Synonyms-

Occasional diarrhea, occasional diarrhea, ulcerative diarrhea, hot fever, bhushoshan fever, gonorrhea, pyorrhoea.

It is called gonorrhoea in English and ‘Sozak’ or ‘Gonorhak’ in Greek.

Disease introduction-

This is an acute infectious disease in which there is discharge of pus with urine and symptoms of inflammation in the urinary tract. In this, pus comes out from the urinary tract of men and the vaginal tract of women.

Causes of Disease-

This disease is caused by a bacterium called “Neisseria gonorrhoeae”. The bacteria infects the urinary tract of men and women.

• These bacteria are extremely microscopic organisms, shaped like ‘coffee beans’ or human kidneys.

When having sex with a woman suffering from this disease, these bacteria enter the urinary tract through the penis and start eating the urinary tract by increasing their numbers abnormally, which leads to the formation of pus. The symptoms of this disease start appearing within 10-12 days of having sex with the infected person.

• The cause of this disease is the bacterium ‘Gono-coccus’ which is shaped like two dots.

Remember- this disease gets transmitted from woman to man by having sexual intercourse with a woman suffering from gonorrhea (pyorrhoea), and from woman to man by having sexual intercourse with a man suffering from pyorrhoea.

Due to the secretion of pus from the urinary tract, this disease is called ‘pyorrhoea’.

Symptoms of gonorrhea General symptoms:-

In the new disease-

• Frequent erection of the penis due to irritation.
• Itching in the head of the penis and pain during urination.
• Gradual development of redness and swelling on the glans penis.
• Unbearable pain and burning during urination.
• There is a strong urge to urinate again and again.
• The penis becomes erect and secretion starts coming from it.
• Sometimes bleeding from the urinary tract due to inflammation.
• In some cases the pus dries up and the urinary tract becomes abnormally blocked.
• The opening of the urinary tract becomes narrowed.
• Urine comes in two streams with burning.
• Mild fever, chills or shivers, and headache.
• Inability to sleep at night due to excessive stiffness of the penis.
• Urine is not clear and comes drop by drop.

When the disease becomes chronic-

• Burning and pain decrease. But pus discharge continues.
• White and sticky like purulent glue.
• In some cases, the pus may stop coming out or come out in lesser quantity. It may start again after some time.

Note- This sequence continues for months or years.

Remember- this disease is associated with heat or fever. The only difference is that in syphilis, wounds occur on the head of the penis.

Typical symptoms of diseases-

Acute gonorrhea in men-

• Pain in the urethra / followed by purulent discharge from the urethra which later turns ‘Frankly Purulent’.
• Patients who are not treated for 10 to 14 days develop inflammation in the urinary tract (posterior urethritis).
• Headache, melissa, rapid pulse and fever.
• Obstruction in the urinary tract is its major complication.

Gonorrhea in women-

• In this, uterus, cervix, Bartholin glands and urethra are affected.
• Back pain.
• Vaginal and vulval inflammation is found in girls.
• Pain and fever in both sides of the lower abdomen.
• On pelvic examination there is pressing pain in both sides. Urine is frequent and purulent.

In children – There is a possibility of Opthelmin Neonatorum in children born to women suffering from fever.

Diagnosis:-

• History of illicit sex is helpful in diagnosis.
• Burning and pain during urination within 3-7 days of onset.
• Discharge of special type of pus from urinary tract is helpful in diagnosing the disease.
• Presence of specific bacteria (in intracellular pair form) in pus examination.

Statement- The above symptoms and signs are helpful in diagnosing the disease.

When a patient of gonorrhea comes for treatment, the pus coming out from his urinary tract should be immediately sent to the laboratory to ensure that he has not contracted syphilis along with this disease.

Remember- if from the statement of the patient it is known that after having intercourse with the diseased prostitute he has also had intercourse with his wife, then treatment of both the husband and wife is necessary so that in future they do not contract the disease from each other.

