A 575514
CONTAGIOUS
DISEASES,
THEIR
TREATMENT ETC
BY
W. MORGAN
M.D.
HOMOEOPATHIC
PUBLISHING
COMPY
CONTAGIOUS DISEASES.
THEIR TREATMENT ETC.
WITH COMMENTS
ON THE
CONTAGIOUS DISEASES ACTS
BY
WILLIAM MORGAN, M.D,

ARTES
1837.
SCIENTIA
LIBRARY
VERITAS
OF THE
UNIVERSITY OF MICHIGAN
•E-FLURIBUS UNUM
SI-QUAERIS-PENINSULAM AMOENAMŰ
CIRCUMSPICE
-616,95
M85
!
CONTAGIOUS DISEASES.
WITH COMMENTS
1
ON THE CONTAGIOUS
DISEASES ACTS.
i
هوت
Dedit hanc contagio labem,
Et dabit in plures.
"Contagion has caused this plague spot, and will
extend it to many more."-Juvenal.
CONTAGIOUS DISEASES:
THEIR
ماقی
HISTORY, ANATOMY, PATHOLOGY, AND TREATMENT.
WITH COMMENTS ON THE CONTAGIOUS
DISEASES ACTS.
BY
WILLIAM MORGAN, M.D.,
Member of the Royal College of Surgeons, England; Member of the British
Homœopathic Society; Physician to the Brighton Homœopathic Dispensary;
Formerly Physician to the North London Homœopathic Dispensary;
Accoucheur to the West End Maternity Institute; one of the
Medical Officers to the London Homœopathic
Hospital and the Cambridgeshire
Dispensary, &c., &c.
FIRST EDITION.
LONDON:
THE HOMEOPATHIC PUBLISHING COMPANY,
2, FINSBURY CIRCUS, E.C.
BOERICKE & TAFEL, NEW YORK AND PHILADELPHIA.
And all Homeopathic Chemists and Booksellers.
1877.
WORKS BY THE SAME AUTHOR.
Sixth Edition, price 2s. 6d.,
THE HOMEOPATHIC TREATMENT OF INDIGESTION,
CONSTIPATION, HÆMORRHOIDS, HYPOCHONDRIASIS, &c.
First Edition, price 3s. 6d.
DIABETES MELLITUS:
Its History, Chemistry, Anatomy, Pathology, Physiology, and
Treatment.
{
First Edition, price 3s. 6d.
THE LIVER:
Its History, Anatomy, Pathology, Etiology, and Treatment.
First Edition, price 2s. 6d.
DERANGEMENTS OF
THE SIGNS AND CONCOMITANT
PREGNANCY:
The Selection of a Nurse, and the Management of the
Lying-in Chamber.
Third Edition, price 1s.; cloth, 1s. 6d.,
THE PHILOSOPHY OF
HOMEOPATHY.
See opinions of the press.
First Edition, price ls.,
CHOLERA: its Pathology and Treatment.
First Edition, price ls.,
DIPHTHERIA: its Pathology and Treatment.
V
PREFACE.
THE views propounded in the following pages,
on the History, Anatomy, Pathology, and Treatment
of "CONTAGIOUS DISEASES" were submitted in
an abbreviated form to the consideration of the
British Homœopathic Society at one of its meetings
held some six years ago; and although many of its
members then present suggested its immediate
publication, yet circumstances occurred which delayed
its appearance in the form it is now presented to
the reader till the present time.
Since then, however, the greater portion of the
work has been re-written, and much practical matter
has been added, which the author hopes may be
found useful as well as interesting to those who may
scan and consult its pages.
In undertaking the task of writing this work, the
chief aim of the author has been to concentrate the
largest amount of practical matter in the smallest.
vi
PREFACE.
possible compass; and whilst occasionally referring
to a case of cure, in illustration of the action of a
specifically chosen drug, he has, from a feeling of
professional delicacy, avoided following the example
of a recent writer on the same subject, by encum-
bering its scanty number of pages with a large
number of claptrap sensational cases; resting content
with the conviction that the practical bearing of the
"Little Book" will be its best and most modest
recommendation to public favour.
STAFFORD HOUSE, OLD STEINE, Brighton :
July 16th, 1877.
į
CONTENTS.
PAGE
Preface.
Homœopathic Medicines: their mode of preparation, potency,
the Dose, and manner of administration
<.
xi
...
INTRODUCTION.
...
History of Syphilis-Theory of Endemic origin-Theory of Ameri-
can origin-Theory of African origin
Antiquity of Syphilis-in China, India, Persia, Judea, Rome, and
Greece--Biblical references, &c.
...
Syphilis in the Middle Ages-Authorities :-Rhazes, Avicenna,
Albucasis, Lanfranc, John of Gaddesden, William Beckett-The
London Ste ws, &c.
Analogous Diseases—in Africa, Sweden, Jutland, Canada, Scotland,
England, and Wales...
...
...
2
5
IS
20
Can Syphilis arise without contagion ?-Authorities :-Clavigero,
Blumenbach, &c.-Venereal diseases in animals, &c., &c.
Summary of its geography, antiquity, hygiene, and epidemically... 24
PART I.
Balanitis-its Symptoms-Pathology-Causes-Treatment
Gonorrhoea Syphilitica-its Symptoms-Pathology-Diagnosis
25
Causes-Treatment
44
30
Gonorrhoea Virulenta in the Male-its Symptoms-Causes--
Treatment
...
33
viii
CONTENTS.
Complications-Chordee-Hæmorrhage-Phimosis-Paraphimosis
-Prostatitis-Dysuria-Buboes-Epididymitis-Cystitis-Oph-
thalmia Rheumatism - Strictures, &c. their Diagnosis—
Pathology-Symptoms-Treatment
...
PAGE
48
Gonorrhoea Virulenta in the Female, viz., Vulvitis-Vaginitis-
Urethritis—Uteritis—their Diagnosis-Pathology-Treatment... 65
PART II.
Chancroids (soft sore), Synonyms of Characteristics-Chief Locality
in male, also in female-its Frequency-Statistics-its Power of
re-inoculation—its Form and usual appearance-Symptoms-
Pathology-Diagnosis Treatment, with cases illustrative of
same
...
...
Complications-Phimosis-Paraphimosis-Phagedæna-Gangrene
—Diphtheria—“ Swan Alley Sore "-their Special Diagnosis—
Symptoms-Pathology-Treatment, medically and hygienically,
with cases illustrative of same
71
73
PART III.
True Syphilis (Hunterian Chancre)-Synonyms-History-Defini-
tions of ancient writers :-Grundpeck, Benedick, Fernel, Hunter,
Wallace, Attomyr, Ricord, Lancereux, Astruc, &c.-Chief
characteristics
...
...
1. Stage of Incubation-Similarity to other Epidemic Diseases
—Table of same—Symptoms—Pathology—Treatment
2. Stage of primary lesions, viz., Chancre-Papule-Chancroid
Erosions their chief Diagnostic signs-Treatment, locally and
generally, with cases
...
Complications-Phimosis-Paraphimosis-Buboes—Lymphangitis
-Phagedæna-Gangrene-their respective Symptoms-Pathology
-Treatment
...
84
88
92
95
;
CONTENTS.
ix
PAGE
PART IV.
Buboes, otherwise Adenites-their Definition-different Forms-
Diagnosis-Pathology-Treatment
Lymphangitis—its
...
106
Symptoms-Diagnosis-Pathology-Treatment 116
Diagnosis and Prognosis of Syphilitic and Syphiloidal Diseases,
with tabular arrangement, &c.
...
117
PART V.
Sycosis, Condylomata, or Figwarts-their divers Forms-Causes-
Pathology-Diagnosis-Treatment
PART VI.
its Symptoms Diagnosis — Pathology—
Congenital Syphilis
Treatment, medically and hygienically
PART VIÍ
Constitutional Syphilis-Secondary Symptoms-their divers Forms
-Diagnosis-Pathology-Treatment
Tertiary Symptoms-their divers Forms-Diagnosis-Pathology-
Treatment
Quaternary or Visceral Lesions their Diagnosis - Morbid
Anatomy-Symptoms-Pathology-Treatment
...
PART VIII.
Auxiliaries-viz., Turkish Baths, Hydropathy, Mineral Waters-
Diet, &c.
1
A 2
120
126
133
138
139
...
156
!
$
X
CONTENTS.
PART IX.
Onanism in the Male-in the Female-Constitutional effects-Local
effects-Treatment in both sexes-Names bestowed at various
times upon Syphilis-Country or Nation-Common name—Name
produced by national rancour-Name produced by religious
impulses
...
PAGE
162
PART X.
Cantagious Diseases Acts, Comments upon the.
the. Index, combining
the indications of medicines, &c.
...
...
169
4
xi
HOMEOPATHIC MEDICINES.
THEIR MODE OF PREPARATION; THEIR CURATIVE
SELECTION; THE DOSE OR POTENCY, AND THE
MANNER OF THEIR ADMINISTRATION, BRIEFLY
EXPLAINED.
Homeopathic Medicines.
THE homœopathic "Materia Medica" contains at
the present time from 260 to 270 medicinal prepara-
tions; the greater number of these have been faith-
fully proved on man, woman and child while in a
state of health, in order to ascertain the pathogenetic
and specific properties of each drug; others have
been but partially proved, and hold a place in its
pages on empirical grounds.
Homœopathic medicines are prepared and kept in
the form of Tinctures, Triturations, Pilules, and
Globules; a few in ether and glycerine, such as the
snake poisons.
The tinctures are chiefly derived from the vegetable
and animal kingdoms; known as expressed juice,
mother tincture, or matrix tincture, the symbol of
which is the Greek p.
From these tinctures the various dilutions or
xii
HOMEOPATHIC MEDICINES.
potencies are prepared; and the higher we ascend in
the scale of dilution the further we depart from the
crude substance, which accounts for the non-poisonous
and consequently non-injurious properties of homœo-
pathically prepared medicines; but they nevertheless
retain medicinal properties of marvellous efficacy,
which are potent against the disease; and inert
against the constitution, when homeopathically or
specifically selected. Triturations, on the contrary,
are chiefly prepared from substances derived from the
mineral kingdom. Among these may be enumerated
sulphur, mercury, arsenic, zinc, tin, baryta, gold,
silver, iron, lime, copper, alum, tellurium, and many
more. The mode of preparing the various potencies,
from the matrix triturations is similar to those pre-
pared from the tinctures, for the manipulation of
which the reader is referred to the pages of the
Homœopathic Pharmacopoeia, recently published
under the auspices of the British Homœopathic
Society.
Pilules and Globules.
These little pellets, which have afforded our
allopathic brethren no scanty field for amusement and
ridicule, are not in reality homeopathic medicines at
all; they are simply elegant and ingenious little
vehicles for the administration of the various remedies
when reduced to the liquid form (tincture), and used
on the same principle as Doctor Dosewell selects
honey, syrup, jam, or jelly for his nauseous compound
of grey powder, rhubarb, senna, or Dover's powder
in quovis vehiculo crasso-in some convenient vehicle;
HOMEOPATHIC MEDICINES.
xiii
or as once facetiously translated by a candidate for
the licence of the Apothecaries' Company-in some
- stout Hackney coach.
On the Selection of Remedies.
The fundamental principle of homeopathic practice
-the law of cure-as discovered, demonstrated, and
promulgated by Hahnemann, is simply and forcibly
expressed in the following maxim:—Similia similibus
curantur, which simply means that diseases are cured
most quickly, safely, and effectually, by medicines
which are capable of producing symptoms SIMILAR
to those existing in the patient, and which charac-
terize his disease; for in accordance with the thera-
peutic law of similarity, medicines cure affections
similar or like unto those they produce. The im-
mortal bard of Avon has well expressed this law in
the following lines:-
"Tut, man! one fire burns out another's burning,
One pain is lessened by another's anguish.
Turn giddy, and be holp by backward turning ;
One desperate grief cures with another's languish :
Take thou some new infection to the eye,
And the rank poison of the old will die.'
Homœopathy, then, proceeds upon the great incon-
trovertible truth, that as the phenomena of chemistry
depend upon positive laws-as the movements and
instincts of the brute creation are regulated in the
most orderly manner-as the physiological functions
of the human organism constitute an harmonious
play of beautifully co-ordinate forces,—so nature has
ordained a definite relation between remedial agents
and diseases. In the discoveries of such relationship,
!
xiv
HOMEOPATHIC MEDICINES.
extending over a field co-extensive with Nature her-
self, ever fresh, ever increasing in interest, consists the
study of homoeopathy in its application as well as
its practice.
The treatment of disease henceforth
must rest on positive and unerring laws; it cannot
possibly depend on chance, but must be regulated in a
manner commensurate with the unchanging principles
of nature and philosophy.
While the differences of sexes in all living beings
beneficently bind them together in prolific union, the
crude matters of inorganic nature are impelled by
like instincts. Even in the darkness of chaos, matter
was accumulated or separated accordingly as affinity
or antagonistic matter attracted or repelled its various
parts. The celestial fire follows the metals, the
magnet the iron; amber when rubbed attracts light
bodies; earth blends with earth; salt separates from
the waters of the sea and joins its like. Everything
in inanimate nature hastens to associate itself with its
like.
The beauteous aspect of the world, the order of
the celestial bodies, the revolution of the sun, the
moon, and all the stars, indicate sufficiently at one
glance that all this is not the work of chance.
Potencies.
Homœopathic medicines have been used by physi-
cians at various dilutions,-from the mother tinctures
to the two thousandth attenuation; for ordinary pur-
poses, however, I would advise my readers to confine
their selections from the mother tincture to the
3rd x, or 6th x dilution, as being the most useful and
HOMEOPATHIC MEDICINES.
XV
efficacious, and, moreover, in accordance with the
views of the majority and more advanced sections
of homoeopathic practitioners in this country and
America. They constitute the ordinary potencies
prescribed by the writer for many years, and have
proved eminently successful in his hands.
Mode of Administration.
We have observed that there are four modes of pre-
paring the medicines — viz., Tinctures, Triturations,
medicated Pilules and Globules; there is also more
than one mode of administering these remedies.
TINCTURES.—The dose of these preparations is,
as a rule, one drop administered at stated intervals.
In acute diseases, and in those severe and dan-
gerous complaints which rapidly run their headlong
course to a fatal termination, as, for instance, croup,
cholera, acute atrophy of the liver, &c., it may be
necessary at the commencement of the treatment to
repeat the dose at intervals of every ten, twenty, or
thirty minutes, until a favourable impression is made.
on the symptoms, when the interval between the
doses should be lengthened as the patient improves.
For this purpose it were well to mix thoroughly
twelve drops of the selected tincture in twelve table-
spoonfuls of water, and administer accordingly.
In chronic diseases there should be an interval be-
tween the repetition of the dose of from twelve to
twenty-four hours; and according to the strict rules.
of Hahnemann, to as many days or weeks.
prolonged action of one dose of a medicine has been
much doubted: I have but little faith in it myself,
This
xvi
HOMEOPATHIC MEDICINES.
:
and generally advise that the medicine should be
repeated once a day, or night and morning.
TRITURATIONS.-These preparations may be taken
dry on the tongue, or in solution: one grain, or as
much as will stand on the point of a penknife, is,
about equal to one drop of the tincture, one pilule,
or six globules.
If the solution be preferred, twelve grains should
be dissolved in twelve table-spoonfuls of water, well
stirred, and taken according to the circumstances of
the case.
PILULES AND GLOBULES.-These elegant and
liliputian medicaments may also be taken either dry
on the tongue or in solution. If the former, one
pilule or six globules may be considered a fair adult
dose; if the latter, one pilule or six globules dis-
solved in a table-spoonful of water may be considered
equivalent to one drop of the tincture in the same
quantity of water.
Medicines, as a rule, should be taken on an empty
stomach, or about two hours after a meal.
The water used for mixing the medicine should be
distilled, filtered, or cold boiled.
The solution should be made in a clean tumbler,
closely covered with half a sheet of note-paper, or in a
bottle well corked and kept from dust and light.
Diet.
All articles of diet and drinks which contain
medicinal properties should be strictly avoided whilst
taking homœopathic medicines, such as coffee, green
tea, and herb teas of every description; ginger,
HOMEOPATHIC MEDICINES.
xvii
pepper, vinegar, mustard, allspice, cinnamon, cloves
and spices of all kinds; every variety of vegetable
food of an aromatic or medicinal character, as onions,
garlic, radishes, celery, or parsnips; and every variety
of animal food strong-scented or difficult of digestion,
as old smoked meat, roof beef, bacon, fat pork,
sausages, rancid butter, strong cheese, &c.
In acute diseases the diet should consist of the most
light and nutritious sorts of food, such as toast-water,
barley-water, rice-water, panada, arrowroot, gruel, and
mutton broth. When the more violent symptoms of
the disease have subsided, and the patient is fairly
convalescent, more substantial food may be allowed
in moderate quantities, such as beef tea or chicken
tea, thickened with pearl barley, arrowroot, or sago,
boiled rice, boiled chicken, or a sweetbread, toast, rice
and bread pudding, and if there exists no derange-
ment of the stomach or bowels, a few grapes, straw-
berries, or peaches may be taken. In chronic
diseases, almost every variety of wholesome, nutri-
tious, and easily digested food may be allowed,
providing it does not answer the description of such
kinds of aliments as are above prohibited.
As an ordinary beverage pure water should be
allowed in all cases, toast-water, apple-water, barley-
water, or rice-water, with an occasional glass of sound
Burgundy, Carlowitz, or Somlau.
xviii
LIST OF MEDICINES.
POTENCY.
LIST OF MEDICINES
PRESCRIBED IN THIS WORK; THEIR NUMBER, OFFICIAL NAMES, ABBREVIATIONS, AND
THE POTENCY USUALLY PRESCRIBED BY THE AUTHOR.
No.
OFFICIAL NAME.
ABBREVIATION.
ENGLISH NAME.
Acon.
...
Ac. N.
Monkshood
Nitric Acid
...
Φ Ι 2 3
...
Ant. T.
Tartar Emetic
$ I
Ars. A.
...
Aur. M.
Bell.
White Arsenic
Pure Gold
Deadly Nightshade
Can. S.
Camph.
Hemp
...
Camphor
...
...
...
...
...
Canth.
Caust.
Clem.
See.
Spanish Fly...
Upright Virgin's Bower
Hydrargyri Nitrico-Oxydum
...
...
...
ΦΙ
$ I
I
ΦΙ
3
33336 33
2 2 2 2~ 2 2
W NW N
3
3 6
2
3.
mo mo
6
Aconitum Napellus
Acidum Nitricum
...
Antimonium Tartaricum
Arsenicum Album
Aurum Metallicum
Belladonna
Cannabis Sativa
Camphora...
Cantharis Vesicatoria
Causticum..
Clematis Erecta
:
:
...
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12
Cinnabaris
LIST OF MEDICINES.
xix
...
Ø I
2
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2 3
2
3
2
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...
$ I
eee O O O
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33333
♡
~MMN ~ ~ ~ NMNO 2 2 2
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$ I
2 3
ΦΙ 2
3
3
ΦΙ 2
1 2
2
221 H
3
2
2
3
2
3
6
ΦΙ
2
3
$ I
2 3
6 12
...
3 6
0 1 2 3
13
14
15
16
17
18
19
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China Officinalis
Dulcamara (Solanum)
Ferri Potassio Tartras
Ferrum Iodidum
Hamamelis Virginica
Hepar Sulphuris
Iodide Potassi, vel Kali Hy-
Chin....
Dulc....
Fer. P. T.
Hama.
Hep. S.
Cinchona, or Peruvian Bark
Woody Nightshade
...
Tartrate of Potash and Iron
Iodide of Iron
Witch Hazel
Liver of Sulphur
...
driodicum
...
20
Kreasotum
...
21
Lycopodium Claratum
22
Mercurius biniodidus
23
Mercurius Sulphuratus Ruber.
24
Mercurius Nitratis
25
Mercurius Phosphatus
26
Mercurius Solubilis
...
...
27
Mercurius Vivus
...
...
28
Nux Vomica
29
Platina
...
33
30
Pulsatilla Nigricans...
31
Petroselinum Sativum
32
Rhus Toxicodendron
33
Sar Saparilla
....
34
Sabina
333m
35
36
37
38
86 96.
Staphysagria
•
Silicea
Sulphur
...
Thuja Occidentalis
...
Lycop.
Merc. b. Iod.
Cinnab.
Merc. N.
Nux V.
Plat.
Puls.
Petros.
Rhus.
Sar Z.
Sabin.
Staph.
Sil.
Iodide of Potassium
Creasote
Common Club Moss
Biniodide of Mercury
Vermilion
...
Nitrate of Mercury
Phosphate of Mercury
...
...
...
...
Hahnemann's Soluble Mercury
Quicksilver
Nux Vomica
Platinum
Wind-flower
Parsley
Poison Oak
Sarsaparilla
Savine
...
...
...
...
...
...
Stavesacre
Pure Flint
...
...
...
Sulph.
...
Thuja
Sulphur...
Tree of Life
...
...
...
...
i
1
1
:
·
į
HISTORY OF SYPHILIS.
ALTHOUGH it is by no means difficult to follow out
the modern progress and dissemination of syphilis
and its allied disorders, the early history of the
complaint is nevertheless a somewhat intricate task,
and has required the united researches of a numerous
body of able men at various eras, and in all civilised
countries; but this evidence is at the present time in a
fair state of completeness, and may therefore be sub-
mitted with little fear that much may be altered in its
main features. This evidence we shall now set down
under the following heads : —
1. Theory of Endemic origin.
2. Theory of American, or St. Domingo origin.
3. Theory of African introduction.
Let us therefore briefly consider these in the order
so arranged. According to the theory of Endemic
origin, syphilis, in a more or less virulent form, has
existed from the very earliest times of which mankind
has any kind of knowledge, either traditional or
historical.
CHINA. According to the testimony of Forneau,
a learned French Jesuit, the Chinese authorities refer
B
1
2
HISTORY OF SYPHILIS.
to its existence among their nation from time
immemorial; and the remarkable work of Captain
Dabray, (La Médecine Chez-les Chinois), published
1863, contains a mass of evidence extracted from their
medical writings, some of which ascend to the
Hoang-ty dynasty, 2-637 years B.C., that syphilis was
well known in that ancient country. Chancres, and
corroding ulcers of the genital organs, the mouth, throat,
nose, and rectum, are freely spoken of as arising from a
specific poison communicated by direct contact, and
appearing from the third to the ninth day. Secondary
and tertiary lesions are also pretty freely described, as
sanious discharge, ulceration, and destruction of the
Septum Nasi, nodes on the bones, &c.
INDIA.-The Sucrutas Ayuvedas, an historic
work on Hindoo medicine written A.D. 400, contains
many passages referring to Syphilis. Chancre is men-
tioned with its loathsome train of horrors, as ozana,
warts, nodes and buboes, for which a system of treatment
is clearly laid down. F. C. Klein, in a series of papers
published in the Fourn. de Médec. 1795, contends,
from the history of Malabar, that it is more than nine
centuries since syphilis was first named, and Mercury
given as a cure. But the complaint, if we may trust
to Strabo, Diodorus, and Pliny, was comparatively rare
in India in their time, doubtless from their plain mode
of living and cleanliness. It may be as well to state
that the Indian codes of law regulating marriages and
sexual intercourse do not appear to have been
influenced by any fear on this head; the principle of
castes was purely religious, and dictated by notions of
policy of a widely different nature.
HISTORY OF SYPHILIS.
3
BIBLICAL REFERENCES.-Several authors both an-
cient and modern, have endeavoured to link syphilitic
and syphiloidal diseases with certain passages in Holy
Writ, such as the running issue out of the flesh;
the sores covering the body from the sole of the foot
to the crown of the head; the Baal-peor plague trans-
mitted to the Israelites by the daughters of the
Midianites, and which was of so malignant a character
that twenty-four thousand of them died in a very short.
time, for the isolation and careful treatment of which
Moses, in the fifteenth chapter of Leviticus, lays down
such stringent rules.
PERSIA. The great historian Herodotus, whose
travels extended over a vast area, and whose general
veracity all modern researches are continually tending
to prove more and more unimpeachably, refers to
certain diseases among the Persians (i. cap. 139). He
speaks of those under the terms λεπρα and λεύκη
respectively Lepra and Leuke, the latter signifying
white; hence is derived the modern term Leucorrhea
for woman's whites. If, however, we bear in mind that
the Persians, the Babylonians, the Massageta, and the
Scythians practised indiscriminate sexual intercourse,
and that in the grossest and most unblushing manner, it
is far more probable that the Leuke applied to sexual
disorders was of a more or less virulent character; and
hence, on the authority of a writer who was alive in the
fourth century B.C., we have clear traditional accounts in
a written form of the existence of something distinct
from Lepra in times long anterior to his own. The
salacity of the Eastern nations, in ancient as well as
modern times, arising from climate, is a matter of
4.
HISTORY OF SYPHILIS.
world-wide fame; and what we know of ancient times,
as handed down by historians, whose veracity is beyond
doubt, confirms us in the inference that the torrid
and arid regions of the globe have always been
cursed with these diseases, in a more or less virulent
form. To this may we fairly attribute the rigid
personal cleanliness, the bathing, and the shaving
strictly enjoined as a religious duty by the priest-
physicians of Egypt and adjacent countries.
GREECE.-Hippocrates, the renowned physician
of ancient Cos, who flourished some 450 years before
the Christian era, in his work on Epidemics (book iii.,
section 3, cap. 7), refers to ulcers and warts (thýmia)
which break out on the sexual organs, and recommends
for the removal of the latter the Pyrethrum parthenium,
or fever-few, and Alum.
ROME. Celsus, one of the oldest Latin medical
writers, devotes a whole chapter to the consideration of
the various forms of venereal affections; and refers to dry
and moist ulcers, the former clean, the latter purulent,
the chancre and chancroid of the present day. He also
refers to serpiginous and phagedanic sores; ulcers on
the nose, mouth, and tonsils. Aretaus of Cappadocia
backs up Celsus as to secondary symptoms, and refers
to the uvula being destroyed to the bones of the
palate, and the fauces to the root of the tongue and
epiglottis. Galen and Ætius respectively mention.
psoriasis of the scrotum, pustules and ulcers on the
pudendum. Plutarch and Marcellus Empiricus refer
to tertiary symptoms in the form of ulcerated and
serpiginous affections of the tibia, and deep-seated
bone pains.
HISTORY OF SYPHILIS.
5
JUDEA. The Jewish historian Josephus speaks
of the private parts of Herod that had become putrid,
and likewise of a corrosive ulcer on the private parts.
of the blasphemer Apion, which cost him his life; this
may have been the phagedanic or gangrenous sore of
the present day.
I. SYPHILIS IN THE MIDDLE AGES.
Passing from ancient times to the Middle Ages, we
find ample proof that syphilis is not to be regarded as
a recent disease, as formerly alleged. A manuscript
of the ninth century discovered by Darenburg contains
a reference showing an evident connection between
diseases of the anus and those of the genital organs.
Ulcers on the genitals were well described about the
same time by the Arabian physicians Rhazes,
Avicenna, and Albucasis, and many others all over
Europe. Both soft and hard sores on the prepuce are
mentioned by Lanfranc, of Milan, in his Chirurgie,
A.D. 1270, and chancres in both sexes are well
described by Valescus at a somewhat later period.
A cloud of contemporary, or immediately succeeding
writers might be cited in reference to this point, did
space permit our doing so. It may, however, be
sufficient here to refer to the labours of Arnauld de
Villeneuve, Theodoric, Trotula, together with the
poets Villon, and Pacificus Maximus. Secondary
symptoms are distinctly referred to in manuscripts of
the thirteenth century, especially by Gerard du Berri,
in his Glossula, where the whole system is stated to
be thus infected, but generally associated with forms
of lepra; whilst John of Gadisden an English
1
6
HISTORY OF SYPHILIS.
physician of considerable repute in his time, clearly
showed that diseases of the genital organs had arisen
from lepra. In fact, leprosy and syphilis in those
early days seem to have arisen from like causes.
Pierre Martyn, in April, 1488, writes on the subject
to his friend Arias Barbosa as follows, which seems
clear and conclusive: "You tell me," says he, "that
you are afflicted with a particular disease, called
Bubas by the Spaniards; Gallico by the Italians;
Elephantiasis by some physicians, and in various
ways by others. You describe, with incomparable
elegance, your evils, your losses, the uneasiness in
your joints, the weakness of your ligaments, the
excruciating pains in your articulations, and lastly,
the ulcers and foetor of your breath." The sympto-
matology of syphilis is here depicted in the strongest
language, and an hypothesis we have advanced in this
work receives strong support from its ultimating in
cirrhosis, softening of the brain, and idiotcy. But the
enormous impulse this disease received at the end of
the fifteenth century should not be omitted as clearly
pointing out its epidemic and contagious properties.
In 1493-4 it showed itself in the following distant
localities: Auvergne, Lombardy, Brandenburg, Bruns-
wick, Mecklenburg, Prussia, Westphalia, Pomerania,
Suabia, Franconia, Bavaria, Paris, Rome, Dalmatia,
Macedonia, and Greece; one-twentieth of the popu-
lation on an average being afflicted with it.
Jerome Fracastorius, a native of Verona, in a work
entitled De Morbis Contagiosis, published at Venice
in 1546, gives a most vivid picture of the early
symptoms of this great epidemic, which are worth
HISTORY OF SYPHILIS.
7
((
recording. Amongst other wonderful phenomena,'
says that author, "which have happened in this age,
we have seen a disease spring up quite new and long
unknown in this part of the world, which has over-
spread almost all Europe, and likewise a great part of
Asia and Africa; but in Italy it broke out about the
year 1490, at the time when the French took possession
of the kingdom of Naples under their king, Charles.
In some persons the disease commenced without
contagion; in others, and these were the greater
number, it was transmitted by contagion. Not
every kind of contact sufficed for producing it; it
required that two bodies should become heated
together, as occurs in the act of coition. And it
was chiefly by coition that the greater number became
infected. However, a considerable number of children
contracted the disease by suckling diseased mothers
or nurses. The disease was not communicable at
a distance, it did not show itself immediately, but
sometimes at the end of one, two, or even four months ;
certain signs, however, announced already that
the disease was in the germ.
"Those affected were sad, weary, and cast down;
they were pale, most of them had sores on the genital
organs, ulcers similar to those which are wont to
develop themselves on those organs after coition, and
which are called caries, but of a very different nature;
they were obstinate. When they were cured in one
place they appeared in another, and the treatment
had to be recommenced. Afterwards pustules arose
on the skin, covered with a crust: in some they
appeared upon the head, which was the most frequent
1
8
HISTORY OF SYPHILIS.
