Part 10

The venereal disease may be considered in different degrees; namely the _first_ and _second infection_.

To the first, I consider the gonorrhœa or clap, the phimosis, paraphimosis, chordee, priapism, shankers, dysuria, bubo, swelled testicles, and venereal excrescences, in their various degrees, in a local state. To the second infection, I consider those diseases that proceed from the venereal virus, infecting the whole mass of blood; namely cutaneous diseases; glandular diseases; diseases of the bones; dry pox; and the confirmed lues itself.

The first infection is what I shall here briefly consider, and give such remedies, which though simple and few, will prove efficacious. But the second I shall here only consider in the general.

_Of the Gonorrhœa_.

The gonorrhœa or clap, commences with an agreeable tickling in the urethra, attended with a thin limpid ouzing, which however soon degenerates into a disagreeable pain. A discharge of sharp fœtid matter, gradually commences with a scalding of urine; the præpuce and glans sometimes swells, with inflammation and a painful involuntary erection, which adds considerable pain to the patient, and under which, the whole system seem disordered.

When all these symptoms appear, there is no room left to doubt a confirmed clap.

The first thing to be done, is to take some of the _fever powders_ (L) in order to promote a perspiration, and to abate the scalding of the urine.

In the next place, and which is the principal object; have immediate recourse to my antacrid injection, which is simply this,

No. XXI

_Take clean water one ounce_, _Calomel_ (N) _one scruple_, _Mix it, and shake it when it is made use of._

Let this be injected up into the urethra, three times of the day, which if duely performed will stop the evil in its first bud; and prevent all the generally attending consequences. For it perfectly eradicates all the malignities of the venereal virus; prevents shankers, priapism, chordee, and any farther spreading of the infection. At the same time the calomel should be given internally; namely the pills, No. X. to be taken every morning one.

_Of the Phimosis, and paraphimosis._

A Phimosis is when the præpuce is so swelled, that the glans cannot be uncovered; and a Paraphimosis is when the præpuce is swelled behind the glans, so as not to cover the glans. Either way proceeds from the venereal virus having insinuated itself into the præpuce.

If the _injection_, No. XXI. is made use of in time, all this will be prevented; but sometimes it is of a very stubborn nature. If the inflammation is very great, the poultice, No. II. should immediately be applied, to which it will yield; being of a very powerful quality, particularly, if to the poultice _mercurial ointment_ (P) two drachmes is added, by which it becomes an immediate antidote to the venereal virus.

_Of the Chordee, and Priapism._

A priapism is an involuntary erection; and the chordee is a stricture in the urethra, by which the penis is bent either ways, according to the seat of the contraction, this however is generally downwards; whereby it makes the involuntary erection prodigiously painful.

It proceeds from some imprisoned virus in the urethra; which together with its contraction, irritates the penis to erection.

The _antacrid injection_ No. XXI. will generally, if timely applied, prevent this; but if by neglect, or the great virulence of the venom, it has actually commenced, recourse should be had to mercurial ointment; which should three or four times of the day be rubbed on the penis. Should the priapism be very violent, the poultice, No. II. with the addition of _mercurial ointment_ (P) must be applied.

_Of the Dysuria._

The dysuria is a scalding of the urine in the urethra; this likewise is obviated by timely using the _injection_, No. XXI. or No. VIII. But when it is actually become troublesome, drink plentifully of diluting drinks, such as _balm tea_, &c. and take a few fever powders which will soon set this to right again; particularly as that is a symptom which generally vanishes, as the disease becomes milder.

_Of Shankers._

These are little ulcers coming upon the glans, the frænum, and the præpuce of the yard. They are not only troublesome, but sometimes tedious in the cure; the _antacrid injection_ No. XXI. if timely applied, will generally prevent them.

But sometimes these very unwelcome visitors will appear even without a clap; and then they generally gain great ground, before timely remedies can be applied.

The _injection_ No. XXI. should in this case be injected betwixt the præpuce and glans; but if this is not sufficient, apply the following.

