The complete works of John Hunter, F.R.S (Volume 2).

  • Hunter, John, 1728-1793.
Date:
1841
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Licence: Public Domain Mark

Credit: The complete works of John Hunter, F.R.S (Volume 2). Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    § 1. Of the different Modes of Practice.—Evacuants,—Astringents. The internal remedies commonly recommended in a gonorrhoea may be divided into evacuants and astringents. The evacuantsare principally of the purgative or diuretic kind, and these not confined to any particular medicines ; for every practitioner supposes that he is in possession of the best. Some use mercurial evacuants, while others carefully avoid mercury in every form. The neutral salts have been given, from the idea of their being cooling. Some of the profession have kept principally to diuretics, perhaps with two views, as evacuants acting upon the urinary passages mechani- cally, to wash off the venereal matter, or as specifics for the latter purpose : nitre has been given with this view; besides, it has been supposed to lessen inflammation; but its virtues in this way I very much doubt. Under these different modes of treatment the patients always get well, and the cures are ascribed by each practitioner to his own method of treatment. To keep the body open in most cases, even when the patient is in other respects in health, must no doubt be proper ; but what idea can we form of an irritation, produced all along the intestinal canal, curing a specific inflammation in the urethra 1 Yet there are cases where a brisk purge has been of service, and even in some has performed a cure. But 1 suspect that in such cases the disease has been continued by habit only, and that this practice would not have succeeded in the beginning. A gentleman had a gonorrhoea, all the symptoms of which continued for two months, and by taking at once ten grains of calomel, which purged him most violently, he was almost immediately cured. The calomel could not have acted specifically, but by a kind of derivation : that is, an irritation produced in one part cured one that subsisted in another. But, even if it should be granted that in some constitutions purges have the power of making the solids less susceptible of this irritation, it cannot be supposed they will have this effect in every case ; in some constitutions they might debilitate, increase irrita- bility, and of course increase the symptoms. These contrary effects must take place in different constitutions in which a medicine has no specific action. On the supposition of the cure being promoted by an evacuation from the blood, what service can purging out some of the blood in form of a secretion from one part do to an inflammation of another part ? On such a supposition, would not a sweat, or an increase of saliva by chewing tabacco, or stimula- ting the nose by snuff, all tend equally to cure a gonorrhoea ? But humours having been considered as the universal cause of every disease, especially those in which pus is formed or a discharge produced, and purging having been supposed to be the cure for humours, purgatives were of course made use of in this disease: and as the patients have always been cured, the practice became gene- rally established. Those who recommended mercury in this form of the disease, did