It is not generally known that there are two kinds of gonorrhoea, one that is essentially chronic, having no disposition to recovery, but continuing on indefinitely and involving the whole constitution in varying forms of symptoms, and one that is acute, having a tendency to recover after a few weeks or months. They are both contagious.
There are also simple inflammations of the urethra attended with discharges which are not contagious, and thus we have simple inflammations of the urethra and specific inflammations of the urethra, and of the specific we have the two kinds I have mentioned, the chronic and acute. The books will treat of them as one disease, treat them in a class, and in a treatise on gonorrhoea we will have a description only of the that which relates to the beginning, viz.; the discharge.
The majority of the cases of gonorrhoea are acute, i.e., there is a period of prodrome, a period of progress and a period of decline, being thus in accordance with the acute miasms. The acute may be really and truly be called a gonorrhoea, because about all there is of it is this discharge. If the suppressive treatment be resorted to in the acute, the system is sufficiently vigorous in most cases to throw off the effects. The suppression cannot bring on the constitutional symptoms called sycosis.
It cannot be followed by fig warts, nor constitutional states, such as anaemia. But while constitutional symptoms cannot follow the suppression of the acute miasm, they will follow suppression of the chronic miasm, and become very serious. Most of the cases of true sycosis that are brought before the physician at the present time are those that have been suppressed, and they are a dozen times more grievous than when in the primary stage.
In both the acute and chronic, the prodromal period is about the same, from eight to twelve days, and there is no essential differences between the discharges of the acute and chronic. It is a mucopurulent discharge, and may have all the appearances that any acute discharge of the urethra might take on. Any simple remedy conforms to the nature of the discharge itself will soon turn the acute miasm into a state of health, but it requires anti-sycotic remedies (remedies that conform to the nature of sycosis) to turn the constitutional sycotic gonorrhoea into health.
In the very earliest stage of the discharge it is not necessary to make a distinction; but after the disease progress for weeks, it becomes necessary to make a distinction, and to follow the remedy that conformed to the more acute symptoms with the remedy that would be suitable in a sycotic constitution fully developed. Remedies are picked out for sycosis in the same way that the remedies are picked out in any miasmatic disease, viz., by making an anamnesis.
An anamnesis of the all the sycotic cases which we have had enables us to look at the constitutional state of sycosis just in the same way as Hahnemann, by an anamnesis of psora, ascertained its nature and worked out the remedies that are similar in nature and action to psora. All medicines that are capable of producing the image of sycosis may be called anti-sycotic, but we can put it in this way also and say all those remedies are anti-sycotic which when given to a sycotic case in its advanced state are able to turn the diseases backward, to reproduce the earlier forms and bring back the discharge. That is the practical way of demonstrating that a medicine is an anti-sycotic. When it conforms to the image of the miasm, it will turn the disease on its backward course. Those remedies that conform only to a particular part of the case are not deep enough nor similar enough to establish a return to earlier symptoms, and hence they are not truly anti-sycotic.
It is hardly necessary to go over a description of the acute form of gonorrhoea, but let us turn our attention solely to sycosis, recognizing it as a chronic miasm, or a disease whose first stage is a discharge from the urethra. These cases I have said are rare in proportion to the large number of cases of acute gonorrhoea, but the disease seems to be on the increase. Every busy physician will see a good many cases in women and children.
Cases of gonorrhoea that have been suppressed by injections in the hands of the old school are considered ended, and soon after he discharge has stopped the sycotic patient may be told by his physician that he is a fit subject to marry as he has been cured. But it is not true, and he should delay marriage. It is not right for him to marry until the discharge has been brought back again, and he has been cured, not by injections, because they only suppress, but by the indicated anti-sycotic. Only then may he marry a healthy wife, and she will continue healthy and bring forth healthy children.
You will never know until you get in practice how it is for a wife to break down, in a year or eighteen months after marriage, with uterine trouble, with ovarian disease, with abdominal troubles, will all sorts of complaints peculiar to the woman; and you will then be surprised on going into the history of her husband (if you are permitted to do so) to discover that in his earlier life he had two or three attacks of gonorrhoea that were treated with Nitrate of Silver or by one of these prescriptions that are carried around in the vest pockets of vicious young men, by injections that are know to stop these discharges. You will not then be surprised if you learn that the man himself has never had a really genuine state of health since that gonorrhoeal discharge disappeared. You will look upon what followed that suppression in the man. You will observe what followed the contagion in the woman and to observe these closely constitutes an interesting study.
Sometimes it is so very severe in form, and the trouble comes so soon after the suppression, that there can be no doubt even in the mind of man himself, that the trouble he is now suffering from relates to the suppression of that discharge. Sometimes they are latent and develop very gradually, and the blood becomes affected, the gradually increasing anaemia comes, the patients being pallid and waxy. What was said in relation to syphilis about contagion in the stage in which the individual has the disease is true in this disease, as also in psora.