1
place; in others they appeared elsewhere. At first
they were small, afterwards they increased to the
size of an acorn, which they resembled in shape, their
appearance otherwise being similar to the crusta lactea
of children. In some cases these pustules were small
and dry; in others, they were large and moist; in
some livid; in others, whitish and rather pale; in
others, hard and reddish. They always broke in a few
days, and constantly discharged an incredible quantity
of stinking matter as soon as open; they were so
many true phagedanic ulcers which destroyed not only
the flesh, but even the bones. Those attacked in the
upper parts of the body suffered from malignant affec-
tions, which ate away sometimes the palate, sometimes
the fauces, sometimes the larynx, sometimes the ton-
sils; some lost the lips, others the nose, others all
the genital organs. Many had gummy tumours on
the limbs, which disfigured them, and were often of
the size of an egg, or of a small loaf. When they
broke, a kind of white mucilaginous fluid flowed from
them. They chiefly attacked the arms and legs;
sometimes they remained callous till death. But as
if all this were not sufficient, there ensued, moreover,
severe pains in the limbs, often at the same time with
pustules; sometimes before, sometimes after them.
These pains, which were persistent and unbearable,
were chiefly felt in the night, and were seated in the
limbs themselves, and in the nerves rather than
in the joints. Some, however, had pustules without
the pains, others pains without the pustules, and most
had both pustules and pains. However, all the limbs
were in a languid condition. The patients were wan
S
HISTORY OF SYPHILIS.
9
and emaciated, without appetite, sleepless, always
melancholy and ill-humoured, and anxious to remain
in bed. Their faces and legs swelled, and a slow fever
sometimes supervened, but rarely. Some suffered
pains in the head, which were persistent, and did not
found
yield to any remedy. If blood was drawn it was
to be pure, and somewhat mucous; the urine was
thick and red: by this sign alone, supervening in the
absence of fever, the disease might be recognised. The
stools were liquid and mucous."
Such were the symptoms of the disease at its com-
mencement. But I speak of a past time; for now, al-
though the disease is still prevalent, it nevertheless
appears to differ from what it was then. We have
seen during about the last twenty years fewer pustules
and more gummy tumours, which is the reverse of
what was observed in the first years. The pustules,
when any appear, are drier, and the pains, when any
Within about six years the
supervene, more severe.
disease has again changed notably. We now see
pustules in but very few patients; scarcely any pains,
or much lighter ones, but many gummy tumours.
A circumstance which has astonished everybody is
the falling off of the hair of the head and other parts
of the body, which produces a ridiculous appearance;
some have no beard, some no eyebrows, and some are
bald. At first these results were attributed to the
remedies, especially to mercury.
Now it is still worse; in many the teeth become
loose, and in many they even fall out.
This pestilential character it did not, however, main-
tain for more than seven years; the great wave of the
!
ΙΟ
HISTORY OF SYPHILIS.
disease had spent itself and passed away within that
brief period, assuming by degrees a less virulent form,
while the epidemic form of the malady had disap-
peared, according to the evidence of a large number
of authorities, towards the middle or the end of the six-
teenth century. Ricord is disposed to connect this
epidemic with certain forms of glanders, farcy, and
such like disorders. In our own day the malignancy
of syphilis has undoubtedly revived, and it would be
instructive to compare modern cases with the state-
ments made by those eminent authorities who observed
it in its then great intensity, a comparison of which
our limits do not at present admit.
In bringing this portion of the history of syphilis to
a close, and without absolutely subscribing to the
endemic character of that dire complaint, nevertheless
we are certainly entitled to regard these authorities as
possessing no slight degree of weight. Assuming it
to be of endemic origin, this evidence to be of similar
importance to that derived from other sources, it would
appear by no means improbable that the disease was
absolutely rooted in nature itself; and those who
unhesitatingly accept the genetical account of the
origin of the evil may see in it the points of man's
first disobedience. Probably, if the modern doctrine.
of the polygenetic origin of mankind be accepted, we
might find it rising up at equal periods of civilization
among all the races of man in the different centres of
original emergence.
2. THEORY OF AMERICAN OR ST. DOMINGO ORIGIN.
This theory as to the origin of syphilis has been
HISTORY OF SYPHILIS.
II
strenuously maintained by many learned men, and
as indignantly repelled by as many more. They
ascribe its first appearances in Europe to the sailors of
Columbus on their return home from the island of
Hispaniola, now known as San Domingo.
But it is hardly fair to impute the origin of such a
disease to the harmless and primitive race inhabiting
that island at the time, comparatively a mere speck
in the great Atlantic Ocean; nor does it seem likely
that so terrible a scourge, which habits of uncleanliness.
materially aggravate, should have arisen among a
race conspicuous for bathing and swimming, and other
methods of ridding the body of foul humours. And
again, it would seem monstrous that to one small area
should be confined a VIRUS so foul in its nature, and
destructive in its properties, as to have killed and
maimed more victims than have fallen by the sword
and cannon from the days of Crecy to the ever-memo-
rable siege of Paris in 1870-1.
It is much more compatible with common sense
and experience to find a disease of such a nature
taking its rise among an effete and heterogeneous
population such as we find Europe to possess at the
era of its sudden dissemination, that is, if we propose
to accept the theory of its novelty at all. For more
than thirty years after its appearance no author ever
dreamt of attributing the origin of syphilis to a West
Indian isle.
3. THEORY OF AFRICAN INTRODUCTION.
A still more startling theory was propounded by
Leonardo Fioravanti of Bologna in a treatise entitled
12
HISTORY OF SYPHILIS.
Capricci Medicinali, 1564, who affirms that he was
informed by the son of a sutler who was in the army
of Alphonso V., King of Arragon, while contending for
the kingdom of Naples in 1456, that being distressed
for provisions, the two opposing armies were supplied
with dressed human flesh, and hence arose the malady;
and Francis Bacon, Lord Verulam, added to this
that the flesh was that of men killed in Barbary, pre-
pared in a similar way to tunny fish. That this theory
is, however, untenable is demonstrated by facts deriv-
able from the history of cannibalism in general; and
it is consequently safer to conclude with Clavigero,
that "as nobody knew, nor could know, who was the
first in Europe that suffered that great evil, neither can
we know the original cause of it." Without absolutely
binding ourselves to the hypothesis of its introduction
from Africa, it must be confessed that the filthy and
degraded habits of the negro render the theory of its
having arisen in the equatorial regions of Africa at
least tenable. It is universally admitted that the
lucrative trade carried on for centuries with those re-
gions incited many Europeans to resort to African.
markets for the purpose of traffic and barter; and the
unbridled licence of the time may have caused the rude
sailors of the European fleets to contract something
of an infectious nature, from the unnatural intermixture
of two such opposite races. It should also be borne in
mind that the appearance of that terrible scourge in
Europe falls within the period of the greatest com-
mercial activity of the Venetians and Genoese, whose
trade with Egypt, and so with Africa, was then at its
height.
1
HISTORY OF SYPHILIS.
13
در)
i
Before drawing my remarks on the history of
syphilis to a close, I would by way of curiosity
briefly refer to other causes assigned to it by some
learned though superstitious writers of that period.
In 1497 Coradinus Gilinus, in 1500 Gaspar Torella,
and in 1502 Wendelinus Brakenaw took an astrono-
mical view of the matter, and ascribed it to the near
conjunction of the sun with Jupiter, Saturn, and
Mercury, an event which took place about these
periods.
In 1497 Nicholas Leonicenus attributed its appear-
ance to the abundant rains and inundations which
occurred in Italy in the year the contagion first ap-
peared.
In 1525 John Maynard ascribed it to the impure
conversation of a leprous gentleman of Valencia with
a courtezan; and Paracelsus assigned it a similar
cause.
In 1551 Bravasolus of Ferrara, with more likelihood,
attributed it to a courtezan in Naples during the
French occupation, who had at the time an abscess
in the mouth of the uterus.
In 1560 Gabriel Fallopius affirmed that the Spanish
soldiers during that war poisoned the wells of the
French, and bribed the Italian bakers who were in the
invaders' army to mix lime with their bread, and hence
originated the scourge.
Another theory which has found many supporters
attributes the origin of syphilis to the Mariani, as they
were called, an immense multitude of Jews, some
400,000 in number, who were expelled from Spain in
1492, wandered into Italy and settled down before
14
HISTORY OF SYPHILIS.
the gates of Rome, by permission of Pope Alexander
VI., when upwards of 30,000 perished from a pestilen-
tial Typhus, accompanied by the exhibition of large
pustules, which broke out among them. But consider-
ing that an Act of Parliament was passed in Paris in
1496 alluding to the great pox, Grosse vérole as
having already existed for more than two years, and
some time before Charles VIII. and his army reached
the walls of Naples, and considering also that the
disease was well known in Westphalia in 1492, the
Mariani theory with many others must fall to the
ground.
In conclusion, I cannot refrain from directing atten-
tion to the following brief extracts gleaned from a
series of important and ingenious papers by one
William Beckett, an English surgeon, on "The Anti-
quity of the Venereal Disease," which the reader will
find in the 30th and 31st vols. of the Philosophical
Transactions, A.D. 1718 and 1720. They are models
of research, and contain references to every printed
or written document published in the British Isles,
with the assistance of which he endeavoured to prove
that every form of Venereal disease was well known in
England centuries before the outbreak of the great
epidemic at Naples in 1493 and 4; and what is most
remarkable in the literary labours of that man
is, the number of cases recorded as having been
caused by intercourse with LEPROUS women, on
which account strict injunctions were laid down
against all sexual intercourse with women thus
diseased.
In his first dissertation he proves the existence
HISTORY OF SYPHILIS.
15
of a Venereal Gonorrhea as having been known in
England ages before 1490, and refers-
I. To a manuscript treatise by John Arden, Surgeon
to King Richard II. and Henry IV. (pub. 1370), who,
speaks of the disease as ardor, arsura, and incendium;
anglicised brenning, or burning.
2. To certain other manuscripts, written about 1390,
containing prescriptions and other formulas for the
treatment of such brenning or burning both in men
and women.
3. To the rules and ordinances of the stews, or
licensed brothels, published as far back as 1162.
These stews, eighteen in number, were situate on the
bankside, Southwark, and were under the jurisdiction
of the Bishop of Winchester in the reign of Henry
VIII. as follows:
"De his qui custodiant mulieres habentes Nefan-
dam infirmitatem."
A. No stew holder to take more for a woman's
chamber for the week than fourteen pence.
B. Not to keep open his doors upon holy-days.
C. No single woman to be kept against her will,
that would leave her sin.
D. No single woman to take money to lie with any
man, except she lie with him all night till the morning.
E. No stew holder to keep any woman that hath the
perilous infirmity of burning, but that she be put out,
upon the pain of making a fine unto the Lord* of
one hundred shillings.
4. To a manuscript by one Simon Fish, a zealous.
promoter of the Reformation, entitled "The Supplica-
* The Bishop of the diocese.
16
HISTORY OF SYPHILIS.
tion of Beggars," presented to Henry VIII. 1530;
wherein he says, speaking of the priests :-
"These be they your Majesty, that corrupt the whole
generation of mankind in your Realm, that catch the
Pokes of one woman and bear them to another."
5. To a work by Andrew Boord, M.D., and Romish
priest, entitled "The Breviary of Health," pub. 1546,
wherein references are made to the same subject.
6. To a manuscript by John Ball, M.D., pub. 1556,
which Beckett had in his collection of Ancient British
Works.
7. To a treatise by M. Wood, M.D., pub. 1553.
8. To a book by W. Bulleim, M.D., Physician to
Queen Elizabeth, entitled the "Bulwark of Health,"
1562, wherein references are made to a brenning or
burning, signifying in the present day a gonorrhea or
clap.
From these and many more instances Beckett main-
tained that a venereal gonorrhea was recognized in the
British isles from times immemorial under the desig-
nation of ardor, ursura, and incendium.
In the second dissertation, published in 1720,
Beckett refers to another manuscript by John Arden,
curiously written on vellum, and beautifully illumi-
nated, wherein references are made to Phymosis, Para-
phymosis, and a Caruncle-quere chancre, sometimes
found in the urethra; to a certain Rector who had
warts growing on the glans; to another who had a
substance as big as a small strawberry growing on the
same part of the organ, which proceeded from the
corrupted matter in the urethra; to contumacious
chancres on the glans, and the difficulty found in curing
HISTORY OF SYPHILIS.
17
them; to buboes in the groins called Dorsers; to nodes
on the shin-bones, termed Boonhaw, the old English
word Hawe signifying a swelling; to falling off of
the hair; hoarseness of the voice; ulcers all over the
body; corruption of the fleshy parts, and of the bones
themselves; filthy ulcers of the throat, corrosion and
falling in of the nose, all of which would yield to no
other remedy but MERCURY.
9. To a remarkable manuscript in Lincoln College,
Oxford, written by the Chancellor of the University,
A.D. 1430, viz.:-
"I Thomas Gascoigne an unworthy doctor of Divi-
nity, who wrote and collected these observations, have
known several men who have died of a putrefaction
of the genitals, and of the whole body; which putre-
faction and corruption as they said, was owing to
carnal copulation. For that great English Duke, viz. :
John of Gaunt, first named Plantagenet, died of a
putrefaction of the kind, occasioned by coition. For
he was much addicted to venery, as was well known all
over England, and when he was upon his death bed
he shewed that mortification to King Richard II.
"This was communicated to me by an honest Batche-
lor of Divinity who was the only person in the secret.
Willis likewise a citizen of London, and pretty far
advanced in years, died of a mortification of the same
kind, occasioned by carnal copulation with lewd
women, which he confessed to several persons before
his death, as he was distributing alms with his own
hands, of which I was a witness in the year 1430."
From these and similar observations, William Bec-
kett maintained that TRUE SYPHILIS also existed in
い
​18
HISTORY OF SYPHILIS.
the British Isles, as well as elsewhere, centuries anterior
to its supposed introduction into Europe by the sailors
of Columbus.
ANALOGOUS DISEASES TO SYPHILIS.
AFRICA.-Large portions of that benighted country
have for ages past been cursed with severe forms of
venereal diseases, known as Yaws, Pian, and Fram-
besia. It was referred to by the Arabian physicians
as early as the tenth century, under the name of
Sahafati. It seems to have committed great ravages
along the left bank of the Senegal, Congo, Senegambia,
and Sierra Leone. It confines itself chiefly to indivi-
duals of the Negrotian type-rarely amongst the white.
SCOTLAND also has been the theatre of an
analogous disorder, known as SIBBENS or SEWENS. It
first appeared A.D. 1694, breaking out almost simul-
taneously in the counties of Galloway, Dumfries,
Wigton, and Ayr. It is now almost extinct. It pre-
sented the usual signs of syphilis—namely, ulcers on
the genitals, buboes, nodes, bone pains, and spongy
fungous excrescences, all of which yielded to MERCURY.
SWEDEN and NORWAY have long been cursed
with a very disgusting form of the venereal, named
Radesyge, which, according to that eminent syphilo-
grapher, Boack of Christiania, is identical to true
syphilis. Its chief indications are throat ulcers, fleshy
excrescences about anus and genitals, indurated glands,
bone pains, caries of the nasal bones, and exostosis. It
is highly contagious, and yields chiefly to MERCURY.
JUTLAND, HOLSTEIN, ETHONIA, COURLAND, and
HISTORY OF SYPHILIS.
19
I
LITHUANIA were visited, some century and a half
ago, by a disease of a syphiloidal nature, which
was chiefly transmitted by means of spoons, drinking-
vessels, clothes, and bedding. It presented itself
chiefly in the form of mucous tubercles.
AMBOYNA is likewise the seat of a severe form of
syphilis, known as Amboyna pimple. It is endemic
throughout the Molucca and Java Islands. It presents
itself in the form of ulcers with hard raised edges,
pains and caries in the bones, and may be communi-
cated to others independently of sexual intercourse.
CANADA. In 1760 a syphiloidal complaint ap-
peared in Canada, and committed frightful ravages
among the Ottawa Indians on Lake Huron, and
like the syphiloidal of the Moluccas, was easily trans-
mitted by pipes, bed-linen, and drinking-vessels. It
presented all the symptoms of syphilis, caries of the
bones being a marked feature.
20
CAN SYPHILIS ARISE WITHOUT CONTAGION?
It has been long a vexata questio as to the possibility
of syphilis arising without absolute contagion.
Taking the French and German writers as the best
authorities, this disease unquestionably assumes the
specific character of cachexia, and the acrimony and
density of the virus is a marked feature.
*
Astruc very properly alludes to the venereal poison
as being of a morbific acid and corrosive nature. That
personal carelessness produces not alone the terrible
symptoms so well known as scarcely to require de-
finition cannot be doubted, and it is even probable
that the fearful complaint, which has hitherto baffled
the skill of the whole faculty of the world, known as
cancer, has arisen from some such similar causes. In
CELIBATE persons of both sexes, for instance, it has
been frequently observed, ultimately to the neglect of
personal cleanliness. The almost veneration paid by
many to the organs affected has led to such neglect.
Melancholia has occasionally exhibited itself, and the
symptomatology points to its perhaps proximate rise
in the misdirected and inverted ideas as to chastity.
It is better," says St. Paul, "to marry than
burn," and prurient religious excitement has been
known so to excite the mind as to induce awful dis-
arrangements of the framework of nature.
*Book ii., cap, 2.
HISTORY OF SYPHILIS.
21
It will undoubtedly display itself, either as INSANITY
from disappointed affections, and the suppression of
natural and healthy excretions; or as CANCER; or, as
otherwise, LEPRA. Inflammation sets in, and the un-
fortunate sufferers labour under bone pains, ulcers, and
other horrors. Dyscrasia sets in, and the degeneration
leads further into the ultimate production of the most
virulent forms of the disease. Clavigero, of whom we
have here made considerable use,* is expressly of
opinion that the evil may be produced without "any con-
tagion or communication with those infected, because
it can absolutely be generated in the same manner as
it was generated in the first person who suffered from
such person could not get it by contagion, because.
he would not in that case have been the first who
suffered it, but from another cause very different;
therefore, by a similar cause, whatever it was, some
cachexia might have been produced without contagion
in other individuals of the human species."
it;
Insufficient or a degraded diet are among the
causes assigned by Astruc. We have in Shakespeare's
King Lear" a cause assigned by Edgar for his
feigned insanity, in his diet of
'Rats and mice, and such small deer,"
and we are entitled to give respectful consideration
to the inductions of a man whose usual insight has led
to many important discoveries. It can scarcely be
doubted that there is a direct and rational connection
between sexual and cerebral disturbances, and that
See Dissertation ix., section 3.
22
HISTORY OF SYPHILIS.
the repression of instincts, natural and healthy in
themselves, must ultimately lead to serious mischief.
*
The testimony of Blumenbach as to natural
nocturnal emissions of a non-acrid character deserves
a passing consideration. He, in his Anthropological
Treatises, says that he regards nocturnal pollutions.
as natural excretions of the healthy man, to the intent
that he may be thereby freed from the annoyance.
and stimulus of superfluous semen when it is suitable
to him on account of his temperament or constitution,
being, therefore, an analogue of the menstrual
discharge in the female, and consequently upon the
prerogative exercised by man of copulation at will.
Recurring to the lower animals for an instant, we
find, to take for instance, the rut of the stag asso-
ciated with all the phenomena of MANIA-that desire to
associate with the female which produces GORING—
of blind, not unreasoning rage decidedly of similar
origin to the ideas connected with NYMPHOMANIA and
SATYRIASIS. From such acridity the symptoms of
lues venerea might not uncommonly arise, and cases
in which symptoms of syphilis have even shown them-
selves in the Quadrumana have been alleged.
This I have observed myself in the horse, the ass,
and on several occasions in the dog, both male and
female. "Extreme acrid seminal fluid," says Clavigero
in another place, “uteri estnantes and virulent courses
have never been wanting either." The human sperm.
is itself of the utmost acridity, and might be so exag-
gerated as to give rise to the cachectic symptoms.
referred to. Plethora, as well as suppression, might
* T. Bendyshe, M.A, Anthropological Journal.
HISTORY OF SYPHILIS.
23
also have been a cause, and history certainly points to
a very different idea from that of an American origin,
as before stated.
That, however, syphilis may have assumed its
present formidable character in the last years of the
fifteenth century is not to be disputed or denied.
Other diseases have appeared in the world, run their
course, and have died out again;
such as the
black death, the plague, the sweating sickness, and
other similar scourges. Another class of diseases, at
one time as much dreaded and almost as fatal as
those just referred to, but which, by the genius of
man and a wise Legislature, have "become so modified
in form, lessened in virulence, and tractable to treat-
ment, as to create at the present time but little
anxiety, such as the Asiatic cholera, typhus, typhoid,
scarlatina, diphtheria, and many more. By analogy,
therefore, it may be possible so to modify that
destructive element of syphilis that in the course of
time the present age may prepare the way for its
entire destruction in our posterity, though it may
be deemed as somewhat Quixotic to anticipate so
grand a revolution as the total annihilation and
stamping out, as it were, of so foul and destructive a
poison in our own times.
SUMMARY.
A brief review of the foregoing historical sketch
will enable us to arrive at the following proposi-
tions and general conclusions :—
GEOGRAPHICALLY.-Syphilis has been found dis-
tributed in a more or less virulent form over almost
24
HISTORY OF SYPHILIS.
the entire surface of the globe. On the coast of the
Adriatic, the Baltic, the Molucca Islands, and Mexico,
it attains such virulence and intensity as to bear a
strong resemblance to the great epidemic of the
fifteenth century.
ANTIQUITY.—Although a clear nosographical
system of syphilis cannot be traced further back
than the fifteenth century, nevertheless that disease
in its varied forms appears to have been observed and
clearly described at a much earlier period,
HYGIENICALLY.-Syphilis rages with greater fre-
quency and greater virulence in proportion as
prostitution is less watched over and cleanliness.
neglected. This has been fully verified in this
country since the introduction of the Contagious
Diseases Acts, as proved by copious statistics and the
Parliamentary Blue-books.*
EPIDEMICALLY.—In addition to its ordinary form,
syphilis sometimes presents itself under an epidemic
or endemic form. The first of these forms is rare,
and only appears under special circumstances; the
second is more general, and may be stigmatised as the
usual form of syphilis and syphiloidal disease.
cropping up in certain localities in our large sea-
ports and other towns, and where there is an
agglomeration of individuals not yet acclimatised.
* See my Comments on the Contagious Diseases Acts (p. 169.).
25
PART I.
THE ANATOMICAL, PHYSIOLOGICAL,
PATHOLOGICAL, AND THERAPEUTIC
CHARACTERISTICS OF VENEREAL
DISEASES.
LET us now proceed to consider the divers forms
of venereal diseases. By VENEREAL I wish it to be
understood as embracing all those disorders conferred
by Venus on her worshippers after an impure coïtus.
These I shall embrace in three main subdivisions,
namely,-
Gonorrhoea and its complications.
Chancroid and its complications.
Chancre, or "true syphilis," and its complications.
To these I would add a fourth, namely, the sycosis
of Hahnemann, otherwise "warty excrescences." The
two former, according to the views of the most eminent
syphilographers of the present day, restrict their
morbid properties to surface and locality; the third,
however, penetrates into the inmost recesses of the
vital organs, and even enters into the very centre of
the citadel of the soul itself; whilst the sycosis is
looked upon as an affection occasioned or engendered
by the presence of a gonorrhoea, a primary or
secondary syphilitic lesion-in fact,
lesion-in fact, a kind of
papillary hypertrophy or vegetation.
26
EXTERNAL GONORRHOEA.
GONORRHOEA.
This form of the "venereal" is essentially a local
disease, but of an inflammatory and very painful kind.
It has an especial affinity for mucous membranes,
beyond which it seldom travels. It has, however, a
remarkable faculty of transporting itself at will, and
attacking various local and remote organs of the body
endowed more or less with mucous membrane ::
locally, the epididymis, testicles, anus, prostate and
inguinal glands; remotely the pharynx, larynx, eyes, and
nose; finally the capsules and synovial membranes as
"gonorrhoeal rheumatism."
The leading typical forms of gonorrhoea are :—
Firstly, synonymously-gonorrhoea spuria, external
gonorrhoea, external blennorrhagia, or balanitis.
This is a form of gonorrhoea which attacks the under
surface of the prepuce and corona glandis.
SYMPTOMS. The patient first complains of
uneasiness, with a sense of titillation and tenderness.
at the tip of the penis, accompanied by itching and
tingling underneath the prepuce, followed by a swollen,
inflammatory, and excoriated condition of the parts,
first bedewed with a sero-mucous exudation, terminating
in a thick muco-purulent pus, which at times strongly
resembles that of gonorrhoea. The excoriated surfaces,
now denuded of epithelium, occur in patches and
fissures; and are the seat of a burning, scalding
sensation, particularly when the urine comes in contact
with them.
י
1
CAUSES AND TREATMENT.
27
:
CAUSES.-Exposure to the virus of gonorrhea,
leucorrhoea, and menstrual secretions, want of
cleanliness, errors in diet, excessive exercise, and a too
frequent and violent coition may be set down as
the chief causes of balanitis.
Men having an unusually long prepuce, and those
troubled with congenital phymosis, are particularly
prone to this complaint, and it is then caused by the
accumulation and retardation of the follicular
exudation, which becomes acrid and offensive, and ill
adapted for the lubrication of so delicate a structure.
TREATMENT.—Strict cleanliness, frequent ablutions
with tepid water and pure soap, the application of
a pledget of lint between the abraded surface, first
saturated with a solution of Calendula, Carbolic acid,
Tannic acid, or the Diacetate of lead, as recommended.
by my friend Dr. Tuckey of Canterbury, with the
administration of Sepia or Mercurius, will quickly
remove the ordinary forms of balanitis. It will, how-
ever, sometimes assume an obstinate form, particularly
when the cause is traceable to the virus emanating
from a gonorrhea, a gleet, a chancroid, or a chancre.
If from gonorrhoea, coupled with inflammatory
symptoms, an occasional dose of Aconite or Belladonna
should be prescribed, followed by Cannabis, Merc. sol.,
Pulsatilla, and Sulphur.
If from a gleet, Corallium rubrum, followed by
Sulphur.
If from a soft sore, Nitric acid both internally
and externally in a very weak solution has afforded
me the best results.
28
BALANITIS.
If from a hard sore, one of the mercurial prepa-
rations should be selected, the Merc. sol. Hah. by
preference.
If from a soft sore, particularly when such sores
assume a corroding or serpiginous form, secreting a
fœtid humour, bleeding when touched, with sharp
stinging pains, I have in many cases witnessed the
most satisfactory results to follow the administration.
of nitric acid in the first or second dilution; with a
very weak solution of the same medicament, or the
calendula applied externally in the form of a lotion.
A balanitis when accompanied by a phymosis,
whether congenital or of recent origin, is perhaps one
of the most troublesome complications we have to
deal with; in such cases the discharge should be
removed by means of a series of syringefuls of tepid
water thrown up under the foreskin, followed by a
solution of calendula, carbolic acid, tannic acid, or black
wash, as suggested by Dr. Tuckey of Canterbury;
this should be repeated twice or three times a day,
conjoined with soothing applications to the diseased
member, either cold or tepid, according to the tem-
perament of the patient, until the inflammation and
pain shall have sufficiently subsided to enable us to
manipulate without giving pain or risk of danger.
In congenital phymosis a similar line of treatment
should be adopted; and if a patient so formed should
be subjected to repeated attacks of a like kind, it
would become a matter for consideration whether a
surgical operation, either by dividing or circumcising
the foreskin, ought not to be performed an operation
as simple as the results are, as a rule, satisfactory.
TREATMENT.
29
NOTE.-Corallium rubrum did good service in
three cases of balanitis recently under my treatment,
which would not yield kindly to other medicines,—two
accompanied a clap, the third a gleet. The provings
of red coral are striking and to the point, namely,
"swelling of the prepuce, with a sore pain at the
margin when touching it. Red flat ulcers on the
glans and inner surface of the prepuce, with a quan-
tity of yellow pus."
Attomyr, in his practical little work on venereal dis-
eases records a case of balanitis accompanying a gleet
cured by the same remedy. He says, "I treated two
cases; one was accompanied with afterclap (gleet).
The glans was red and swollen. It had slight fissures
here and there, and one or two days afterwards it
secreted some ill-smelling mucus, which in a short time
increased very much, and drew the foreskin into
sympathy. Corallium 3rd trituration, one grain,
repeated after four days, cured the gonorrhoea of the
gland," but Cannabis sativa and Sulphur cured the
gleet.
The second case presented itself with chancre, was
not so bad, and healed under the influence of mercury.
30
SYPHILITIC GONORRHEA.
F
GONORRHEA SYPALITICA-SYPHILITIC
GONORRHOEA.
I have long considered it as an established fact,
proved by the indubitable evidence of experience,
that there are two kinds of contagious or venereal
gonorrhoea, one arising from the specific virus of
clap-the seed organ, in fact, of "gonorrhoea;" the
other the result of a true syphilitic chancrc, situate in
some part of the urethra; the former constituting a
more or less local affection, yielding kindly enough to
such well-proved remedies as aconite, cannabis, cantha-
rides, petroselinum, pulsatilla, sepia, and sulphur.
The other, unless boldly and vigorously attacked by
a well-selected preparation of quicksilver, the born
enemy of the true "Hunterian sore," leaves in its
train a motley and hideous group of phenomena,
which is characteristic of the true syphilitic type.
This is a form of gonorrhoea the real cause of which
is too frequently overlooked by many medical men,
whilst the obstinacy of the complaint-" discharge,"
which goes on perhaps for months, in spite of the
most judiciously selected gonorrhoeal specifics, and the
most powerful injections—is too frequently attributed
more to a peculiar idiosyncrasy of constitution, than
to the treacherous chancre that lays nestling, as it
were, within the folds of the mucus membrane of the
urethra.
The leading symptoms of this form of gonorrhoea
SYPHILITIC GONORRHŒA.
31
should hold a prominent place in the memory of those
who undertake the treatment of such disorders. True,
there is a certain bluntness and obscurity, "if I may so
term it," in some of the most prominent phenomena;
but that very obscurity should lead the mind to con-
jecture that there may be something more in the
urethra than a trifling clap or an obstinate gleet.
In carefully noting the symptoms of a patient so
afflicted, he will invariably tell you that he has suffered
but little inflammation even from the very outset of
the complaint that he has suffered but little pain-
that he has scarcely had any scalding in passing his
water, and that the discharge has been going on
steadily from day to day and week to week, in defiance
of all the medicines he may have taken, and all the
injections he may have thrown into the urethra.
A careful examination of the lips of the urethra-
the corona glandis and reflections of the prepuce-will
frequently reveal concealed under a thickish deposit of
balanitis, not only erosions and figwarts, but a real
chancre as well; but if not found here, and not satis-
fied with such a diagnosis, trace carefully with the
fingers of both hands the course of the penis from
the tip to its root, and you will find somewhere
about midway a hard cartilaginous substance which
will not yield to pressure, or gives but little pain;
this is the "fons et origo mali.”
