The principles and practice of modern surgeryPark, Roswell
Science
The principles and practice of modern surgery
Park, Roswell
Surgery
=Treatment.=--The treatment of gonorrhea is directed not alone toward
the mere alleviation of symptoms, but to the destruction of the
invading germs. The patient should abstain from much exercise, and in
cases of severity should be kept in bed, avoid alcohol and tobacco, and
eat sparingly of meats and of richly seasoned foods. He should wear a
“gonorrhea bag,” or large condom, and there should be no obstruction
to the outflow of pus. His hands should be washed immediately after
contact with the parts involved, and all dressings and linen which may
have been contaminated should be promptly burned.
The actual treatment of gonorrhea should be both internal and local.
_Internal treatment_ should consist (1) of the administration of
laxatives; (2) of such amount of alkali as may be necessary to
overcome hyperacidity of the urine and mitigate the distress caused
during its passage; (3) of remedies which, being eliminated by the
kidneys, serve to medicate the urine and give it the effect of a
retrojection; (4) of such anodynes and sedatives as may be necessary to
give comfort, allay distress, and produce sleep or relieve and prevent
chordee.
Of the drugs which are supposed to be eliminated by the kidneys, the
balsams have sustained a high reputation. Among these is cubebs,
of which 2 or 3 Gm. may be taken every two or three hours, as this
remedy favorably influences the amount of discharge, though sometimes
disturbing the stomach. Of the oleoresin of copaiba a ¹⁄₂ Gm. capsule,
taken several times a day, is more pleasantly borne by the stomach,
and with nearly as good effect as cubebs. Copaiba is known to produce
a vivid scarlatiniform rash. The oil of sandal-wood, or santal oil, is
the most efficient of these remedies, and may be given in the same dose
as copaiba. That these drugs are eliminated by the kidneys is shown
by the odor which they impart to the urine. It must be said, however,
that these remedies are of but trifling benefit until the bladder is
involved; when this occurs, they may prove of great value.
The urine should be diluted that it may be less irritating, and also
to overcome its acidity. Fluids should be administered in profusion
and alkaline diuretics in considerable doses. Hyperacidity is readily
controlled by the administration of liquor potassæ, or the common
sodium bicarbonate.
Sedatives may be necessary even from the first. The stronger anodynes
are rarely needed during the first day or two, but by the end of the
first week vesical tenesmus and chordee may be so marked that remedies
such as cannabis indica, lactucarium, chloral, and the bromides may
prove insufficient, and an opiate should then be administered. When
required, morphine or heroine subcutaneously and in doses sufficient to
promptly bring about the effect desired are preferable.
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