The statements of this great specialist are supported by every surgeon who has to deal with the special diseases of either men or women, and it is a fact, lamented by the whole profession, that an immense amount of suffering among innocent married women is due to the old standing uncured gonorrhoeas of their once profligate husbands. Tlie Treatment of Chronic Gonorrhoea. Many patients become so neurasthenic and hysterical over their condition that they exaggerate their symptoms and run from one doctor to another, selecting him who will gratify their anxiety by adopting the most active line of treatment. Many such cases, which are submitted to over treatment by energetic and unwarrantable methods, suffer great damage by the perpetuation of an intractable gleet.
Treatment will, of course, promise better results in recent cases than in old, neglected, or over treated ones, and there will be a better outlook if the chronic gonorrhoea is not complicated with stricture or neurasthenic symptoms, such as pollutions, prostatorrhoea, and intense excitability in the sexual domain. While the prognosis may be favorable in simple, uncomplicated cases, we must always bear in mind that the sequel» and involvements and extension of the disease to other organs not infrequently cause serious and permanent damage, and even death.
So intractable are these chronic gonorrhoeas that the physician cannot predict with any assurance the length of time which may be required for their treatment, nor, in fact, whether any marked relief can ever be looked for; nor can he, in some of the cases, ever countenance the marriage of any woman to such an unfortunate man.
There is one point, surprising as it may be, which must be given the greatest consideration and this is, that a stricture, or retraction and drawing together of the tissues which were once the seat of the localized inflammation, may develop many years after the patient has considered himself entirely cured.
Out of 164 cases of stricture, Sir Henry Thompson gives the period of development as follows:
10 cases occurred during the acute gonorrhoea.
71 " developed in 1 year.
41 " " 3to 4 years.
22 " " " 7 " 8 "
20 " " " 20 " 25 "
When a man is yet in the prime of his life his tissues reist morbid influences more powerfully, the repair and the waste of all the structures of the body keeping an approximately parallel course; but when he begins to go downhill, and has turned his face toward the evening of life, the balance between repair and waste is disordered in favor of the latter, and those parts of his body which are least resistive are the first to suffer from unfavorable influences. The noonday of life is reached early or late, according to the previous habits of the individual and his ancestral legacy; but after this meridian has passed the weak spots begin to appear.
Thus, strictures may develop, according to Thompson's statistics, even as long as twenty five years after the supposed termination of the gonorrhceal attack scar tissue forming at the site of the ancient gonorrhceal inflammation. This is what we mean by saying that a cure a restitutio ad integrum cannot be promised, even in any case, however mild. In a work of this nature it would not be wise to attempt even an outline of the various methods of treatment which different cases require.
The Complications of Gonorrhoea. Gonorrhoea is exceedingly liable to be followed by one or more of various complications. The male may escape with no perceptible remote results; but if the female become infected, it is regarded as a natural consequence and to be expected as a foregone conclusion that the process will spread throughout the whole extent of her sexual apparatus and render her a miserable and incurable invalid. No disease has a more gloomy outlook for the female than gonorrhoea, while for the male there may be the assurance that in a majority of cases he has been more or less permanently injured and rendered, not infrequently, a poisonous and dangerous man for a husband.