There is another landmark connected with this form
of gonorrhoea which I wish to direct the attention of my
readers to; it has, however, not failed me in diagnosing
twenty-five cases of a like kind which have come under
my observation; namely, a peculiar puckering and
drawing in, as it were, of the lips of the urethra, which
32
SYPHILITIC GONORRHŒA.
always reminds me of the same phenomena observed
in case of scirrhus of the breast. This symptom was
very prominently marked in an exceedingly interesting
case which came under my notice some months ago.
The patient, a man of fifty years old, had contracted
what he was led to believe was an ordinary attack of
gonorrhoea, and was treated as such by four different
medical men. Deriving no benefit from these gentlc-
men, he applied for advice at one of the London Lock
Hospitals. I saw this patient on his first visit, listened
to the history of his case, and watched the progress of
the treatment till an excellent cure was effected. There
was distinctly marked the peculiar puckering and
inversion of the lips of the urethra, as if drawn by some
power from within; there was the constant weeping of
matter, unattended by any particular pain or ardor;
about an inch or so below the orifice of the urethra was
diagnosed a hard, firm, unyielding body, about the size
of a small filbert, which seemed to encircle the canal
like a ring, unattended by any marked tenderness or
pain. The age and sallow look of this man; the size
and cartilaginous feel of the tumour, coupled with
other circumstances, raised suspicions in the minds
of the medical officers in attendance that the discase
was of a malignant typc. Amputation was suggested,
but happily deferred, and he was placed - as an
experiment-under a course of mercury, according to
the ordinary formula in use at that institution. In
fourteen days the substance, "which I shall now
designate as chancre," was reduced to half its original
size. In twenty-eight days there was a further reduc-
tion; and in eight weeks every vestige had disappeared,
and an excellent cure was effected.
GONORRHŒA.
33
GONORRHEA VIRULENTA.
Of all the varied forms of venereal disease there
are none, it may safely be affirmed, that inflict so much
torture and acute suffering on the patient than a well-
developed case of gonorrhoea, which may be defined
"as a specific inflammation of an acute form affecting
the mucous surface of the urinary and sexual passages
in both sexes; followed by a copious puriform or
muco-purulent, sanguineous discharge, propagated by
contact, and in some instances occasioning severe
and dangerous consequences."
To the medical practitioner, also, a gonorrhoea will
sometimes prove an obstinate and troublesome com-
plaint to deal with. This I attribute partly to its metas-
tatic propensities, and partly on account of its tendency
to assume a chronic form, under the epithet afterclap,
or gleet. To the peculiar idosyncrasies of constitu-
tions; to the daily pursuits of some, the habits and
mode of living of others; to the restricted calibre of
the urethral canal, coupled with the naturally indolent
character of the mucous membranes, must undoubtedly
be attributed this unsatisfactory and uncertain state of
things. Thus we may frequently perceive that catarrhs,
which often in themselves and per se are unimportant,
will continue for several weeks and even months; and
the same may be observed in various affections of the
mucous membrane of the bronchi, the rose, ears, vagina,
and rectum, which often become more protracted in
D
1
34
GONORRHOEA.
1
their duration in proportion to the increase of the
secretion of mucus.
SYMPTOMS. An ordinary attack of gonorrhoea
runs a somewhat similar course to an ordinary attack
of inflammation, namely, the stage of irritation or
congestion; the stage of inflammation; thirdly, the
stage of suppuration; terminating, fourthly, in the
stage of decline,' or a gleet.
I. THE STAGE OF CONGESTION.-After a period
of incubation varying from two to five or six
days there is experienced a slight itching or tin-
gling at the orifice of the urethra, the lips of which
are slightly tumid, accompanied by a slight smarting
sensation in passing water, and a trifling discharge of
a thin transparent mucus, or a milk-and-water-like
fluid, which after two or three days reveals under the
field of the microscope mucus and pus globules. To
this succeeds the-
2.
INFLAMMATORY STAGE, which is charac-
terized by an intensely painful, highly sensitive,
and cord-like touch of the penis; an increased puffi-
ness of the urethral lips; excoriation, and a peculiar
cherry-like colour of the glans; a burning, scald-
ing sensation in passing water, which is diminished
in quantity, and comes away either in drops, or in a
curling, broken, or twisted stream; with a copious dis-
charge of a thick yellow purulent or sanguineous green-
ish matter. In some cases, particularly in first claps,
occurring in young robust and inflammatory persons,
the inflammation and swelling of the penis is so intense
as to lead for some hours to a complete retention of
urine, and the extension of the pain along the whole
SYMPTOMS."
در)
35
course of the urethra to the bladder, the perinæum
the hypogastric region, and even down to the hips and
thighs; and so intense a nature do these symptoms
sometimes assume, that the discharge is almost sup-
pressed, constituting that form of the complaint desig-
nated "gonorrhea sicca," dry gonorrhoea.
This stage
may continue with more or less severity for seven, ten,
or fourteen days, when the more prominent symptoms
will gradually subside; the discharge diminishes in
quantity and purulency, and the pain and scalding
become less intense; and at the expiration of from
three to six weeks all traces of the disease may dis-
appear. I have, however, met with many cases of
gonorrhoea which have entirely disappeared in twelve,
fifteen, and twenty days, particularly in those who
have sought early advice, and were blessed with a good
constitution and contented mind; who were likewise
in a position to lay up, and carry out strictly the
dictetic, hygienic, and therapeutic rules set down for
their guidance.
Sometimes, however, although the acute symptoms.
shall have subsided, and the discharge considerably.
lessened and altered in quality, the urethra, instead
of resuming its natural healthy mucous secretion, will
persist in pouring out from time to time for an in-
definite period a thin, glairy milk and water, or light
green coloured matter, constituting what I am dis-
posed to designate the fourth stage of the complaint,
known as a "gleet," or afterclap.
Such, then, is a brief outline of the course and
various stages of an ordinary attack of gonorrhoea,
and 'twere well, both for patient and physician, if it
36
GONORRHŒA,
never deviated from that course,
painful though
some of the symptoms might be." This, however, is
not the case. A gonorrhoea is at best, and under the
most favourable circumstances, a capricious and
whimsical disorder to deal with one case will run an
even and unchequered course to convalescence, and
totally disappear in the course of fifteen to twenty.
days; whilst another, in spite of the most careful
nursing, the strictest diet, and the most judiciously
selected medicines, will assume an obstinate and ag-
gravated form from the very commencement of the
attack, by developing some of its most serious and
painful complications, which hang on and torture the
patient for weeks and months.
In ordinary cases of gonorrhoea the inflammation
does not extend further along the urethra than an inch.
and a half or two inches from the orifice-the specific
extent of John Hunter; but in severe forms of the
complaint the inflammation passes along the whole
course of the urethra, and even implicates the mucous
membrane of the bladder as well. It deposits fibrine
in the corpora spongiosa urethra, the exciting cause
of that very painful complication, chordee. It invades
the prepuce, which becomes thickened, swollen, ex-
coriated, and oedematous, producing that condition
termed phimosis. It extends to the inguinal region
and descends into the scrotum; hence those painfully
sympathetic buboes in the groins, and inflammatory
enlargement of the testicles. In its course along the
urethra towards the bladder it invades the prostate
and Cowper's glands, creating a most painful and dan-
gerous form of inflammation, which either terminates
CAUSES.
37
;
in suppuration, or chronic enlargement, coupled with
the most distressing form of dysuria.
For a more concise description of the symptoms
and treatment of these disorders the reader is re-
ferred to that section of the work which treats of the
"Complications of Gonorrhoea," page 48.
CAUSES. Many and varied are the causes capable
of inducing an inflammation of the urethra, which may
terminate in a gonorrheal discharge, and which need
not necessarily be the result of an impure embrace;
amongst these I would briefly mention-
I. MECHANICAL CAUSES--such as the introduc-
tion of a catheter or bougie, the passage of calculi,
or the introduction of other foreign bodies into the
urethra.
2. CHEMICAL CAUSES-such as the injection of
irritating substances, abuse of spirits, new wine, un-
fermented beer, stimulating spices, and salt food.
3. CLIMATIC CAUSES. It is considered that
gonorrhoea occurs more frequently in a hot than a
cold climate, and it has been observed that exposure
of the organs to the wind while urinating* is a frequent
cause of a discharge from the urethra, which runs the
same course as an ordinary attack of gonorrhoea.
4. CONSTITUTIONAL CAUSES.—The forms of con-
stitutional irritation which predispose one more par-
ticularly to gonorrhoea are scrofula, tubercles, gout,
rheumatism, piles, and various cutaneous eruptions;
and as regards predisposition or temperament it may
This I have observed among the farm labourers and shepherds
of the Welsh mountains, who take the Petroselinum, or Parsley-root tea,
as a remedy-a remedy of great antiquity.
38
GONORRHŒA.
1.
be noted that persons of a plethoric habit, with blond
hair, a fine white colour, and delicate frame, or those
whose constitutions savour of the sanguine or scro-
fulous taint, are more liable to be infected, and have
it in a more severe form than those who do not
possess those qualities.
1
5. MASTURBATION.-I have occasionally observed
that some of those young men who seek my advice
for the ill-effects produced by that deplorable and per-
nicious vice, self-pollution or onanism, are subject to
a gleety discharge from the urethra. This was well.
marked in the case of a youth of sixteen, who was
brought to me from a large seminary at Blackheath
some few days since, the discovery of which was the
means of checking a habit which had obtained a firm
hold upon many of his confrères as well.
FINALLY, a gonorrhoeal discharge may be in-
duced by excessive sexual intercourse, by leucorrhea,
by ulceration of the neck of the womb, and by having
intercourse with women during the menstrual period.
I have occasionally met with cases of the latter kind
which have really been the cause of a very sharp
attack of the complaint, and have particularly noticed
the pain to be of a peculiarly stinging character.
This form of gonorrhoea did not escape the observa-
tion of the ancient physicians, as John of Gadisden,
M.D., Merton College, Oxford, in his Rosa Anglica,
1320, refers to the "menstrual flux as a cause of
gonorrhoea; while similar observations are to be
found in other works extending from that period to
the present day. But the most frequent cause of
gonorrhea, and the one we are more immediately
39
}
TREATMENT.
39
¿
interested in at the present time, is that which springs
from a “specific virus," communicable to a healthy
person by an impure coit, or by inoculation.
Of the nature, character, and chemical properties
of this virus we know no more than we do of the poison
of the viper, the rattlesnake, or the spear-headed ser-
pent of South America; its effects on the healthy
organism are, however, tangible enough, and form
a group of morbid phenomena so prominent and
graphic that, once seen or felt, can never be forgotten,
and present an apt simile to the burnt child who
never forgets the element that inflicted upon him
so much suffering.
To the treatment of gonorrhoea I would now direct
attention.
It is an exceedingly interesting study, and one
peculiarly fitted to convince the opponents of homœo-
pathy of the beauty and simplicity of its guiding
principle, similia similibus curantur, and the efficacy
of drugs administered, comparatively speaking, in
inappreciable doses. This treatment we shall divide
into PREVENTIVE and CURATIVE.
1. The PREVENTIVE or prophylactic treatment I
adopt on the same principle as we do the adminis-
tration of Belladonna in scarlet fever, Pulsatilla in
measles, Quinine in intermittent fever, and vaccination
against small-pox, &c. A gonorrhoea, "like many
febrile and eruptive diseases," has its stage of incuba-
tion, the duration of which varies, according to Druitt,
from four to five days, but may extend, according to
Cooper, to two and even three weeks. It is during
this stage that a well-selected PREVENTIVE should be
40
GONORRHOEA.
administered, and of sufficient potency to create in the
organism a group of syptoms similar to those produced
by the virus of gonorrhoea, particularly in the mucous
membrane of the urethra. We have in Mercury such
a remedy; at all events, let us compare notes, and
see how near it approaches in its homoeopathicity to
that disease.
MERCURY causes a burning and smarting in the
urethra.
It causes a frequent desire to urinate.
It causes blood to pass with the water.
It causes shreds and flocks of white mucus to pass
with the water.
It causes a burning, cutting, prickling pain in pass-
ing water.
It causes a cutting, biting pain all along the urethra,
especially at the orifice during the emission of the
last few drops of water.
It causes itching of the glans, prepuce, and orifice
of the urethra.
It causes inflammation and cedematous swelling of
the prepuce, as if filled with water.
It causes swelling of the penis, especially at night,
often accompanied with painful erections.
It causes condylomata on the prepuce, and the exu-
dation of pus from the urethra and behind the "corona
glandis."
In the female also Mercury acts with considerable
energy.
It causes an inflammatory swelling of the vaginal
mucous membrane, with a feeling as if the parts were
raw and excoriated; a discharge of flocks of mucus
TREATMENT.
41
!
E
and pus from the vagina ; it likewise causes a purulent,
corrosive leucorrhoea.
The general symptoms also "produced by this
drug" bear a strong resemblance to the first impression
made upon the system by the contagious virus, and be-
fore the appearance of any local symptoms; namely,-
depression of strength, præcordial anxiety, frequent sigh-
ing, a sense of coldness, partial or general tremors, an
anxious or pinched countenance, and a small quick pulse.
These symptoms, which so fully point out its pri-
mary action on the nervous system, are frequently
felt by sensitive and observant patients about to suffer
from an attack of gonorrhoea; and if there be any truth
in the homoeopathic law, and any reliance to be placed
on the preventive power of any drug, I know of no
medicine so closely allied in its homeopathicity, or so
certain in its effects, as one of the mercurial prepara-
tions, more particularly the Merc. vivus or the Merc.
sol. Hah.
Dr. Croserio, of Paris, had unbounded faith in the
preventive power of these preparations; indeed, he
never found them fail, provided his instructions were
strictly carried out. His favourite potency was the
30th-a dose every night during three or four days.
Whenever a patient consults me who has been ex-
posed to a doubtful contact, I invariably lay down the
following simple rules :-
A. That he should live plainly, avoid all stimulants
and unnecessary excitement.
B. That he should immediately wash the parts with
tepid water and pure soap; to which may be added
carbolic acid, or Condy's fluid.
42
GONORCA.
;
C. That the urine should be quickly voided, using
more than ordinary force in doing so, because by this
means the morbid matter which might have adhered
to thelips of the urethra may be expelled or carried
away with the rush of water; and-
D. That he should take Merc. sol. Hal. 3x or 6x
night and morning for some days.
2. CURATIVE TREATMENT.—In the incipient or
congestive stage of gonorrhoea, when the patient sim-
ply complains of a tingling, titillating sensation at the
orifice of the urethra; a slight redness and pouting
of its lips, with no perceptible discharge beyond a
thin glairy, albuminous-looking mucus, and barely
sufficient to close the orifice of the urethra by agglu-
tination, I generally prescribe Sepia 6, a dose three
times a day, which has in some cases cut short the
further progress of the complaint, and in others has
had a very modifying effect on the inflammatory
stage.
SEPIA fairly covers these symptoms. It produces
a tingling, titillating, or smarting sensation in the
urethra during micturition, itching of the prepuce,
and a discharge of a milky fluid. It is not often, how-
ever, that the physician has an opportunity of treating
the disorder at so early a stage, as the generality of
such patients are too prone to delay seeking advice
till it reaches that condition sometimes described as
a roaring clap. This may be attributed to various
causes. Syphilitic and venereal patients, with few
exceptions, are young and single men, who live at
home with their friends and relatives; at a boarding-
house, an hotel, or with their employers; consequently,
TREATMENT.
43
feel a delicacy in communicating to those around them
the filthy nature of the disease contracted, and the
fix they have got into; and, in order to avoid sus-
picion, make no alteration in their pursuits or mode
of living, and thus allow the disease to go on from
stage to stage, until they can bear it no longer. Some
will treat a gonorrhoea as they would a cold, and do
a little domestic prescribing; some will, with a false
economy, seek the advice of some ignorant chemist:
if allopathic, he is well drenched with copaiva and
cubebs; and, if homeopathic, is badly doctored under
the guidance of some tinkering "domestic," concocted
and strung together by some penny-a-liner. It is
thus found that a considerable number of persons
so afflicted do not seek proper advice until the com-
plaint has made rapid and destructive inroads on the
constitution, and, in many cases, laid the foundation
of incurable disorders.
In the inflammatory stage Aconite, Cannabis sativa,
and Merc. sol. step in as admirable remedies, conjoined
with perfect rest, a bland diet, copious draughts of
cold water, barley water, gum water, or linseed tea;
the frequent ablution of the penis with tepid water
and soap, and the constant application of compresses
saturated with either cold or tepid water. It is
seldom I have had occasion to vary these remedies.
except it be in those concomitant symptoms described
under the head of "Complications of Gonorrhoea."
Aconite will calm the nervous system, subdue fever,
and considerably modify that painful and anxious
urging to urinate; that difficult and scanty emission
of hot, scalding urine; that burning and tenesmus
44
GONORRHEA.
1
which sometimes extends to the neck of the bladder;
that itchingof the prepuce, and that piercing and
pinching in the glands on urinating, often met with
in this stage.
It should be administered in drop
doses of the tincture, or a pilule of the second or
third decimal dilution every one or two hours, till the
more urgent symptoms are subdued.
Cannabis sativa ranks high, and deservedly so, as
a curative agent in the acute form of gonorrhoea; it
is a medicine which has met with general approval
from those who have paid anything like ordinary
attention to that class of diseases designated venereal.
Its pathogenetic effects on the urinary organs are
remarkably striking, and form as true a picture of the
complaint as any drug I know of. Thus we find it
develops a burning, smarting, darting, stitching,
tearing pain in the urethra, which extends from its
orifice, as far back as the bladder, producing a form
of CYSTITIS.
It develops a discharge of pus from the urethra ; a
sensation of tearing in the fibres of the canal, with a
smarting, stinging pain during micturition. It de-
velops strangury, with painful discharge of drops of
bloody urine.
It develops a swelling of the pros-
tate gland; a swollen condition of the penis, glans,
and prepuce; with a corrosive burning and stinging
of the preputial margin; and it creates a tensive
pain in the spermatic cord, contraction of the
scrotum, with a sense of pressure, and dragging of
the testicles; thus completing, as it were, a picture of
gonorrhoea.
With regard to the best potency and repetition
TREATMENT.
45
Many
of the dose, differences of opinion exist.
physicians give several drops of the mother tincture
night and morning, but Hahnemann laid it down
as a rule that the high dynamizations, and even
the very highest, develop the medicinal virtues of
this plant to a much greater degree; so that during
the latter years of his life he always gave it in the
30th dilution, dissolved successively in two glasses
of water. Drs. Croserio, Hartmann, and Gross fol-
lowed the example of our master, the latter de-
claring that with a single dose of the 200th he
succeeded much better than with repeated doses of
the mother tincture. Jahr recommends the 3rd,
Attomyr the 4th, repeated every fourth or fifth day,
and invariably cured his patients in one month,
some in fourteen days. Hempel varies his potencies
from the matrix upwards, and quotes a case
"where chordee was a very prominent and painful
symptom," which he cured in fourteen days by means
of large doses of the tincture, commencing with five
drops the first day, and gradually increasing it to
thirty drops in the course of the twenty-four hours.
Yeldham, in his sensational little brochure on Vene-
real Diseases, in terms not very complimentary to the
memory of Hahnemann, or the experience of those emi-
nent men just mentioned, dogmatically states that to do
good, Cannabis must be given in palpable doses. "I am,"
he says, "in the habit of prescribing from five to ten, or
even fifteen drops of the mother tincture three or
four times a day. In my own practice," he further
observes, "the dilutions have proved nearly if not quite
inert." A somewhat considerable experience during
46
GONORRHEA.
t
the last twenty years enables me to refute such state-
ments, and confirm the views set down by the revered
master of our doctrine and his early disciples, as I
have over and over again witnessed the most favour-
able results to follow the administration of Cannabis in
potencies varying from the first to the thirtieth dilution,
selected with due regard to the temperament and
constitution of my patients.
Merc. sol. Hah. ranks next in importance as a
curative agent in the acute form of gonorrhœa;
indeed, a careful study of its pathogenesy gives it
even a closer homeopathicity to the disease than
the preceding remedy. I generally select it when the
local inflammatory symptoms run high, either from
neglect of the patient, or from previous bad treatment;
when the discharge is green and bloody, with painful
erections and a swollen prepuce.
Here are its pathogenetic effects on the urethra :
Constant desire to urinate.
The urine looks as if mixed with pus or mucus.
Burning in the urethra between the
micturition.
Discharge of blood from the urethra.
Cutting pains in the urethra, and a
acts of
Greenish gonorrhoeal discharge from the urethra.
On the genital organs we find the following :
Inflammation of the prepuce, with burning
pain.
Swelling of the prepuce, as if distended into a blis-
ter with water or air.
Inflammatory redness on the internal surface of
the prepuce, with great sensitiveness to pain.
TREATMENT.
47
!
Swelling of the anterior part of the urethra, with
suppuration between the prepuce and glans.
Drawing pains in the testicles, extending into the
groin.
Drawing in the spermatic cord.
Hard swelling of the testicles, with shining redness
of the scrotum.
Painful erections, &c.
Potency and repetition of the dose. Hahnemann
never used the medicines lower than the 30th dilution.
Croserio the same, and when febrile symptoms ran
high, he gave one dose of Aconite; then Merc. every
second or third day, according to circumstances; and as
soon as an evident amelioration took place all medicine
was suspended. Gross declared that a single dose of
the 200th was sufficient to cure the disease, if permitted.
to act a suitable time. Attomyr selected the 4th
when he found the discharge of a greenish colour.
and attended with ulcers," what kind of ulcers he
does not say."
Thuja is another remedy I am disposed to class
with the foregoing; it bears a strong resemblance in
its mode of action to Cannabis sativa, and has done
good service in many cases where that remedy was
indicated, particularly when attended by warts-a
phimosis or paraphimosis. In the female I invariably
select it in preference to any other, and vary the
potency from the 1st to the 3rd dilution.
!
E
48
COMPLICATIONS OF GONORRHOEA.
COMPLICATIONS OF GONORRHŒA.
Following in the wake of the inflammatory stage of
gonorrhoea, we sometimes encounter a series of con-
comitant symptoms, some of a mild form, others
of a very painful and distressing nature. Amongst
these I would mention-
I. That long-continued and very painful erection
of the penis familiarly known as a CHORDEE. John
Hunter recognised two forms of it, the inflammatory
and spasmodic. The first arises from a deposit of
lymph in the corpus spongiosum urethra, which glues
together the cells, and prevents their distension, so
that when the penis is full of blood it is bent forward
"crescentic-like," with its concavity looking down-
wards. The second comes and goes at no fixed
periods; at one time there will be an erection, entirely
free from pain or curvature; at another the pain will
be severely felt; and this will frequently recur at
varied and sometimes short intervals. Cantharis,
Capsicum, or Pulsatilla, exercises a marked influence
over the former, conjoined with the application of
cold compresses to the penis, the use of cold hip
baths, one or more Turkish baths, a plain and
moderately low diet, such as boiled cod, sole, or tripe,
diluent drinks, and no stronger stimulant than a wine-
glassful of Hungarian Somlau, diffused in one-half to
a tumblerful of distilled water, or better still, copious
draughts of barley water or linseed tea.
COMPLICATIONS OF GONORRHOEA.
49
In the spasmodic form, Nux vomica and Camphor,
both internally and externally, have yielded me the
most satisfactory results.
2. HÆMORRHAGE.-Bleeding from the urethra is
not an uncommon symptom of an acute attack of
gonorrhoea, and arises from a rupture of some of the
over-distended capillaries during a violent and pain
ful erection, or that condition termed chordee. A
moderate loss of blood may act as a palliative by
relieving the over-gorged blood-vessels, subduing
inflammation, and thus modifying the severity of the
chordee, consequently should not be checked; but an
excessive loss of blood should be arrested by placing
the patient in the horizontal posture, the application
of cold compresses, and the administration of such
remedies as Aconite, Nitric acid, Cantharides, or
Hamamelis.
3. PHIMOSIS, which signifies a muzzle, is another
painful attendant on acute gonorrhoea, frequently
caused by and consequently closely allied to the
last-named condition. It consists of an inflammation
of the prepuce, which becomes thickened, puffy, and
swollen, and so constricted as to render it a frequent
impossibility to uncover the glans.
The treatment should consist of cold water com-
presses; the removal of all discharge from under-
neath the prepuce by means of a syringe and tepid
water, to which may be added carbolic acid or
Condy's fluid, and the administration of Merc. sol.,
Thuja, and sometimes Cannabis. This sometimes
terminates in-
4. PARAPHIMOSIS, which signifies a bridle,-the
E
50
COMPLICATIONS OF GONORRHEA.
circumligatura of Galen, or the strangulating phimo-
sis of Good. It consists of a constricted condition
of the prepuce behind the glans, which cannot be
brought forward again. If the constriction is not
speedily removed the inflammation soon reaches a
dangerous height, and invades the whole penis.
The treatment here should be prompt and decisive,
our first step being to reduce the glans to as small a
size as possible: this may be accomplished by first
applying cold lotions, ice, or ice water, and then com-
pressing the glans equally and unremittingly for some
minutes between the fingers and thumbs of both
hands, and when as much blood as practicable is
pressed out, and the organ is reduced to its smallest
size, we should then press it back with the thumbs
through the constricted prepuce, while the fingers at
the same time are used in coaxing the prepuce for-
ward over the glans. Should these means however
fail, which is seldom the case, and the constriction be
such as to threaten to terminate in more serious
mischief, such as ulceration and sloughing of the
parts, no time should be lost in dividing the con-
striction by means of a sharp-pointed, narrow-curved
bistoury. The stricture will invariably be found be-
hind the crown of the glans, and separated from it by
a raised ring, consisting of a swollen portion of the
prepuce, thus forming for itself a kind of depression or
groove; into this groove the point of the knife should
be passed deeply enough to go under the stricture,
which may then be divided by cutting upwards. The
member should then be wrapped in lint or soft
linen, first saturated in a weak solution of Arnica or
COMPLICATIONS OF GONORRHOEA.
5 I
%
Calendula, either tepid or cold, according to the
temperament of the patient; and the administration
of either Cannabis, Sativa, Merc. sol., or Sabina.
5. PROSTATITIS.-Acute inflammation of the pros-
tate gland will sometimes arrest our attention, as a
prominent and painful complication of a gonorrhoea,
and is most frequently met with in those cases which
occur in irritable and scrofulous constitutions. The
symptoms, as a rule, are well marked: there is a
sensation of pressure and heat in that part of the
perinæum which is in close contiguity to the neck of
the bladder and rectum, with a painful and almost
constant desire to evacuate the contents of those
organs; there is a sensation as if a foreign body
were lodged in the rectum, with a correspondingly
outward swelling, easily diagnosed by external ma-
nipulation or an internal exploration, the parts as a
rule being highly sensitive and painful on pressure. It
may terminate in one of three different ways; namely,
resolution, suppuration, or chronic enlargement, of which
the last may prove a very troublesome companion
to the patient during the remainder of his days. The
treatment here also should be prompt and decisive.
The recumbent posture becomes a sine quâ non.
stimulating substances should be strictly prohibited,
and cold evaporating lotions should be kept constantly
applied to the perinæum, prepared according to the
following formula :—
Liquor Plumbi. Diacetatis. 5ij.
spr. Vin. Rect. Zij.
Aqua puræ 3xiv. Misce.
Fiat Lotio.
All
52
COMPLICATIONS OF GONORRHOEA.
Bland diluent drinks only should be allowed, such
as gum water, barley water, or linseed tea, and the
administration of Aconite second decimal, or Bella-
donna in drop doses every one or two hours. Merc.
sol. and Pulsatilla should not be forgotten, as they
chime in as excellent remedies, either alone or in
alternation with either of the foregoing, more par-
ticularly the latter, as it offers in its SYMPTOMOLOGICAL
EFFECTS, the largest number of symptoms which accord
to this disease. The action of the selected medicine
should be rigidly administered, and carefully watched
until a change takes place for better or worse. If
the former, there will be observed a gradual cessation
of pain, a more prolonged desire, with less pain and
difficulty to pass water, a diminution in the size of
the swelling, and a more uniform ease and comfort
will pervade the whole frame; in fact, its terminating
in the most favourable form, namely, resolution.
Should, however, suppuration, "in spite of these re-
medies," take place, we then have, as indices, general
rigors, a dull throbbing pain, with a sensation of
weight, and obscure swelling of a doughy feel in the
perinæum; this should be hastened to maturity in
the shortest possible time, and I know of no medicines
better adapted for that purpose than Hep. sulph. and
Silicea. A repetition of either of these remedies every
two to four hours, for twenty to thirty hours, will
bring the abscess to a point, so as to enable the
surgeon to operate without risk, which should at once
be done, by making a free puncture with a sharp-
pointed bistoury. This form of abscess, if left to
take its own course, may burst into the rectum or
COMPLICATIONS OF GONORRHOEA.
53
urethra, or into the cellular tissue of the perinæum,
and cause considerable constitutional disturbance,
and sometimes irreparable mischief, which may ter-
minate in death.
In chronic enlargement of the prostate gland I
have found great benefit to follow the administration
of Merc. bin-iod., Kali hydriodicum, with an occa-
sional dose of Sulphur.
6. DYSURIA.-Irritation, and sometimes inflamma-
tion, of the mucous membrane of the bladder, is another
occasional symptom of a severe clap. It is attended
with extreme suffering and annoyance, the bladder
at times becoming so irritable that the retention of
the smallest quantity of urine puts the patient to the
most intolerable anguish. In addition to these
symptoms we have generally considerable fever, a
quick pulse, with listless, sleepless, and distressing
nights. A perpetual tenesmus is also present, which
creates a constant desire to evacuate the contents of
that viscus, which comes away in small quantities,
causing a burning, scalding sensation, which reaches
its climax while passing the last few drops. The
urine is generally turbid, and highly charged with
mucus, blood, and pus.
TREATMENT.--The principal remedies for this very
painful and distressing form of the complaint are
undoubtedly Aconite and Cantharides, which may be
administered alternately every half to one hour,
until the more acute symptoms shall have subsided;
the medicine may then be administered at longer
intervals, and, if all feverish symptoms have subsided,
Acon. may be omitted, and Canth. given a little
54
COMPLICATIONS OF GONORRHŒA.
longer. In the more chronic form Merc. sol. and
Nux vom. step in as very useful remedies; Merc.
when the urine is turbid, fœtid, and charged with
thick, flocky mucus; Nux vom. when there exists.
a peculiar irritation at the neck of the bladder,
causing a frequent desire to urinate; gastric and
hepatic derangement, with constipation and hæmorr-
hoidal affections. A diet of the blandest kind,
hip baths, warm applications to the perinæum and
anal region, in the form of linseed meal or bran
poultices, with gum water, barley water, or linseed
tea as beverages, constitute the dietetic and hygienic
rules which I am in the habit of adopting.
