Gonorrhea

Gonorrhea is a common sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae. The usual symptoms in men are burning with urination and penile discharge. Women, on the other hand, are asymptomatic half the time or have vaginal discharge and pelvic pain. In both men and women if gonorrhea is left untreated, it may spread locally causing epididymitis or pelvic inflammatory disease or throughout the body, affecting joints and heart valves.

Treatment is commonly with ceftriaxone as antibiotic resistance has developed to many previously used medications.

Gonorrhea if left untreated may last for weeks or months with higher risks of complications. As of 2010 injectable ceftriaxone appear to be one of the few effective antibiotics. Because of increasing rates of antibiotic resistance local susceptibility patterns need to be taken into account when deciding on treatment. Many antibiotics that were once effective including penicillin, tetracycline and fluoroquinolones are no longer recommended because of high rates of resistance. Cases of resistance to ceftriaxone have been reported but are still rare.

It has been suggested that mercury was used as a treatment for gonorrhea. Surgeons tools on board the recovered English warship the Mary Rose included a syringe that, according to some, was used to inject the mercury via the urinary meatus into any unfortunate crewman suffering from gonorrhea. The name "the clap", in reference to the disease, is recorded as early as the sixteen century.

Silver nitrate was one of the widely used drugs in the 19th century, but it became replaced by Protargol. Arthur Eichengrün invented this type of colloidal silver, which was marketed by Bayer from 1897 on. The silver-based treatment was used until the 1st antibiotics came into use in the 1940.

The exact time of onset of gonorrhea as prevalent disease or epidemic cannot be accurately determined from the historical record. One of the first reliable notations occur in the Acts of the (English) Parliament. In 1161 this body passed a law to reduce the spread of "...the perilous infirmity of burning." The symptoms described are consistent with, but not diagnostic of, gonorrhea. A similar decree was passed by Louis IX in France in 1256, replacing regulation with banishment. Similar symptoms were noted at the siege of Acre[disambiguation needed] by Crusaders.

Coincidental to, or dependent on, the appearance of a gonorrhea epidemic, several changes occurred in European medieval society. Cities hired public health doctors to treat afflicted patients without right of refusal. Pope Boniface[disambiguation needed] rescinded the requirement that physicians complete studies for the lower orders of the Catholic priesthood.

Medieval public health physicians in the employ of their cities were required to treat prostitutes infected with the "burning", as well as lepers and other epidemic victims. After Pope Boniface completely secularized the practice of medicine, physicians were more willing to treat a sexually transmitted disease.