This disease is also known by names such as “Ushnavata”, “Mutrakrichhra”, “Puyameha”, and “Aupsargik Meha”. This disease commonly affects men who have sexual intercourse with a woman already infected with the disease. There is a cavity in the male urethra, and from this cavity, the disease spreads to the bladder and testicles. In women, the disease spreads to the urethra, bladder, or uterus. Apart from this, the disease can also spread quickly through the clothes, towels, soap, leftover food, or close contact with an infected person.
Early Symptoms
The patient experiences a burning and itching sensation in the urinary tract. During urination, there is burning and pain. A yellow or white discharge is released with the urine. The patient’s testicles swell. Initially, the disease is limited to the penis in men and the vagina in women. Gradually, it spreads throughout the body. The patient starts developing warts. The infection spreads throughout the body. Pain in joints, burning in the eyes, frequent urination or urinating drop by drop with burning, and hard and painful urination are common. Sometimes, due to increased body heat, the patient may also develop a fever, chills, and shivering.
Transmission and Onset
As mentioned above, the disease is transmitted from an infected woman to a man or from an infected man to a woman through sexual intercourse. Symptoms appear on the third to fifth day after intercourse (but in some patients, symptoms may appear after 2-3 weeks). The opening of the urethra becomes swollen and red. Urination occurs with burning and pain, and pus begins to discharge from the urethra.
After 3–4 days, the patient’s discomfort increases. Sometimes, urination stops completely or blood-mixed urine with severe pain and burning is passed. The pain in the male penis becomes so severe that even the slightest touch of cloth causes unbearable pain. The glands in the thigh joints swell, and sometimes fever also occurs.
Initial Signs in Mild Cases
In some patients, it begins with minor irritation and itching at the urethral opening and a pus-like discharge. Gradually, the urethra swells. Due to excessive pus, the urine appears smoky or cloudy. At night, painful erections occur in male patients. (This condition is referred to in medical terms as “Chordee” or “Painful Penile Erection”). Because of the pain, the penis bends to one side or downward. (However, some patients experience no discomfort in the early stages and think the pus discharge is due to some other cause, thus ignoring the condition.)
After 3–4 days, the patient’s discomfort increases. Sometimes, urination stops completely or blood-mixed urine with severe pain and burning is passed. The pain in the male penis becomes so severe that even the slightest touch of cloth causes unbearable pain. The glands in the thigh joints swell, and sometimes fever also occurs.
Chronic Stage of the Disease
For up to three weeks from the onset, the symptoms remain the same. After 5–6 weeks, pus discharge stops, and urine becomes clear. (However, pus threads may still be visible in the urine.) For some patients, the suffering continues as before. After persisting for several weeks, the disease becomes “chronic”. Pus is discharged in small quantities (mainly during the first urination after waking up in the morning). In most patients, after 3–4 weeks, the infection spreads to the end of the urethra and then reaches the spermatic ducts, seminal vesicles, prostate gland, and ejaculation ducts. Due to swelling in the urethra, urination becomes painful, slow, and comes with a burning sensation. A few drops of blood may appear when urination ceases. Swelling of the prostate gland increases the suffering. Eventually, the gonorrhoea bacteria spread through the blood and infect the entire body.
Systemic Infection
Once the bacteria enter the bloodstream, other body organs and joints begin to show symptoms. If not treated timely, the disease can persist for years. A man infected with gonorrhoea can transmit it to any woman he engages in sexual intercourse with. The infected man may become infertile and unable to impregnate his wife. Because of the toxicity in the blood, joint swelling, hardened joints, blood-mixed urine, and testicular swelling may occur.
Gleet – Chronic Gonorrhoea
When this disease becomes chronic, it is referred to in medical terms as “Gleet”, which causes long-term suffering. The urethra develops sores and fibrous tissues, causing it to contract and narrow. As a result, urination becomes extremely difficult. During sexual intercourse, due to blockage in the urethra, semen flows back into the bladder. The narrowing of the urethra is medically termed as “Stricture”.
Diagnosis
This disease is confirmed through the examination of the patient’s urine and blood and the presence of gonorrhoea bacteria in them. Only then is it diagnosed as gonorrhoea. However, sometimes due to a narrow, dry, or inflamed vagina or in women suffering from leucorrhoea (white discharge), if a man engages in intercourse, he may develop similar symptoms like swelling and pus discharge from the urethra. Such conditions are referred to as “Simple Urethritis”.
The Bacteria of Gonorrhoea
The bacteria responsible for gonorrhoea is called “Gonococcus”, which resembles coffee beans or the shape of a human kidney and is extremely tiny. They can only be seen under a microscope when examining the patient’s urine and blood. They are invisible to the naked eye. These bacteria enter the male urethra through sexual intercourse with an infected woman or prostitute and multiply rapidly inside the urinary tract, eating away at the inner lining and producing pus.
As we mentioned earlier, this is a contagious (infectious) disease, transmitted from infected women to men and vice versa through sexual contact. However, this disease does not occur in animals. It generally spreads in men through intercourse with prostitutes and to healthy women due to immoral behavior by their infected husbands.
Other Modes of Transmission
In some cases, women may contract the disease through vaginal speculums or other medical instruments previously used on an infected woman during a gynecological exam. If these instruments are not sterilized, healthy women may also get infected. In infected women, a specific type of swelling occurs in the vagina. Four to five days after intercourse, irritation, burning, and swelling begin in the vagina and gradually spread to the vulva, clitoris, fallopian tubes, and ovaries.
Advanced Stage in Women
Initially, the woman experiences discomfort while urinating, and with vaginal discharge, a bluish pus appears. When the infection spreads to the uterus, inflammation and pain increase drastically. The woman experiences constant burning and restlessness, fever, and excessive pus discharge. She finds it painful to sit, stand, or walk. There is intense burning in the pelvic region, and stiffness in the nerves there. The glands of the thigh joints swell. Sometimes the Bartholin glands swell so much that the vaginal opening completely closes, preventing discharge of pus or fluids. The infection can even reach the kidneys and bladder. If treated properly in the early stages, the woman recovers fully within 15–20 days. Otherwise, the disease becomes chronic. In such cases, all major symptoms fade, but urination still causes burning. Occasionally, a thick white discharge (mixed with pus) continues from the urethral and vaginal opening. Menstruation occurs with burning. Some infected tissues form at the affected area. This condition is very painful. The mucous membrane of the vagina becomes loose and pink in color. Chronic gonorrhoea in both men and women is termed “Gleet”.
Complications in Women
Due to this disease, the woman’s urine becomes infected and toxic (uremia), inner heart lining gets inflamed, eyes may swell, joint pains occur, wounds and inflammation in the uterus, miscarriage, stillbirths, and frequent child deaths may happen. Other complications include cystitis (inflammation of the bladder), proctitis (inflammation of the anus), and blood in the urine.
Differentiating Gonorrhoea and Uterine Discharge
In cases where a woman suffers from chronic gonorrhoea, the disease may resemble uterine discharge. These conditions can be distinguished using the following signs:
If the physician presses the urethral opening with a finger, a thick white liquid discharges in the case of gonorrhoea. However, in uterine discharge, pressing the urethra does not result in any discharge. Furthermore, microscopic examination of urine and blood in a laboratory reveals a high presence of gonorrhoea bacteria in the pus, which confirms the diagnosis of gonorrhoea.