7. BUBOES.-Inflammation and enlargement of
the inguinal glands constitute another painful attend-
ant on a gonorrhea, and may be set down as one of
the metastatic forms of the complaint; they, how-
ever, seldom suppurate, and generally appear in
persons infected for the first time, whose constitutions
savour of the sanguine or scrofulous taint, and who
too frequently, from the commencement, treat a clap
as a trifle, by indulging in walking, dancing, riding,
and cricketing, with no small amount of high living.
I have met with many cases arising from each of those
causes; in some the glands assumed an enormous size,
were exceedingly painful, and slow in dispersing.
These glandular swellings supervene in about the
first twelve or fourteen days of a gonorrhoea, that is,
while it runs through its inflammatory stage, and is
caused by the pus being absorbed by the lymphatic
vessels of the penis, which carry it into the groin, and
there set up an inflammatory action, which will in
COMPLICATIONS OF GONORRHOEA.
55
some cases run through its regular stages to sup-
puration.
In the treatment of this type of bubo we must
in a great measure be guided by the stage and con-
dition of the gonorrhoea; remove this, the other fol-
lows; strike at the root, the branches fall and wither.
Should it result from a sudden suppression of the
gonorrhoeal discharge, which may follow the use of
astringent injections, or exposure to wet and cold,
the re-establishment of the discharge should be our
first object. This I have succeeded in accomplishing
with Pulsatilla in the majority of cases, and with
Sulphur in others, where the former had failed.
These cases were afterwards cured by Cannabis,
Sativa, Merc. bin-iod., Kali, and Sulphur.
The buboes, if very painful, hard, and tense, should
be treated with cold evaporating lotions, and perfect
rest in the semi-recumbent posture; but should this
fail, and there is followed an increased redness, a feel-
ing of fluctuation which would lead us to infer that
pus had formed, we should then treat the case as a
common abscess, and hasten the suppurative process.
by the help of Hep. sulph. or Silicea, and the appli-
cation of warm poultices till the abscess is ripe for
opening, which I am in the habit of doing with a
curved, sharp-pointed bistoury, carried from above
downwards in a straight line.
8. ORCHITIS, or EPIDIDYMITIS BLENORRHAGICA,
absurdly set down as "hernia humoralis" by the old
writers.—Acute inflammation of the epididymis con-
stitutes one of the most frequent, painful, and dan-
gerous of the metastatic concomitants of gonorrhoea;
56
COMPLICATIONS OF GONORRHOEA.
it not only produces irritation and inflammation of a
severe and alarming nature, but sometimes termi-
nates in abscess, extensive sloughing, in hydrocele,
and in hypertrophy, with more or less deterioration
in the functions of these organs. A swollen testicle
may arise from various causes, such as the injection
of irritating lotions, the passage of instruments, the
lodgment of calculi, a blow, exposure to cold, or
violent exercise; but the form we are now more par-
ticularly interested in, is that which takes place as the
result of a suppressed gonorrhoea, terminating in
metastasis—literally, the transfer of a disease from one
organ of the body to another.
The symptoms are prominent and unmistakable.
About a fortnight more or less after contracting a
clap, the patient observes a partial or complete cessa-
tion of the urethral discharge, followed by a sensation
of weight, fulness, and tenderness in the spermatic
cord. When the case is further advanced, the swell-
ing extends to the whole of the testicle, which be-
comes so swollen that the scrotum loses its natural
corrugated appearance, and becomes tense, smooth,
shining, and reddened, and sometimes of a purplish hue.
The pain now is of the most excruciating kind, and ex-
tends to the lumbar and inguinal regions, as well as
the hips and thighs. Serious constitutional symptoms
now set in, in the form of a small, quick, jerking
pulse; a hard, stunning headache; great restlessness,
thirst, a furred tongue, loss of appetite; a hard, dry
skin; obstinate constipation; and, in some cases,
vomiting, with other symptoms of inflammatory
fever.
COMPLICATIONS OF GONORRHOEA.
57
In the treatment of swollen testicles, we have in
Acon., Bell, Aur. met., Clematis, Merc. sol., Puls., and
Sulphur, brilliant remedies. On the first indication
of inflammatory symptoms the patient should seek the
recumbent posture; avoid all highly seasoned food
and stimulating drinks; he should, in fact, restrict
himself to almost fever diet; and he should take a warm
bath every second or third day. The testes should
be well supported, or allowed to rest on a small
pillow placed between the thighs, and a lotion con-
sisting of Tr. Aconite, 3ij, Rectified Spirit, Zij, to six-
teen ounces of water, should be kept constantly
applied to the affected parts by means of a linen
compress or lint. Aconite, second dec., a drop or two
in water should be administered and repeated at
intervals of two hours for the first day. It will not cure
the TESTITIS but it will go far to help us in calming
the nervous system, in toning down that restlessness,
in blunting that terrific stunning headache which I
have seldom missed, and deem almost pathognomonic
of the complaint; in moderating the heart's action, in
substituting for that hard, dry skin a soothing glow
and dewy perspiration, and in rendering the system
more susceptible to the action of its specific.
The Anemone pratensis, or little Pasque-flower, is,
however, a valiant remedy, and slays its victims with
unerring aim, and the power of a Samson. Its virtues
have been lauded, and its praises have been sung by
Hahnemann, Croserio, Jahr, Hempel, and many more,
as an almost infallible specific. Twenty-four cases of
the acute inflammatory form, as recorded in my case-
books during the last three years, yielded quickly to
`
58
COMPLICATIONS OF GONORRHOEA.
"
Pulsatilla, with the help of an occasional dose of Acon.
or Bell. In the majority of those cases the scrotal
symptoms were traced to the too early use of injections,
exposure to cold and wet, and irregularity in diet.
Here are its leading SYMPTOMOLOGICAL EFFECTS
on the genital organs in man-Swelling of the
right spermatic cord and testicles, with a tensive.
pain; drawing tensive pains pass out of the abdomen
through the spermatic cord into the testicles, the
testes and spermatic cords are painful and swollen
with discharge of fluid; swelling of the scrotum with
lacerating pains in the testes. The potency I vary
from the 2nd to the 6th decimal dilution repeated
every third or fourth hour, and when the inflamma-
tion assumes a phlegmonous form I alternate it with
Belladonna third dilution.
The Clematis Erecta is another medicine which
has done me good service in twenty cases of orchitis,
the symptoms of which indicated the use of that drug,
namely, a bruised painful feeling of the testes on being
touched; a drawing pain in these bodies and spermatic
cord from below upwards, with a frequent sexual desire.
The last of this group of cases came under my notice
in January, 1876, which I will briefly record. J. P., æt.
47, married, an elastic brace manufacturer, consulted me
January 17, 1876. Notes. Contracted a clap three
weeks since, for which he treated himself with salines and
Sulphate of Zinc injections. There is scarcely any dis-
charge per urethra, but there is considerable swelling of
left testicle, the scrotum is tense and of a bluish red;
he is feverish, has rigors, alternating with heats;
the tongue is coated with a brownish mucous deposit ;
1
COMPLICATIONS OF GONORRHOEA.
59
there is a dragging pain in the lumbar region, which
extends to the hips, groins, and thighs; the bowels
are costive, urine thick and scanty, and there is a
peculiar drawing up of the testicle and spermatic
cord, with a frequent desire for venery.-Clematis
6th dec. every two or three hours.
January 20.-The testicles are smaller and less.
painful, but he continues feverish to take Acon. 2 at
bedtime and Clematis every four hours.
January 22.-There is considerable improvement,
the feverish symptoms have subsided; the swelling and
pain is considerably diminished; there is an increased
discharge per urethra; urine more copious, and the
bowels have been moved freely by the aid of a
Seidlitz powder. To continue the Clematis.
January 25.-The testicles are reduced to their nor-
mal size and free from pain; has an increased discharge,
but no heat or scalding; he, however, complains of a
sudden and frequent desire to make water, a symptom
I covered with Sulphur 6, which removed every vestige
of the disorder in the course of another seven days.
Dr. Hirschel regards the Clematis as a valuable
agent when orchitis supervenes on exposure to cold
after a gonorrhoea; the testicle becoming indurated,
sensitive to pressure; the scrotum red, swollen, with
tearing, drawing pains, "and retraction of the testicles
and spermatic cord," the chief indication for the
selection of that medicine. Ruckert, Marcy, and
Hunt speak favourably of it, and record some in-
teresting cases of the kind. Attomyr also is not
silent on the same subject, a she records two cases
of swollen testicles: one was cured by Clematis and
· 60
COMPLICATIONS OF GONORRHOEA.
Aurum, the other by Aur. met. and China, the par-
ticulars of which are herewith transcribed in his
own quaint style :-
"Two cases only occurred in my experience, one
was in company with gonorrhoea. The patient went
hunting in damp cold weather while suffering from
the clap, and returned with violent pains in both
testicles. In the succeeding night the disease
increased, and both testicles were swollen hard, not
bearing the least touch; the scrotum was red and
tense; some fever set in, which lasted till the evening
of the next day. The gonorrhoea had ceased almost
entirely.
"Two doses of Clematis, 12th dilution, three globules
repeated at intervals of three days, cured the disease,
whereupon the clap returned. The swelling of the
other testicle, which continued longer, was cured by
Aurum metallicum iv 000.
"The second case was a relapse of a previously
endured inflammation of the testicle, allopathically
treated, which yielded to Aur. met. ivººº and China
ivooo."
9. OPHTHALMIA.-Among the varied complica-
tions which attend an attack of gonorrhoea, there are
none which inflict so much torture on the patient, or
leave in its train so destructive and ghastly a group of
phenomena as that dangerous metastatic form termed
Gonorrhoeal Ophthalmia, often caused by contact of
purulent matter from the urethra, which consists of
a violent inflammation of the mucous membrane of the
eyeball and lids, attended with profuse discharge of
matter closely resembling in all its properties that
COMPLICATIONS OF GONORRHEA.
61
which issues from the inflamed urethra in clap, and
having some connection with the latter complaint.
In an acute and fully developed case we can
generally trace three distinct stages. The first sets in
with a violent burning and itching at the margin of the
lids and canthi, accompanied by a profuse flow of acrid
tears, and considerable photophobia; the conjunctiva is
uniformly reddened, and the lids, particularly the
upper ones, are considerably swollen, with a highly
vascular engorgement of that portion of the membrane
which extends from the lids to the eyeball; there is
acceleration of the pulse, fever, dulness of the head,
a coated tongue, and constant thirst.
In a few days the second stage commences with
considerable swelling of the conjunctiva, producing
that condition termed chemosis. At first there is a
whitish-yellow mucus, which speedily increases in
quantity, and after awhile it assumes a greenish tint;
the pain now becomes extremely acute, and extends to
the surrounding parts of the head and face. If this con-
dition is not quickly arrested by proper means, it soon
terminates in the third stage, and with it ulceration,
sloughing, or opacity of the cornea, prolapsus of the
iris, adhesions of the iris and cornea, followed frequently
by suppuration, total disorganization and collapse of
the whole globe. All the symptoms of vascular con-
gestion are likewise present in an intense degree,
attended with the most agonizing pain and tension,
hemicrania, intolerance of light, and severe constitu-
tional disturbance. Some idea of the severity of this
inflammation may be conceived when it is stated that
of fourteen cases related by that eminent surgeon,
62
COMPLICATIONS OF GONORRHOEA.
the late Mr. Lawrence, vision was entirely destroyed
in nine, and in three of the remaining five there was
partial opacity of the cornea, and anterior adhesions.
of the iris.
TREATMENT.—This is a complicated form which
calls for the most prompt and energetic handling, both
locally as well as constitutionally, and in addition to the
faithful Aconite, Belladonna, Merc. sol., and Corrosivus as
internal remedies, recourse should be had to the topical
application of a solution of Alum, Sulphate of Zinc,
Bichloride of Mercury, or the Nitrate of Silver, whilst
the eye itself and inner surface of the lids should be
cleansed six or seven times a day with a tepid solution
of Carbolic Acid or Condy's fluid. Ten cases of this
type have come under my notice; one was treated
allopathically, some years since, by means of leeches,
blisters, purgatives, scarifications, and the topical
application of Nitrate of Silver according to the for-
mula of Guthrie. In spite, however, of such heroic
treatment, ulceration of the cornea set in, followed by a
deep layer of opacity and loss of vision. The remaining
cases were treated homœopathically, and with far
more satisfactory results. They were seen in the first
stages. Aconite, first decimal, was administered every
two hours, as the "deep intense pain, redness of the
lids and conjunctiva, swelling, pulsation, and profuse
lachrymation, indicated the action of that medicine."
These symptoms were considerably toned down, but
did not prevent the disease from assuming a muco-
purulent form, which was successfully combated in each
case by Merc. cor., second decimal, in alternation with
Aconite, the frequent washing of the eye and inner sur-
1
COMPLICATIONS OF GONORRHOEA.
63
!
face of the lids with a solution of Carbolic Acid and
water by means of a soft sponge and a syringe, followed
each time by the injection of a solution of Nitrate of
Silver of the following proportions :-Arg. nit. gr. iv.,
distilled water Ziij.
In the chronic stage Sulphur is sufficient to complete
the cure, which was accomplished in one case in four-
teen days; in the other cases, at the expiration of
three weeks.
10. RHEUMATISM.-Before bringing this section of
my labours to a close, I would briefly refer to another
complication, which I think fairly completes that circle
of complications which more or less attend an attack
of Gonorrhoea, namely, Gonorrheal Rheumatism.
This proves a very painful and obstinate symptom,
and supervenes upon that complaint in from ten to
thirty days from the first appearance of the urethral
discharge, which at this stage becomes considerably
diminished, and sometimes entirely stopped.
It generally attacks young persons of delicate,
strumous constitutions, and others who have neces-
sarily exposed themselves to cold, wet, or sudden
changes of temperature.
The leading SYMPTOMS are-a severe aching or
acute burning in one or more joints, generally the
knees and ankles, followed by a rapid effusion within
the capsules and bursæ, which become greatly dis-
tended. There is no perceptible redness or inflamma-
tion on the external surface, a peculiarity worth
noting, but the pain is considerably aggravated by
motion, and by the warmth of the bed. The affected
limb is usually kept in a semi-flexed position, while
64
COMPLICATIONS OF GONORRHOEA.
stretching or bending it tends to increase the suf-
ferings of the patient.
The tongue is usually loaded with a brownish
mucus; there is more or less fever and thirst; the
pulse is quick, and sometimes rises to 120 strokes in
the minute; the bowels are costive; the perspiration
profuse and offensive; the urine is scanty and highly
charged with lithates. These symptoms under favour-
able circumstances may subside in the course of two or
three weeks, but they too often terminate in a chronic
state, which may continue to torment the patient for
some months. This occurred to me some years ago
while in practice at Dover. The patient, a youth of nine-
teen, and of a highly strumous diathesis, was treated.
by an allopathic practitioner with large doses of
Copaiva, which seriously disarranged the whole
system. In that condition he went out boating, caught
cold, which checked the urethral discharge, and ter-
minated in a severe attack of rheumatism.
He was
treated by the same official for another six weeks, but
with no relief to any of the symptoms. I was then re-
quested to see him, and prescribed an occasional dose
of Aconite at bedtime, with Puls. and Sulphur in alter-
nation: a series of lamp baths, and packings, which was
soon followed by a marked improvement. He was
then sent out in one of his father's ships to China,
and was fairly rid of his rheumatic companion ere
he sighted the shores of the Celestial Empire.
Aconite and Pulsatilla have done good service in
three cases of the acute form of rheumatism of
this type which have occurred in my own prac-
tice; the former quickly subdued the febrile and
GONORRHOEA IN WOMEN.
65
inflammatory symptoms; the latter completely re-
establishing the urethral discharge. Two were con-
valescent in fourteen days, the third within twenty-
eight days. In the chronic form I would suggest the
selection of such remedies as Merc. sol., Merc. vivus,
Pulsatilla, Sarsaparilla, Thuja, and Sulph.; the fre-
quent use of the lamp, or Turkish bath; an occasional
pack; sea air; a resort to the thermal springs of
Bath, or Wiesbaden; and finally, a long sea voyage.
GONORRHOEA IN WOMEN.
Gonorrhoea is both of less frequency, and greater
difficulty of detection in women than in men. The
reasons for this include the following; viz., the less
sensitiveness of the mucous membrane lining the
genital organs of the female, as compared with that
of the urethra in the male; its being constantly
bathed in its own natural secretions; the protected
position of the urethra; and the absence in men of
the menstrual flux and leucorrhoeal discharge, which
we have already found to be so fruitful a cause of
the disease in the opposite sex.
The disease presents itself for consideration, how-
ever, under four different phases :-
I. When it attacks the vulva, as gonorrhœal
VULVITIS.
2. When it attacks the mucous membrane of the
urethra, as URETHRITIS.
3. When it attacks the vagina, which is the most
usual and common form, as VAGINITIS.
4. When the interior of the uterus becomes involved,
F
66
GONORRHEA IN WOMEN.
as UTERITIS. As the symptoms and treatment, how-
ever, differ, it would be well to describe them
separately, premising, however, that they may be,
and usually are, more or less combined in each case.
1. GONORRHŒAL VULVITIS is a specific inflamma-
tion of the mucous membrane of the external organs
of generation, and corresponds to balanitis in the male.
The early symptoms are-heat of the part and
a troublesome pruritus, whilst on examination the
mucous membrane will be seen to be of a deeper
colour than natural, slightly swollen, and moist. This
condition soon becomes aggravated, and there is
severe aching pain, which is increased by motion or
by touch, with superficial excoriations, scalding on
urinating, bearing-down pains, and a feeling of weight
in the external genitals. The discharge from it,
being simply albuminous at first, assumes after a
time a purulent character, and is most irritating and
offensive. It is the most painful variety of gonorrhea,
and perhaps the most distressing complication is, a
form of "Nymphomania," which is occasionally pre-
Small abscesses also are apt to form in the
vicinity of the vulvo-vaginal glands.
sent.
2. GONORRHOEAL URETHRITIS.-The urethral form
of gonorrhoea is rarely met with alone in the female;
but it usually co-exists with that of the vulva or
vagina. It is indicated by a burning pain along the
urethra, which is greatly intensified on micturating.
There is but little discharge, but the lips of the meatus.
are swollen and painful, and the introduction of a
catheter causes the most excruciating agony. The
finger, when introduced per vaginam, detects a
GONORRHOEA IN WOMEN.
67
thickening of the canal; and if pressure be made
against the pubic arch, it will feel as firm as a piece of
whipcord. Fortunately, this variety is not liable, as
in the male, to degenerate into a gleet; but abscesses,
however, occasionally form in the vagina and
perinæum, and often the glands in the groin suppurate
as well.
3. GONORRHOEAL VAGINITIS.-The vagina is more
frequently the seat of gonorrhoea than any other part
of the mucous tract. When seen at an early period
the membrane looks red, is hot, and devoid of
moisture. Itching, smarting pains, with frequent
desire to pass water, and dull aching are complained
of in the hypogastric region. The vagina feels hot
and puffy, and soon secretes a large quantity of
offensive purulent or muco-purulent matter, of a
yellow, or milky, or greenish ichorous character.
In the course of a few days the discharge decreases
in quantity, the disease now becomes chronic, and is
extremely difficult of eradication. It will usually be
found that the anterior half of the vagina, immediately
under the arch of the pubis, is the part affected, and
presents an aphthous appearance when examined with
the aid of the speculum. As there is in the chronic
stage generally some degree of vulvitis, we often see
a warty and even condylomatous condition of the labia
majora as well.
4. GONORRHOEAL UTERITIS.-Gonorrhoea but sel-
dom attacks the internal surface of the uterus, except
as an extension from the vagina.
When it is present
the disease assumes a most serious aspect. The
ovaries are apt to become implicated, the general
68
TREATMENT
health undermined, and the reproductive processes
interfered with. The uterus becomes congested, the
os excoriated, and usually we have a constant oozing
from it of a highly offensive, gluey, yellowish-white
matter. The bladder and rectum also sympathize,
and both defecation and urination are painful.
This form of the disease is difficult to diagnose and
to cure, and, we have little doubt, is for the most
part left behind as leucorrhoea; either from want
of cleanliness or care in the patient, or through
inappropriate medication by the practitioner.
DIAGNOSIS.—It is admitted by all experienced ob-
servers to be all but impossible to differentiate in some
cases between gonorrhoea and leucorrhoea, but fortu-
nately homœopathy furnishes us with such weapons
wherewith to attack the disease, that it is not of much
importance. The moral symptoms, however, of the
patient will be the best guide to a correct diagnosis.
TREATMENT.-This will vary, more or less, ac-
cording to the stage and seat of the malady.
1. VULVITIS will require a similar treatment to
balanitis in the male. Great cleanliness, warm emol-
lient fomentations, and frequently repeated doses of
Mercurius and Aconite in the acute stage; whilst the
chronic form will be best cured by Alum or Tannic
acid lotions, Thuja, and Sulphur.
2. VAGINITIS.-If we are fortunately called in at
the commencement of the attack, we give Bell. and
Merc. or Puls. in alternation every three hours,
order the patient to sit over hot marsh-mallow fomen-
tations every six hours, and take a hot sitz bath every
night at bedtime.
When the acute symptoms have
OF GONORRHOEA IN WOMEN.
69
been subdued, or have passed away before the case
presents itself for treatment, we find Kreasote or
Sepia, especially the latter, afford the most efficient
aid. Slightly astringent injections, as Alum gr. ij. to
water 3j., or alterative ones, as Tr. hydrastis 3ss.
to water zviij., will sometimes be found of great benefit.
3. URETHRITIS.-Here the treatment will be essen-
tially the same as in gonorrhoea in the male, though
of course injections will help but little. Aconite and
Cantharides, followed by Cannabis sativa and Sulphur,
according to presenting symptoms, will soon eradicate
this form of the complaint.
4. UTERITIS.-This is the most difficult form to treat,
and probably is but seldom cured, unless a very correct
diagnosis is established.
The acute symptoms must be met by Aconite and
Canth. or Nitric acid; and Sepia or Platina may be
pretty reliably expected to cure the chronic form.
Here, as in vaginitis also, we require injections;
they should be introduced into the cavity of the uterus
by means of a proper instrument; and I know of none
which can compete with either Tannic acid, or the
Hydrastic canadensis.
Three cases of gonorrhoeal uteritis have come
under my notice within the last six years. The last
case was that of a London Demi-monde who consulted
me at Cambridge about three years ago. She was in
the habit of paying periodical visits to that classic seat
of learning, and kept her "TERMS" with as much
regularity as the most studious and industrious under-
graduate that struts along under the canopy of those
grand old avenues which adorn the equally classic
70
GONORRHOEA IN WOMEN.
grounds of King's and Trinity. She frankly and un-
reservedly confessed to me the nature of her "profes-
sional calling;" that she was much perplexed to know
what to do; and that although she indulged in frequent
ablutions; and the use of a syringe three or four times
a day, although she had consulted some of the leading
syphilographers in London for eighteen months, and
had visited two of its Lock Hospitals; yet, in spite of
all this, every man who approached this "Sirenic
Goddess"—and they were many-left her chamber
inoculated with the seed of gonorrhoea. But the
most astounding part of her narrative was, that out of
the numerous medical men she had consulted,
not one even suggested the womb as being the source
from whence the foul virus might have emanated.
careful and steady dilatation of the mouth of the
womb, by means of sponge and sea weed tents, en-
abled me at the expiration of four days to obtain an
excellent view of the interior of the organ, where the
cause of all the mischief was soon discovered. A
solution of Tannic acid, with a slight dash of Condy's
fluid, was injected night and morning, and at the
expiration of seven days all discharge had dis-
appeared. A similar mode of treatment was adopted
in the other cases. One, more obstinate than the other,
and where I suspected a syphilitic taint as well,
yielded to the combined action of the lotion and
Mercurius vivus 3x in the course of one month.
A
!
71
i
PART II.
CHANCROID AND ITS COMPLICATIONS.
LET us now briefly consider the second subdivision
of this truly Protean disease.
1
SYNONYMOUSLY—the common, simple, soft, non-
infecting, non-indurated, or superficial chancre, with
raised edges.
The chancroid of Bassereux, the false or local
syphilis of Ricord, Lancereux, and others.
Its chief characteristics are—
1. Its period of INCUBATION, which seldom extends
beyond three or four days, but generally appears
within twenty-four hours of an impure coition.
2. Its supposed localization.
3. Its marked power of multiplying itself by suc-
cessive inoculations; consequently it seldom appears
alone, but is attended by two, three, or more sores of
a like kind.
4. Its frequent termination in suppurative buboes.
Lastly. Its tendency to produce a very painful and
destructive group of complications of a local cha-
racter.
In form this ulcer is somewhat oval, flat, superficial,
with raised and well-marked edges; it has a tendency
to spread and burrow beneath the sound skin; it
secretes a thin, profuse ichorous fluid or yellowish pus;
and often throws out indolent fungous granulations.
72
CHANCROID SORES.
:
In the male it is found both on the external and
internal surface of the prepuce; sometimes on the
"corona glandis; sometimes garnishing the outer
margin of the prepuce in the form of a wreath; and
sometimes it invades one side of the frænum, which
is soon destroyed, if not quickly checked by proper
treatment."
In the female we generally find it on the labia
majora et minora. It is a form of the venereal disease
which appears much more frequently than its allied
representative of the fourteenth century. Amongst
10,000 chancres recorded by Puche, there were found
of-
Soft or chancroid sores
8,045
Indurated, or Hunterian sores, 1,955
And amongst 341 chancres observed and recorded by
Fournier there were found of—
Indurated sores
Soft or chancroid sores
126
215
The power of this form of sore for self-inoculation
is very remarkable, as it is no uncommon thing for
some patients to have as many as three, four, five, six,
and even fifteen sores at the same time. Lindmann,
according to that eminent syphilographer Ricord,
effected on his own person more than 2,200 primary
inoculations.
The course of a simple chancre is continuous and
progressive, and after a certain time, which seldom
exceeds a month, the ulcer ceases to spread. Its floor
then becomes clean, its surface covered with red or pink
granulations, which secrete a healthy yellow pus.
The redness and swelling disappear; in short, the
COMPLICATIONS.
73
contagious virus loses its specific character, and the
ulcer becomes transformed into a simple sore; whilst
cicatrices form from the circumference towards the
centre. Such, then, is a brief outline of an ordinary.
case of "a soft chancre; but in many cases it
exhibits a strong tendency to strike out, invade and
destroy neighbouring tissues, and establishes as "out-
posts" a very painful and destructive group of—
COMPLICATIONS—such as that virulent suppurating
BUBO in the inguinal region, whose ravages at times are
so frightful as to lay bare muscles, nerves, vessels,
tendons, and even the bones; undermining to its very
foundation the strongest constitution, and secreting a
virulent pus, of a similar character to that of the
chancre which caused it.
It will sometimes create a very painful and danger-
ous form of PHIMOSIS and PARAPHIMOSIS, rendered
still more painful and complicated by the series of
ulcers and excoriations which are frequently found
studding the glans and prepuce. It will sometimes
assume a creeping form, the SERPIGINOUS SORE
of some writers. At other times it will ultimate
into a still more virulent form, the PHAGEDÆNIC
SORE, which, as its name implies (payw, to eat),
is an angry, corroding ulcer, highly painful, rapid
and destructive in its progress; irregular in form,
the edges ragged and undermined; the surface
yellow, and dotted with red specks. It sometimes
eats deeply into the substance of the penis; at other
times it undermines the skin; but in general it spreads
superficially and rapidly, carrying, "like a prairie fire,"
destruction and death in its course, until the whole
}
:
74
CHANCROID SORES.
or the greater portion of the genital tissues are totally
disorganized, and sometimes irremediably destroyed.
It is destitute of any marked degree of surrounding
hardness; but the skin encircling the sore looks
puffy, swollen, and of a vivid red colour, whilst the
ulcer itself bleeds freely, showing an inflammatory
and depraved condition of arterial action.
GANGRENE is another type which this terrible and
destructive ulcer sometimes assumes, and frequently
exhibits that characteristic form within the first few
days of the existence of the ulcer. It generally pre-
sents itself as a red circle, more or less bright in
colour; the surface is tumefied and covered with
brownish points, and secretes a dirty or rusty-coloured
pus; the circle becomes deeper and deeper, the parts
included in it assume a grey, brown, or sometimes
a blackish tint, which finally becomes detached.
The slough so formed will sometimes attack a portion
of the prepuce only, at other times it will invade a large
portion, or even the whole of the glans, leaving con-
siderable destruction of the parts behind it.
DIPHTHERITIC, and a "thrush-like secretion is
sometimes found deposited on this kind of sore, the
floor of which assumes a yellowish tint, and mixed with
bloody striæ; the edges are of a violet colour, and the
surrounding tissues considerably swollen. The patient
complains of considerable pain, the pulse is quick,
he loses his appetite, and has generally much fever.
The presence of this pultaceous deposit, has a tendency
to blunt the sensibility of the chancre, as the latter
becomes insensible to external agents, and sometimes.
even to the action of cauterization.
}
COMPLICATIONS.
75
1
This phagedænic and gangrenous chancre may
appear in a primary form, or a secondary form. The
primary is usually met with in weakened, vitiated, or
scrofulous constitutions; the secondary type as a
consequence of neglecting a primary sore, by
abandoning one's self to filth, intemperance, an
irregular and depraved diet, the use and abuse of
mercury, and having connection with women whilst
in such a diseased condition of body and depraved
condition of health. A case of this kind came under
my notice in 1867, which I consider worth recording
as an instance of the depravity of human nature, and
as an illustration of the transfer of a simple sore, to a
foul, gangrenous, and destructive onc.
The patient, a man of thirty-eight to forty years
old, had been leading a very debauched life for some
days, by luxuriating in some of the London hells by
night, and sleeping in some of the lowest brothels by
day. On the fourth or fifth day of such a career, he
observed a sore on the penis, which he deemed un-
worthy of notice, and, reckless of consequences,
continued to pursue the same course. On the ninth
day, "but not before he had disseminated the foul
poison far and wide," his reckless mission
brought to a close, by the total transmission of a
simple chancre into a black gangrenous mass. He
then sought the counsel of a chemist, who, ignorant
of the character of the sore, plied him freely with
blue pill and black wash; this only added fuel to the
fire, which blazed away at such a terrific pace as to
well-nigh destroy the whole appendage. On the
twelfth day, at 9 p.m., I was summoned to the bed-
was
}
76
CHANCROID SORES.
side of that man, who, in the agonies of pain and a
stricken conscience, was appealing lustily to high
heaven for forgiveness. Nearly the whole of his penis
was one blackened fætid mass, from whence eman-
ated a stench of the foulest description, which
permeated the whole room. This was a case which
demanded prompt attention, and energetic treatment;
there could be no parleying with such an enemy, or
coaxing with the 30th dilution of any medicine.
Like uterine hæmorrhage, or a wounded vessel, it
demanded immediate and effectual means to save life.
