Reply to Professor Christison's criticism in the Edinburgh Medical and Surgical Journal for April 1827, on Dr. Mackintosh's evidence in the case of Mrs. Smith, tried for poisoning / [John Mackintosh].
- Mackintosh, John, -1837
- Date:
- [1827]
Licence: Public Domain Mark
Credit: Reply to Professor Christison's criticism in the Edinburgh Medical and Surgical Journal for April 1827, on Dr. Mackintosh's evidence in the case of Mrs. Smith, tried for poisoning / [John Mackintosh]. Source: Wellcome Collection.
17/60 page 135
![INJECTIONS IN GONORRHOEA AND GLEET, have little hesitation in making use of any remedy which will put a sudden stop to the disease, provided that remedy will not, or is not likely to, produce worse conse- quences than the disease itself. When a sore on the genitals is destroyed by caustic, and the part it occupied speedily heals, the patient by such treatment is not secured from secondary effects ; but the matter is far different as regards gonorrhoea. If it be cured by such a proceeding, no consti- tutional symptoms need be feared to fol- low. That this doctrine is not univer- sally admitted I am aware, and some surgeons are inclined to the opinion that secondary symptoms may follow; but I am borne out in stating, that the majority of practitioners are on the opposite side ; and even Mr. Carmichael, who places go- norrhoea under the head of papular ve- nereal disease, admits that constitutional symptoms after a gonorrhoea is a very rare occurrence. That I do not arrogate to myself ori- ginality in the use of nitrate of silver is clear; with whom the practice commenced is of little moment; my object is to direct the attention of the profession to its value, by a recital of a few cases out of many in which I have used it, and to state the symptoms and results attendant upon the practice. Case 1.—Mr. A. B., aged 30, five days after a suspicious connexion, observed a discharge on his linen of a light-greenish colour, and also one or two stains of a yellow hue. He felt an itching at the orifice of the urethra, and, upon making water, an uneasy sensation not amounting to pain. Upon examination, the lips of the urethra were slightly swollen, and redder than natural. The peculiarity of his situation requiring a speedy cure, he felt no hesitation in submitting to any treatment likely to effect so desirable an object. I accordingly injected the follow- ing J]o Argent, nitrat. gr. x ' Aq. ros<e §i. M. The first application produced a good deal of pain at the moment, which gra- dually subsided in jabout twenty minutes. Upon his next making water, he ex- perienced great soreness as far as the injection had reached, which lasted only a few minutes. At bed-time (ten hours after the first injection) I again repeated it, with similar effects. Upon his making water the following morning, a thick drop of purulent matter appeared on pressing the lips of the urethra; the soreness was less severe on micturition; no further discharge, and in twenty-four hours alKsymptoms had disappeared. I have been in daily intercourse with this patient since he first consulted me, and no bad symptoms of any kind have followed. In all the other cases a similar cure was effected, when the disease was treated within the first forty-eight hours. It would, therefore, be only a useless repe- tition to occupy your pages with the par- ticulars of them. The following, however, is of some interest as regards the effect to be produced by the injection on the seat of the disease, before a salutary result is to be hoped for. The patient being a mem- ber of the medical profession, drew up the particulars; I give the case in his own words:— Case 2.—Two days after connexion, an unusual sensation at the orifice of the urethra directed my attention to the part, and I perceived a slight discharge. Twenty-four hours after, it increased, but supposing the person I had connexion with would not have deceived me, I hesi- tated to use a remedy. The day following, the discharge was so great, of a yellowish colour, accompanied with scalding, as to place beyond all doubt the existence of the disease. The nitrate-of-silver injection was used at two o'clock p.m., and at twelve o'clock that night. The following morn- ing the discharge ceased, but there was no appearance of the purulent drop you led me to anticipate. At the end of two days, when the irritation caused by the in* jection had ceased, the gonorrhceal dis-« charge returned. The injection was used again for two turns, as before, and at the same hours. The morning following, on pressing the urethra, I forced out a thick drop of purulent matter ; no further dis- charge followed, and the pain gradually- subsided. Failure of the Injection in Gleet. I was desirous to ascertain if the strong solution would prove as successful in gleet, and used it in the following cases for that purpose. Case 3.—Mr. , aged 26, contracted a gonorrhoea three months before I saw him, which, after the usual routine of treatment, terminated in gleet. I used the solution four times in two days, without producing effect on the disease. It was satisfactory that no bad symptoms of any kind were produced, although the patient at the time indulged freely, both at dinner and after. Case 4.—Thiswas]a similar case, in the person of a poor man, in which the injec- tion also failed, but did not produce any- bad consequences. h 2](https://iiif.wellcomecollection.org/image/b20444217_0017.jp2/full/800%2C/0/default.jpg)