No. XXII

_Take mercurial ointment, two drachmes; calomel_ (N), _two scruples; precipitate_ (O), _ten grains. Mix it into an ointment._

By the dressing with this, all the shankers will speedily heal up.

If warts sprout out, they should immediately be cut off, with a pair of good sharp scissars, and then dressed with the above ointment.

Shankers, when they appear, without a previous gonorrhœa or clap, ought always to be taken as a forerunner of the pox itself; and the patient must have immediately recourse to the _mercurial pills_, No. X. one to be taken night and morning, in order to prevent the threatening evil consequences.

_Of the Bubo._

A Bubo is a swelling that appears on a venereal infection, sometimes in one, sometimes in both groins. This swelling proceeds either from a transposed virus, or comes as the first messenger of a venereal infection.

A bubo appears with symptoms of a heavy dull pain in the groin, which on examination discovers itself with a little kernel that is painful to the touch: If left to itself it gradually encreases both in bulk as well as in pain, and at length forms a collection of matter.

The moment a bubo appears, take a purge, No. IX. rub the part in the groin with _mercurial ointment_, and spread a _mercurial plaister_ the bigness of a crown-piece, which, (the hair being removed,) lay on the part; let it remain on, till it separates from the skin, and the swelling is dispersed; the patient should be kept warm, and not have much exercise; at the same time the body should be kept open.

By this means the bubo will soon disperse, and the virus be destroyed in its first bud. But if it has already gained too much head to be dispersed, and matter is formed, it becomes larger and soft, and a fluctuation of matter is felt, then suppuration must be promoted; and when ripe be opened as soon as possible, for an outlet of the matter.

When it is come to its maturity, (that is the matter plainly perceived,) open it and dress it like an ulcer, first with the ointment, No. I. and when it discharges pretty well, dress it with the ointment, No. XXII.

By this management, though easy, you will not fail of success.

_Of Swelled Testicles._

The venereal virus is liable to attack the testicles, which makes one of the most disagreeable circumstances of all venereal diseases; sometimes one, and sometimes both will be the seat of this complaint.

It begins with a heavy dull pain, attended with a disagreeable tightness in the spermatic vessels, leading from the testicle into the bowels. Gradually the testicle swells, becomes hard and grows very painful, and if not timely remedied, a suppuration, or a scirrhus, or even a gangrene and sphacelus, may be the consequences.

The moment the pain in the testicles is perceived, remove the hair all round the scrotum, and apply a mercurial plaister spread upon leather; over which put a suspensorium, and tie it up to the body as tight as it can be borne; which together with a purge, No. IX. will not fail of giving immediate relief.

The patient should be kept as quiet as possible; for hard labour not only retards the cure, but becomes very painful. Should this not be sufficient, apply the poultice, No. II. with the mercurial addition as warm as sufferable, and repeat it as often as it is necessary for keeping it warm to the part. By this method it will not fail of dispersing.

Should it however against all expectation come to a suppuration, it must be opened the same as another aposthume, and treated accordingly. But should a scirrhus, or a mortification ensue, extirpation is the only recourse. For which see my treatise.

_Of Venereal Excrescences._

Besides all these disorders before mentioned that are the consequence of impure coition, there is one more to be mentioned, and that is a variety of disagreeable excrescences, which sometimes arise about the penis, the scrotum perinæum, and about the fundament.

When these appear, I generally take it for granted, that the pox is in the blood, and the patient ought to be treated accordingly.

If there is a possibility of extirpating them, either by a bistoury, or a pair of good sharp scissars, it ought to be done, and dressed with the following ointment.

No. XXII

_Take mercurial ointment_ (P), _and precipitate_ (O) _equal parts: mix them._

The roots of these stubborn companions are frequently seated very deep; if this is particularly taken notice of, together with proper internal medicines, the excrescences taken away at the root, and the ointment applied, they may all of them soon be drove off from the field.

_Of the second Infection._

In regard to the second infection, this is too tedious here to enter into, and to do properly justice, I must refer the reader to the treatise itself.