One application of strong Nitric acid sufficed to
check the onward march of the enemy; the member
was afterwards wrapped in a warm bread and water
poultice, and in twelve hours the whole of the charred
mass dropped off, bringing to view a reddened exca-
vated surface; this was dressed with a weak solution
of Nitric acid, which was also administered internally,
being the only medicine prescribed. In three weeks
this patient was convalescent, save a very ugly de-
formity in the contour of his penis.
There is another form of the phagedænic and
gangrenous chancre which is still more severe and
destructive than the one we have just considered, but
not often encountered west of Temple Bar; namely,
the sloughing ulcer-better known at some of the
London hospitals, particularly those situated in the
Borough and East End, as "the Swan Alley sore."
The late Mr. Travers has described this form of
chancre with great accuracy, and states that the
genuine type is usually seen in very young girls
who reside in a place called Swan Alley, situate
COMPLICATIONS.
77
near St. Katharine's Docks, who have intercourse
with sailors, Lascars, Negroes, and other dirty
foreign seamen, as many times in the day as there are
hours. It usually shows itself in the cleft of the nates,
in the groin, or on one of the labia towards the
perinæum, and as it enlarges, the surrounding skin
puts on a crimson colour; the surface of the sore is
covered with a deep ash-coloured slough,—in fact, a
kind of diphtheritic deposit. This form of sore ex-
tends with alarming rapidity, and produces great con-
stitutional disturbance and intense pain; the appetite
is lost, and extreme prostration of strength attends.
the disease throughout the greater part of its course.
We further learn from the same able authority that
most of the young girls brought from that locality
have but little wholesome food, being generally kept
by Jews and Jewesses, who ply them with plenty of
gin and other ardent spirits, though with but little
In this manner their constitu-
proper nourishment.
tions very soon get into a depraved condition, and ex-
tremely disadvantageous for the favourable progress
of any disease; consequently it is not to be wondered
that their impaired, imperfectly developed frames, their
wretched course of life, their uncleanliness, their
constant indulgence in ardent spirits of the worst
kind, and the deprivation of pure air and wholesome
food should promote phagedænic ulceration, and give
it a more than ordinary severe character.
Two cases of this form came under my notice four
years ago, the respective ages of the patients being
sixteen and nineteen. In the younger there were two
large ragged ulcers, onc on cach cleft of the nates, in
!
78
CHANCROID SORES.
the other nearly the whole of the left labia majora
was destroyed, each being covered by a deep ash-
coloured slough, and each bled profusely.
These cases were treated with Nitric acid both in-
ternally and externally, and Aconite at bedtime; a cold
sitz bath night and morning, a generous diet, with half
a pint of good sound claret daily; and at the expiration
of four weeks a very satisfactory cure in each case
was effected.
It may here be observed that these phagedænic
ulcers and sloughing sores may occur as a compli-
cation of any kind of ulcers, whether they be of the
Hunterian or the chancroid type; and that such
unfavourable changes often depend on constitutional,
climacteric, dietetic, hygienic, and therapeutic causes;
such as a scrofulous or broken-down constitution;
ill-ventilated and badly drained courts and alleys,
such as we find in the purlieus of St. Giles, the
rookery at Westminster, and the habitat of the Lon-
don Arab in the far east; intemperance; an irregular
and depraved mode of living; and particularly the
reckless administration of mercurial preparations,
which I have witnessed in many cases to produce the
most frightful and destructive forms of phagedæna,”
may likewise be set down as causes.
It is also, I think, a well-established fact that a
woman may communicate to man, under peculiar
circumstances, a phagedænic sore of a very aggra-
vated form, although she may at the time have but a
trivial complaint herself. This was well exemplified in
the case of the celebrated Lisbon opera dancer, which
has now become an historic fact. The late Mr. Samuel
COMPLICATIONS.
79
Cooper, of University College Hospital, was wont to
relate in his own happy style, the circumstances con-
nected with that captivating woman, whose charms
attracted so many officers of the British army into
her embraces during the Peninsular war, while great
numbers of them received as a reward for their ado-
ration of that irresistible goddess the present of
something more than a trifling clap. Indeed, such
was the CORROSIVE and DESTRUCTIVE nature of that
phagedænic sore that it received the name of the
BLACK LION. And yet that woman continued to
dance every night for months together as if she were
perfectly healthy; whilst her gallant adorers were
suffering the torments of the damned inflicted upon
them through the power of so fascinating a goddess,
whose poison, like that of the viper, hurt not
herself.
In the treatment of A CHANCROID SORE and its
complications it is seldom I have had occasion to
travel beyond the range of Acid nit., Arsenicum,
Causticum, and the Potassio-tartrate of iron; strict
cleanliness; the local application of a solution of the
former and latter, and sometimes Carbolic acid or
Condy's fluid, with a judiciously selected diet.
Acid. nit. I hold to be as formidable an opponent
to the so-called soft sore, as the Merc. sol. is to
the hard "Hunterian" chancre. Its symptomatical
effects on the body in health prove this in a marked
degree; thus it causes—
Frequent itching of the glans.
Red spots on the glans, which become covered
with scabs.
1
So
TREATMENT.
Deep ulcers on the glans, with elevated, lead-
coloured, sensitive edges.
Inflammation and swelling of the prepuce, with a
burning pain.
Swelling of the prepuce-phymosis.
Chancre-like sores, with flat edges, studding the in-
ternal surface and border of the prepuce, attended
with lancinating pains.
Small itching vesicles on the prepuce.
In the female it causes irritation, and inflammation
of the labia majora et minora, with ulcers in the vagina,
covered with yellow pus, and attended with itching,
burning pains. From these provings we infer that
Acid nit. stands foremost as a curative agent in that
form of "pseudo-syphilis" sometimes found at the
orifice of the urethra; the edge and inner surface of
the prepuce, at the root of the corona glandis, and
close to the frænum, presenting a somewhat oval form ;
the edges well marked, flat, and painless; the surface
perceptibly raised above the margin; clean, flesh-
coloured, and fungus-like; secreting a thin, fœtid,
ichorous, sanguineous pus, which does not adhere to
the sore, is easily wiped away, and moreover has no
perceptible hardness at its base, and with no dis-
tinguishing difference between it and the surrounding
surface.
In ordinary cases of this type, I prescribe the acid
in the second or third decimal dilution, repeated
three or four times a day; conjoined with strict clean-
liness, the application of a solution of Calendula,
Carbolic acid, or Nitric acid to the ulcers, and a good
plain diet. Such cases generally get well within from
TREATMENT.
80
(6
fourteen to eighteen days. Attomyr, who had consider-
able experience in venereal diseases, invariably pre-
scribed this medicine with the same satisfactory results.
In the common superficial ulcer, says that author, Acid.
nit. is the principal remedy when it exists without any
complications: the acid acts very soon, and at farthest
in twenty days the disease is cured. Gollmann states,
Among the remedies to be employed for the cure of
chancre I mention particularly Acidum nitricum,
the specific effect of which has scarcely ever disap-
pointed me." Allopathic authorities, from John
Hunter to the present day, recommend excision and
cauterization, as a means of curing this form of
chancre. "The most simple method of treating a
chancre," says Hunter, "consists in destroying or
extirpating it." "To reduce a specific ulcer to the con-
dition of a simple ulcer," says Ricord, "appears to be
the proper object of the treatment; and cauterization,
if sufficiently deep, fulfils this purpose." It is performed
by various substances, such as the Carbo-sulphuric
paste of RICORD; the Chloride of Zinc paste of DIDAY ;
the actual cautery at a white heat of ROLLET; or the
Potassa fusa, Potassa cum Calce, or strong Nitric
acid, as recommended by PARKER.
I am, however, firmly of opinion, which is borne out
by more than an ordinary amount of experience, that
there exists no necessity whatever for the use of such
severe and brutal measures in the ordinary form of
soft chancres; and I further attest that some of the
most severe and complicated cases which have come
under my immediate notice were in a great measure
caused by such vicious meddlings-quaintly, but too
G
82
CHANCROID SORES.
truly described by Attomyr as plasterings, corrodings,
incising, re-corroding, and re-incising, methods pursued
in old physic.
It should be borne in mind that a soft chancre has
a strong tendency to assume an irritable form ; to re-
inoculate itself ad libitum; to creep along or spread
abroad, and transfer a portion of its virus to the
inguinal glands, where it establishes the most HIDEOUS
and DESTRUCTIVE forms of suppurative buboes; it is,
moreover, allied with a peculiar and specific form of
inflammation, which may assume the adhesive, the
suppurative,ulcerative, or gangrenous form; in fact it sets
up an inflammation "sui generis," and of a peculiarly
irritable nature. To treat such a sore by such
means as are here recommended, would only be adding
fuel to the fire. Twenty-three cases of this type of
sore which have come under my notice within the
last sixteen months, yielded kindly enough to Nitric
acid and Carbolic acid dressing, an occasional poultice
when inflammation ran high, and Aconite at bedtime;
which invariably had a very soothing and tranquillizing
effect on the nervous system.
Causticum is clearly indicated when a series of sores
appear under the prepuce, secreting an acrid, corrosive
pus of a watery or greenish colour, with a disposition to
fungous formations, occurring in persons of a gouty
disposition, or those subject to cutaneous eruptions.
I generally prescribe this medicine in the second and
third decimal dilutions.
Arsenicum steps in as an admirable remedy when
the sore assumes the gangrenous form, with bloody
edges, secreting a corrosive, watery, fœtid discharge,
TREATMENT.
83
occurring in weak, scrofulous, or broken-down consti-
tutions in such cases the potency should not
exceed the second or third decimal, in which dose
it acts as a powerful tonic, irrespective of its homœo-
pathicity to the condition of the ulcer. Fowler's
solution also offers a ready and useful form for the
administration of this drug.
Potassio-tartrate of iron.—I have seen very satis-
factory results follow the administration of this drug
in a large number of cases which came under my notice
while watching for some time the treatment of venereal
diseases at one of the London Lock Hospitals. It
is one of Ricord's favourite remedies, who styles it
the "born enemy" of the soft chancre, and prescribes
it as follows:-
Distilled water
Potassio-tartrate of iron
250 parts,
30
Mix. Three tablespoonfuls to be taken daily.
The
sore to be dressed three times a day with lint dipped
in this solution.
84
PART III.
TRUE SYPHILIS.
IN the former sections of this monograph it has been
endeavoured to set forth, in as succinct a form as
compatible with space, in what the historical evidences.
concerning SYPHILITIC and SYPHILOIDAL diseases
consist. These, with the help of authorities of un-
impeachable veracity, have enabled us to trace its
course from the remotest landmarks of civilization to
the present time; and we have seen step by step its
peculiar characteristics stamped with indelible marks
upon the historic page of every people possessing
records worthy of credence. We have referred to its
analogous diseases-to its contagious origin; and we
have disposed of two of its main subdivisions, namely,
the so-called local gonorrhea and its painful complica-
tions; the chancroid with its suppurating buboes, its
phagedanic and gangrenous complications; but a
very important section of our task still remains to be
considered, constituting the third subdivision of my
programme, namely, the Syphilis of Fracastorius, 1514;
the Leues Venerea of Fernel, 1530; the Pestilential
Scorra of Joseph Grundpeck, 1496; the Morbus Gallico
of Nicolus Leonicenus, 1496; the De Dolore in Puden-
dagra of Gaspar Torella, 1500; the Grose Verole of the
French; the indurated sore of the great John Hunter;
the indurated, non-suppurating, syphilitic, infecting
SYPHILIS.
85
chancre of Lancereux; in a word, the "Hunterian
chancre," with its constitutional ravages of modern
Europe, and the civilized world.
Whilst dwelling on the records of the past, we can
plainly see that syphilis proper is constantly indicated,
but the indications remain symptomatic, and only
symptomatic. No general definition has as yet been
promulgated sufficiently concise and comprehensive to
meet the requirements of the present age.
Into the
intimate nature of syphilis, in essentia, we have not
yet been able to penetrate, surrounded as it is by such
a halo of mystery. It nevertheless becomes an im-
portant question to inquire in how far others have
already defined syphilis, and by their definitions.
endeavour to attain some certainty to guide us in the
further prosecution of the search. We shall therefore.
proceed to quote several definitions from authorities
to which all schools of medicine are agreed to pay
respectful deference. Of these we would first refer to
the ancients.
In 1493, Joseph Grundpeck defined it as a plague
sent down from the citadel of the immortal gods upon
the French; a most horrid and terrible prodigy—a
disease repugnant to nature, and formerly unseen,
unknown, and quite unheard of.
In the same year
Alexander Benedict, of Verona, attributed it to a
pestiferous aspect of the stars, and that it first burst
in upon them from the west.
In 1530, John Fernel-surnamed the modern Galen-
defined it as a disease in which the whole of the body is
morbific, being contagious, presenting tubercles, spots,
ulcers, sores, and pains, produced in succession, either
86
SYPHILIS.
from the act of a single concubinage or from other
impure contact.
John Hunter was of opinion that the effects pro-
duced by the syphilitic poison arose from its peculiar
or specific irritation, joined with the aptness of the
living principle to be irritated by such a cause, and
the parts so irritated acting accordingly. Hence he
considered that the virus irritated the living parts in
a manner peculiar to itself, and produced an inflamma-
tion peculiar to that irritation, from which a matter is
produced peculiar to the inflammation.
In Nysten's dictionary there is the following defini-
tion :-"Syphilis is a specific malady, not spontaneous,
transmitted by contact and heritage, characterized at
its different periods by certain accidents, the evolution.
of which is subordinated to the action of the syphilitic
virus, the course of which is usually determined."
Wallace defines syphilis as a specific morbid poison,
which when applied to the human body has the power
of propagating or multiplying itself, and capable of
acting both locally and constitutionally.
Samuel Cooper defines it as certain morbid changes
produced in various textures of the human body by
the action of a specific morbid poison.
Attomyr denominates as syphilitic every disorder
presented by Venus Pandamos to her votaries, and
first exhibited on the organs of reproduction.
Franklin defines it as a specific disease transmitted
by means of its own peculiar virus, coming in contact
with an abraded surface, by inoculation through the
medium of the secretions, or by hereditary descent.
Ricord only gives a general definition, and states
SYPHILIS.
87
that syphilis is a contagious disease engendered by a
virus commencing by a peculiar affection - the
CHANCRE; syphilis springs from a chancre, and re-
cognises no other origin.
Lancereux defines syphilis as a specific disease,
transmissible by contact or by inheritance; charac-
terized by a slow periodical progressive development,
and especially by changes in the cellular tissue, with-
out direct tendency to suppuration, being acquired or
hereditary,—the former by contagion or inoculation,
the latter traceable to father or mother already infected.
Finally, Astruc, in his remarkable work on the "His-
tory and Pathology of Syphilis" (1754), in endeavouring
to define syphilis-or, as he called it, "the confirmed
pox" says: "The nature of this disease is of so wide
an extent, and it comprehends such an infinite number
of different symptoms, that it rather appears to be a
world of diseases than one; therefore it were vain to
attempt a definition of a disease that cannot be compre-
hended within the narrow limits of a definition; and
it is much better to place in one view the nature, form
and disposition of this disease, and the series and
connection of the effects which it produces, by an
accurate description and enumeration of its more
remarkable symptoms."
With such a definition we must be content; and
with the closing remarks of that eminent physician I
quite agree; let us therefore proceed to examine briefly
the peculiar characteristics of this terrible form of the
venereal disease, with a description and enumeration
of its more remarkable phenomena.
SYPHILIS is essentially a constitutional disease,
88
SYPHILIS.
and, according to Ricord, is divisible into three
periods :—
I. PRIMARY LESION, a chancre, the result of conta-
gion.
2. SECONDARY LESIONS, or constitutional poisoning,
resulting from that infection.
3. TERTIARY LESIONS, which rarely show them-
selves before the end of the sixth month. To these I
would add-
4. QUATERNARY LESIONS, constituting the invasion
of the various viscera.
Lancereux, however, not quite satisfied with the
above arrangement, proposes the following classifica-
tion, as more clearly showing certain analogies of
evolution between that disease and some of those
termed EPIDEMIC and VIRULENT, namely:-
A. The period of incubation.
B. The period of local eruption, a chancre, or primary
lesion.
C. The period of general eruption, otherwise
secondary symptoms.
D. The period of gummy products, otherwise
tertiary and quaternary affections.
This arrangement is a decided improvement on the
former, as we have here, well-defined prominent
landmarks separating each of these periods.
In the first, there is complete absence of any local
manifestations. In the second, we have outward
manifestations in the form of a pustule at the supposed
spot where the contagious virus first entered-I say
supposed,” for no one has yet ever seen it. In the
third, we have numerous superficial lesions; and in
SYPHILIS.
89
the fourth, we have more deep-seated lesions, followed
by extensive disorganizations and cicatrices.
Let us therefore proceed according to Lancereux's
classification.
By INCUBATION, it should be understood as em-
bracing the interval of time which elapses between
the moment of the absorption of the syphilitic virus
and that of the appearance of the first local mani-
festation-the chancre.
The period of incubation in syphilis, we find, bears
a singular analogy to the general symptomatology of
other febrile, epidemic, and contagious disorders. We
quote the following periods as examples.
In yellow fever there is a period of incubation
varying from ...
In small-pox
دو
""
scarlet fever
measles
,, typhus
,, typhoid
""
chicken-pox
,, ague
دو
diphtheria
, cow-pox
:
:
:
:
:
:
...
•
...
:
:
:
:
:
:
:
:
""
"3
erysipelas
hooping cough
the plague
...
:
:
3 to 10 days.
12 to 16
4 to 6
6 to 16
2 to 12
10 to 18
""
""
")
"
2 to 3
"
>>
6
""
IO to 14
2 to
2 to 6
3 to 7
""
6 to 10
,, relapsing fever
وو
from a few hours to 3 weeks.
3 to 6 days.
simple continued fever, generally only a few hours.
gonorrhoea
dry papule
,, chancroid (soft chancre)
:
2 to 14 days.
4 to 21
دو
2 to 3
>>
90
SYPHILIS.
In TRUE SYPHILIS however, the period of
incubation in the generality of cases ranges from
SEVEN to TWENTY-ONE days from the occurrence
of a coit; and there are strong grounds for con-
sidering that the more or less rapid exhibition
of the disease arises from a constitutional sympathy
in the person receptive of contagion, thus regu-
lating, as it were, the period of incubation. The
disease being more actively absorbed, is more ener-
getically protested against and repelled in cases of
sanguine temperaments in proportion to the vital force
of the recipient, and to the sympathy so constitu-
tionally existing for diseases of a contagious epidemic
nature. I would even urge that the germ of the disease
is developed at the greatest period of excitement, when
offspring is not thought of, but the mere gratification
of physical and animal passion. The symptoms indi-
cating the stage of incubation are sometimes well
marked, and should be prominently remembered by
those who run the risk of such infection, as they may be
the means of sounding the alarm bell and seeking the
early advice of their medical adviser. These may be set
down as dejection of spirits; pain in the head; slow fever;
weight about the shoulders; sleeplessness; carelessness of
employment; indistinctness of vision; general heaviness;
flying bone pains; and loss of flesh. Such, in fact, are
the leading symptoms which have been described to
me from time to time by those who have suffered from
syphilitic affections. Prophylactic and private hygienic
measures have been suggested by physicians from the
historic period of ancient Rome and Greece to the
present time. Celsus speaks of it at some length;
SYPHILIS.
91
Lanfranc (1290) and others advised washing the penis
with vinegar and water; others lemon juice;
some, solutions of alum, tannic acid, lime water,
alcohol, and corrosive sublimate; and others, fatty and
oily products. Phenic acid, more generally known
as carbolic acid, may likewise be mentioned as an
agent which, according to an eminent French autho-
rity, "is capable of neutralizing a certain number of
animal poisons, and among these the poison of
SYPHILIS;" but hitherto no satisfactory cases have
been brought forward in confirmation of such a state-
ment. The evidence we, however, possess of the
remarkable prophylactic properties of Belladonna in
scarlet fever and small-pox, "as attested by French
authorities," of Pulsatilla in measles, of vaccination in
small-pox, of Quinine in ague, and of Cuprum and
Veratrum in Asiatic cholera; and the striking analogy
that exists between the pathogenetic effects of MER-
CURY and SYPHILIS, lead me to infer that we may find
in Hahnemann's celebrated preparation a most for-
midable opponent to the so-called incubated stage of
that foul miasm. Here are its symptoms :-"Anguish,
with lowness of spirits; pains in the head; low fever,
with a feeble, slow, and trembling pulse; a general
'malaise ;' pains about the shoulders, as if pressed
down; sleeplessness, anxiety, and restlessness; exces-
sive indifference to everything; dim-sightedness;
general heaviness; all his bones ache, with general
weakness, as if his limbs gave way." I would suggest
that two grains of the second decimal trituration be
taken two or three times a day for a period commen-
surate with the incubated stage of the syphilitic poison.
92
SYPHILIS.
PERIOD OF LOCAL ERUPTION.-The primary lesion
of true syphilis presents varied aspects, with which
every student of medicine ought to be familiar, in
order to be able to form a correct diagnosis. These
we will set down in the following order :-
1. The dry papule.
2.—The chancrous or chancriform erosion.
CC
3.—The indurated or Hunterian chancre."
I. DRY PAPULE.-This is the rarest of the different
forms which syphilis assumes.
SYMPTOMS.—After an incubation of considerable
duration, sometimes "weeks," there will appear at
the supposed point of infection a papular patchy pro-
tuberance of a round or oval form, firm and elastic, of a
dark or brownish red colour, and covered with whitish
or silvery scales; its base is indurated, it seldom or never
suppurates, and gradually disappears by absorption,
leaving behind it a slight violet-coloured or blackish
depression. It is attended by the usual sympathetic
buboes in the groins, and leaves in its wake consti-
tutional symptoms, but of a mild form. Here is a
case in point:
J. L., æt. thirty-eight, a warehouseman in the City,
consulted me November 12, 1870. Twelve months pre-
viously he observed what he termed a large pimple
behind the corona glandis; its base was hard, and felt
like a kernel; its surface was covered with copper-
coloured scales; it never broke, but remained as such
for some weeks, when it gradually diminished in size,
and entirely disappeared, leaving behind a dark, violet-
coloured depression. Some weeks afterwards he felt
languid and dejected, his tongue felt larger than
SYPHILIS.
93
usual, his voice became husky, his tonsils enlarged,
uvula elongated, and there appeared on the posterior
palatine region, both tonsils, and sides of the tongue,
superficial erosions. He was first treated allopathically,
and took considerable quantities of mercury and
Potass. iod. for some months before he consulted me,
with no decided benefit. He was placed under Aur.
met. and Hep. sulph., and in three months all these
symptoms disappeared.
It
2. CHANCROUS, OR CHANCRIFORM EROSIONS.-
This, according to the statistics of Bassereau and
Diday, is the most frequent form which primary
syphilis presents; viz. 144 times in 170 cases.
coincides with the patchy excoriation of Carmichael;
the superficial primary syphilis of Wallace; the parch-
ment-like chancre of Ricord; the Venerola Vulgaris of
Evans; the condylomatous affection of Renecker; the
superficial erosion of Langlebert; the chancrous erosion
of Bassereau; and the chancriform erosion of Diday.
SYMPTOMS.—After an incubation of more or less
duration there will appear on some part of the penis,
most frequently behind the corona glandis, a copper-
red spot, scarcely raised, papular and dry, which
scales off, and becomes covered with a crust or
thin scales, and is afterwards slightly ulcerated. In
form it is round, or irregular; the surface is flat, and
level with the surrounding parts, the surface is rose-
coloured, its base is indurated, more superficially than
deeply, and secretes a scanty serous fluid. It is
attended with the usual hard and indolent condition
of the inguinal glands, and is followed by secondary
symptoms, particularly in the form of mucous patches.
i
94
1
SYPHILIS.
This form of chancre is sometimes covered with a
crust, particularly when situated on the skin, or on any
portion of the mucous membrane exposed to the air;
it then assumes the character of herpes, ecthyma, or
a squamous eruption. Attomyr termed it the itch
chancre, and regarded it as a complication of syphilis
and itch, which presumption was confirmed, not only
by the form of the sore, but also by the violent itching
of the same, and the favourable result which followed
the administration of Sulphur. I am able to confirm
the views propounded by that author, as I have met
with several cases having the characteristic symptom
of "itching," which quickly yielded to an occasional
dose of Sulphur, given in alternation with its true
specific, Mercury.
3. THE INDURATED, OR HUNTERIAN CHANCRE.—
After a longer or shorter period of incubation, there
will appear on some part of the penis a minute red
spot, which is soon followed by an elevation, or papule,
which gradually reaches the size of a lentil, or pea;
of a red or dirty yellow colour; rounded and hard to
the touch. This papule in the course of a short time
becomes covered with greyish scales, which gradually
become thicker, and end by forming in most cases a
true crust, under which a cup-shaped ulcer of greater
or less depth rapidly develops itself. It may also be
described as having a sharp-edged circular form, as
if cut with a punch: it has a glossy, iridescent surface,
which is surrounded by a copper-coloured areola ;
and a floor which is bathed with a whitish-yellow,
tough, gluey, corrosive, offensive secretion, difficult
of removal, and leaving stains on the linen like melted
tallow―"lardaceous;" its other characteristics are—
SYPHILIS.
95
I. Its tendency to dip down instead of spreading.
2. The scanty and adhesive property of its secre-
tion.
3. The peculiar hardness of its base, which feels
when grasped between the thumb and forefinger like
one half of a split pea, or a cartilaginous cup set in the
flesh; enveloped-as Ricord expresses it-in a kind
of hard, circumscribed nucleus, which serves it both
for a covering and a bed; it has good claims for being
called the most characteristic lesion of syphilis at its
commencement.
4. Its isolation, being seldom or never accompa-
nied by others of a like kind; consequently its non-
power of inoculation,
5. Its power of creating a series of sympathetic
buboes in the groins, which seldom suppurate.
6. Finally, its power to resolve itself into constitu-
tional symptoms of a loathsome and painful character,
to be described hereafter.
GANGRENE and PHAGEDANA are almost the only
complications attending a primary syphilitic sore. The
former usually appears in the course of the ulcerative
stage. The surface of the chancre, previously red or
greyish, deepens in colour, and is dotted with dark
points of ecchymosis; there is increased pain, and a
sanious secretion which contains the remains of tissue,
and shreds of blackish blood; the sore spreads and
gradually destroys the surrounding hardened tissues.
The latter presents a more or less irregular shape, with
livid, jagged edges, a base slightly hardened, and oede-
matous; an uneven floor, which is covered with a
yellow or greyish matter, or sanious pus. Its tendency
96
ANCIENT TREATMENT
A
is to spread superficially rather than deeply, and there
is generally a smarting or burning pain.
CAUSES.—The abuse of spirituous liquors in warm
seasons, hot climates, unhealthy dwelling-places, bad
food, want of cleanliness, the abuse of mercury, and
various unhealthy and cachectic conditions of the
body, may be set down as some of the chief causes
of such complications.
(
TREATMENT.-The first manifestations of the great
syphilitic epidemic of the fifteenth century-" of which
the hard Hunterian chancre' of the present day is a
descendant and true representative," having been a
complete surprise for the physicians of that remote
period-were not treated at all. It was, in fact, con-
sidered disgraceful for a practitioner to occupy him-
self with such a disease. But it should be observed
that the chief cause of such neglect was attributed
more to ignorance of the nature of the complaint than
to anything else.
"The learned," writes Gaspard Torella in 1500,
"avoided treating this disease, being persuaded that
they knew nothing about it; for since this strange
disease had never been seen up to our time, no one,
however clever, however experienced he might be,
could treat it according to the rules of art." It was
from this and other causes that the treatment of
syphilis fell into the hands of druggists, herbalists,
and various impostors of the healing art from that
remote period even up to a very recent date; and
the remedies used were as singular as they were dan-
gerous—such as vipers infused in wine, or made into
broth, or syrup, or the flesh roasted or boiled. To
:
OF SYPHILIS.
97
these we may add the marrow of deer, foxes, human
fat, Venice soap, and a decoction of henbane, &c. ; and
in China, a decoction of toads.
The physicians in Germany at the first outbreak of
the epidemic were quite as remiss as those of Italy,
for Lawrence Phrisius, a physician at Mentz, in a dis-
course entitled De Morbo Gallico, cap. I, 1532, says
that “at first the poor people who were infected with
this distemper were expelled from human society like
a putrid carcass; and being forsaken by the physicians
(who would neither give their advice about them nor
visit them), they dwelt in the fields and woods ;" and
at last, says Astruc (chap. vi., p. 140), "the disease.
spreading wider than can well be imagined, and the
number of such as wanted assistance increasing daily
more and more, the physicians grew ashamed of neg-
lecting their duty in so grievous a scourge, and thus
medicine was first applied, and a cure attempted,
rather through a sense of shame than any confidence
of success." Guided by the theoretical views of the
time, several eminent physicians agreed to a method
of cure which they called Methodical or Rational.
Firstly, they ordered a spare diet according to the
9th aphorism of Hippocrates, consisting of food easy of
digestion.
Secondly, bleeding, both generally and locally, by
means of leeches and cupping.
Thirdly, mild laxatives, composed of cassia, senna,
manna, tamarinds, and syrup of apples, succory, and
roses.
Fourthly, they endeavoured to purify the blood by
means of the juice of wild succory, bugloss, spleenwort,
H
98
ANCIENT TREATMENT
asparagus, parsley, horehound, and the tops of hops, with
syrups composed of the same juices. For the same
purpose they prescribed warm baths, either alone or
boiled with marsh-mallows, water lilies, chamomile,
linseed, or the roots of the wild cucumber.
Fifthly, for pustular eruptions they recommended
liniments of mastic, myrrh, soot, quicksilver, and orris
root, first reduced to a fine powder; and for bone pains
hot oils, containing laurel, chamomile, dill, spike, and
saffron. In obstinate cases they recommended sweat-
ing in stoves, or even in a moderately hot oven, and,
according to Gaspar Torella, with good success; for
says that author, "Amongst all things which I had
tried for curing the pains, and even the pustules, the
best was to make the patient sweat in a hot oven, or
bagnio, for five days successively in the morning
fasting." Finally, they sometimes recommended cautery
to the head, arm, and leg, with the view of letting out
the latent reliques of the foul distemper."
From that period we are enabled to trace the use
of a medicine which has become celebrated--and
deservedly so in the history of syphilis, namely,
Mercury; the Hydrargyrum of the Greeks; the Ar-
gentum Vivum of the Latins; and the Mercurius of
the more modern chemists.
Mercury was first introduced into the domain of
therapeutics by the Arabian physicians, and recom-
mended by Rhases to destroy vermin; by Avicenna
as a cure for the itch; by Serapion for herpes; and
by Mesue as a cure for impetigo, the Malum Mortuum,
a form of lepra," and other cutaneous eruptions.
Analogy naturally led to the employment of this drug
(C
OF SYPHILIS.
99
for syphilitic eruptions, and, encouraged by earlier au-
thorities, the first syphilographers followed therein.
the precepts laid down by Celsus, who says in his
preface “that in case any unknown disease starts up,
the physician must not therefore think of ordering
out-of-the-way medicines by conjecture,' but must
first consider what disease this new one is most akin
to, and try remedies of the same sort with those
which most frequently succeed in analogous diseases,
and by such resemblance find out a proper method."
At first Mercury was chiefly used externally, in the
form of liniment, ointment, cerate, fumigation, and
lotion; but it produced such terrible effects, parti-
cularly in the hands of illiterate persons, that the
remedy soon became worse than the disease, and fell
for a time into great discredit. This was materially
hastened by the introduction into Europe in 1517 of the
guaiacum or holy wood, a remedy largely used by
the natives of Hispaniola in venereal affections. Few
remedies became so rapidly popular; but after a time
this also fell into disrepute, from the supposition that
it laid the foundation of diseases of the lungs, liver,
kidneys, and stomach. "I have observed," says P. A.
Matthiolus, in his Treatise De Morbo Gallico, pub.
1535, "that men of a dry habit of body, who are
infected with the French disease, by drinking of this
decoction fall into a hectic fever and consumption."
Thus guaiacum, which at first was received with great.
applause, was obliged to give way to the Cinchona
officinalis, introduced into Europe about the year 1535,
and raised once more the expectations of both doctors
and patients. To this succeeded sarsaparilla, sassa-
Uor M
100
HOMOEOPATHIC TREATMENT
fras, juniper, millet, soap wort, burdoc, and the flesh of
the sea tortoise.
In 1661 opium was introduced by S. Pauli, and in
1779 by other physicians, but with no satisfactory.
results. Towards the end of the last century nitric
acid was advocated by Girtanner, Scott, and others,
but this also underwent the same fate as others.
Gold, silver, brass, platina, Arsenic, Iodine, and the
Iodide of Potass have likewise had their day, but, with
the exception of the latter, have not stood the test of
experience in the primary form of syphilis. Such is a
brief outline of the "therapeutics" connected with the
history of the great epidemic of 1494-5. Let us now
to the more immediate object in view, viz., the
Homœopathic or Specific treatment of the divers forms
of chancre; for the rapid and successful treatment of
which, it may safely be affirmed that there is no class
of medicines contained in the wide range of either the
allopathic or homeopathic materia medica, that can
for a moment compete with the various compounds of
Quicksilver, administered in potencies varying from the
first to the sixth decimal dilutions, such as the Merc.
sol. Hah.; Merc. vivus; Merc. præc. rub.; Merc.
bichloride; Merc. iod.; Merc. nitros; and Merc. phosph.;
selected with due regard to the form, stage, and con-
dition of the chancre, its accompanying complications,
and the constitutional peculiarities of the patient.
1. The Dry Papule.-Thirteen cases of this type have
come under my notice; two of recent origin; they were
treated with Merc. sol. Hah., first and second decimal
trituration, three grains twice a day: the callosity
of one disappeared in four weeks, the second entirely
OF SYPHILIS.
ΙΟΙ
within five weeks, and left no secondaries behind. The
remaining cases were first treated allopathically, and
terminated in secondaries, which yielded to Aur. met.
and Hep. sulph.
application.
This form requires no outward
2. Chancriform Erosion-which is by far the most
frequent form of primary syphilis. Fifty-six cases of
this type are recorded in my case books. In the
majority of these I found the Merc. præc. rub. to be
the best preparation in the ordinary type, in the second.
decimal trituration; others, which looked angry, with
a tendency to spread, yielded to Merc. corr. 3x, and
Nitric acid, first decimal trituration, in drop doses; and
others, which assumed more of the Hunterian form,
yielded well to Hahnemann's solution of Mercury, in
the first and second trituration.
Outward applications here are very necessary, but
they must be of a soothing nature. The well-known
black wash and Tannic Acid I find far too irritating,
but a combination of Calendula, Carbolic acid, and
Gum-water act admirably. In some, where great
irritation and sensibility existed, with threatened sup-
puration of the inguinal glands, I found it necessary
to apply a poultice composed of chamomile and poppy-
heads, which had a very soothing effect, reducing the
inflammation, and setting up a more copious discharge,
to the great relief and comfort of the patient. The
duration of cure varied from four weeks to two months.
Twelve of these cases terminated in secondaries, but of
a mild form, and yielded chiefly to Iodide of potass,
Biniodide of mercury, and Turkish baths.
3. Indurated or Hunterian Chancre.-In this form
1
102
HOMEOPATHIC TREATMENT
of chancre, says Jahr, the leading remedy is and
always will be Merc. sol. Hah. Half a grain of the
centesimal trituration, given morning and evening,
will in most cases prove sufficient to effect a cure,
Seventy-five cases of true Hunterian chancre, as
recorded in my note-books for the last few years,
enables me to confirm these views to a great extent;
but there are some cases which will require the help
of other preparations of mercury to establish a radical.
cure. "A chancre," as Vehsemeyer very justly says,
“exhibits in its course two stages, viz., an ulcerative
and a reproductive stage. The character of the first
stage is, loss of substance, the second, adventitious
growth. The syphilitic ulcer, if attacked on its very
first appearance, leaves this stage under the persistent
use of Merc. sol. in from twelve to fourteen days, in
doses of one to five grains of the second or third
decimal trituration, repeated three times a day. On
the sixth or eighth day an improvement becomes.
apparent; the ulcer is arrested in its course; the
tenacious lardaceous substance which covers its floor,
like a false membrane, becomes eliminated or ab-
sorbed, and is replaced by a healthy secretion ; granu-
lations form, the callosity gradually diminishes, the
edges drop in, and cicatrization takes place from the
circumference towards the centre, leaving for a time a
dark brownish bronze colour, which after a longer period
terminates in a white mark. But if this change does
not, from various causes take place within the time.
indicated, another remedy should be selected. It may
be that the ulcer will assume a tendency to spread, in
such a case the Merc. corr. is well indicated; or it may
OF SYPHILIS.
103
assume an indolent form; then Merc. phosph, will be
found the most appropriate remedy. Other cases will
sometimes occur, that instead of becoming cleansed
from the circumference, the cleansing process of the
ulcer proceeds from the centre; the edges then become
raised, grow like condylomata, and heal rapidly under
the influence of the foregoing medicines; and the
second stage, or what has already been stated as
"adventitious growth," set in, which should be com-
bated by Nitric acid, two or three drops of the second
dilution in water three times a day, and a weak solution
of the acid or Alum externally.
Nitric acid is likewise a very valuable remedy in
those cases of syphilis which attack scrofulous and
broken-down constitutions, where mercury in any
form save the Iodide would act most injuriously. In
such cases, however, I do not hesitate to prescribe the
compound of Mercury and Iodine, and have never
found it act injuriously on such constitutions.
1
OUTWARD APPLICATIONS.-Strict cleanliness with
tepid water frequently suffices for the treatment of
infecting chancre. Some recommend the black wash,
in which I have no faith, as being too irritating;
others the yellow wash. Lancereux recommends
washing the sore with spirit and water, and the
application of tincture of guaco, and afterwards
dressing with calomel ointment, of the following
proportions Opiate cerate 30 parts, Calomel x
part; mix, and apply three times a day.
I am
in the habit of prescribing a lotion consisting of
Tinct. calendula, Carbolic acid, and a weak solution of
gum. This has a soothing, cleansing, and disinfecting
1
104
SYPHILITIC COMPLICATIONS-
effect. It destroys the lardaceous deposit which
covers the floor of this chancre, and promotes healthy
granulations, and a more normal secretion.
COMPLICATIONS OF CHANCRE-THEIR
TREATMENT.
Gangrene, Phagedana, Buboes, Phimosis, Paraphi-
mosis, Gonorrhea, and Moist Warts are among the
chief complications of a contagious syphilitic chancre.
When a chancre assumes a gangrenous or phage-
danic form I omit for a time all mercurial prepara-
tions, and administer Arsenicum in low potencies,
one grain of the third decimal trituration, or five
drops of Fowler's solution three or four times a day.
Perfect quietude in the recumbent posture, soothing
applications, a plain non-stimulating diet, plenty of
ventilation, and strict cleanliness, will form the most
judicious plan of treatment.
Chancre and Buboes.-The syphilitic poison in its
passage through the inguinal glands frequently gives
rise to inflammation and enlargement of these organs,
which in many instances terminate in suppuration
and ulceration. In the treatment we ought to be
guided by the same principles as in the treatment of
the primary sore, by continuing the Merc. sol. But if
the buboes become intensely inflamed, and threaten
to break, then I substitute the Merc. præc. rub., or
Nitric acid. And if suppuration becomes inevitable,
I hasten the bubo to maturity by means of Hep. sulph.
or Silecia, and, when ripe, open it from above down-
wards with a curved-pointed bistoury.
THEIR TREATMENT.
105
i
2
Chancre with Phimosis and Paraphimosis.-Strict
cleanliness, cold evaporating spirituous lotions, the
recumbent posture, an occasional dose of Açon. or Bell.
to subdue inflammatory action, and the repeated ad-
ministration of Merc. corr. constitute the chief mode
of treatment I am in the habit of adopting in this
form of complication.
Chancre and Gonorrhea.-In such complications great
cleanliness is strictly enjoined, with the administration
of Merc. sol. or Merc. corr., and if considerable scalding
exists, with chordee, &c., I alternate the selected
mercurial preparation with Cannabis sativa, or Can-
tharis.
Chancre and Condylomata.-Here Merc. sol. may be
given, with an occasional alternating dose of Thuja or
Nitric acid. Some recommend clipping these warts
with a pair of scissors. I object to such treatment as
a useless piece of barbarism and unscientific blunder;
for I have had no difficulty whatever in removing
them by a properly selected medicine; viz. Thuja,
Nitric acid, or Alum, in the form of lotion.
106
PART IV.
BUBOES.
A BUBO may be defined as a swelling of the lym-
phatic glands, particularly those of the groin and
axilla.
The venereal virus in its course through the in-
guinal glands frequently gives rise to inflammation and
enlargement of them, which in many instances is
followed by suppuration and ulceration. The swelling,
abscess, or sore thus produced is termed a bubo, a name
derived from the Greek (Boußwv, the groin); though
if a patient happen to have a primary venereal sore on
one of his fingers, he might have a bubo just above the
elbow, near the inner edge of the biceps muscle, or in
the axila; so that a bubo does not always signify a
disease in the groin, as the etymology of the word
would imply. Lancereux objects to this term, as not
being sufficiently lucid or correct; he, however, retains
'it on account of its antiquity, but gives preference to
the word Adenopathy,* which indicates more exactly
what organ is affected.
In the Middle Ages, and even in more ancient
times, suppurating buboes, and the co-existence of
abscesses in the groin with ulcers of the genital
organs, were well known and clearly defined.
Hippocrates, who flourished some 450 years before
* From the Greek àðýv, a gland.
SYPHILITIC BUBOES.
107
/
the Christian era, in his third book on Epidemics,
refers to "defluxions to the private parts; pustules,
ulcers, abscesses, and suppurations, mutilations
of the bones and nerves, baldness, and falling off
of the beard;" finally, "swellings in the groin,"
clearly showing that syphilis and its attendant
evils was well known at that remote period. Galen,
A. D. 200, confirms the views of Hippocrates. In
1270, William de Salicet of Placenza, writes thus:-
"This disease is called a bubo, dragoncelli, or
impostume of the groin, which sometimes proceeds.
from a hot humour, and sometimes it comes upon a
foulness in the yard (in virga corruptio) contracted
by lying with a slovenly woman." Lanfranc of Milan,
about the same time refers to these impostumes in the
groin arising from ulcers of the yard. In 1470, Peter
de Argelata, of Bologna, in describing venereal ulcers.
on the penis, also refers to buboes in the groin, which,
if they suppurate, carry off the disease; in 1532,
Nicholas Massa to ulcers on the yard, which are
obstinate with callous hardness, followed by "tumours
in the groin." Paracelsus in 1536, Jerome Fracas-
torius in 1546, and, more particularly, Anthony
Gallus in 1540, are very clear upon this point. "It
sometimes happens," says the latter," when the disease
is confirmed, that a virulent humour appears in the
groin, in the form of a hard boil, besetting as it were
the glands, called àdéval. This some call a bubo,
others pulinus (a colt), by way of sneer, because they
who are thus afflicted straddle with their legs as if
they were riding on a colt."
Gaspard Torella appears to be the first who gave a
108
SYPHILITIC BUBOES.
description of an affection of the lymphatic system
concomitant with the indurated or Hunterian chancre.
Starting from that period, buboes continued to be
described by most syphilographers up to the present
time. Thus, Astruc, in 1754, describes syphilitic buboes
as hard, resistent tumours of the lympathic glands of
the groin, which do not readily suppurate, and are
produced mediately or immediately from an impure
connection.
"Therefore when this species of venereal happens
either to man or woman, immediately from impure
coition, in a few days, few or more glands, in either
or both groins, give some small pain in walking, and if
you handle them, you may observe them to be enlarged.
The tumour increases by degrees, and grows hard
and tense; hence the part has a more acute sense of
pain and heat, but still retains its natural colour; the
patient by degrees finds more difficulty in walking;
at length a manifest bubo appears, various in its figure,
viz., jorbicular, oblong or round; sometimes of the
size of a pigeon's or hen's egg, sometimes as large as
one's fist." Finally, Ricord, Lancereux and others, like
the ancient physicians, draw a prominent line between
the sympathetic or virulent bubo of the chancroid or
soft sore, and the hard indolent bubo which accompanies
the indurated or Hunterian chancre-a distinction
which is recognised more or less by most modern
syphilographers. For all practical purposes buboes
may be set down under the following heads, viz.,—
1. Simple or sympathetic buboes.
2. Gonorrhoeal buboes.
3. The virulent, inoculable buboes of soft chancre.
!
SYPHILITIC BUBOES.
109
4
4. The indolent, multiple, indurated, non-inoculable,
or true syphilitic buboes.
5. The phagedænic buboes.
Simple or Sympathetic Buboes.-The generality of
buboes of this type, and not strictly venereal, are
preceded and accompanied by more or less disorder
of the general health. They constitute the "bubo at
the first outset" of John Hunter, and the bubon d'emblee
of the French. Diday, after a critical examination of
the theory of buboes at the first outset, admits on the
strength of a considerable number of cases, that these
lesions have no virulent character; that their incuba-
tion is long, and their duration about a month; they
are accompanied by an inflammation which is always
slight, and a feverishness and feeling of discomfort
comparatively intense; they are connected in many
cases with excessive coition, and similar to such as are
observed in soldiers after long, fatiguing, and forced
marches; or wounds lying in the track of lymphatics.
leading to the inguinal glands. Whenever a patient
consults me for a swelling in the groin, who denies hav-
ing ever contracted a sore of any kind on his penis, traces
of which cannot be discovered by the most searching
inquiry or the closest examination, I invariably lay it
down as a rule-first, to inquire into his general state
of health; and, secondly, to ascertain whether there is
any inflammation, wound, boil, carbuncle, or sore about
the foot, leg, thigh or nates; any bunion on the great toe,
or any inflamed bursa, or painful corn; for it cannot have
escaped the observation of any practitioner of mode-
rate experience that the inguinal glands are liable to
sympathetic inflammation and enlargement from any
IIO
SYPHILITIC BUBOES.
of these causes.
Buboes of this type generally affect
the deep-seated glands; their progress is usually slow,
with but little tendency to suppuration.
In the treatment of such buboes we must in a great
measure be guided by the exciting cause; remove
this, the other naturally follows; strike at the root,
the branches fall and wither.
Gonorrheal Buboes.-For the symptoms, causes, and
treatment of buboes of this type see "Complications
of Gonorrhæa," page 54.
Virulent, Inoculable, Non-infecting buboes of Soft
Chancre.-The soft chancre, says Lancereux, most com-
monly runs through all its periods without exciting any
sympathy in the inguinal glands. In a certain number
of cases, however, sixty-five times in 207 cases (accord-
ing to the statistics collected by Ricord) there supervenes
in the course of this lesion, or soon after its appearance,
acute adenitis, essentially monoglandular, which almost
always runs on to suppuration, and furnishes a virulent
pus which is inoculable like that of the chancre which
caused it. Soft ulcers of the frænum, the prepuce, and
meatus are, by virtue of the great number of lymphatic
vessels with which those regions are supplied, especially
disposed to the development of this form of bubo.
Although it may occur at any period of the existence
of the chancre, yet it does not usually show itself
before the end of the first week, the chancre being lined,
up to that time, by an inflamed tough tissue, which
to a great extent prevents the absorption of the
matter. The inflammatory process in the gland
generally proceeds with great rapidity, and almost
invariaby ends in suppuration.
SYPHILITIC BUBOES.
III
"
DIAGNOSIS.-The form of bubo under consideration
is not difficult of recognition, chiefly on account of the
usual nature of the surrounding walls of the focus of
suppuration and neighbouring parts. We likewise
observe that instead of contracting gradually, and
showing a tendency to heal (as in a simple sympathetic
bubo), the opening spreads, and in many cases to
considerable dimensions, burrowing under the sound
skin, and secreting a serous or bloody pus. Another
diagnostic sign worth recording is the anatomical
range of the swelling; for if we find one gland only
affected, and that situate above Poupart's ligament,
we are led to infer that it is of venereal origin; but
if a series of glands are swollen, and they are located
below the margin of that ligament, the probability
is that it is caused by some irritation in the lower
extremity. The most frequent complication of a
virulent bubo is undoubtedly phagedana, the ravages
of which in some cases are so frightful, that the
muscles, vessels, and nerves are laid bare, the limbs
deprived of their cutaneous covering, and the patient
worn out by a suppuration at times most difficult to
check. Such are the leading characteristics of a bubo
connected with a soft chancre.
TREATMENT.-Venereal swellings of the inguinal
glands are more dreaded by patients than any other
form of venereal disease, and this terror is to a very
great extent justified by the torturing mode of prac-
tice adopted by many practitioners of the allopathic
school, such as leeches, blisters, purgatives, cauterization,
and the like. The buboes of soft chancre are not as
a rule attended by any great pain or inconvenience,
112
TREATMENT OF
and patients so affected are able from first to last to
get about and attend to their ordinary avocations.
The remedies best adapted are those selected for the
chancre itself; such as Nit. ac., Ars. causticum, and
the Potassio-tartrate of Iron; and it sometimes happens
that these remedies act so powerfully that a bubo
runs through the ordinary stages to suppuration and
heals again before a complete cure of the chancre is
effected. I have met with six cases of this kind. On
the first indication of swelling in the groin the patient
should remain quiet and seek the recumbent posture
the greater part of his time; cold water pledgets or a
cold spirit lotion should be applied to the affected
region; the sore on the penis should be kept strictly
clean by bathing or syringing it three or four times a
day with tepid milk and water, to which may be
added a few drops of carbolic acid or Condy's fluid;
and if much irritation exists, with a tendency to spread
or creep along, I have observed great benefit to follow
the application of emollient poultices, such as carrot,
marsh-mallow, or bran, and in some cases a lotion con-
sisting of Calendula, Carbolic acid, and solution of
Gum arabic. The chief object in view is to blunt the
sensibility and check the spread of the sore, for the
larger it gets the larger the number of lymphatics
become implicated; the direct source of communica-
tion between the chancre and neighbouring glands.
Should suppuration, however, take place, in spite of
these preventive measures, I hasten its maturity by lin-
seed-meal poultices, Hep. Sulph., or Silecia, and as soon
as the abscess points, I open it with a curved pointed
bistoury. The destruction of tissue is then incon-
SYPHILITIC BUBOES.
113
siderable, the wound small and clean, and under
favourable circumstances healthy granulations spring
up, which fill the cavity to the surface of the skin.
But if the matter be allowed to accumulate until it
finds its way to the surface, or until the skin is deeply
and extensively implicated, or the abscess is opened by
means of caustic or potassa fusa, a practice recommended
by many eminent surgeons; then a large, ragged,
irregular wound is established, followed by extensive
sloughing of the adjacent parts; for it must always
be borne in mind that the tendency of a soft sore is
to SPREAD, EAT, and DESTROY, its power of re-inocula-
tion being so remarkable, that wherever pus is de-
posited there a chancre is produced.
In ordinary cases of suppurating buboes the Nitric
acid or Potassio-tartrate of Iron both internally and as
a lotion will suffice; the first or second decimal of the
former, and Ricord's formula of the latter, viz., dis-
tilled water 250 parts; potassio-tartrate of iron 30
parts; three tablespoonfuls to be taken daily. The
sore to be dressed three times a day with lint dipped
in the same solution; but I myself prefer, as an out-
ward application, a combination of Calendula, Carbolic
acid, and Gum-water.
The chief complication of a soft sore is phagedana,
which is not only a troublesome but a dangerous form,
and demands the most prompt and careful manage-
ment, both locally and constitutionally. It is chiefly to
be met with in scrofulous, debilitated, and broken-
down constitutions. The chief remedy is undoubtedly
Arsenicum, which should be administered in the second
or third decimal, or in the form of Fowler's solution.
I
:
1
I 14
TREATMENT OF
In a case of gangrene of the penis, with bubo in the
right groin, which came under my notice three years.
since, I obtained brilliant results from the Secale cor-
nutum, second dilution, with a lotion of the same
preparation as an outward application.
Mercury, in any form, I have no faith in, as it rather
tends to aggravate the disease than otherwise. In
extensive sloughing and rapid destruction of sur-
rounding tissues it will sometimes be found necessary
to apply the actual cautery.
Cooper recommends a combination of Opium and
Nitric acid; Collis, the strong Muriate of Antimony;
others, a strong solution of Nitrate of Silver; a caustic
solution of Iodine, Potassa fusa, or undiluted nitric
Acid. In one case of gangrene, and two cases of
phagedana, recorded in another part of this work, one
application of Nitric acid sufficed to check the onward
march of the enemy. Since then I have witnessed
the most gratifying results to follow the prolonged
use of cold sitz baths, both in the corroding and pha-
gedanic forms of chancre and buboes. The patient's
powers should be well sustained by a nourishing and
generous diet, such as fresh milk, well-made cocoa
or beef tea for breakfast; boiled or roast mutton, with
a glass or two of Carlowitz or Ofen auslese for dinner;
and a proportionately nourishing meal in the evening.
He should be kept quiet, free from all care, and
recline as much as possible in the recumbent posture.
INDOLENT, MULTIPLE, INDURATED, NON-INOCU-
LABLE, SPECIFIC, OR TRUE SYPHILITIC BUBOES.
Unlike the monoglandular suppurative adenitis of
soft chancre, the indolent and indurated buboes of
SYPHILITIC BUBOES.
115
true syphilis present themselves in the form of a
series of small tumours not larger than filberts
which stud one or both inguinal regions, and seldom
suppurate. They are constant attendants on primary
syphilis, appearing almost contemporaneously with or
during the first or second week of the initial lesion.
At first there is simply a slight glandular tension,
which gives but little pain, and is scarcely recognised
by the patient himself; but when more developed they
feel like so many rounded or oval, resistent, elastic,
movable balls, which recall to the finger that presses
them the sensation conveyed by that peculiar indura-
tion indicative of a true Hunterian chancre. They are
generally of the same size, but sometimes a larger one
appears in the centre, around which other glands of
smaller size form, like so many satellites. This gland
sometimes suppurates, but the abscess quickly heals,
and the matter is not inoculable. This form of bubo is
remarkable for its tenacity, and outlives in the majority
of cases by months and even years the original chancre.
This important circumstance, as Lancereux very justly
observes, is not devoid of practical utility, as it may
put us on the track of concealed or unrecognised con-
stitutional syphilis. Resolution then is the usual ter-
mination of true syphilitic buboes, suppuration being
only observed five times in thirty-three cases. Specific
butoes are in themselves without serious inconve-
niences, but it must not be forgotten that they repre-
sent a sure sign of a True Syphilitic Infection.
TREATMENT.-Jahr very justly remarks that a bubo
should, no more than a chancre, be treated with cau-
terizing or desiccating agents, if we desire to avoid the
116
SYPHILITIC LYMPHANGITIS.
danger of seeing secondary constitutional syphilis
break out in its place. The only external applications
necessary are warm poultices, and these only when
the inflammation becomes too painful, or when sup-
puration has taken place, with the view of hastening
that process and bringing the abscess to a point; con-
sequently general treatment in the majority of cases.
suffices for combating the adenopathies of syphilitic
chancre, and the remedies should be selected from that
class termed Mercurial, as being the only true specifics
against that particular form of venereal disease. All
schools are more or less agreed upon that point. "For
my part," writes Ricord," a well-marked induration
suffices to cause me to prescribe a general treatment,
and from the first day on which I can discover it, I attack
the diathesis point-blank." "Against the indurated
or Hunterian chancre," writes Diday, "give mercury (the
proto-iodide by preference). Homœopathic physicians,
from the founder to the present time, are more or less
in favour of the Merc. sol. Hah., which alone suffices
in a large proportion of cases. But it may be that
some cases will assume the gangrenous or phagedænic
form, for which Arsenicum should be selected.
become aggravated through a scrofulous taint, when
the Biniodide of Mercury, Nitric acid, or the Iodide of
Potassium may be advantageously prescribed. For
old indurated buboes, Carbo animalis, Hep. sulph.,
and the Iodide of Potass. ; and for mismanaged buboes
and constitutions already impregnated with allopathic
doses of mercury, Aurum metallicum, Nitric acid,
and Hepar sulph., will prove our best friends.
Others
LYMPHANGITIS. The lymphatic vessels which
A
1
SYPHILITIC LYMPHANGITIS.
117
1
serve as a channel of communication between the
chancre and the inguinal glands sometimes become
affected with the syphilitic poison. It is characterized
by the presence of small, hard, indolent, knotty cords,
which are swollen at some points and follow the
course of the lymphatic vessels; they are movable
under the skin, and remain more or less sound in
their locality. The course of lymphangitis is slow,
and its duration continues for several months. It
generally terminates in resolution; seldom in sup-
puration, except when some complication exists with
the initial lesion.
TREATMENT.-Similar to that of the buboes.
DIAGNOSIS AND PROGNOSIS OF SYPHILITIC AND
SYPHILOIDAL DISEASES.
Before we proceed to consider the remaining
sections of this monograph, it may be as well
to recapitulate briefly the diagnosis and prognosis
attending the initial forms and lesions of venereal
diseases. This, for brevity's sake, we shall en-
deavour to arrange in a tabular form, as being more
in accordance with the general programme of the
work, and more convenient as an index for reference;
for it is not enough, as Lancereux very justly remarks,
to distinguish syphilis from what may simulate it. It
is of vital importance, both for the patient as well as
the practitioner, to be able to know how to distinguish
true syphilis from false syphilis-the constitutional ini-
tial lesion from the purely local one; for it is upon such
knowledge that a proper line of treatment can be laid
down for each particular case. In this respect the
118
DIAGNOSIS OF SYPHILIS.
following table, which sums up the chief characteristics
of each morbid condition, may not be without its
use:-
TRUE SYPHILIS.
Primary lesion. Hunterian
chancre.
PSEUDO, OR FALSE SYPHILIS.
Chanroid, or soft chancre.
Nil, or from a very few hours, to
two days.
Many, and indefinitely re-inocul-
able on the subject of it.
First shows itself in the form of
a vesiculo-pustule, then terminates
in an ulcer more or less deep, with
perpendicular edges,
INCUBATIVE STAGE.-A mean
duration of twenty-seven days.
LESION.-Mostly single, and not
re-inoculable on the subject of it.
CHARACTERISTICS OF SORE.-
First consisting in a papule of
greater or less size, which erodes
or ulcerates, always forming a
superficial ulcer, without detach-furnishing an abundant purulent
ment of the edges, and without secretion. In form irregular, base
suppuration, unless it be during the soft, with a tendency to spread
period of cicatrisation. In form, superficially.
round or oval; base hard or carti-
laginous, with tendency to dip down.
BUBOES.-Always accompanied
by a series of firm, indolent, non-
suppurating buboes in one or both
groins, which sometimes suppurate;
pus not inoculable.
GENERAL CONDITION OF THE
SYSTEM.-A feeling of uneasiness,
fatigue, lassitude, unusual weak-
ness, vague pains, palpitations, a
marked discolouration of the skin,
a sensation of restlessness, melan-
choly, and a bellows murmur in
the carotids.
BLOOD.-The red globules di-
minishing in quantity, the albumen
proportionately increased.
CONSECUTIVE PHENOMENA.
Secondary, tertiary, and visceral
lesions frequently result from a true
Hunterian chancre.
COMPLICATIONS.
Gangrene,
phagedæna, phymosis, and para-
phymosis, rare.
TREATMENT.-Amenable to the
influence of mercurial and iodine
compounds.
detached
Accompanied in some cases only
by buboes, which freely suppurate
and furnish inoculable pus.
None.
:
No change; blood remains pure.
None.
More general, and accompanied
at times by pultacious or diph-
theritic deposit.
Entirely unaffected, and some-
times considerably aggravated by
the same remedies.
AND SYPHILOIDAL DISEASES.
119
PROGNOSIS.
The question of prognosis is another point worthy
of our best and closest consideration. The existence.
of true syphilis having been recognised, what leading
indications are there which would enable us to form a
correct prognosis as to whether the attack will be
a severe or a mild one? In other words, is there a
kind of relationship existing between the form of the
primary lesion, and the mildness or severity of the
consecutive manifestations?
This question, already considered by Carmichael
and others, has been made by Bassereau the subject of
many interesting researches, which have enabled him
to form into a law the following indexes :-
1. Benignant or mild indurated chancres are fol-
lowed by mild eruptions, and by affections of the
various tissues, not tending to suppuration.
2. Phagedenic indurated chancres are followed by
severe pustular eruptions; ulcerating affections of the
skin, suppurating exostoses, necrosis, and caries.
Diday, Bazin, Dubuc, Verneuil, and Langlebert are
of opinion that a true chancre corresponds to severe
syphilis; a chancriform erosion, to a mild form. The
latter regards chancre as the touchstone of the con-
stitution, and states that the benignity of the chancre
will announce constitutional symptoms of little
severity; while its malignity, on the contrary, will lead
us to expect consecutive symptoms of much greater
severity.
120
PART V.
SYCOSIS.
