. Though he had 
found relief from the loose stools, yet he 
continued restless in bed the whole even- 
ing, and the pain became as severe as be- 
fore. An emulsion with castor oil, was 
given

[84]
given by spoonfuls, every half-hour, to 
which was added, five drops of tinct. the- 
baica. About twelve at night, his atten- 
dant came to acquaint me, he was very 
restless, and desired to get up. I found 
him very hot, and at times delirious, with 
subsultus tendinum. An anodyne glyster 
was administered, his legs were put into 
warm water, and the following emulsion 
was ordered. 
ꝶ. Julep e camphor. uncias sex, 
Aq. cinnamon. simp. uncias duas, 
Syr. e meconio drachmas tres. 
Cujus sumat cochl. duo subinde in lan-
guoribus. 
He seemed more composed, and one of 
the following pills was given. 
ꝶ. Tart. emet. grana quatuor, 
Extract. thebaic. grana tres. m. 
Pro pilul. duabus. 
He was ordered to drink plentifully of 
the following mixture. 
ꝶ.

[85]
ꝶ. Aq. hordeat. Libras sex, 
Mel. uncias quatuor, 
Aceti vinos. uncias tres, 
Nitri drachmas duas m. 
He fell asleep in about half an hour af- 
ter taking the pill, when a plentiful sweat 
broke out, which continued until near 
eight o’clock in the morning, when the other 
pill was given, and he drank freely of the 
nitrous mixture. His pain was much a- 
bated, and his pulse soft and regular. 
Throughout the day, he took frequently 
of the mixture, and a free perspiration 
continued until next morning. He got up 
about noon, free from pain, the swelling 
much abated, with a small discharge from 
the urethra. He wore a suspensory truss 
about a fortnight, when, by the moderate 
use of the solution of mercury, he was per- 
fectly freed from all his complaints, only 
the epididymis remained hard, but not 
painful. 
But when the swelling proceeds from a 
latent venereal taint in the habit, though not 
attended with such acute pain, yet it is ge- 
nerally longer before a radical cure can be 
effected.


[86]
effected. In plethoric habits, moderate eva-
cuations may be necessary, previous to the 
use of mercury, which, in this case, may be 
rubbed in liberally; at the same time that 
the bark is given. When it is attended with 
great pain, I have always found speedy re- 
lief from the pill of opium and antimony, 
with the camphorated emulsion, given as 
in the preceding case. If practicable, a 
discharge from the urethra, should be 
brought on, which has always a good 
effect, in producing a radical cure. In 
these cases, a sufficient quantity of mer- 
cury should be used, otherwise, an effec- 
tual cure cannot be expected. The decoc- 
tion of sarsaparilla may be given with ad- 
vantage, and should be continued for some 
time after the swelling is reduced. 
A waiter at a tavern in town, who, from 
his own account, had for some years been sel- 
dom free from a venereal complaint, applied 
to me for a swelled testicle, which was at- 
tended with very little pain: he told me, 
that he had taken, and injected, the balsam 
of copaiva for a clap, which he had coor 
tracted about two months before, which 
stopped the running in a few days, and he 
thought

[87]
thought himself cured. I attempted to 
bring on the discharge, by a suitable in- 
jection; but as it was not so soon accom- 
plished, as he wished, he contrived to get 
a fresh infection, which had the desired ef- 
fect. By promoting the discharge for about 
a fortnight, and rubbing in the mercurial 
ointment on the scrotum and thighs, with 
the constant use of a suspensory truss, 
testicle was reduced to its natural size; and 
he was cured of his gonorrhœa in a few 
days, by proper mercurial injections. 
The above case, with the method he took 
to bring on the running, is related, only 
to shew the pernicious consequences of 
stopping the discharge, in a virulent go- 
norrrhœa, before the venereal virus is sub- 
dued by mercury; and also to demonstrate 
the speedy relief obtained from its repro- 
duction, whereby the tumor of the scro- 
tum gradually subsided.
SECTION 

