Put a bandage on it

on the rapid treatment of gonorrheaThe treatment of venereal disease was one of the main functions of the medical profession from the Middle Ages until the adoption of antibiotics in the late 1940s greatly reduced their incidence and seriousness.  It was an uphill battle: although they had some success with mercury, there was little that was truly effective against infections like syphilis and gonorrhoea.  In 1843 Dr Conway Edwards of Bath Easton wrote to the Provincial Medical Journal to announce that he had stumbled across a regime which he believed produced a rapid cure of the latter complaint.  If nothing else, if provides an interesting snapshot of the truly global nature of the pharmacopeia at this date: his medicines included herbal remedies from several continents. 

From the unsettled opinion of the profession in the treatment of this complaint, no system has been proposed which the practitioner could regard with confidence and satisfaction. Cubebs, copaiba, liquor potassae, tartar emetic, iodine and its preparations, injections of zinc, nitrate of silver, have each in their turn been vaunted as a specific, or greatly praised for the relief it was capable of affording. Yet, on none of these could much dependence be placed; they have all disappointed the practitioner, for, however valuable they may be in themselves, and however especially local their action, they generally fail to effect a speedy cure, from the variety of symptoms which usually attend the severe forms of the disease; and the reason is obvious: gonorrhoea can be divided into three distinct stages, and, if so, the treatment must undergo a similar division.

If you’re treating the symptoms and have little idea of the cause of the disease, maybe…

During the period when the Great Western Railroad was in the course of formation, the larger proportion of illnesses from which the “navigators”

i.e. navvies, the men building the railway

suffered consisted of gonorrhoea, and other forms of the venereal disease. The dissolute habits of these men caused the inflammatory symptoms to rage with great intensity; and, without acting on any “system,” I was obliged frequently to resort to very energetic measures, and whenever sharp antiphlogistic means were adopted, before exhibiting the usual copaiba and liquor potassa mixture, the complaint invariably ran a milder as well as a shorter course. This was but in accordance with the first principles of the practice of medicine; and it seemed, in my humble opinion, only necessary to make the whole treatment accord with such principles, in order to subdue the disease at once safely and rapidly.

Dr Edwards then explains his method:

The treatment was consequently divided into three parts; the first had reference to the inflammatory stage, the second to its effects, and the last to the atonic state of the lining membrane of the urethra, and the vessels with which it is supplied. It consisted of ten grains of calomel, divided into three doses, one to be taken every four hours, and of the following mixture:-

Sulphate of magnesia, half an ounce; Jalap, two scruples; Scammony, fifteen grains; Potassio-tartrate of antimony, three grains; Water, eight ounces. Three tablespoonfuls to be taken every four hours, beginning an hour after each powder.

Jalap was a powder obtained from the roots of a Mexican climbing plant, used as a purgative.  Scammony, another plant remedy, had a similar effect. To add a degree of variation, antimony potassium tartrate is a powerful emetic.  In essence, this mixture would leave you violently ‘going at both ends’ and – in all probability – wishing you were dead.

Diet low, and drink barley water, linseed tea, &c. The first dose of the mixture was generally rejected, but the stomach soon became accustomed to bear the tartar emetic. The genital organs to be frequently soaked in tepid water, and suspended.

Suspended? I’m sure that made a great deal of difference.

In four and twenty hours the suppurative stage may be anticipated, if not already established. The mixture to be omitted, and the following substituted:- Liquor potasse, one ounce; Oil of cubebs, half an ounce; Balsam of copaiba, half an ounce; Hydriodate of potash, half a drachm; Hydrochlorate of morphia, two grains. A teaspoonful to be taken in two ounces of barley water every four hours.  

Cubeb, a species of pepper, was much used for the treatment of gonorrhoea, and was believed to have antiseptic properties.  Copaiba is taken from the bark of South American trees and has anti-inflammatory and antiseptic properties.

The parts to be rolled with a bandage, and kept wet with an acetate of lead lotion…

 If in doubt, wrap it in a bandage.

…barley water to be drunk very plentifully, and the diet improved. This treatment to be continued for three days; on the evening of the third a dose of calomel to be given, and a gentle aperient the next morning. The following injection may now be used every two or three hours for two days: Acetate of lead, one drachm; Water, eight ounces. Make an injection. This powerful lotion speedily arrests the remains of the secretion, and appears to restore the lining membrane to its normal condition. The treatment is now merely palliative, comprising a dose of the drops once a-day for a few days, and an injection of cold water twice every second day for the same time.

Dr Edwards claims some remarkable results for this method.

In no instance has a single unpleasant symptom arisen, nor the slightest contraction of the urethra supervened; and, unless the patient is very rebellious, and will drink spirits, beer, or stout, the cure is completed within the week.

Or you could just take a dose of antibiotics, of course.

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