}
ACCORDING to the programme laid down in the second
section of this work, there remains a fourth species.
of the venereal disease to be added to those already
described; namely, warty or condylomatous excrescences
of the genitals, which sometimes succeed an impure
coition, but more generally follow, and sometimes
appear conjointly with chancre or gonorrhoea. The
original nature of condyloma is, however, still a
disputed point: some regard it as the products of
chancre; others of gonorrhea; while Hahnemann and
many others contend that it springs from a peculiar
poison of its own,-" the sycosic miasm.” But
whatever may be said concerning the syphilitic or
idiopathically sycosic nature of these excrescences,
there is no disputing the fact of their being venereal;
that is, products arising sooner or later from venereal
infection, either as primary or consecutive phenomena,
and endowed with the power of transmitting a like.
disease during the act of coïtion. Practically, however,
such a distinction has no great value, as the history and
symptoms of the complaint, "like the polar star,"
will lead the physician, "whether he recognises the
former or the latter," to the selection of a proper
remedy,- —a great advantage enjoyed by homoeopathy,
but which allopathic physicians decline to recognise
ANATOMY OF SYCOSIS.
121
in their treatment of disease; merely in order to
vindicate the dignity of a tottering system.
HISTORICALLY.-Venereal warts were first recog-
nised and described by Peter Maynard, A.D. 1519, as
follows:-" Wherefore I say that the chief sign of this
disease [syphilis], as we see by experience, are
pustules appearing on the extremity of the yard
in men, and in the orifice of the vagina or neck of
the womb in women. These pustules for the most
part ulcerate: I say for the most part, because in some
I have seen them hardening in the manner of WARTS,
CORNS, and PORRI."
ANATOMICALLY, there are two kinds of sycosic
excrescences which present themselves to our notice.
1. The GRAFTED, or IMPLANTED.-These are of
greater density than that of the skin, to which they
adhere by their base, or a sort of pedicle. Most of the
sycosic products of this class are termed fig-warts:
they are generally dry, or secrete but little.
2. HYPERTROPHIC EXCRESCENCES.-These arise
by a simple swelling of the cellular tissue of a fold of
the skin or mucous membrane-a kind of papillary
hypertrophy they quickly ulcerate, and secrete a
fœtid, slimy pus.
Like syphilis, they first appear upon those parts.
that have received the contagion in men upon the
glans, the folds of the prepuce, and orifice of the
urethra; in women on the labia majora et minora,
the clitoris, and around the urethra. If no impedi-
ment is put in the way of their growth, they rapidly
increase in size and number; if, on the other hand,
they are destroyed by caustic, amputation, strangulated
122
SYMPTOMS OF SYCOSIS.
1
by ligature, or any other external appliances, the
disease disappears from that place, but breaks out
with greater vigour in another. We may then find
them studding the anus, the axilla, the fauces, lips, eyes,
or tongue; indeed, there is scarcely any part of the
body which is exempt from the invasion of these ex-
crescences, once they are ill-used, tampered with, and
driven back into the system.
In form they vary considerably some are shaped
like cauliflowers; some like warts; some like long
stems or goose-quills; and some like raspberries, mul-
berries, or grapes; others are fig-shaped, and others
assume the form of a cockscomb. These varieties
in form depend in a great measure upon the shape,
extent, and vitality of the organ or part originally
infected. When for instance they appear on the
corona glandis, or prepuce, they generally assume the
form of stems or goose-quills; if on the clitoris, and
round the orifice of the urethra, they assume the form
of a raspberry or grape, which are sometimes as red ast
the fruit itself. On the labia we meet with the cauli-
flower form; animal vegetation, like the products of
the earth, requires space and prolific soil for growth
and development.
At the anus these vegetations accommodate them-
selves to the natural folds of the skin, and being
flattened on either side, assume the characteristic form
of the "crista galli," or cockscomb. Condylomata,
whether venereal or non-venereal, most frequently attack
persons who do not keep themselves clean, and on
parts of the skin or mucous membranes where two
flat surfaces come in contact with and rub against
each other, from which corrosive secretions ooze
1
TREATMENT OF SYCOSIS.
123
out. They occur more frequently in females than in
males.
But there is a considerable number of other de-
rangements of nutrition dependent upon the same.
cause, which, strictly speaking, ought perhaps to come
under the category of "secondary phenomena:" such
as, for instance, the hypertrophy of the tonsils which
follows syphilitic angina, and accompanied by mucous
patches; the elongation and hypertrophy of the pre-
puce, with contraction of its opening after a chancre;
hypertrophy of the labia after the same cause, and
also syphilitic contraction of the rectum.
TREATMENT.-From what has been said on the
origin and pathology of condyloma, it must be
evident to the most ordinary mind that such ex-
crescences cannot be eradicated by mere outward
manipulation, and surgical appliances. To recognise
such an abortive system would be to eschew altogether
the fundamental principles of pathology-the FONS
ET ORIGOMALI, as well as the leading principles of
homoeopathy. "To remove a condyloma," says
Cooper, "the practitioner may either destroy it with
CAUSTIC, tie its base with a LIGATURE, or remove it at
once with a KNIFE." A recent writer on the homœo-
pathic treatment of venereal diseases adopts this
ad captandum mode of treatment; for in describing a
case of gonorrhoea with a "luxuriant crop of warts
encircling the anus," he SNIPS them off with a pair of
scissors, applies dry lint to the parts operated upon,
and gives Thuja internally, "veni, vidi, vici.”
A CONDYLOMA, be its cause or form what it may, is
as amenable to homœopathic treatment as any other
disease I know of; and, like the varied and multi-
124
TREATMENT OF SYCOSIS.
farious eruptions on the skin surface, is simply an
outward manifestation of some internal dyscracy,
which will yield kindly enough to its specific remedy.
A host of such cases may here be recorded; but I
forbear on the plea that such might be construed by
some of my readers as claptrap, sensational cures.
Warts of a non-venereal or uncomplicated nature are
best treated by Causticum, Dulcamara, Rhus, or Thuja.
Warts complicated with gonorrhoea, will in the
majority of cases yield to the internal and external
use of Thuja. It is in the power of the ARBOR VITÆ
to produce-besides gonorrhoeal affections-cutaneous
excrescences on the parts of generation, and on other
parts of the body, in the form of tubercles and warts,
as secondary products. It was this which induced
Hahnemann to regard Thuja as a specific in those
condyloma which so frequently attend gonorrhœa.
This has since been amply confirmed by the experi-
ence of Trinks, Mayrhofer, Warnatz, Hufeland,
Rummel, Mohnike, Jahr, others, and myself.
The special therapeutic indications which point to
the selection of Thuja are, Gonorrhea, past or present;
Leucorrhea; Condylomata on a broad base, and cracked;
a mulberry-shaped moist surface, with itching and burn-
ing in the excrescences. Lycopodium, Cinnabaris, and
Sabina, used externally and internally, have in many
cases performed excellent cures.
Warts complicated with the chancroid, or soft
chancre, yield remarkably well to Nitric acid and
Causticum; and warts complicated with the hard
Hunterian sore, to Merc. sol., Merc. corr., Phosph. ac.,
or Staphysagria.
TREATMENT OF SYCOSIS.
125
Some practitioners have the selected remedies in
accordance with-
I. The form of the condylomata.
2. According to their locality when first manifest-
ing themselves.
3. According to their origin on first appearing.
Thus for broad, flat, bean-shaped condylomata,
they select Thuja and Nitric acid.
For elevated, cauliflower, raspberry, or mulberry-
shaped, Thuja.
For fan-shaped, Cinnabaris.
For pedunculated, Lycopodium and Nitric acid.
For cone-shaped, Merc. sol.
When dry, Thuja, Merc. sol., Merc. corr., Nitric ac.,
or Lycop.
When moist and suppurating, Nitric ac., Thuja,
and Sulph.
When soft and spongy, Sulph.
When they appear on the glans or corona
glandis, Nitric ac., Thuja, Cinnab., Lycop. and Sulph.
When on the prepuce, Thuja, Nitric ac., Lycop. and
Merc. corr.
When on the scrotum, Thuja.
When on the anus, Thuja and Merc. corr.
After chancres, Thuja, Merc. sol., and Staphys.
After gonorrhoea, Thuja, Lycop., and Cinnab.
Hempel has found Tartar emetic a valuable cura-
tive agent when other remedies have entirely failed.
He prescribes a lotion consisting of ten grains of the
tartar emetic to four ounces of water; and the one-
hundredth of a grain dissolved in eight ounces of
water; a tablespoonful to be taken every four hours.
;
126
PART VI.
CONGENITAL SYPHILIS.
HISTORY.-Gaspar Torella in 1500, and Nicolas
Massa in 1532, were about the first physicians who
noticed at any length the hereditary form of syphilitic
disease. "The hereditary diseases," write these men,
"may be communicated to the foetus by either of the
parents, father or mother,―by the father as the seminal
particles discharged from him, and fraught with the
venereal venom, may infect the embryo, which they
touch with the like disorder; and from the mother,
as at the time she supplies the foetus with nourish-
ment during her pregnancy, she must convey
into it the seeds of the distemper she labours
under."* "Thus, from an infected mother," remarks
another, "has been observed to come squalid, semi-
putrid, ulcerous, and downright venereal births; nay,
which is still more wonderful, by a venereal father
have been begot ten infants actually venereal and
ulcerous, though the mother was sound, or at least
not affected with any manifest symptom of the
venereal disease; as if the poison which destroys the
tender body of the embryo was not strong enough to
hurt the firmer habit of the mother." But hereditary
syphilis, although partly recognised by these early
syphilographers, has only been carefully studied.
since the close of the last century, by such men as
* Victor Trincavellus, Venice, 1561.
:
CONGENITAL SYPHILIS.
127
Doublet, Desmarres, and Diday in France; Babington,
Hutchinson, and others in England.
Hereditary syphilis, then, is that form of the specific
disease in infants which is acquired during the period
it tarries in the womb, intra-uterine life. It is neces-
sary for practical purposes to make this distinction;
for when the complaint has contaminated the system
after birth, it runs the same course even in the
youngest children as in adults. The possibility, but
not the probability of infection in transitu from the
womb is clearly admitted; but neither of syphilis thus
contracted, nor of it when imbibed during lactation,
nor of it when transmitted by vaccination or any other
accidental cause, do we now speak.
Congenital or hereditary syphilis may be either
due to both parents, to father alone, or mother alone,
having had at the time of conception the morbific taint
circulating in their, his, or her system,-or, conception
having taken place, the mother acquires the disease.
and infects her offspring. It is by no means necessary
that there should be any outward manifestation of
that terrible affection in either of the parents; would
that it were! for then one of the most fruitful causes
of abortions and infantile mortality might be stamped.
out, or at all events very considerably lessened. Now
alas! the poisonous and all-destructive seeds of the
malady may lie dormant for months, and even years,
unsuspected, and yet all-powerful to break forth in
augmented fury in proportion to its lengthened
quiescence. The period of the first appearance of the
hereditary taint varies considerably, but the more
virulent it is, the sooner it appears. A certain number of
128
CONGENITAL SYPHILIS.
children succumb at an early period of growth in their
mother's womb; others come into the world with
unmistakable lesions of a syphilitic type; but the
majority of cases at birth show no signs whatever of
so foul an inheritance, and matters go on as merry as
a marriage bell. Thus a child may exhibit no
symptoms of any cachexia at first, but during a period
varying from a few days to two or three months, is
noticed to present a miniature picture of decrepitude,
as Doublet has it. This stage of the disease may end
in death, or pass on to another. The countenance
then puts on a peculiar colour and expression ; there
is difficulty of breathing through the nostrils, a kind
of obstruction known as snuffles. "The face," says
Trousseau, "is of a peculiar sooty tint, as if a layer of
coffee grounds, or of soot mixed with a quantity of
water, had been passed over the features." An
earthy complexion with a peculiar cadaverous odour,
cracks, fissures, and condylomata show themselves
around the mouth, nose, eyes, and anus; the eyebrows
and lashes drop off, and the eyelids are frequently
reversed. Roseolar, papular, vesicular, pustular, ecthy-
matous, tubercular, and scaly eruptions appear on the
skin. Iritis, interstitial keratitis, choroiditis, and
amaurosis affect the eyes; vomiting, thrush, a frequent
and obstinate diarrhoea, with sometimes bloody stools,
affect the alimentary canal; and insomnia, coma, con-
vulsions, epilepsy, paralysis, and hydrocephalus may
affect the brain. The child may survive these, or some
of these phenomena if not injudiciously treated, and
survive till the period of puberty, when a desperate
struggle now appears to take place for the mastery,
CONGENITAL SYPHILIS.
I29
1
between the disease and the constitution; and either
death may claim its victim, or retarded growth, or one
or more of the numerous morbid phenomena, such as
deafness, blindness, idiotcy, disease of the liver,
kidneys, or an affection of the skin of peculiar severity
and extreme obstinacy set in.
PROGNOSIS.-The more nearly to birth that the
symptoms develop themselves, by so much the more
unlikely it is that the patient can be cured.
Trousseau has never seen an infant recover when the
disease appeared within a few days after delivery.
Children who are not attacked till they are two
or three months old usually recover, under judicious
treatment, a fair degree of health in a short time; but
the complete eradication of the cachexia requires a
prolonged administration of carefully selected anti-
psorics, and a well-regulated hygienic treatment.
When congenital syphilis manifests itself for the
first time at adult age, it will generally be amenable
to medication, particularly if attacked before per-
manent disorganization has taken place.
DIAGNOSIS. The disease will, when it has once
been seen, never be forgotten. The poison so
thoroughly permeates the whole system, attacks
mucous membranes, the skin, the glandular and
osseous structures, as to give unmistakable evidence
of its presence. The pathognomonic symptoms are,
however, met with in the mucous membrane of the
nose, and in the permanent incisor teeth of the upper
jaw. The nasal mucous, or " Schneiderian" membrane,
is attacked by inflammation, giving rise to the
secretion of highly offensive mucus, and causing a
K
130
TREATMENT OF
peculiar and characteristic snuffling noise. This in-
flammatory action but too frequently extends to the
cartilaginous and osseous parts of the nose, and we
see then the protuberant forehead and snubbed nose.
The upper incisor teeth of the temporary set are
prematurely lost, and the great diagnostic symptom
of the disease is met with in the permanent central
upper incisors, which are usually observed to be of a
bad colour, short and peggy, round at the angles,
standing apart, or converging, and marked by a deep
notch. Normally these teeth are chisel-shaped, that is
broader at their cutting edges than at their insertions
into the gum. The malformation indicative of con-
genital syphilis consists, firstly, in a reversal of the
normal shape so far as this, that the two teeth above-
named are narrower at their cutting edges than at
their insertions into the gum; hence their frequent
comparison to "screwdrivers." Secondly, the teeth.
are often notched; hence such teeth are often
called "notched teeth." It is, however, important to
bear in mind that Mr. Jonathan Hutchinson, to
whose able researches on constitutional syphilis we
owe this valuable diagnostic sign, has pointed out that
it is rare to find teeth so malformed except in the
eldest living of a syphilitic family, the exceptions
being few.
TREATMENT.-Congenital, transmitted, or hereditary
syphilis calls for treatment in the fœtus, in the new-
born child, and at a more advanced period of life. To
combat the disease during fatal life, medicines must be
transmitted through the mother, Merc. sol. Hah. being
one of the best preparations. A grain of the first or
CONGENITAL SYPHILIS.
131
second decimal trituration should be taken night and
morning for at least ten days or a fortnight, or even
longer.
To attack the syphilitic diathesis in the new-born
child, Mercury, Iodide of Iron, and China are our chief
remedies. Various modes have been adopted by
allopathic physicians for the administration of Mercury,
which by common consent is looked upon as the most
efficacious remedy extant. It has been transmitted
through the mother's milk, through nurses, and through
goats and asses. The idea of treating the disease in
this way was first promulgated by the renowned
physician of Cos, 450 B.C., and imitated by Garnion
of Lyons in 1699, Burton in 1775, Doublet and many
more at a more recent period; this was called the
indirect treatment, in contradistinction to baths and
inunction, termed the direct external mode of treat-
ment. This mode of treatment has, however, long since
fallen into disuse, as a course of strict chemical analysis
failed to discover any traces of mercury in the milk
of those animals.
Homœopathy, however, gives us not only a principle,
but a mode of manipulation, which enables us to
reduce our drugs to the smallest fractional dose without
speculation, consequently they neither disturb the
system, nor act injuriously upon the constitution. I
am in the habit of commencing the treatment with a
few doses of Sulphur 6. Not that that medicine has any
specific control over the syphilitic poison, but it ap-
pears to me to render the system more susceptible to
the action of the true specific; for I generally find an
aggravation of symptoms to follow the administration.
132
TREATMENT OF CONGENITAL SYPHILIS.
of a few doses of that medicine, or a fresh crop of
pustules to spring up, as if the latent powers of
nature were roused to do battle against the common
enemy with fresh energy. After this I administer one
of the mercurial preparations, the Merc. sol. or Bin-
iodide by preference, one grain of the second or third
decimal potency night and morning, and a dose of China
or Iodide of Iron two or three times a day. With these
means, coupled with warm baths, vapour or Turkish
baths, cod liver oil, and a well-selected, generous diet,
I have been able to jog on remarkably well. Should,
however, Mercury have been given allopathically before
the case comes under notice, I antidote the ill effects of
that drug by Hep. sulph., followed up by China, Iodide
of Iron, and cod liver oil, either by the mouth or the
skin; and sometimes by Nitric acid. Dyspeptic
symptoms should be removed by an occasional dose
of Nux vom., Puls., or Sulphur.
The ophthalmic derangements by Merc. corr., Bell.,
and cod liver oil.
The ozæna by the Iodide or Bichromate of Potassium,
and a weak solution of carbolic acid or Condy's fluid
used as an injection.
The various eruptions on the body, constituting
what may be termed the secondary phenomena, are
best treated by one of the mercurial preparations,
Arsenicum and Sulphur, and the deep-seated dyscrasia
by Aurum metallicum, Iodide of Potassium, and cod
liver oil. The diet should also be strictly attended to,
and in every available manner we should seek to
support the strength of the sad and innocent inheritor
of youthful folly and parental crime.
133
PART VII.
CONSTITUTIONAL SYPHILIS.
HAVING now disposed of the main features con-
nected with the primary form of Syphilis and syphi-
loidal diseases, together with their various complica-
tions, let us proceed briefly to review the constitutional
ravages inflicted on the various tissues of the body by
the foul invader known as-
1. Secondary Symptoms, or the period of general
eruption.
2. Tertiary and Quaternary Symptoms; otherwise
known as the period of gummy products, and visceral
lesions.
Instead, therefore, of appearing in the form of a
simple local lesion-a chancre-true syphilis now
begins to show, in its manifestations, the tendency to
generalization, and to a multiplicity of morbid forms,
whence it has justly received the name of " Proteus,"
which Fallopius, in 1560, was one of the first to
give to it. We have already observed, in describing
the leading characteristics of a "true Hunterian sore,"
that after a longer or shorter period of incubation
there will appear on some part of the penis a minute
spot or papule, gradually reaching the size of a lentil
or pea; that it is usually of a red or dirty yellow
lour, ROUNDED and HARD to the touch; that this
le becomes in course of time covered with greyish
t
¡

134
SYMPTOMS OF
1
scales, which increase in thickness, and end by
forming in most cases a true crust, under which a cup-
shaped ulcer of greater or less depth rapidly develops
itself, assuming at times a serrated or sharp-edged
circular form, as if cut with a punch, the floor of
which is lined by a greyish, tough, lardaceous secretion,
which is not re-inoculable. The nature of this sub-
stance is of so stubborn a character as to resist every
appliance at the command of the surgeon, its singular
toughness not giving way to the most vigorous treat-
ment until fairly established in the system. Indeed,
the remedies adopted by most inexperienced pre-
tenders only magnify and stimulate the formation to
a far greater obstinacy and virulence; the more it is
outwardly attacked, as in some other complaints
where callosities are presented, the greater force it
displays in recruiting itself for a renewed onslaught.
on the already enfeebled constitution. This CHANCRE,
which is a living representative of the great epidemic
of the fourteenth century, may in truth be compared.
to a fortified citadel, possessing within its walls an
almost inexhaustible store of ammunition and imple-
ments of destruction, whence a powerful garrison
continually sallies forth to spread ruin and destruction
throughout the whole frame. Having established
itself during the period of incubation, it has thus
returned to the surface from a searching expedition,
and satisfied by this preliminary raid, its efforts are in
future definitely directed from the surface as a radius
against the subcutaneous tissues, the blood, muscles,
bones, viscera, spinal marrow, and finally the br
itself. Its appearance in the system is first ann
•

CONSTITUTIONAL SYPHILIS.
135
by the development of febrile symptoms-syphilitic
fever-marked by an intense headache, pallor of the
countenance, a morose, taciturn, gloomy physiognomy,
a dark circle round the eyes; erratic shooting pains
wander over the whole body, rigors alternating with
heats, followed by more or less perspiration, closely
resembling intermittent fever. The pulse is quick,
and sometimes amounts to IIO or even 120 strokes to
the minute; the digestive functions become deranged,
there is want of appetite, a bitter taste in the mouth,
nausea, and sometimes a diarrhoea; the urine becomes
red and febrile, at the same time the patient feels a
lassitude and restlessness which unfit him for work.
The sense of fatigue and weakness is at times so great
that walking becomes irksome, the legs totter and
bend under the weight of the body, and neither bed
nor sleep affords the hapless sufferer either repose or
refreshment. Following these symptoms we behold,
more or less in succession, on the surface of the body,
the palms of the hands, and the soles of the feet-
erythematous, papular, pustular, vesicular, squamous,
pigmentary, and foul eczematous eruptions-
"And swift as quicksilver it courses through
The natural gates and alleys of the body;
And with a sudden vigour it doth posset
And curd, like eager droppings into milk,
The thin and wholesome blood;
And a most instant tetter barks about
Most lazar-like, with vile and loathsome crust
All the smooth body."
It will destroy the hair of the head, the beard, eye-
brows, and eyelashes, producing partial, and even
complete alopecia; a symptom first noticed by Jerome
136
SYMPTOMS OF
Fracastorius in 1546, and later on by Fallopius in
1560.
It will attack the epidermis of the scalp, face, beard,
eyebrows, and more specially the palms of the hands
and soles of the feet, in the form of a fine branny
desquamation, producing that disease known as
pityriasis.
ONYXIS. It will attack the nails of the hands, feet,
and surrounding structures, rendering the former
wrinkled, brittle, distorted, and exfoliated; the latter
ulcerated, presenting a fungous, moist brownish sur-
face, which readily bleeds when touched, and furnishes
an ichorous and foetid discharge; a symptom which,
according to Brassavola, did not appear till about 1533,
some forty years after the first appearance of the great
epidemic.
It will invade the mucous membrane, and extend
its ravages from the lips and nares to the vaginal and
anal regions; developing in succession erythematous
patches, papules, pustules, mucous patches, erosions, ul-
ceration and exfoliation of the Schneiderian membrane,
the inner surface of the lips and cheeks, the tongue,
uvula, tonsils, velum palati, pillars of the fauces, the
pharynx, larynx, vocal chords, trachea and bronchial.
tubes, the œsophagus, stomach, and intestinal canal.
It permeates the glandular and lymphatic system,
and marks its presence by a firm elastic and swollen
condition of a series of glands in the cervical, inguinal,
and other regions, with a chord-like feel of the
lymphatic vessels.
It engenders a series of vegetations or glandular
hypertrophies, known as sycosis, fig-warts, and condy-
}
!
}
CONSTITUTIONAL SYPHILIS.
137
loma, which vary in form from a fan or cone to that
of a grape, raspberry, mulberry, or cauliflower, which
John de Vigo in 1519 was about the first to describe.
SYPHILITIC OPTHALMIA.-It will attack the various
structures of the eye in the form of iritis, choroiditis,
retinitis, sclerotitis, and amaurosis; ulceration of the eye-
lid, and deposits in its appendages; sties, warts,
and other unsightly excrescences.
It frequently destroys the functions of hearing by
setting up a papular or ulcerative process, which
either thickens or breaks down the tympanum and
ossicula audita, followed by an offensive sanious or
ichorous discharge.
Various derangements of the organs of hearing were
recognised at a very early period of the great outbreak
of syphilis. Gabriel Fallopius, a native of Modena, in
a discourse, De Morbo Gallico, 1540, says: "Till
within these ten years I never heard any mention of
a noise in the ears which I can only compare to the
sound of bells. I first observed it about eight years
ago, and there are few now who have it not when the
disease is quite confirmed. Observe this very dili-
gently," adds he, "for you will not meet with it in
other authors."
It will attack the various nerves that spring from
the brain and spinal column, producing the most
excruciating facial pains in some, partial or total
paralysis in others.
PERIOSTITIS.-The bones do not always escape the
attack of secondary syphilis. Those which are super-
ficial, such as the tibiæ, the clavicles, and bones of the
skull, are the most liable to them. They are affected
138
SYMPTOMS OF
1
with pains of the most violent kind, fairly supportable
during the day, but sometimes intolerable during the
night, particularly from nine or ten p.m. to four or
five in the morning.
SECONDARY SYPHILITIC JAUNDICE. Various
authors maintain that congestion, and it may be in-
flammation of the liver, terminating in jaundice, is
occasionally met with as a secondary phenomenon. It
was first observed by Paracelsus, and afterwards by
Garnier, Astruc, Ricord, and others. This form of
jaundice is not of great severity or of long duration,
and yields kindly enough to Merc. sol., Podophyllum
peltatum or the lodide of Potassium.
Thus have I endeavoured to enumerate the principal
features connected with that group of morbid pheno-
mena termed secondary symptoms; and it will be
observed that the disease has hitherto confined itself
chiefly to surface and locality,-to the bark, so to
speak of the human tree; but here it does not tarry
long unless confronted by well-selected medicines and
quickly eradicated from the system, but glides into
the-
Tertiary and Quaternary symptoms, known as the
period of gummy products, and visceral lesions. To
the transient and superficial changes described in the
above catalogue now succeed lesions of far greater
gravity, which do not spare the deep-seated structures
and viscera, any more than the common tegumentary
covering itself. It is now no longer, as Lancereux
says, simple hyperæmia, with or withoutexudation;
inflammations, slight and of short duration; but
profound changes, essentially slow in their evolutions
CONSTITUTIONAL SYPHILIS.
139
and marked by chronic inflammation, sometimes.
extensive and disseminated in a single organ, some-
times more limited and circumscribed. These changes
appear in the form of nodules and tubercles, and it is
then that the name of gummy tumours is more par-
ticularly reserved for them. In fact, while the lesions
of the secondary period leave no appreciable trace
behind, those of the third change or destroy more or
less completely the organ or structure in which they
exist, and frequently commit the most frightful and
irremediable ravages.
On the skin there is now developed pustules, tubercles,
impetigo, ecthyma, rupia, lepra, cracks and fissures which
plunge deeply into the subjacent structures, having a
greyish, dirty, purulent floor covered with thick,
wrinkled, brownish or green crust, and surrounded by
a copper-coloured margin. On the head we frequently
encounter, in addition to alopecia, the deposit of
gummy tumours, phagedænic ulceration of the scalp,
and necrosis of the bony structure. On the fingers and
toes we meet with deep-seated ulcers at their ex-
tremities, the nails become thickened, wrinkled and
soft, and frequently fall off, leaving the ends of the
phalanges in a state of caries or necrosis.
In the sub-cutaneous cellular tissue of the head,
chest, shoulders, clavicular regions, and other parts
of the body, we often meet with gummy tumours,
which present themselves in the form of irregular
masses varying in size from a nut or walnut to a hen's
egg, and sometimes they stand alone.
In the mammary glands, the same abnormal structure
is found deposited; and it is to be regretted that the
Jor M
1
140
SYMPTOMS OF
study of them has been hitherto incomplete and
obscure; for an exact knowledge of these morbid
manifestations would permit, more frequently perhaps
than is generally imagined, of substituting for an
operation which carries with it no ordinary amount
of speculation and danger, a treatment certain and
inoffensive.
Bones, Cartilages, and Foints.—The knowledge of
syphilitic affections of the bones goes back as far as
1519, when John de Vigo thus described them in his
"Practic. Chirurg.," lib. 5, cap. I.:-"At the same
time likewise with the above-mentioned pustules,
or at least after their appearance, within six weeks or
thereabouts, the patient was tortured with violent
pains, sometimes about the forehead, sometimes in
the shoulder-blades, and sometimes in the shins, hips,
and haunches. A year or more afterwards there arose
scirrhosities like bones, excessively painful, especially
in the night-time, and easier in the day. The pain
for the most part ended in corrupting the bone and
marrow, after the same manner as it happens in the
spina ventosa." Tertiary syphilitic lesions of the bony
tissue extend from the most simple form of inflam-
mation of its outer covering to the most profound dis-
organization of the whole substance. Thus we find
that the syphilitic poison will attack the bones in the
form of osteo-periostitis and exostosis, which is a
frequent result of the former; also gummy tumours,
which may occupy the periosteum or the medullary
substance of the bone itself, as caries, necrosis,
atrophy, or dry caries, hypertrophy, and softening.
GENITAL ORGANS IN THE MALE,-Like most
CONSTITUTIONAL SYPHILIS.
I4I
syphilitic lesions, the changes in the testicle in
syphilis show themselves under two distinct forms; one
diffused, the other circumscribed. The diffused con-
sists of the deposit of fibrinous or tendinous bands,
which traverse the whole or greater part of the organ
and insinuate themselves between the seminiferous.
tubes. The testicle then becomes hard, swollen, and
resistent. Pathologically, the whole organ undergoes
a true fibro-fatty transformation.
The circumscribed form consists of the deposit of
gummy products in the epididymis, or the sub-
stance of the testicles. The symptoms at first are
somewhat obscure, in consequence of the absence
of any particular pain, swelling, or redness. The
leading indications are, a gradual increase in volume.
of the organ, which becomes heavy, hard, and firm
to the touch. It is uneven, indurated, and commu-
nicates the sensation of an agglomeration of tumours,
which are indented, rounded, and elastic. At other
times it conveys the impression as if it were enclosed
in a firm and resistent shell. There is little or no
venereal desire. The functions of generation gradually
become weakened; erections occur with more and
more difficulty; the secretion of semen diminishes, or
may cease entirely, particularly if both testicles are
diseased; and hence the impotence and sterility so fre-
quently connected with the existence of syphilitic
orchitis.
The tongue, tonsils, velum palati, palatine arch,
the pharynx and larynx become the seat of deep,
perforating or serpiginous ulcers and gummy
tumours.
}
J
142 SYMPTOMS OF CONSTITUTIONAL SYPHILIS.
Morbid anatomy, with the aid of the microscope,
has revealed the startling fact that no organ or
structure of the body, however minute, escapes the
ravages of this foul invader. Follicular hypertrophy,
excoriations, aphthous ulcerations, endometritis, and
warty excrescences have been found in the vagina
and uterus; atrophy and gummy tumours in the
ovaries and fallopian tubes. Ulcerations and
cicatrices are met with in the canal of the urethra,
and tubercles in the corpora cavernosa. To be brief,
gummy tumours, circumscribed syphiloma, lardaceous,
amyloid, cirrhosis, and fatty degeneration are fre-
quently found deposited in the heart, lungs, liver,
pancreas, spleen, kidneys, and supra-renal capsules,
the result of syphilitic poison.
