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Gonorrhea is nothing new. The sexually transmitted infection (STI) has been written about since 2600 BCE and it’s been known as “the clap” since medieval times (Lee, 2012). Something about the nickname clearly resonated because many still refer to it as “the clap” nearly half a millennium later. We’ll get to the possible reasons why in a moment but first, a reminder.
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What is gonorrhea?
Gonorrhea is an infection caused by the Neisseria gonorrhoeae bacterium, which likes to take up residence in mucous membranes. It spreads through vaginal, oral, and anal sex (as well as during birth) and can infect the penis, vagina, throat, rectum, and eyes. Genital infections are most common, but oral gonorrhea is a growing concern.
In 10 to 15% of men (and up to 80% of women), gonorrhea has no symptoms (NYSDH, 2006). But it can also cause painful urination, a pus-like discharge, or pain or swelling in one testicle. Oral gonorrhea might cause a sore throat. Symptoms usually show up between 1 and 10 days after infection. Left untreated, it can cause a testicular infection in men, pelvic inflammatory disease (PID) in women, and in rare cases, spread to the blood and joints.
Why is gonorrhea called “the clap”?
The first reference to “the clap” appeared in a collection of English poems published in 1587 (Boyd, 1955):
They give no heed before they get the clap
And then too late they wish they had been wise.
So where did it come from? Historians have settled on the most likely explanation. But a few other intriguing possibilities (and at least one horrifying one) have circulated through the years.
Can you get gonorrhea from kissing?
It was named after the red light district in Paris
The most likely origin of the nickname was “Les Clapiers,” a medieval-era brothel district in Paris. It literally translates to “rabbit huts,” referring to the small rooms in which prostitutes serviced their customers.
It came from an archaic English word
Some etymologists think that “the clap” might have evolved from “clappan,” an Old English word meaning “to beat” or “to throb.” This likely reflected gonorrhea’s symptoms, which can include burning, itching, or pain.
It was named for an early method of treatment
In 1857, the cause of gonorrhea was found to be a bacterium. After the discovery of penicillin in 1928, it has been treatable with antibiotics (although we do not use penicillin to treat it).
But before then, therapies were just a little bit more invasive. One treatment involved injecting mercury, silver or another anti-bacterial agent into the urethra. Some clinicians might have pressed their hands on the penis to ensure the medication would get where it needed to go. (A WWII-era Army hygiene (US Navy, 1942) film showed that soldiers were given tubes of medicine to squeeze into the urethra, but higher-ups advocated massaging it in — no blunt force necessary.)
Another, more spurious claim is that men who couldn’t avail themselves of medical treatments would clap their hands on the penis—or slam it between heavy objects—in an attempt to clear the discharge. Because this would have done nothing to eliminate the gonorrhea bacteria, results were less than stellar.
But the vivid nature of the treatment ensured “the clap” would endure.
Gonorrhea (“the clap”): causes, symptoms, and treatments
Gonorrhea claps back
The gonorrhea bacterium has proven to be unusually adept at evolving to elude whatever treatment is thrown at it; N. gonorrhoeae has been showing signs of antibiotic resistance since at least the 1940s (Benedek, n.d.). Today, experts worry that it’s becoming resistant to the latest drugs, with no stand-alone therapies waiting as a backup. (That’s why you’ve seen stories about a potential lurking “super gonorrhea” in recent years.)
Because of gonorrhea’s ability to survive attempts to snuff it out, the CDC recommends dual therapy with two different antibiotics: ceftriaxone (a cephalosporin) and azithromycin. Each of these antibiotics has a different mechanism of action against N. gonorrhea—the bacteria that causes gonorrhea (CDC, 2015). Cephalosporins work against gonorrhea, and the addition of the azithromycin will hopefully slow down the emergence of antibiotic resistance to the cephalosporins (CDC, 2019). This double-barreled approach increased the chances that the treatment will be effective. And, conveniently, the azithromycin also works to fight chlamydia infection, which may have been caught at the same time as gonorrhea.
The best way to protect yourself against gonorrhea is to use a condom. Get regular screening for STIs and get them more often if you have multiple partners.
And if you experience symptoms of gonorrhea such as a discharge from your penis, as tempting as it may be to slam it between a couple of encyclopedias, it’s a far better idea to make an appointment with your healthcare provider ASAP.
- Benedek, T. (n.d.). History of the Medical Treatment of Gonorrhea. Retrieved August 23, 2019 from http://www.antimicrobe.org/h04c.files/history/Gonorrhea.asp
- Boyd, R. H. (1955). Origin of Gonorrhoea and Non-Specific Urethritis. Sexually Transmitted Infections, 31(4), 246–248. doi: 10.1136/sti.31.4.246. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1054050/
- Centers for Disease Control and Prevention (CDC). (2015). Gonococcal Infections – 2015 STD Treatment Guidelines. Retrieved August 23, 2019 from https://www.cdc.gov/std/tg2015/gonorrhea.htm
- Centers for Disease Control and Prevention (CDC). (2019). Basic Information about ARG – STD information from CDC. Retrieved August 23, 2019 from https://www.cdc.gov/std/gonorrhea/arg/basic.htm
- Lee, K. C. (2012). The Clap Heard Round the World. Archives of Dermatology, 148(2), 223. doi: 10.1001/archdermatol.2011.2716. Retrieved from https://pubmed.ncbi.nlm.nih.gov/22351822/
- New York State Department of Health. (2006). Gonorrhea Gonococcal Infection. Retrieved August 23, 2019 from https://www.health.ny.gov/diseases/communicable/gonorrhea/fact_sheet.htm
- Sex Hygiene – Us Navy Training Film. (1942). Retrieved August 23, 2019 from https://www.youtube.com/watch?v=Pgw1tzf6q90&feature=youtu.be
Dr. Mike is a licensed physician and the Director, Medical Content & Education at Ro.