The homoeopathic approach to the treatment of gonorrhoea in either the male or the female does not differ from that for any other disease. The fact of a gonorrhoeal (or a luetic) infection is no warrant to forsake homoeopathic procedure in favor of pathologic prescribing. Do not allow the urgency of the local symptoms to obscure the general constitutional state of the patient.

In the presence of careful homoeopathic prescribing and the absence of antecedent treatment of a suppressive and irritating nature there is no acute condition that yields more promptly and satisfactorily than does the average case of Neisserian infection. This assumes, of course, good patient cooperation as stressed in an earlier article in this series.

There is a tendency on the part of some prescribers to inquire most carefully into the nature and characteristics of the gonorrhoeal discharge and to build the case around that as the all important centre or pivotal point. This method will prove successful only if the totality of the symptoms and the differentiating modalities are obtained with equal solicitude.

It is far beyond the scope of this series to discuss every remedy which might be indicated in patients suffering from gonorrhoeal infection for we would have to consider most every drug in our entire materia medica. It is rather our purpose to demonstrate a few remedies and the means by which we determine their homoeopathicity to the individual case.

Take Pulsatilla as an illustration. The Pulsatilla patient is emotionally susceptible to venereal infection by reason of the mild, yielding, changeable disposition and the desire to be comforted and consoled, especially by someone other than a member of the family. Now if a constitutionally Pulsatilla patient should contract gonorrhoea the chances are that the same remedy picture will continue to present itself. The nature of the Neisserian toxemia is not at variance with the pathogenesis of Pulsatilla. On the other hand, if syphilis is contracted by the Pulsatilla patient, the probabilities are that a different remedy will become indicated.

The outstanding characteristics of Pulsatilla include the following:.

1. Mild, gentle, yielding, tearful yet touchy and easily irritated.

2. Changeable disposition and symptoms. Cheerful and laughing, then sad and weeping. One minute too warm, the next complaining of chilliness. Wandering pains.

3. Often indicated in plethoric blondes and “is said to be a very good remedy for women.” Yet it is often indicated in spare brunettes and almost as many men require Pulsatilla as women.

4. Pulsatilla is essentially warm blooded, but is often chilly in acute conditions and particularly in a warm room.

5. Marked amelioration in the open air. Must have doors and windows open.

6. Relief by slow motion, especially walking about out of doors. Violent motion which relieves in Sepia will aggravate in Pulsatilla because of the overheating effect of the exertion.

7. Aggravation from rich food, pastry and fats. Aggravation from pork.

8. Often with the sense of dryness in the mouth and throat there is thirstlessness. If there is any thirst the preference is for cold drinks.

9. Local Symptoms: Pulsatilla is one of the most frequently indicated remedies in both early and late as well as suppressed cases of gonorrhoeal infection. In the acute or florid stage of the disease the discharge may be described as profuse, thick and yellow-green in color. It may be either acrid or bland and sometimes bloody. Later on the discharge often becomes milky and bland.

10.The only cases of stricture of the urethra the homoeopathic physician will have to treat are those resulting from meddlesome and irritating local treatment. For this complication and for this complication and for chordee Pulsatilla is very frequently indicated remedy. Where suppression of a gonorrhoeal discharge has occurred, either as a result of local treatment or as a result of getting the feet or clothing wet, Pulsatilla will frequently be needed. In these cases the characteristic evening aggravation of this remedy will often be noted in addition to the other modalities.

In cases of sycosis or constitutional gonorrhoea Pulsatilla is occasionally indicated, but must be confused with Kali sulph.,

which is often more suited to this deeply deranged state of the constitution.

Nitric acid is related to both syphilis and sycosis. In fact in chronic work it is one of the most frequently indicated remedies and is frequently required for patients who have experienced repeated attacks of Neisserian infection as well as for those who are the victims of both sycosis and syphilis. It is rare to find Nitric acid indicated in young subjects who are experiencing their first attack of gonorrhoea and /or who show no evidence of lues either in their history or symptom totality.

The Nitric acid type is as characteristic as that of Pulsatilla and more fixed and reliable as a guide to the remedy. The individual is apt to be dark complexioned and of slender build. Liver spots, freckles, warts and areas on the skin resembling nitric acid stains are distinguishing objective symptoms. Such an appearance is evidence of much past medical history and a chronic acidosis condition, a profound toxemia. It is observed in those individuals who combine in their constitution two or more of the chronic miasms plus plenty of treatment of a suppressive nature. Kent says, “deep lines of suffering characterize the Nitric acid face,” and it is “pale, yellow, sallow and sunken.”.

