The "man about town" often has a panacea for clap, which he says has cured him time after time, when, in reality, he never was cured of the virulent attack which he had acquired perhaps years before these fresh attacks of "bastard clap" being merely outbreaks of the original un cured malady. From false reports such as these the ignorant are often deluded into self medication by the use of internal remedies and injections which are "warranted to cure in three days". The penalty in such cases is usually a stricture or sterility.
Gonorrhoea is inevitably a self limited disease, and just as a bone requires at least six weeks for its firm union in spite of the most renowned surgeon's skill, so this disease also requires from five to six weeks for its cure, even under the most favorable methods of treatment; and if a remedy can ever be found which will give such results in every case, it will be hailed by the profession as a medical triumph. The truth is that gonorrrhoea is one of the most thankless of all diseases to treat if one is to expect recovery with no evil consequences left behind i.e., a cure, or restitutio ad integrum.
This view every specialist on venereal diseases supports with emphasis. In many ways this class of patients are most undesirable: social conditions usually make concealment necessary, and any disease treated in privacy is always unsatisfactorily controlled, and the sexual appetite, the most powerful of all impulses in these men, is by the nature of the disease abnormally stimulated, while for the subsidence of the inflammatory process this passion should be at rest.
Patients with gonorrhoea under all circumstances wish to be soon rid of it, and in many instances consider a rapid cure imperative. A plan has been adopted to meet this class of cases, called the abortive method.
The Abortive Method. This method aims to cut short the disease at its very inception, before the gonoccoci have had time to develop but this can rarely be effected.
Any attempt to abort gonorrhoea after pus has been seen at the meatus is useless, but the patient's importunity sometimes leads the physician of small experience to make the trial.
This method which need not be described is very painful; and inflammation, sometimes slight, sometimes severe, is sure to follow, so that there will be a sloughing of the parts touched and an escape of pus from its effects. If the attempt at aborting the gonorrhoea fail, the acute stage win then be rendered much more severe.
The abortive method, consequently, is unjustifiable unless it be used within a few hours after the impure intercourse and before gonorrhoea has actually been diagnosed. General Management and Considerations on the Treatment of Clap. The abortive method having failed, as it ordinarily does, the acute stage, which we now have to treat, is rendered worse. However, in most cases, the abortive method will not have been tried, since the patient rarely consults the physician until the acute stage is well established.
Impelled by the solicitations and anxiety of the patient, the doctor will frequently employ active treatment at the outset, using a clap syringe and nauseating potions; but the severity of the disease is often enhanced by these means, for doctors are human in spite of the trust and confidence which the ordinary patient reposes in them. Even the medical student, who has just received his license to practise, will often lightly assume the responsibilities of treating gonorrhoea, while he would exercise a greater degree of care and assure himself that he was well informed on modern methods before performing delicate surgery or treating diseases of the eye. Modern requirements have of late years been far more severe, however, and it is too often true that many an old time practitioner, who perhaps does not even possess a microscope, is less fitted than the younger man to pronounce when the case is cured.