In this condition the virile organ becomes rigid and bent, partly on account of an increased flow of blood to one part of the penis corpus cavernosum which makes it less extensible than the corpus spongiosum, and partly owing to a spasm of the longitudinal muscular fibres in the urethra.
Chordee, though not occurring in the majority of cases, is a most distressing symptom, sometimes so maddening the sufferer by the discomfort and pain that he strives to "break the cord" by straightening the penis forcibly, or by laying the distorted organ on a book and giving it a smart blow. This manoeuvre, however, is exceedingly dangerous, since it is apt to cause a tear in the urethra which may be followed by a serious hemorrhage and which will surely result in stricture; and cases are reported where death has followed from gangrene of the penis, or from bladder and kidney infection, or from general blood poisoning.
The patient's nights are full of misery; the warmth of the bed and the state of sleep promote the tendency to painful erections and chordee, and as soon as the patient has awakened and relieved himself of one attack by walking on the cold floor and the use of cooling applications, he falls asleep only to be reawakened by the same occurrence time after time. His nights are so much disturbed that he rises in the morning tired and dejected, and unfit for the duties of the day.
There is a discharge of greenish often blood tinged pus during this acute stage of the disease. The discharge of pus from the urethra is often surprisingly profuse, but is not to be wondered at when one considers the extensive amount of tissue involved.
Every case of acute septic urethritis, or clap, does not run precisely this course, but this is a typical description of a typical case. Proper treatment of course modifies the severity of the symptoms.
In some cases the voiding of urine causes only moderate suffering, and the erections are painless and cause little discomfort; but every individual who elects to acquire gonorrhoea makes himself liable to the severest and most dangerous forms, and but little comfort can be derived from having a mild attack for the remote complications may become apparent months or years afterward, and the future wife may be rendered an incurable invalid.
In a typical case of gonorrhoea, to sum up, there is a period of incubation, usually of three to five days duration, during which there are no symptoms by which the disease can be recognized; this is followed by a prodromal stage of about two days duration in which the first evidences of symptoms appear. The process increases in severity for about fourteen days and reaches its most acute stage during the third week; but then, if the patient has received proper care as to rest, diet, and hygiene, the severity of this acute stage becomes modified at the end of the second or beginning of the third week after the acute symptoms developed.
At the end of two or three weeks more the symptoms may disappear, and in an uncomplicated and fortunate case the entire process would last from five to six weeks.
As recovery begins, the discharge becomes more scanty, less greenish, and thinner in consistence, and eventually, under favorable circumstances, becomes a grayish muco pus which stains the shirt and bed linen and glues together the lips of the meatus.
The foregoing description applies only to gonorrhoea of the anterior urethra, where the process always originates and luxuriates for the first few weeks; if the disease spread to the posterior urethra, as it does in a large majority of cases, the results are much more serious, as will later appear.