The principles and practice of modern surgeryPark, Roswell
Science
The principles and practice of modern surgery
Park, Roswell
Surgery
Among the laity the idea is prevalent that gonorrhea is a disease of
more or less trifling import, while many of the profession regard it as
rarely worthy of serious consideration. This is an unfortunate notion
regarding this disease, and those who have had largest experience
unite in expressing the opinion that gonorrhea reckons more victims
in the death list than does syphilis--not because it is more common,
but because of its complications and the ravages, especially in the
kidneys, resulting therefrom. It has been shown that the specific
organism producing it may linger for years in the follicles of the
urethra, whence it may issue forth, unexpectedly, to produce vaginitis,
perhaps in the most innocent of women, and thus bring on a train of
pelvic disorders which may involve the ovaries, the tubes, and the
peritoneum. Doubtless _gonorrhea has made_ in this indirect way _many
more victims than syphilis_.
Regarding gonorrhea thus seriously, it is well to treat it cautiously
and to inculcate vigilance in the daily life and habits of the patient.
There are no arbitrary limits during which danger exists and then
passes; peril lurks about such a case for an almost indefinite time.
There is danger not alone to the individual, but to all with whom he
may have sexual or even other relations. This advice pertains not alone
to the urethral discharge and the care of the urethra, but especially
to the avoidance of all possible contamination of the conjunctiva.
One of the saddest spectacles in the domain of medicine is to see one
or both eyes of an innocent victim injured or ruined by gonorrheal
infection.
There is no denying the clinical fact that individuals vary
considerably in their susceptibility to this disease; moreover,
individual susceptibility varies at different times. Alcoholic and
sexual indulgence seem to materially lower this susceptibility. Thus
from the same individual, and within twenty-four hours, one may acquire
the disease while others escape. In some instances immunity seems to
be afforded by repeated attacks; in other individuals repeated attacks
seem only to enhance the liability to the disease. The gonococcus
grows best in alkaline media. Prolonged sexual excitement diminishes
the acidity of the urethral fluids, and this favors the growth and
development of the germ. No credence should be given to popular notions
concerning the possible avoidance of infection after exposure. Even a
careful _toilet_ is usually inefficient for this purpose, while the use
of prophylactic injections is to be reprehended. They do more harm than
good. If strong enough to be bactericidal, they should be extremely
irritant; if weak enough to be tolerated, they will prove useless.
The patient should also be warned concerning possible transfer of the
disease without sexual contact, and all toilet utensils, towels, etc.,
should be kept by themselves, and all syringes and instruments used in
the treatment of the case should be carefully sterilized.
Public-domain text, read in full here on John Shaqi.
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