Here is a common instance. A sycotic patient has been “cured” as far as the discharge is concerned, and now marries for he is told that no harm can come hereafter but shortly afterwards his wife comes down with illness, whereas she had always been a healthy woman before. In the old school there is no recognition of a gonorrhoeal condition, nor could the homoeopathic physician be sure of this, except for his careful prescribing
You take a man who has gone from ten to fifteen years with this sycotic trouble. He is waxy, subject to various kinds of fig warts, his lips are pale and his ears almost transparent; he is going into a decline; he has various kinds of manifestations, and these manifestations appear in numerous particulars that we call symptoms. The physician sits down and makes a careful study of the case, and if his perception of it is similar to some long acting, deep acting medicine, and he administers this medicine to the patient, the patient begins to improve. The treatment is kept up, and in the course of weeks or months the patients comes into the office and says: “Doctor, if I had exposed myself I should think I had an attack of gonorrhoea.” Now, knowing the disease get well in the reverse order of coming, you certainly cannot be surprised to hear this story.
On the other hand, however, the trouble may have manifested itself in other mucous membranes of the body, and thus saved the man from his waxiness; he is not so pallid when the condition becomes busy in another region. These catarrhal manifestations may be catarrhal conditions of the eyes, but are commonly catarrhs of the nose. It is not an uncommon thing for a nasal catarrh to be sycotic and to have existed only since the gonorrhoea was suppressed.
The catarrh is located in the nose and posterior nares with thick, copious discharge, and in spite of local treatment it has been impossible to suppress it. When the constitution is vigorous enough it will keep up the discharge in spite of the different specific remedies that have been administered, but in constitutions that are feeble diseases are easily driven to the centre, leaving the outermost parts of man. So it is often the case that a man with a thick, yellowish-green discharge from the nose, after a dose of Calcarea, which is an anti-sycotic, one of the deepest in character, has his old discharge brought back, and he says: “Doctor, I am not able to account for this, for I have been nowhere but with my wife.”
It is time to sit down and tell that man that in his earlier life he had a gonorrhoea, and that its nature was sycotic; for if it had not been of a specific character, it could not have transferred itself to the man’s economy, affecting in that way his nose; that it has disappeared from its new site under the action of a truly homoeopathic prescription, and the original discharge has been brought back, the trouble that he had in the first place. This must be explained to him, and you can now tell him that he is in a position to regain his health, to become well, to get rid of his catarrh; but that if he meddles with that discharge from the penis he will never recover. Just this kind of a case has been seen so often that there it is no longer a doubt about it.
It is in the nature of gonorrhoea to go to the surface in the earlier stage, and so when the catarrh comes on in vigorous constitutions soon after the suppression of the discharge from the urethra it may locate itself in the nose, but if the catarrh does not come on soon the constitution is too weak for the catarrh to represent the disease, and it will be represented on the deeper tissues. Bright’s disease may come, breaking down of the lungs, breaking down of the liver, rheumatic affection of the worst form, finally killing the patient. It is only in the earlier stages that it becomes catarrhal. The man thinks he is cured and he has escaped the outward manifestations because his constitution is not very vigorous, but the disease goes on into an advanced state until it attacks the blood and he becomes anaemic.
Now, if in this condition he marry, his wife does not get the catarrhal state, because the contagion is contracted in the bladder trouble, but she gets the anaemic state. You may call it a secondary state if you like, but it is really the more interior form of the disease. From this anaemic state it spreads in to all functions of the body. The woman does not get the catarrhal state, because the contagion is contracted in the woman at the stage which the husband has reached.
If he has passed the catarrhal stage, what she gets is beyond the catarrhal state. She gets fibrinous condition, inflammation of the uterus and the soft tissues, or low grade changes in the kidneys. She may go on and have any of the peculiar constitutional diseases that the woman of today is subject to. It is rather strange that it affects the soft tissues and not the bones. Syphilis affects the soft tissues and the bones. Psora affects the whole economy, nothing escape; it causes a general breakdown.
Sometimes in the man it does take the catarrhal form, but produces inflammation of the testes, or it may affected the rectum. Again, if you go to the bedside of a man who has used strong injections for the purpose of suppressing a gonorrhoeal discharge, and you find him in bed writhing and turning, tossing and twisting with the pains, and the only relief for him is to keep in continual motion; the pains are tremendous, they are rending and tearing from head to foot; if he can get up he will walk the floor night and day.
There is seldom much swelling with this rheumatism; it seems to be along the sheath of the nerves and is relieved by motion. The superficial physician will say, here is a patient relieved by motion, here is a case for Rhus. You give Rhus, and then find it does not do a single thing for the man; but remember, when you have studied sycosis in its innermost nature, Rhus is not an anti-sycotic remedy and will not help this patient in his restlessness; it will not help his awful distress and anxiety. This state will go on, and when it has attacked him so violently his tendons will begin to contract, they will shorten, the muscles of the calves will become sore, the muscles of the thighs will become so sore that they cannot be touched or handled; sometimes were is infiltration of the muscles and hardness, and this soreness extends to the bottom of the feet so that it is impossible for the patient to walk.
He is compelled to sit or lie or crawl around on his hands and knees, so violent are some cases. These cases will go on for years. I have known external applications of the allopathic physician to be applied to these sore feet and limbs for weeks and months and even years, and yet they give no relief; but a correct prescription made by a homoeopath, carefully taking in account and covering the whole nature of sycosis, will take the soreness out of the feet and bring back the gonorrhoeal discharge., The return of the old symptoms means recovery. When the discharge comes back the relief of these horrible symptoms comes, and do not consider any patient cured until the discharge is brought back.
With reference to the woman, in whom you know that the contagion has taken place in the stage in which it existed in the husband, supposing she has inflammation of a fibrinous character and goes into the very worst forms of anaemia, with all the sallowness and waxiness and patchy condition of the skin and the withering and the organic troubles, if a homoeopathic prescription be made that is truly anti-sycotic you need not expect that a gonorrhoeal discharge will appear in her case; it is not necessary, m she can get well without it. If she had no discharge she can get well without its return.
The reverse of the symptoms in her case means only the reverse order of the symptoms in her case means only the reverse order of those she has had. She may not have had the primary, but all that that patient has had she must go back through, stage by stage and symptom by symptom. The woman is the most grievous sufferer; she is an innocent person, an when there are anaemic conditions and a going down steadily in the wife that has come on a few years after marriage you should always be suspicious of his disease, at least do not allow it to pass unless you have made a suitable investigation of the matter.
Send for the husband, talk to him quietly, tell him you want to know whether he has gone through any of the specific diseases in his younger days that it shall be considered in confidence. When you are the family physician that must be done.
With fear and trembling he will likely tell you the whole story; he has gone into his marriage with a degree of innocence, because he was advised by his physician that what he has had will not affect his wife. When you have discovered this state in the family, watch their children; they will be few, for sycosis very commonly makes a woman sterile, or if she has a few children you will find in them a strong tendency to marasmus in the first year, or in the first or second summer a strong tendency to consumption, or you will find a withering, old appearance of the face.
Any one of these three miasmas may predispose this child to these things, but when the child is waxy and anaemic, is accustomed to have lienteric stools, has no digestion, when every hot spell brings on complaint that look like cholera-infantum, and it does not grow, does not thrive, you have a right to suspect it is a sycotic case, for sycosis is the most frequent cause.
This disease, you see, does not manifest itself by many eruptions, except those of a warty character, it does not manifest itself by eruptions like syphilis and psora, but operates by bringing about a rheumatic state and an anaemic condition of the blood. It takes hold of the blood first and conforms to the subjects who are advanced in deep-seated troubles, subject to epithelioma. They are especially subject to Bright’s disease and to acute phthisis. If they have pneumonia, it is likely to end in a breakdown of some sort in the lungs. If they have any acute disease of a prolonged character, like typhoid, the recovery is always slow.
Manifestly it is a good thing to know the history of a patient, all the peculiarities of the life of a patient. It is important to know whether that patient is syphilitic or sycotic. You know that everybody, is psoric, but those that have lived a proper life have escaped the two contagious disease which man acquires in the first place by his own seeking. When a patient has gone to the end of typhoid or some lingering disease, you know that he is psoric; but if you also know that he is syphilitic, or that he is sycotic, you can conduct his convalescence into a speedy recovery, and if he denies these things you may be puzzled.
The sycotic patient may go into a state of do-nothing and decline at the end of a typhoid fever; convalescence will not be established, he will lie with an aversion to food; he does not react, he does not repair, there is no tissue making, no assimilation; there is no vitality. He lies in a sort of semi- quiescent state; there is no convalescing in the matter. If you know he is a sycotic patient, he must have an anti-sycotic remedy, and then he will begin to rally. If a syphilitic patient, he must have an anti-syphilitic remedy.
If neither of these miasms are present, a remedy looking towards his psoric state will cause him to rally. The nature of these cases must be kept in view, you must remember that these chronic miasms are present in the economy and after an acute illness very often have to be fought. If this is not known, many patients will gradually sink and die for apparent want of vitality of convalesce.
Of course, the anti-sycotic treatment for the infant will bring back, as you will readily see, only that stage which the infant began with. It will not bring out a discharge in the infant. The infant has only the interior nature of the disease, and has not the primary and outermost forms of it. You will also remember another thing, that these infants when they grow up are increasingly sensitive to sycosis; that they are already prepared for a sycotic gonorrhoea whenever the first exposure comes.
The susceptibility is laid by his inheritance, just as the susceptibility to psora is laid by our parents and the susceptibility to syphilis is laid by our parents. Man can only have one attack in his natural life-time of one of the three chronic miasms; a man cannot take syphilis twice, he cannot take sycosis twice, he cannot take psora twice. This is not known; a man when asked how many times he had gonorrhoea will say: “about half a dozen times;” but only one of these was sycotic.
The sycotic constitution cannot be taken a second time. One attack gives immunity to that person forever after. The offspring becomes increasingly susceptible to all the miasms the more they become developed in the human race. The more they become complicated with each other the more the human race becomes susceptible to acute and epidemic diseases. Now, you have a general survey of the chronic miasms.