All I have at present to say, is, that my method of cure is particularly easy and simple, in itself; and I am happy to think at the same time, that it is more efficacious, than any former method, or practice, made use of.

The _antacrid injection_ No. XXI. is the most efficacious for subduing the gonorrhœa, and all the evil consequences in that part; and the other mercurial preparations in the manner I have recommended them, is equally powerful.

I am utterly averse to salivation; it is using mercury as a poison; very few have ever been cured by it, and those few have been more indebted to their good constitution, than the treatment which they have with so much danger undergone. But many, very many, have had their constitutions ruined by salivation, past the art of man to recover; and thousands have been sent miserable objects to the grave.

I am also averse to bleeding in venereal cases, unless the greatest necessity requires it; for in general it serves only to infect all the fluids, since the veins emptied, will naturally absorb from all parts of the body, and thence liable to infect the whole mass of blood. Purging needs but be used very sparingly.

Mercury inwardly taken, should be used with the greatest moderation, and taken in very small doses; for with such judicious management it becomes one of the best medicines in the whole Materia Medica; but if abused, it is converted into a poison. The decoction of the sassafras should be plentifully made use of during the whole course of the venereal disease.

And lastly, from the real effect that the mercury has on the blood, I must add, that the same gentle method with respect to its internal use, as is recommended for the first infection, must also be pursued for the second infection; let the malignities be ever so bad, even in the most inveterate diseases of the bones themselves; with this difference, that in proportion as the disease is engrafted, time must be allowed for the cure.

Nature may be led by the gentle hand of assistance, and tenderness; but he who attempts to do good by main force, acts as a fool, and deceives not only himself, but those who are so unfortunate, as to trust to his pretended skill.

SECT. VI.

_Of the Bite of Venomous Animals_

It has been observed by all diligent inquirers into nature, that poisons are of two kinds, with respect to their effect in the animal œconomy. One kind will destroy if taken inwardly, but not have such ill consequences in wounded parts, externally. Another kind will be fatal in wounds; at the same time it does not affect the viscera.

The first which destroys internally, are poisons, either from corrosive minerals, or vegetables; but of the latter, namely what seems inoffensive taken in the mouth, is the poison that follows the bite of most venomous animals whose poison are natural; such is the scorpion, the adder, the rattle snake, &c. whose poison have by various experiments, been found to be attended with no ill consequences internally taken. This was known to the ancients, as well as to us; for we find Celsus,[13] to have spoken of this in his medical works.

Footnote 13:

_Nam venenum serpentis, ut quaedam etiam venatoria venena, quibus Galli præcipue utuntur non gusto, sed in vulnere nocent. Ergo quisquis, exemplum Psylli secutus, it vulnus exsuxerit, et ipse tutus erit, et tutum hominem præstabit. Medicin. lib. v. c. 27._

Without any farther preface, I shall proceed to give the immediate remedies for such unfortunate accidents as happen by the bite of these animals.

_To Cure the Bite of a Rattle Snake._

The poison from this venomous beast, is more deadly than any other of the serpentine tribe. If its venom by a wound is infused into the blood, a mortification, and speedy death must follow.

The part bit, should immediately be sucked with the mouth, either of the patient itself, or one who will risk himself to be so much the friend of the wounded. Dr. Mead has recommended, that oil should be held in the mouth all the time of sucking, but we have it from good authority, that the spittle itself is an antidote to that kind of poison.

It is needless to say, that the person who sucks the poison, should frequently spit out, as not to run the risk of swallowing it; and care should be taken, that his mouth is free from sores, or wounds.

When this is performed for a quarter of an hour, the part should be dressed with _mercurial ointment_ (P). Sweet oil is much recommended, and may be plentifully used as an embrocation to the inflamed part; particularly if the oil is impregnated with camphor.