[88]
SECTION VII. 
Of Buboes. 
THE venereal Bubo generally happens 
in a recent disease, and is occasioned by the 
acrimony of the infected lymph, which, 
by its stimulus, affects the inguinal glands, 
through which it should pass. But it 
sometimes arises from the whole habit 
being infected. 
Though frequently many weeks elapse, 
after the infection is received, before this 
swelling makes its appearance, yet that 
is not sufficient to determine, whether 
it arises from a confirmed lues or pox, 
without other concomitant symptoms, in- 
dicating, that the whole mass of fluids are 
infected. 
The most frequent cause of a venereal 
bubo, arises from an improper method 
of treating the virulent gonorrhæa; as 
when the morbid discharge is prematurely 
suppressed; or from the use of irritating appli- 
cations, where those symptoms of venereal 
infection appear, such as chancres on the 
glans, and præpuce, without any running. 
It may also be produced, by the indis-
cretion 

[89]
cretion of the patient, by cold, too much 
exercise, or intemperance. 
Buboes have been distinguished by some 
authors, into three kinds; the inflamma- 
tory, the œdematous, and the schirrous. 
This difference in their appearance, seems 
as much to depend on the patients habit 
of body, as the nature of the venereal 
poison. The length of time before any 
swelling is perceived in the groin, may 
probably depend on the different degrees of 
malignity of the venereal virus; as well 
as on the method of treatment pursued 
for its cure. Having frequently observed, 
that when the running in a gonorrhœa has 
been prematurely suppressed, and mercury 
too freely administered at the same time, 
a bubo is generally the consequence. 
It may be no improper hint to those 
who are inclined to use astringent injec- 
tions, in a recent infection, to be cau- 
tious how they give mercury, or strong 
heating medicines, while such injections 
are employed. 
It has been observed, that the poison, 
which is communicated by the bite of a 
mad dog, has remained inactive many 
months, and sometimes a much longer 
M time,

[90]
time, before it has shewn any symptoms of 
malignity, which has been attributed to 
want of sufficient stimulus in the poison, 
to excite absorption; may we not ascribe 
to the same cause, a similar effect, in the 
case of a venereal bubo?  But as the par- 
ticular manner in which the venereal virus 
acts, is imperfectly understood, we may be 
less solicitous about its particular mode of 
affecting the parts, so long as we know 
the effect it produces, and how to subdue 
them. 
As a swelling in the groin may proceed 
from other causes, that are not venereal, 
it is very necessary to be certain, whether 
it is occasioned by venereal infection, or not, 
before we undertake its treatment. 
The causes it may arise from, are, 
1. A hernia inguinalis, or bubonocele. 
2. One of the testicles remaining in the 
groin. 
3. A tumor formed by the absorption of 
acrid matter from an ulcer. 
4. From an obstruction in the inguinal 
gland. 
5. An aneurism of the crural artery. 
1st. A hernia inguinalis is known from 
the form and position of the tumor, as it is 
not


[91]
not a circumscribed or detached swelling, 
but is felt quite up to the ring of the ab- 
dominal muscles, where the spermatic ves- 
sels pass down from the belly, like a stalk; 
whereas one indication of its being venereal, 
is, the patient having venereal symptoms, 
as a gonorrhœa, chancres, &c. previous to 
the swelling; a stiffness or slight pain in 
the groin is generally felt a day or two 
before its appearance; it is also hard, and 
circumscribed. When recent, it is incom- 
pressible, and free from any connection with 
the spermatic process; and when it is in a 
state of suppuration, the difference between 
matter, and a piece of gut or cawl, is easily 
distinguished by the feel. 
2d. When one of the testicles is detained 
in its way to the scrotum, it lies across the 
the groin; and on examination no testicle 
will be found in the scrotum on that side. 
3d. Every ulcer situated in the lower 
extremities, which furnishes sharp acrid 
matter, may occasion inflammation and 
swelling of those glands, to which the lym- 
phatics lead. When it is produced by 
the acrid discharge of an ulcer in the lower 
extre-