Complications:-

Among men-

• Urinary tract arthritis.
• Penis inflammation.
• Asthma.
• Penile abscess.
• Inflammation of the small intestine.
• testicular inflammation

In women-

• Inflammation of the labia.
• Inflammation of the urethra.
• Vaginal inflammation.
• Cervical inflammation.
• Uterine inflammation.
• Inflammation of the abdominal cavity.
• Inflammation of the seminal vesicles.
• Various menstrual disorders.
• Miscarriage while pregnant.

Statement- This is a stubborn disease but not fatal, but it is difficult to cure. If proper treatment is not done in the beginning, then the disease remains for life.

• The infection of the disease disorders the entire reproductive organs of both men and women.
• The abdominal cavity and eyes can also be severely affected by this infection.

Ways to avoid it:-

• Complete abstinence from sexual intercourse.
• Do not have sex with a prostitute or an adulterous woman even by mistake.
• In case of a mistake (infection), clean the genitals with soap or ‘Savlon‘ lotion, clean the urinary tract with potassium permanganate (1: 5000) solution, enter 20-30 drops of 2% Protargal solution or ‘Betadine’ solution and hold it for 5-7 minutes. Along with this, by feeding 1 tablet of ‘Auriprim’ twice a day, there is no fear of getting gonorrhea.

Ancillary therapy: –

• Give bed rest to the patient.
• Giving up running, dancing, cycling, etc.
• Give him milk, coconut water and soda water.
• Provision of ‘Mildurechak’ in case of constipation.
• Give the patient a mixture of 4 litres of water + 1 litre of raw milk several times.
• The patient needs to take a bath daily.

Diet for gonorrhea patient: –

• Light and cold food which can be easily digested like milk, double roti, barley porridge cooked in milk, moong dal, khichdi and thin chapati.
• Green vegetables include spinach, bathua, ridge gourd and bottle gourd.
• Milk lassi and lemon sherbet are beneficial.

Unhealthy for a gonorrhea patient: –

• Tea, coffee, garam masala, meat and fish, chutney, pickles, red chili, alcohol, things made from jaggery and oil etc. are unhealthy.

Treatment of Gonorrhoea:-

• Procaine penicillin 3-5 mega units muscle mass 1 time only.
• Campicillin 3-5 gm in divided doses. Amoxicillin 3 gm + Provenicid 1 gm.
• Tetracycline 0.5 gram 4 times a day for 7 days. Doxycycline 100 mg 2 times a day for 5 days. Or spectinomycin 2 gram IV.
• Cefoxitin 1 gram intramuscularly + Provenicid 1 gram. Or cefotaxime 1 gram intramuscularly.
• Nowadays Taxim injection is given.

Nowadays, the treatment of this disease is done in the following manner-

• Procaine penicillin 2-4 lakh units are divided into two equal parts, half each is given on both sides of the hips along with 1 gram Probenecid orally.
• Ampicillin 3-5 gm + probenecid 1 gm by mouth.
• In those who react to penicillin, tetracycline is initially given as 1.5 grams and then given as 500 mg four times a day (for 10 days).
• Inj. Cefotaxime 1 gram by I/M.
• Surgery for urinary tract obstruction.
•  Tab. Cotrimoxazole (Septran) 1 tablet twice a day. Give it for 7-10 days.
• Ciprofloxacin 500 mg tablet is given twice a day.
• Give syrup Alkacitrol or Alkasol 5-10 ml 3-4 times a day.
• Cifran is given by I/V followed by oral administration of 500 mg tablet twice a day.
• In pregnancy, penicillin or erythromycin 500 mg is given 4 times a day for 5 days. In case of eye disease in newborns, wash the eyes with 10% lukewarm normal saline. Along with this, put 1-2 drops of Locula 1% Albucid eye drops in both the eyes every 4 hours.
• Tablet Norfloxacin 800 mg. Give 1 tablet immediately or 400 mg tablet twice a day for 1 week.