No. XXII

_Take oil_ (C) _two ounces; camphor, one scruple; mercurial ointment, one drachm; mix it._

The patient should take a vomit of _ipecacuanha_ (S) _one scruple_; and a few drops of the essential _oil_ of _peppermint_ (U), on a lump of sugar, and dissolved in water, which should be repeated after the operation of the vomit as often as occasion requires. The fat of a rattle snake, is accounted a sovereign specific, if applied immediately to the wounded part, and the patient drinking a decoction made of _snakeroot_.

The same remedy here recommended to the bite of a rattle snake, (namely, sucking the fresh made wound) is also recommended to all other venomous bites. The _viper_, the _adder_, the _santapea_ or _scolopandra_, the _scorpion_, _tarantula_, &c.

That oil is an antidote, (or as we may say a poison) to all these venomous animals is evident from their expiring in great agony, when oil is poured on them; but whether this effect is because of the penetration it has on their bodies, or annihilating their poison, is as yet undetermined.

I was once told a secret for the sting of a scorpion, avered to have been experienced, by a commander of a ship, trading to the bay of Honduras, viz. that the part stung by a scorpion should be touched with the glans of the penis, which would immediately draw out the poison, without effecting the glans that touched it; and it differs not, whether the patient himself or any other person does it.——If there is any virtue in this, I own it is beyond my comprehension.——I thought proper however to mention it, though I cannot advise it as a safe experiment, unless farther confirmed by those who have actually experienced it.

I have however a great opinion of mercurials in such exigencies; and would advise recourse to be had to it immediately, both external as well as internal; this we are at least assured of, it cannot be attended with danger.

SECT. VII.

_Of the Bite of a mad Dog_

There are many surprizing things in nature, in so much, that ocular demonstration can only convince us of their existence. Amongst those wonderful phenomenons, the direful effect of the bite of a mad dog is equally astonishing as it is melancholy.

That dogs and wolves are more liable to madness of this kind, called the _Rabies_, is because of their deficiency of external perspiration; and are obliged to supply that defect with their open mouth and their lolling-out the tongue; whence their blood is subject to become overheated, and thence generate a malignant inflammation, which infects the saliva with this direful poison. But the astonishment is, why it should have so very powerful a contagion as to infect the mass of blood of every animal that receives the least atom of it? Yet so it is, confirmed by sad experience.

From frequent observation we are able however to communicate such signs, which attend the symptoms of madness in a dog, whereby we may the better avoid the danger of being plunged into the most deplorable misery by this wretched animal.

_The Signs of a mad Dog._

The dog with symptoms of madness evidently discovers a malignant fever; he runs confusedly forwards; the tongue hangs out of the mouth with much slabber; his head hangs downwards; his eyes look dull and heavy; his tail is drawn up between his legs; and in every respect he has all the sign of confused wildness and pain; he runs confusedly forward, and snaps about him without distinction of persons or fear. He is always restless; will neither eat nor drink; and is terrified at the sight of water; the tongue hanging out of his mouth, grows black; and at last expires a spectacle of horror, unless the poor beast is put out of his misery, and thereby many dreadful consequences prevented.

_The Effect of the Bite of a mad Dog._

So subtile is this fatal poison, that the symptoms do not appear immediately; but the part bitten will sometimes even heal up, the same as any other wound; and two, four, or six months after the injury, the symptoms of the malady will appear and gradually reduce the patient to the most deplorable state in nature.

The first symptoms of the disease are, a pain in the part where he was bit, which gradually spreads all around; the whole body in general is attended with a dull heavy pain, a lassitude and weariness. The mind grows depressed and anxious, together with a loss of appetite and a nausea at the stomach; and, in particular, a difficulty of swallowing, sore throat, and accumulation of spittle.

Soon these symptoms encrease. The peculiar soreness of the throat, which renders the swallowing liquids very painful, begins to create the utmost horror and dread of every thing that is liquid; and this first gives rise to the _Hydrophobia_, or dread of water, which compleats the patient’s misery in this terrible disorder.

