Gonorrhoea is a sexually
transmitted infection that has been known to mankind since medieval times. It
was referred to as the “clap” before the actual cause was discovered.
Discovery of the infection and its cause
The exact time when
gonorrhoea started cannot be
ascertained. Earliest records of the disease are found from 1611 when the
English parliament enacted a law to ensure that the spread of the infection is
decreased and curbed. This shows the magnitude of the public
health problem this infection had posed then. However, even then the cause
of the infection was unknown.
This was followed
by a similar law in 1256 in France during the reign of Louis IX. The symptoms
of the infection were observed when the crusaders lay siege of Acre. After the
Pope Boniface secularized the practice of medicine, the doctors began to treat
common men as well as prostitutes for this infection.
In 1879 Neisser
discovered the gonococcus or Neisseria gonorrhoeae and it was soon proven to be the
causative agent of gonorrhoea. He demonstrated its presence consistently in
patients with symptoms. In addition, when discharge and cultures of gonococci
was introduced into the urethra of healthy men, it caused the disease
History of gonorrhea treatments
The earliest
treatment of gonorrhea was
with the use of mercury. Earliest findings from an English warship “Mary Rose”
show that several special surgical tools were used to inject mercury via the
urinary opening.
In the 19th century
gonorrhea
was treated with the help of silver nitrate. Silver nitrate was soon
discontinued and instead protargol was used which was a type of colloidal
silver sold by Bayer from the year 1887.
Around 1859 another
treatment was popular. These were cubebs, an Indonesian variety of pepper of
which the dried powdered unripe fruit was used, and balsam of copaiba (or
copaiva), which was extracted from a South American tree. The indication of
their effectiveness was cessation of the discharge.
In the 1890s the
first vaccine prepared from killed gonococci taken from Neisser’s laboratory.
This vaccine
was introduced in 1909.
Before antibiotics
came into being metals were tried against the infection this included arsenic,
antimony, bismuth, gold etc.
The use of other
drugs for treatment continued right until the 1940s
till antibiotics – notably Penicillin - came into use. Other antibiotics
that arose during this time were the sulphur compounds or Sulphanilamide,
Sulfapyridine and sulfathiazol.
Penicillins continued to be mainstay of therapy until
1970’s. In 1980 the first gonococcus isolates were identified that were
resistant to penicillin.
In 1983 a local epidemic caused by a penicillin resistant strain occurred in
North Carolina. Patients were successfully treated with spectinomycin.
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