[92]
extremities, the inferior glands in the groin 
are most commonly affected; but when 
venereal, the superior ones become en- 
larged. 
4th. The lymph sometimes accumulates 
from an obstruction in the inguinal glands, 
and gives the appearance of a venereal bu- 
bo. This may proceed from the viscidity 
of the lymph, as well as from some of the 
ducts or vessels which compose the gland, 
being obliterated from preceding inflam- 
mation. In this case, the limb below be- 
comes œdematous; and if from disten- 
sion the gland bursts, the discharge is 
lymph, not matter. In this case, some of 
the lymphatic vessels will frequently dilate 
and carry it off, especially if assisted by dry 
friction of the parts, as varied mo- 
tion is found to have particular influence 
on the glandular system. 
5th. An aneurism of the crural artery is 
easily distinguished, by applying the finger 
to the swelling, where a considerable pul- 
sation is felt. As a mistake of this kind is 
said to have happened in this metropolis, 
this caution is the rather necessary, as an 
incision (through mistake) would be attend- 
ed with the most fatal consequences. 
It

[93]
It has already been observed, that the
lymphatic vessels sometimes pass the inguinal 
glands, without entering them; though it is 
rare and uncommon, yet it shews the possi- 
bility of the infection being carried into the 
system, without the gland in the groin be- 
ing affected. Therefore the general rule, 
that the inguinal glands are always affected, 
so as to give sufficient previous notice of 
the infection pushing its way into the ha- 
bit, must be cautiously received. 
With regard to the method of cure, 
practitioners differ in opinion, whether it is 
better to disperse, or bring the tumor to 
suppuration. This must be determined by 
circumstances. 
When a venereal bubo appears soon after 
the infection is received, attended with a 
discharge from the urethra, I have fre- 
quently experienced, that it may be dispers- 
ed with the greatest safety, provided proper 
methods are taken to secure the general 
mass of fluids from infection. 
But when it arises, without any other 
symptom of venereal infection, or is not 
accompanied with a discharge from the 
urethra, it will be more prudent to attempt 
a

[94]
a suppuration, and evacuate the contents 
of the bubo. 
I know, it is the opinion of some emi- 
nent practitioners, that when a venereal 
bubo is brought to suppuration, and 
opened at a proper time, that the venereal 
poison is entirely evacuated, together with 
the contents of the bubo; but if a mercu- 
rial course is not pursued at the same 
time, this opinion may be productive of 
disagreeable consequences. I must assure 
my readers, that within these six months, 
three persons found it necessary to apply 
to me for want of proper care having been 
taken to secure the habit, after the bubo 
had been opened, and its contents discharged. 
It is true, that in one of the three this might 
be owing to the want of a sufficient dis- 
charge. 
When we have reason to suppose the 
complaint is local, and mean to disperse 
the tumor, if attended with a running 
it should by no means be suppressed; 
and if the patient is of a plethoric
habit, 


[95]
habit, or the swelling is painful, bleed- 
ing should be directed early and libe- 
rally; and when the habit is bad, recourse 
must be had to such evacuations, as particu- 
lar symptoms may require; in general, the 
milded laxatives will be found to answer 
best, which should be repeated occasional- 
ly, until the pain and other inflammatory 
symptoms are abated. Where there is no 
discharge from the urethra, or it has been, 
prematurely suppressed, these evacuations 
should be freely made, and frequently re- 
peated, together with nitre, and plentiful 
dilution. If the patient is desirous to ex- 
pedite the cure, and prevent the forma- 
tion of matter in the gland, besides the 
use of antiphlogistic remedies, a strict ob- 
servance of low diet and regimen, are 
indispensably requisite, as well as to abstain 
from all kinds of exercise. Should the 
pain in the groin be very severe, I have ob- 
served very speedy relief obtained by the 
application of leaches. 
When the swelling and pain are in some 
measure abated, we must have recourse to 
mercurials, which should be used freely, 
so

[96]
so as to subdue the venereal poison, in 
the most speedy and effectual manner. 
In a variety of these cases, I have 
found no method answer so well, as in- 
unction, by rubbing the ointment on those 
parts of the thighs, where the superficial 
lymphatics pass before they enter the in- 
guinal glands. 
It does not appear a circumstance of the 
consequence generally supposed, that the 
ointment should be applied to particular 
parts of the legs and thighs, since the lym- 
phatics are universally diffused over the 
surface of the body. Inoculation illus- 
trates this fact, for to whatever part the 
matter is applied, the absorbent vessels 
take it up and convey it into the blood. 
Inunction is generally directed in the 
evenings; for what reason, I am at a loss 
to determine, for, absorption is stronger in 
the morning, not from inanition, but be- 
cause the body has been recruited during rest. 
On the supposition that mercury subdues 
the venereal disease, by coming in immediate 
contact with the infection; may not the 
method of treating local complaints by in- 
unction

[97]
unction, where mercury is applied more 
immediately to the affected part, be found 
more effectual on that account? by 
such means it is not liable to undergo 
any changes, whereby it might be de- 
prived of its specific power, which may 
probably in some degree, be diminished in 
the long round of circulation, when 
wardly administered. The advantages ob- 
tained from its external use in certain local 
venereal complaints, will appear obvious, 
when it is considered, that if it is ad- 
ministered internally, it is first taken up 
by the lacteals in the intestines, whose 
orifices are so small, as to be impercep- 
tible to the naked eye. It is carried to 
the mesenteric glands, and from thence 
to the loins, where it mixes with the 
lymph, which comes from the lower ex- 
tremities and genitals, in one common 
trunk, called the thoracic duct, which re- 
ceives the contents of the lacteals, and lym- 
phatic vessels of the lower extremities and 
abdominal viscera; in this duct it is car- 
ried upwards, passing behind the ascending 
aorta, and terminating in the angle, (on the 
left side) between the jugular and subcla- 
N vian

[98]
vian vein, near where the collar bone and 
first rib are inserted into the breast bone. 
If is here, and not before, where the mer- 
cury, internally taken, mixes with the 
blood, and then partly goes the round of 
circulation, before it gets to the affect- 
ed gland in the groin. But notwith- 
standing this long course, repeated expe- 
rience convinces us, that when such prepa- 
rations as are adapted to the symptoms, are 
properly given by the mouth, the cure is 
both speedy and effectual. Certainly then, 
the more minutely the mercury is divided, 
the greater probability there is of its being 
carried with greater efficacy to those distant 
parts of the body; from which we may in- 
fer the superior efficacy of the mercurial 
solution before mentioned. 
When a bubo appears some months 
after the infection is supposed to have been 
received, and is not attended with any dis- 
charge from the urethra, it is certainly pru- 
dent to bring the tumor to a suppuration, 
that we may more effectually eradicate the 
venereal poison, by evacuating the contents 
of the bubo. By this salutary drain, less 
mercury will be required to perfect a cure,
which

[99]
which may be used internally, in such 
quantities, as will, with proper regimen 
and diet, promote a complete and speedy 
suppuration. 
In order to promote and quicken the 
maturation of the tumor, topical appli- 
cations are generally found requisite: To 
answer this purpose, warm fomentations, 
with a poultice of bread and milk or lint- 
seed meal is generally sufficient. What- 
ever application is deemed proper to pro- 
mote suppuration, should be applied as 
warm as can be endured, and removed 
as often as it becomes cold. But where 
secrecy may be necessary, or hot poultices 
not easily procured, I have found the fol- 
lowing cataplasm answer as a good substi- 
tute, if the part is well fomented and kept 
warm by proper covering. 
ꝶ. Mel ℥iij 
Ung. gum. elemi ℥ij 
Terebinth. venet. ℥ss bene miscean- 
et adde 
Farin. tritici q. s. ut. ft. cataplasm 
emol. 
This

[100]
This spread pretty thick on tow or linen 
rag, saves much trouble in making poulti- 
ces, and is a good superficial dressing to 
promote a free discharge after the bubo 
is opened. 
The suppuration being completed, which 
is known by the softness of the tumor and 
fluctuation of matter under the finger, it 
should be opened, rather than suffer it to 
burst of its own accord, as the aperture 
through which the discharge is made, is 
generally too small, and not often situated 
in the most dependent part. 
Therefore care should be taken, that the 
opening be made sufficiently large, and 
also in a proper direction, so as to allow 
the matter to have a free exit. When 
the contents are sufficiently discharged, 
lint is the best application, as it answers 
every intention, and at the same time lies 
soft on the part without occasioning pain; 
it absorbs all superfluous moisture, and 
hastens the formation of pus, or that glu- 
tinous matter, in which the new vessels 
are explicated. Previous to each dres- 
sing, warm fomentations, will be found 
serviceable. At first over the lint may be 
applied

[101]
applied a pledgit of the digestive already 
mentioned. In order to cleanse the ulcer, 
it is a common practice to use detergent ap- 
plications, such as precip.rub, alum. ust. &c. 
we are not to imagine, that ointments loaded 
with those escharotic ingredients will al- 
ways dispose the parts to heal sooner, as 
generally speaking, nature is sufficient for 
this purpose, except in some very shat- 
tered constitutions, where the bark, with 
a proper diet, are chiefly to be depended 
on; and mercury should now be used, 
in such quantities, as to secure the con-
stitution from the effects of any of the 
morbid fluid, which may have got admit- 
tance into the general circulating mass. 
By these methods, we clear the habit of 
all infection, nor will it seem surprising 
that this discharge should rid the con- 
stitution of the venereal poison, when it 
is observed, that in the plague itself, a 
suppuration in the glands of the neck, 
arm pit, or groin, will prove a perfect 
crisis. 
SEC-

[102] 
SECTION VIII. 
Of Chancres. 
When chancres arise from a fresh vene- 
real infection, they are generally seated on 
those parts, which have a thin and tender 
covering, as the glans penis, or inside of the 
præpuce near the corona glandis; but 
they particularly affect those parts, where 
there is any crack or excoriation. They 
appear at first, like small pimples, attend- 
ed with itching, but soon degenerate into 
corroding ulcers. They are known to be 
venereal, from a slough at the bottom, of 
a yellowish white colour, and by having 
hard callous edges. When recent, they 
are not usually attended with difficulty in 
the cure, especially if they happen to per- 
sons of a healthy habit. Although these 
ulcers may in most cases be healed by ex- 
ternal applications, yet it is never pru- 
dent to trust to them alone. When there 
is pain and inflammation, they often oc- 
casion a phymosis, which is more tedious 
in



[103]
in the cure, from the difficulty of applying 
proper applications. 
On the 7th of June 1777, a gentleman 
applied to me for a painful swelling of the 
penis, which had prevented him getting any 
sleep for several nights. On examining the 
parts, I found the præpuce swelled to three 
times its natural size, and so closely con- 
tracted round the glans, that although there 
was a copious discharge, we could not dis- 
tinguish from where it flowed, but from the 
pain it seemed to proceed from chancres 
which were under the præpuce on the 
corona glandis. 
Notwithstanding he was bled plentifully, 
and gentle laxatives administered, with 
warm fomentations and emollient poultices; 
the pain and swelling continued for two 
days, nearly as bad as ever. He was or- 
dered to bed. and anodynes were liberally 
given, which brought on a free perspira- 
tion, for twenty four hours, after which the 
swelling was much abated, and I was able 
to throw up an injection betwixt the glans 
and præpuce, which immediately abated the 
pain. By continuing the injections with 
warm fomentations and poultices, he was 
able

[104]
able to draw back the præpuce, which dis- 
covered three deep, ill conditioned ulcers. 
By mild mercurial preparations, topically 
applied, with gentle laxatives, the chancres 
were healed, and the parts were reduced to 
their natural size, in less than a fortnight. 
He continued the use of a diet drink, with 
the mercurial solution, for six weeks longer, 
and got perfectly well. From the first time 
of using the preparation for the heat of 
urine, the pain entirely ceased, and never 
returned. 
In women, when the infection is receiv- 
ed by coition, these ulcers are situated on 
the inside the labia, and sometimes upon the 
clitoris and its covering or præpuce. I 
have remarked, that women are more liable 
than men to that species of venereal infec- 
tion, which happens without a discharge. 
When it is a primary complaint, it is 
cured with as much ease, and certainty, as 
in the male subject; but mercurials should 
be used, either internally, or by unction, 
otherwise a radical cure cannot be expect- 
ed. 
A gentleman applied to me last summer, 
in behalf of a female friend, who had a 
small