The eyes become full and staring, the face bloated, florid intermixed with lividness; the mind is impaired; rage, lust and mischief, agitates the confused will; at length, convulsions, foaming of the mouth, priapisms, and seminal emissions, barking, howling, and endeavouring to bite every thing near, ends the wretched life of the most deplorable object in nature.

_Of the Cure of the Bite of a mad Dog._

With respect to the remedies, we have had many delivered to us; but few indeed with success. Before I enter on the best method that I know, by experiment, to recommend, I must beg leave to mention a peculiar successful instance, in the course of my practice, in this deplorable case.

A mad dog on shore, in the West-Indies, bit two men, one belonged to my ship’s crew, the other to a ship in the same harbour; both were bit in the calf of the leg. It happened that the surgeon of the other ship and myself were immediately at hand at the time of the accident. I was for cutting the part bitten fairly out without delay; to which the man of my ship readily contented; and it was done accordingly upon the spot, having fortunately my pocket instruments about me. But this operation was not approved of by Mr. E——; nor suited it the timidity of the man belonging to his care; it was therefore omitted.

When I had performed the operation, viz. (as near as I can guess) I cut more than an ounce and a half of flesh out of the gastrocnemius muscle (every where round the bitten part) I spread a pledget with basilicon, mixed with precipitate, and laid it on the wound, having first let it bleed, perhaps six or eight ounces; over the pledget I laid plenty of dry lint; and when he was carried on board, I fomented it with spirits of wine and camphor, in which _sublimate mercury_ was dissolved (about one grain to about four ounces of the spirit). Inwardly I gave him one grain of calomel every morning and night for at least a fortnight. The sore I continued to dress with mercurial ointment; which within a month healed up perfectly sound. From the mercurial treatment, the patient had a small ptyalism, which I checked by gentle cathartics. My patient, by this severe, though efficacious method, recovered perfectly well, and remained so at least three months after the accident, when we parted. The other unfortunate man, however, had not so good luck; for, as I was afterwards informed (the ship going soon to sea after the accident) the unhappy sufferer died a horrible object, raving mad in the _hydrophobia_.

Mercury is certainly the greatest antacrid we have; and I am firmly of opinion, that in this case it is the most powerful of any medicine that is yet known.

The cold bath is strenuously recommended by Dr. Mead; and since his recommending it, is generally practised on suspicion of this misfortune; but in real cases, very seldom with the wished-for success. Yet, Reason says much in its favour, and should by all means be had recourse to. Others have recommended strong salt brine, which also is not to be rejected.

Before I lay down the method to be observed, I shall first give Dr. Mead’s recipe in his own words.

“Let the patient be blooded at the arm nine or ten ounces. Take of the herb called in Latin, _lichen cinereus terrestris_; in English _ash-coloured ground liverwort_, cleaned, dried, and powdered half an ounce. Of _black pepper powdered, two drachmes_, mix these well together, and divide the powder into four doses, one of which must be taken every morning fasting, for four mornings successively in half a pint of cow’s milk warm. After these four doses are taken, the patient must go into the cold bath, or a cold spring, or river, every morning fasting for a month: he must be dipt all over, but not stay in (with his head above water) longer than half a minute, if the water be very cold. After this he must go in three times a week a fortnight longer.”

But to speak my real sentiments, I have no great opinion of this recipe; yet as other methods may be pursued along with it, I thought proper to insert it, as in a malady of this consequence, nothing should be left undone that is practicable with propriety.

Celsus I think was the first who recommended cold bathing[14]; but indeed to a degree of drowning and reviving the patient again alternately. In the mania itself, it carries much reason with it in this miserable extremity, for the poor wretch at the eve of expiring, a spectacle of horror, may as well run the risque of drowning; and besides, the shock that plunging gives to the whole system, may probably work an alteration in the malignant habit.—But alas! when the hydrophobia has actually commenced; Death, and death only—can give relief! Yet let it ever be a maxim, (and especially with a seaman) _never_ to forsake _hope_; for _despair_ is only a punishment reserved for the damned. I repeat it; no means should be left untried, that has the least prospect of recovery.

Footnote 14: