This gleety discharge trickles away from what is termed the "pendulous urethra", i.e., that part of the urethra situated in the portion of the penis which naturally hangs downward when not in a state of erection. Sometimes the discharge is profuse and sometimes there is merely a drop or two of a yellowish or grayish white secretion seen only in the morning. This is often lightly spoken of by roues as the "good morning drop".
This gleety discharge is the most frequent symptom of chronic gonorrhoea, not, as a rule, causing much pain, though productive of a varying degree of mental distress and melancholy dependent on the sensitiveness of the patient. Often this symptom persists for years and nothing seems to be able to check it.
Cases of gleet are occasionally seen that defy all measures of treatment. Although trite, the expression of Bicord with regard to the obstinacy of gleet is decidedly pat. This famous specialist once said that he dreamed he was dead and had been sent to purgatory. Upon being asked what sort of a place it was, he replied that it would have been pleasant enough if it had not been for the fact that whole troops of male spectres stalked about him, each pointing its ghastly finger at him and exclaiming: "Bicord! Bicord! - you could not cure my gleet".
This gleet is kept up by a patch of inflammation in the urethra, and so long as it remains localized on the surface of the mucous membrane it will continue until it heals by the formation of scar tissue. If this inflammatory process spread more deeply into the structures beneath the mucous membrane, and into the substance of the body of the penis, as it frequently does, then the condition is much more serious, because scar tissue forms at that area and retracts, so as to form a dense, gristly constriction, or stricture, which encroaches on and narrows the urinary passage to a dan' gerous degree.
If the chronic gonorrhoea be localized in the posterior urethra, the conditions present a much more serious prognosis. This portion of the urethra not being pendulous, the discharge will of course gravitate downward into the bladder.
In some cases there is a frequent desire to urinate, with uneasiness or severe pain either at the beginning or end of the act; in others there is a stabbing pain or a throbbing in the perinseum or testicles or in the rectum. These symptoms may not be continuously present, but may vary from day to day.
If the inflammation has extended to the prostate gland, which is an extremely sensitive and complex organ in close relationship to the sexual apparatus, there are bound to be irritative sensations on urinating, defecating, or on performing the sexual act, and, in addition, irritation of the whole nervous system.
Often there is bladder tenesmus, or a straining effort to pass urine without success, or sometimes there is simply a desire to urinate very frequently, only a few drops passing at a time.
In other cases there is derangement in the sexual sphere; pollutions are common, with a corresponding loss of sexual appetite and power. During copulation erection may occur, but there is a premature emission without pleasurable sensation, and even with severe lancinating pains in the testicles, groins, back or thighs.
Sometimes on account of a thickish, opaque mucous fluid which escapes involuntarily, the patient imagines that he has spermatorrhoea; but this is merely a prostatorrhcea, or catarrhal discharge from the prostate gland.
However, in not a few cases there is a true spermatorrhoea, and spermatozoids can be found in the urine; and in other instances there is a free discharge of semen during each act of defecation and urination. Conditions like these would, of course, rapidly bring about impotence and sterility with attendant melancholia and apathy.
Sometimes there is inflammation and irritability of the caput gallinaginis a longitudinal fold of mucous membrane and other subjacent tissues, exceedingly rich in nerves, situated on the floor of the posterior urethra and intimately associated with the voluptuous sensations of the sexual act. There is then apt to be a condition of sexual neurasthenia, or increased excitability and irritability of the nervous system in regard to sexual and sensual matters.