[105]
small sore on the labia pudendi, attended 
with continual itching; he told me, there 
was no reason to suspect it proceeded from 
a venereal cause; however, I hinted to him 
my suspicions of its being a chancre. As 
he persisted in its not being venereal, I gave 
him proper medicines, with direction
how to proceed. The parts apparently 
got well, but about two months after, 
he called to acquaint me, the complaint 
was returned with greater violence. I 
perswaded him to bring the lady to town, 
when I found they were venereal chancres. 
By the use of the preparation for the heat of 
urine, the pain and itching were imme- 
diately relieved, and by such mercuri- 
als as were adapted to the nature of her 
complaint, she was cured in a few weeks, 
and remains so at this time, which is 
about eight months since she applied to me. 
It is observed by some eminent authors, 
who have wrote on this subject, that women 
are cured of venereal complaints, with 
greater difficulty than men; I have 
found it the reverse, except in some cases, 
where there were excrescences near the 
O anus,

[106]
anus, which denote a confirmed taint in the 
habit of long standing, These were cured, 
by attending to the general health, whilst 
the venereal poison was subdued by mer- 
curial medicines, previous to extirpation. 
When chancres proceed from an uni- 
versal taint in the habit, there is generally 
some other venereal symptom which ac- 
companies them, or appears soon after; the 
most frequent are ulcers in the throat, and 
scurfy eruptions on the forehead or amongst 
the hair. The chancres in this case are 
not confined to the glans penis, or præ- 
puce, but appear in different parts of the 
body, and are then called venereal ulcers.
The difficulty of cure will be in propor- 
tion to the malignity of the disease, and 
inveteracy of the symptoms, as well as the 
patients habit of body, These ulcers may 
sometimes be healed, but never radically 
cured, until the venereal virus is entire- 
ly subdued by a thorough mercurial 
course, and proper internal remedies. 
Under these circumstances, I have found 
the continued use of sarsaparilla, with 
some proper preparation of the bark, gene-
ally

[107]
rally necessary whilst mercury is used. 
Where the blood is supposed to be affected 
With a scorbutic taint, if the antiscorbutic 
plan be pursued, the ulcers will heal more 
kindly. 
I have directed the solution of corrosive 
sublimate, in a variety of venereal cases, but 
have observed it fail in many instances. In 
weak tender habits, it often occasions 
great pain in the stomach, which I have 
known return after the medicines had been 
left off many months. 
I shall give an instance, where the solu- 
tion of mercury produced a perfect cure, 
after the sublimate solution had been tried 
to no purpose. 
A gentleman, who some years ago had 
taken mercurials in large quantities, by 
imprudently riding out in bad weather got 
wet, although he perceived no immediate 
bad effects; yet some months after his 
hands became hard and scurfy. Hav- 
ing frequently observed the good effects of 
the sublimate solution in those cases, where 
the disorder seemed to proceed from per- 
spiration being obstructed, he begun to take
the

[108]
the decoction of sarsaparilla with the sub-
limate, which he continued for several 
weeks, without any apparent benefit.
He applied to me again in the spring tor 
the same complaint, attended with the loss 
of appetite; when he begun the use of 
a diet drink with the solution of mercury. 
his hands in a little time became soft and 
smooth, he became fat and hearty, and 
his appetite was as good as ever, after 
drinking a few bottles of his medicine. 
This he continues to take every now 
and then, as he finds himself better in 
health, by its use.
SECTION IX. 
Of a Gleet.
When this follows a venereal disease, it 
is generally brought on by improper treat- 
mem of the preceding gonorrhœa, and fre- 
quently by the use of strong mercurial me- 
dicines and drastic purges; the immediate 
cause then is relaxation. It is also occa- 
sioned by intemperance and severe exercise, 
and

[109]
and often occurs in patients of a scrophu-
lous or scorbutic habit. 
The method of treatment must be a-
dapted to the cause that produced it. 
If it be merely a local complaint in the 
urethra, it may be relieved by injections 
and the judicious use of bougies. 
When it arises from relaxation and a 
debilitated habit, provided a proper mercu- 
rial course has been previously pursued, 
Peruvian bark with steel, will be found to 
answer in most cases.
When a gleet it occasioned by excessive 
coition, the bark with chalybeates will have 
the most salutary effects, no symptom con- 
traindicating the exhibition of such tonic 
medicines, especially if a milk diet is 
strictly observed. 
It should be remembered, that excess in 
venery will inevitably defeat every attempt 
to cure this complaint, therefore it ought 
to be avoided. 
FINIS.