In the mental sphere the patient is depressed and apprehensive. He is apt to be “irritable, hateful, vindictive and headstrong.”.

Sensations are peculiar in that they are sharp and sticking as of a splinter, a fish bone or pins irritating the affected parts.

Nitric acid is apt to manifest its action at the margins of orifices where it produces its characteristic irritation and pathologic sensations. It is frequently the indicated remedy in patients who suffer from anal fissure and in those who have been the unsuspecting victims of the proctologist and the genitourinary specialist and his crude instruments of torture.

Eructations have a strong, acrid pungent odor resembling that of nitric acid fumes. The urine has a particularly strong, unpleasant odor resembling hippuric acid or horse urine.

The Nitric acid patient is sensitive, chilly, nervous and weak and the tendency is toward anaemia and emaciation. While the symptoms often present the picture of an acute condition, the remedy is essentially a chronic one with progressive decline of the vital force.

The modalities of the remedy include the following:

Aggravation from touch and jarring. Worse from cold and dampness (also from heat in some cases). Worse evening and night. Better riding in a car or train.

The gonorrhoeal discharge is acrid, thin and ranges in color from yellow to brown. It is often bloody. The discharge, especially in women, is apt to be offensive and very excoriating. With the discharge there are sticking, splinter-like pains and burning sensations. The suffering of the Nitric acid patient are so severe that the relief from the remedy is often phenomenal and most gratifying to both patient and physician. Incidentally this remedy has a few outstanding symptoms which are of high selective value.

1. Splinter-like pains.

2. Hippuric acid odor of the urine.

3. Desire for fat, for hearing and for lime, chalk, clay, etc.

No other remedy in the materia medica can duplicate the symptoms under these three groups. Some would refer to them as key-notes.

As a warty remedy Nitric acid ranks with Thuja and Natrum sulph. These three remedies will cure some of the worst cases of sycosis or constitutional gonorrhoea and they are all very frequently indicated medicines.

Sepia is another remedy of great value in the treatment of gonorrhoea. It is another of the so-called woman remedies although nearly as often indicated for men.

When a new patient arrives and his face is covered with freckles it is more than probable that one of about twenty remedies will cover the case, and of these we would put Lycopodium, Nitric acid, Phosphorus, Sepia and Sulphur at the top of the list.

Sepia is one of the leading antisycotic remedies and as would be expected warts as well as freckles are often present. Warts are as, Hahnemann discovered, unquestionably the result of constitutional gonorrhoea, either inherited or acquired.

There are perhaps no other two remedies that more closely resemble each other in general bodily and facial appearance than do Sepia and Nitric acid. Both are apt to be dark complexioned although blondes are by no means excluded from the symptom totality of either remedy. Lycopodium is another remedy that looks objectively like the other two and may easily be confused with them by the hurried and careless prescriber.

Sepia has none too nice a disposition and there is often indifference or even aversion to those loved best. Too much family and aversion to ones family are symptoms of high selective value in both sexes. Sallowness is the word that fits the Sepia face-also the Sepia saddle or brownish discoloration over the nose.

Both men and women are prone to sit in the cross-legged position as this gives a feeling of support to the pelvic organs. Contrary to Pulsatilla, the Sepia patient is relieved by fast motion, real exercise and exertion, whether out of doors or in makes little difference. Sepia is one of the few remedies definitely aggravated at the seashore like Arsenicum and the Natrum series particularly Natrum sulph. (> at seashore, Med.).

Sepia is often a rather chilly remedy though less so than Ars., Nit. ac. and Psor.

There is not as sharp a time aggravation as in Ars., Kali carb. and Lycopodium, but an aggravation occurring daily from 3 to 6 p.m. should call attention to Sepia as a possible remedy. There is, however, a very definite 28-day periodicity in this remedy showing its very definite relation to the menstrual cycle.

The gonorrhoeal discharge in Sepia is often milky in color. Sometimes it is yellow or it may be of a mucous character. This remedy is often indicated in the later stages of acute gonorrhoea with a persistent milky, gleety discharge or in women when the discharge becomes lumpy, irritating and offensive. The character of the discharge will rarely disclose the remedy. Consider first the patient and his general symptoms.

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