Finally, neither is that great centre of the nervous
system, the supposed citadel of the soul, proof
against the destructive armaments of this fell
destroyer. Gummy tumours and other syphilitic
products have been found on the dura mater, the
arachnoid, pia mater, and in the various chambers.
and hemispheres of the brain; causing in some severe
and prolonged headache, in others the most painful
form of neuralgia, insomnia, loss of memory, vertigo,
dulness of mind, difficulty of speech, chorea, hemi-
plegia, paraplegia, general paralysis, epilepsy, and
catalepsy in its worst and most hopeless form; in
others, dementia, melancholia, and hallucinations. In
fact, as Professor Griesinger very truly observes, "the
mental derangements connected with syphilis present
themselves under forms varying from the most
violent MANIA, to the most complete IDIOTCY."
1.
TREATMENT OF CONSTITUTIONAL SYPHILIS. 143
Such, then, is a very brief outline of the chief morbid
phenomena met with in the tertiary and quaternary
forms of true syphilis; let us now to the-
TREATMENT.-"The chief therapeutic agent to
oppose the manifestations of secondary symptoms,"
writes Lancereux, "is Mercury." "With a vesicular,
squamous, or pustular syphilide," writes Diday, “give
Mercury-the bichloride, protochloride, and proto-
iodide by preference, particularly the first." This, to
a great extent, has been amply confirmed by those
eminent syphilographers, Cazenave, Ricord, Bazin,
and many others. Numerous other preparations are
in use, all of which contain quicksilver in some form
or other; such as the celebrated pills of Belloste,
Sédillot, Cullerier, Dupuytren, Cazenave, and Ricord;
the drops of Van Swieten; the mixture of Mialhe;
and the syrup of Larrey, Puche, and Gibert, for-
mulas for each of which will be found at the end
of this work. Such are the various preparations.
usually employed by the leading French physicians
in the treatment of secondary syphilis, the bichloride
by preference; but a wide field of experience has
taught them that it is sometimes necessary, for the
purpose of obtaining a more rapid cure, to vary the
preparations. "I have seen," says Bazin, "syphilides,
favourably modified at first by the protoiodide, be-
come stationary all at once, although the treatment
was continued strictly, and only present a fresh,
tendency to resolution when another compound of
Mercury was substituted for the protoiodide, such
as Van Swieten's drops, or Dupuytren's pills." Bazin
begins the treatment of the syphilides with a pill
144
TREATMENT OF
[
containing three-eighths of a grain of the proto-
iodide, and asserts that "it is useless to give more
than three quarters of a grain, seeing that no
advantage is obtained from larger doses "-a very
wise and judicious provision, coupled with a strong
tendency towards homœopathy.
Lancereux, in his very able work on syphilis,
from the perusal of which I have derived much
valuable information, particularly that section de-
voted to the constitutional ravages of the disease,
puts this very important question,-" How long ought
Mercury to be continued, and what indications follow
to induce us to omit that medicine?"
John Hunter was in the habit of giving a quantity
of Mercury in proportion to the number of ulcerated
surfaces and the violence of the disease. Dupuytren
continued the treatment up to the complete ex-
tinction of the symptoms, plus a period equal to that
required for the cure. Ricord says, "Six months of
mercurial treatment, plus three months of treatment
with preparations of Iodine, is the method which
furnishes the most permanent cures; and which
succeeds, in an enormous majority of cases, in really
neutralising the poisonous influence, and curing the
syphilis."
Diday administers the mercurial preparations till
the syphilides completely disappears, then omits it,
but returns to it again should a fresh eruption appear.
Bazin adopts a somewhat similar plan, but relies
more on hygiene than therapeutics to eradicate the
remnants of the disease, and restore the organism to
its normal standard whenever relapses take place.
"
CONSTITUTIONAL SYPHILIS.
145
A bad
As a special remedy for secondary syphilis, Mer-
cury does not on that account suit all cases.
condition of the primæ viæ, debility of the organism,
and a certain degree of chloro-anæmia, are so many
contra-indications which should be taken into ac-
count. "In persons of a delicate constitution, affected
with scrofula, predisposed to phthisis and to other
diseases of the same class, Mercury should not be
given," says the late Sir Benjamin Brodie, "until it has
been ascertained to be indispensable. But," adds the
same observer, “I believe that scrofulous subjects who
have a well-marked syphilitic affection are treated
with more advantage by the aid of this medicine, for
if the Mercury be deleterious for them, the syphilis is
still more so." It is very evident from the foregoing
remarks that the late Barandt was unacquainted with
the safe and valuable properties of the compound of
Mercury and Iodine which in my hands has proved
eminently successful in constitutions savouring of the
scrofulous taint. Individuals who have all the ap-
pearances of vigorous health are not always those
who best support the preparations of Mercury.
Those who are in the habit of drinking much, and
who lead an irregular life, place their constitutions in
a condition little favourable for the employment of
those preparations; with them it is better to defer
the use of Mercury until the constitution has been
improved, so as to avoid having to combat, later on,
both mercurial and syphilitic affections. Sometimes,
for reasons which could not be foreseen, Mercury acts
as a poison; for this reason we must carefully watch
all those to whom we administer this drug, if they
L
146
TREATMENT OF
have not taken it before. In short, far from exerting
a favourable action, and effecting the cure of
secondary affections, Mercury may disturb the
general health, and aggravate the manifestations of
the disease in proportion to the quantity in which it
is given. Under these circumstances the use of it
must be suspended for a time, or until the patient
shows an improvement in his general state of health,
when recourse may be had to the remedy, and this
time with more satisfactory results. In like manner,
Mercury ought not to be continued when, after the
period necessary for its action, it does not manifest
any therapeutic effect. A suitable hygiene, com-
bined with tonics, then becomes useful, as also the
employment of certain mineral waters, and the water
cure.
Such are the views and leading therapeutic
agents employed by the highest allopathic authorities
for the treatment of secondary symptoms, good in
their way, but their arsenal contains too limited a
number of weapons to meet the varied manifestations
of this stage of the disease.
Let us therefore see what homoeopathy can do.
"For the treatment of the various syphilida," writes
the veteran Jahr, "we scarcely require any other
remedies than those which are used for primary
products (viz., chancre, buboes, mucous tubercles,
and fig-warts), such as the various mercurial prepara-
tions, Nitric Acid, and Thuja; to which may be
added Aurum, Lycopodium, Staphysagria, Kali
iodatum, Lachesis, and in some cases Hepar sulph.,
Sarsaparilla, and Sulphur." This has been amply
CONSTITUTIONAL SYPHILIS.
147
verified by Attomyr, Vehsemeyer, Lobethal, Clotter,
Müller, Trink, and others, as well as by myself. In so
far as mercury is concerned both schools are agreed, and
by common consent give preference to the various com-
pounds ofthat mineral, which in a large number of cases
will effect all that is required. But there are other cases,
which, from some peculiar idiosyncrasy of constitution,
or from some antagonistic and resisting force in the
system, will not yield kindly to any of the mercurial
preparations, particularly when administered in the
form of the crude drug, and even in the first or second
decimal trituration; but if first administered in the
twelfth, and gradually descending to the lower poten-
cies very satisfactory results frequently follow. This
has occurred to me on several occasions. Failing this,
we may then resort to Nitric Acid, Phosphoric Acid,
Lycopod., and Aurum. Jahr generally commences
the treatment of secondaries with Merc. sol. or Merc.
præcip. rub., with an occasional change to Merc. corr.,
Merc. nitros. or Cinnabaris, and continues the use of
the selected remedy for some time, unless no
improvement follows in ten days or a fortnight; or,
the improvement obtained, ceases to continue.
is the mode of practice I am in the habit of adopting,
and when I find the medicine loses its effects, or that
the disease becomes stationary, I omit the selected
drug for a few days, and give Sulphur, and recom-
mence the mercurial preparation again.
This
For the early manifestations of those secondary
phenomena, when they appear more or less conjointly
with the primary lesion the chancre--mercury
stands foremost as our chief remedy, judiciously
148
TREATMENT OF
:
chosen from the following list of preparations, viz.,
Merc. vir, Merc. sol. Hah., Merc. sulph. rub., Merc.
præcip. rub., Merc. præcip. alb., Merc. chlorid., Merc.
bichlorid., Merc. nitros., Merc. biniodide, and the
Merc. proto-iodide. The chief indications for the
selection of these mineral agents, conjointly with some
of the most approved anti-syphilitic vegetable
preparations, will be found in the following
arrangement.
1. For the erythema roseola, papules, pustules,
vesicles, squamous and pigmentary eruptions, with
or without the primary lesion, Merc. sol. Hah.,
Merc. proto-iodide, or the Merc. biniodide in the
first, second, or third decimal trituration, one grain
three times a day, which should be steadily persisted
in until the eruptions entirely disappear; “and when
a chancre appears at the same time," until that
product entirely heals and all callosity vanishes.
2. For angina syphilitica, which we sometimes
encounter as the result of wet or cold, we shall not be
far wrong in commencing the treatment with a dose
or two of Aconite to subdue febrile symptoms, fol-
lowed by Apis, Bell., and the Merc. sol. or Merc. corros.
3. For those herpetic eruptions which sometimes
stud the mouth and throat, we have in Lycopodium
and Nitric acid admirable auxiliaries, fully con-
firmed by the experience of Hartmann and Jahr.
4. For excoriations and erosions in the mouth and
fauces, Merc. sol., Nitric ac., and Lachesis will give
us material help.
5. For those elongated and patchy ulcers and
cracks which generally appear on the sides of the
1
CONSTITUTIONAL SYPHILIS.
149
tongue, Merc. præc. ruber and Nitric acid are our
chief remedies. Many surgeons touch these ulcers
with caustic.
6. For ulcers in the throat some of the mercurial
preparations should first be selected, such as
Merc. sol. H. præc. ruber, or Bichlorid., followed by
Lachesis, Aurum Met., Lycopod., Iodine (by inhalation),
and the Hydriodate of potass.
7. For affections of the Schneiderian membrane,
which at times becomes red and turgid, secreting a
scanty, thick, yellowish matter, with loss of smell,
Merc. sol., Aur. met., Merc. biniod., Kali iodatum,
and Bichromate of potass are our chief remedies.
8. The testicles, or "more generally the epidi-
dymes," like the muscles and bones, undergo the
influence of secondary syphilis. They sometimes.
accompany or closely follow the skin eruptions; at
other times they appear at a more remote period.
Here also the mercurial preparations, such as the
proto and bin-iodide, and gold, should be our chief
medicines.
9. For bone pains, ostitis, and periostitis great
relief will follow the administration of Aconite,
Mezereum, or Guaiacum, and the local application of
the tincture of aconite in the matrix form.
10. Syphilitic Ophthalmia. — Of all the mani-
festations of syphilis, writes Lancereux, the affec-
tions of the eyes are perhaps those which it is the
most difficult to classify. They sometimes accom-
pany the exanthematous syphilides; sometimes,
when more tardy in their appearance, they constitute,
so to speak, a transition period between secondary
150
TREATMENT OF
2.
and tertiary affections. In general they invade the
eye from its anterior to its posterior boundary, and
are the more circumscribed and more serious, in propor-
tion as the period at which they supervene is further
removed from the first appearance of the primary
lesion. In reality, no membranous structure of the
eye is exempt from the attacks of syphilis; the iris
and choroid being the most liable. Mercury here also,
the bichloride by preference, is our chief remedy. The
first or second decimal trituration should be selected,
one grain every second or third hour, either alone or
in alternation with Bell., and a dose of Aconite every
night. Irrespective of the anti-syphilitic properties
of Mercury, that drug exercises a marked influence
over all serous effusions; and it is in this disease
that Mercury most conspicuously displays
its
remedial powers, in preventing the deposition, and
promoting the absorption of lymph; it should be
early administered, and continued during a period of
some weeks.
II. For the sycosic excrescences which attend
secondary symptoms, Merc. sol, and Staphysagria, with
a solution of Alum or Ant. tart. as local applications,
generally suffice in the majority of such cases.
TREATMENT OF THE TERTIARY AND QUATER-
NARY AFFECTIONS, otherwise known as Gummy
Products." While the secondary manifestations of
syphilis," writes Lancereux, "rarely require any other
than a general treatment, the tertiary lesions, more
deeply seated and more persistent, generally require
further the employment of a local treatment, the hand
CONSTITUTIONAL SYPHILIS.
151
of the surgeon being frequently required." IODINE is
here the basis of our treatment, as was MERCURY in
secondary syphilis. First administered by Martin
and Lugol, it has more recently been lauded by
Guillemin, who prescribes it according to the following
formula:-Tincture of iodine, 5 parts; distilled water,
1,000 parts: two or three spoonfuls before each of
the two chief meals of the day suffice in general, ac--
cording to that author, to combat not only tertiary,
but even secondary affections.
Some
Iodine, however, is seldom given uncombined;
recourse is most generally had to one of its salts, the
iodide of potassium and Iodium. The dose in which
iodide of potassium is given varies from seven and a
half and fifteen grains to forty-five, sixty, seventy-five,
and even ninety grains in twenty-four hours.
practitioners carry the dose to 150, 180, and 225 grains,
or even more, but without advantage to the patients,
for with iodide of potassium, as with all other medicinal
agents, the organism cannot utilize more than a given
quantity. Moreover, experience has shown that, under
these circumstances, the therapeutic influence of the
remedy is never in proportion to the dose taken, and
that the pathogenetic effects alone are increased.
object of the physician in such cases is, therefore, to
arrive gradually at a dose which produces therapeutic
effects without producing pathogenetic effects injurious
to the patient. This salt is administered in solution
or in the syrup of gentian, saponaria, quassia, or
sarsaparilla. Ricord gives it in syrup of gentian, 30
parts of potass to 500 of syrup, three table-spoonfuls
daily; Melchior Robert in sarsaparilla. The larger
The
152
TREATMENT OF
doses of iodide of potassium are generally given in
advanced and deep-seated lesions, such as diseases of
the bones and visceral localizations. But if the
disease does not extend beyond the external or in-
ternal integument, and especially if the patient finds
himself in that stage of the complaint recognised by
some authors as the period of transition, the mixed.
treatment as prescribed by Gibert and Bazin is the
best means of removing these symptoms, viz., the bin-
iodide of mercury, combined with iodide of potassium;
or syrup
of the iodurated biniodide of mercury is the
preparation to be employed with most advantage.
against deep-seated, tuberculo-ulcerated, and puro-
vesicular syphilides, affections for the most part
exceedingly obstinate.
Like mercury, the iodide of potassium destroys the
manifestation, but does not prevent relapses, and
consequently does not affect the diathesis. The space
of time which it is desirable to continue the use of
this medicine is from two, three to four months, de-
pending of course on the obstinacy or otherwise of the
disease. The iodide of iron in pills, or better still in
syrup, may be substituted with advantage, in debili-
tated persons, for the iodide of potassium, like the
mercurial preparations, and the preparations of iodine.
require to be assisted in their action, whenever the
patient presents a certain degree of cachexiaoranæmia.
Bitter drinks, infusion of cinchona, Bordeaux wine,
the juice of meat, roast meats, and even preparations.
of iron become under these circumstances more or
less necessary. Such are the views, and such is a
brief outline of the treatment adopted by the most
CONSTITUTIONAL SYPHILIS.
153
វ
eminent of our allopathic brethren in the tertiary and
visceral manifestations of syphilis.
Can homoeopathy do more? let us see. We will, how-
ever, in limine observe that the tertiary manifestations
of supplies differ in many respects from the secondary
phenomena; viz., they no longer retain their infecting
properties; they are no longer transmissible to the
fœtus; they seldom appear earlier than six months
after the appearance of the primary lesion. This is,
however, the shortest period. Cases have occurred
where the disease has broken out ten, fifteen, or even
twenty years after the first infection, either as local
diseases or as general cachexia, and having lost all
traces of a specific character, they degenerate into a
form of dyscrasia analogous to scrofulosis, affect the
whole organism, and develop what Astruc has truly
said, a world of diseases."
(C
I. For the various exanthematous eruptions and
gummy tumours which appear in the subcutaneous
cellular tissues we shall not be far wrong in adopting
the precepts laid down by our allopathic colleagues,
by commencing the treatment with iodine and its
compounds failing this we may then resort to Merc.
sol, the biniodide and corrosive sublimate; and for
pustular and scaly eruptions Arsenicum,which may be
given in alternation with one of the mercurial pre-
parations.
2. For alopecia, gummy tumours, ulceration of the
scalp, and necrosis of the bony structure, we should.
commence with the Iodide of potassium or the Binio-
dide of mercury, followed by Aur. met., Phosphorus
and Mezereum.
!
154
TREATMENT OF
3. For gummy deposits in the mammary glands,
Merc. biniod. and Hydriodate of potash.
For affections of the periosteum and bones, viz.,
bone pains, Merc. sol., Merc. corr., Merc. biniodide,
and Ars.; periostitis, Acon. and Mez.; gummy
tumours, Merc. biniodide and Hydriodate of potassium;
exostosis, Aur. m. mez. and Hydr. pot.; caries, Merc.
corr. and the iodides.
Caries of the facial bones, nasal and palatine,
Aur. m. and Mez. ; caries of the humerus, jaw-bone,
malar, tibia, and vertebræ, Aur. m., Hep. s., Calc. c. and
Sil.
For affections of the testes, we have in the mercu-
rial preparations Aur. met., Con. clem., Iod., Pot.,
Puls., Phosph. and Sulph., admirable remedies, selected
with due regard to all the concomitant symptoms.
For those deep perforating and serpiginous ulcers
which attack the tongue, the soft parts of the mouth, the
pharynx and larynx, likewise the skin, Merc. corr.,
Iodine, and its salts, constitute the chief remedies; and
when these ulcers assume an indolent, ill-conditioned
form, indisposed to heal, they should be touched once
or twice a day with glycerine, alcohol, or tincture of
iodine, or a weak solution of tincture of iodine, con-
taining a small quantity of iodide of potassium. Some
recommend touching these sores, particularly when
they assume the serpiginous form, with nitrate of
silver or perchloride of iron.
For the various visceral lesions, when we more
particularly suspect gummy deposits, the treatment
should be commenced with some of the mercurial
preparations, followed by iodide of potassium, and
CONSTITUTIONAL SYPHILIS.
155
when considerable cachexia exists, leading us to sus-
pect some amyloid degeneration of viscera, such as
the liver or spleen, "organs more frequently affected
with syphilis than any of the others," Nitric acid is
our chief remedy. Administered for a certain time
the acid possesses a remarkable tendency to cause
absorption of the morbid deposit to which the enlarge-
ment of the organs is due, to restore their normal
texture, and to produce an improvement of their
general conditions. For syphilitic affections of the
brain and spinal marrow, some of the mercurial pre-
parations, Iodide of Potassium, and Iron are the
remedies we can place most confidence in.
UorM
156
PART VIII
AUXILIARIES.
THE therapeutic and hygienic means which I am
in the habit of using as "helpmates" to the various
medicinal agents prescribed in this work, consist of
the turkish bath, hydropathy, or the water cure,
mineral waters, and diet.
1
TURKISH BATHS.-From the most civilized to the
most degraded of nations, sweating baths have been held
in high esteem as a curative agent. Synonymously, the
hammam of the Turks, the sudatorium of the Romans,
the temazcalli of the ancient Mexicans, the Abâyah
of the Arabs, and the Turkish bath of the English.
In the early treatment of the great syphilitic out-
break of the fourteenth century it was frequently used
by the leading syphilographers of that period. "In
difficult cases," writes Astruc, "they use bagnios, in
which the patients were thrown into a plentiful sweat,
by receiving the mild vapour of warm water, or the
smoke of perfumes, and thus the filth which adhered
to the skin was carried off." For poor people, instead
of bagnios, they promoted sweat by the heat of an
oven, and if we may believe Gaspar Torella, with
good success, for in his treatise De Dolore in Puden
dagra, 1500, he says, "that among all things which
he had tried for curing the pains, and even the pustules,
the best was to make the patient sweat in a hot oven
1
AUXILIARIES.
157
or bagnio for five days successively in the morning
fasting."
The Turkish bath invariably renders me infinite
service in the treatment of syphilis, in cases varying
from the primary lesion to the tertiary and
quaternary periods.
HYDROPATHY, or the so-called water cure, is another
valuable adjuvant, and is very useful for combating
the chloral anæmia so frequently met with in patients
affected with constitutional syphilis: this influence is
very marked in feeble lymphatic individuals with a
tendency to scrofula. In fact, the good effects of the
water treatment in the tertiary and quaternary stages
cannot be denied; and it is to be regretted that this
mode of treatment is not more frequently applied, in
lieu of the ponderous doses of the various mercurial
and iodine compounds so freely prescribed by the
majority of medical men. This treatment consists in
a series of packing, douche, and sitz baths, in con-
junction with the spirit lamp or Turkish bath.
MINERAL WATERS.-Jerome Fracastorius, in 1530,
was about the first physician who drew the attention
of the faculty to the value of mineral waters, parti-
cularly SULPHUR, as a curative agent in syphilitic
diseases. The early syphilographers, however, regarded
them as injurious, on account, most probably, of the
property which they possess of developing manifes-
tations which had previously remained latent. Thermal
waters do not constitute a specific treatment for
syphilis, but like the Turkish bath and the water cure,
they render in the first place the system more sus-
ceptible to the action of medicines, and secondly,
}
F
158
AUXILIARIES IN TREATMENT.
exert upon the most obstinate secondary and tertiary
affections an action favourable to the employment of
a specific treatment. Thus, under certain circum-
stances, especially in obstinate cases, conjoined with a
low cachectic condition of the system, mineral waters.
are specially indicated, as they permeate the whole
system, and give to the albumino-hydrargyrous com-
pounds arrested in the web of the organs the fluidity
necessary for the completion of the cure. Dassier,
Pégot, and others, record some very interesting cases,
which place beyond doubt the good effects of mineral
waters when combined with the compounds of
mercury and iodine. “Not only," says Pégot, “the
thermal treatment combats successfully syphilitic
affections, by imparting to mercury and iodine pro-
perties they no longer possessed, but it also stimu-
lates the organism, restores languishing functions,
especially of nutrition, and is one of the chief remedies.
to be opposed to syphilitic cachexia." Moreover it is
not only sulphur waters which would appear to have
the property of unmasking the hidden effects of
syphilis; as the waters of Plombières, Vichy, and
Carlsbad, have in many intances brought to light
old syphilitic affections.
Warm sulphur waters take precedence, however, of
all the other classes of mineral waters when it is a
question of assisting the cure of syphilis or of repro-
ducing its manifestations. Of these we may mention
the thermal springs of Bath, Hotwells, Clifton,
Matlock, Buxton, and Knaresborough; and the cold
sulphur of Nottingham and Radipole at Weymouth,
Giesland in Cumberland, Holbeck near Leeds,
DIETETICS.
159
1
Askern near Doncaster, Harrogate in Yorkshire, the
famous waters of Llandegly and Llan-y-drindod in
Radnorshire, and the bromo-iodine water of the
Woodhall Spa, Lincolnshire.
On the continent the thermal waters of Barèges.
Aix-la-Chapelle, Weilbach, and Kreuznach, when-
ever the syphilis is accompanied by scrofulosis, in
which case it is generally obstinate.
DIETETICS.
Diet has from the earliest times been regarded as
a powerful auxiliary in the treatment of syphilis;
and the ancient syphilographers attached far more
importance to it than those of the present time.
They strictly adhered to the ninth aphorism of
Hippocrates, which signifies," the more impure bodies
are nourished, the worse they grow." They gave
meats of easy digestion, and such other things as
might tend to cleanse the blood. According to Fra-
castor a syphilitic patient was forbidden to leave his
bed for a whole month, was only allowed just suffi-
cient nourishment to sustain life, viz., three or four
ounces of bread, two ounces of chicken, and one ounce
of raisins. He was debarred from taking wine or
any other stimulant, and took as his only drink a
weak decoction of guaiacum sweetened with honey.
Afterwards he recommended exercise in the open
air, the pure air of the hills, the pleasures of the
chase, the tillage of the land, the exercise of wrest-
ling, leaping, tennis, and riding. Fallopius in 1560,
and Brassavolus in 1553, wrote in the same strain,
and the latter gives a striking instance of the good
160
DIETETICS IN SYPHILIS.
effects of gymnastics in the history of a man who
cured himself of nocturnal pains by going often to
pull the rope of the great bell of Ferrara. In like
manner it is by diet that the inhabitants of Abyssinia,
the fellahs of Egypt, the negroes of Africa, and other
half-civilized and barbarous nations cure their vene-
real affections?
It follows from this "that rules and indications
exist in dietetics." The food should be little changed,
for the habits of the patient should be respected. As
a general rule the diet should be plain, simple, and
nourishing, cocoa, milk, or tea, with a moderate
amount of bread and butter, or stewed fruit, for
breakfast. Roast or boiled (fresh) meat, with a fair
quantity of seasonable vegetables for dinner; and if
the patient be accustomed to stimulants he may be
allowed a moderate quantity of some light wine,
such as a red or white Burgundy or Bordeaux, or the
Hungarian, Edenbergh, or Somlau. The evening
meal should consist of either plain black tea, cocoa, or
porridge, with an ordinary amount of bread and butter,
or stewed fruit. The amount and quality of the food
must, however, be selected in accordance with the
general constitution of the patient; for a low diet, if
injudiciously prescribed, will sometimes aggravate the
disease, while a reparative and tonic one will consti-
tute the condition of a successful treatment. Pure
fresh air also should not be neglected. "Remember,"
writes Diday, "that the air and sun bath often
becomes a succour which is indispensable for those
subjects in whom vital action languishes. Inaction,
both of body and mind, is at all times a serious
DIETETICS IN SYPHILIS.
161
obstacle to a rapid and satisfactory cure of syphilis ;
and without requiring so much as Fracastor did, a
patient so afflicted should continue to attend to his
usual occupation, and during his leisure hours he
should undertake pleasant walks, fencing, riding,
gymnastics, join in agreeable society, read some light
amusing works, or any other occupation that would
tend to divert the mind from pondering over the
subtle poison still lurking in the system. Continence
is another hygienic measure which should be strictly
observed by a patient so afflicted; he should avoid
the pleasures of the flesh as well as the pleasures of
the table, and enjoy with the greatest moderation
women as well as wine. High living, spirituous.
liquors, and tobacco should be strictly prohibited ;
they are a source of infinite mischief, and have but
too often occasioned symptoms which otherwise.
perhaps would never have manifested themselves ; and
they so change the character of a disease as to convert
a mild form into a malignant one, in illustration of
which many cases are recorded in other sections of
this work.
M
162
PART IX.
ONANISM.
IT would be foreign to the scope of this work to
depict the effects of this unnatural vice on those who
are the victims of it during childhood. Suffice it to
say, careful watching, moral tonics, and the careful
selection of the indicated remedy to be hereafter
mentioned, will eradicate the evils resulting from the
pernicious practice. When perpetrated by those of
adult age, however, its symptoms and treatment will
differ in the male and female sexes; hence it will be
convenient to divide our subject under the two heads
of (1) male onanism, and (2) female onanism.
I. MALE ONANISM.-This is usually accomplished
by friction of the virile member by the hand in the
early stages; and it may be defined as seminal emis-
sion obtained by other means than that of sexual
intercourse, for it will be found that before long this
emission will take place without even the slightest
friction. When first practised the whole sensual
orgasm is in an excited condition. The penis is fre-
quently erect, the passions fervid, and the gratifica-
tion intense. The ejaculation follows prolonged
irritation of the penis only, being but seldom noc-
turnal. This stage of excitement is soon succeeded by
corresponding depression-a depression, both moral,
ONANISM.
163
sexual, and physical. The symptoms are those which
affect the system-constitutionally; and those which
affect the irritated part-locally.
Constitutional Effects.—These are mental debility,
corporeal lassitude, sunken eye, dilated pupil, pale
face, emaciated frame, and nervous prostration;
society is shunned, and all exertion avoided.
Local Effects.-The emission now takes place in-
voluntarily, or is occasioned by a lewd thought or a
lascivious glance, and becomes nocturnal. Erection is
feeble, and at times absent; the semen runs from
the flaccid penis as it chafes against the trousers whilst
walking, or even whilst the victim of the debasing
vice is passing water or fæces. All voluptuous feeling
is gone long before the patient ceases to masturbate.
If continued till this stage arrives, epilepsy or insanity
closes the scene-"he ceases to be a man." The
constitution is undermined, the system enervated, the
intellect weakened, and he sinks into a grave dug
by his own folly, and filled by a body polluted by his
evil practices.
2. FEMALE ONANISM.-This is far more frequently
practised than some would try to persuade us, whilst it
acts in an equally injurious manner upon the constitu-
tion. The local symptoms are those of an elongated,
highly irritable, or often hypertrophied clitoris, and a
subacute inflammation of the vagina, giving rise to a
slight discharge of acrid greenish leucorrhoeal matter.
There is also considerable irritability of the bladder.
TREATMENT.-Ist, and of vital importance, is the
avoidance of the cause; 2nd, frequent ablution of the
loins and private parts with cold water; 3rd, regulation
164
TREATMENT OF ONANISM.
i
of the hygienic surroundings-by use of simple diet,
abstinence from stimulants, plenty of exercise in the
open air, early hours, large airy bedroom, and hard
mattress (not lying on back); 4th, the substitution
of healthy moral literature for the prurient trash which
so constantly forms the library of the youth of the
present day; 5th, dissipation is to be shunned, and
slight intellectual occupation sought; and 6th, to
administer one of the following remedies, great care
being taken in its selection.
Veratrum Viride, in the early stages, and before the
habit is formed; when emissions take place fre-
quently, and after study, cheerful company, or more
than once in the week. It may be given in or
drop doses of the third dilution every four hours.
1
Calc. Carb. is one of the most frequently useful medi-
cines; it is indicated for great pain in the back of the
head and neck, and between the shoulders, after emis-
sion, with great depression of spirits and mental
confusion, and loss of memory. The habit is fully
formed, but a great desire is felt to be freed from it.
The prescription should be-Calc. Carb. 3x three
times a day, and Sulph. 30, twice a week.
Phos. Acid cures the debility of onanists; it also
removes absence of sexual desire, the profuse perspi-
rations, frequent erections without desire for coitus,
discharge of semen during a stool or while urinating,
and a gnawing pain in the testicles. Third dilution
is the best.
Staphysagria is indicated by excitement of the
sexual instinct, followed by hypochondriacal indif-
ference. After emission there is great weakness of
TREATMENT OF ONANISM.
165
the arms, the eyes are sleepy and surrounded by a
dark ring; weakness of memory and dullness of
the intellect, with inability to perform any mental
labour; dislike to society and conversation. The
3x dilution is the most serviceable, and should be
followed by Calc. Carb. China is required when
there is desire to be alone, great anxiety and dis-
couragement, general debility, emaciation, nocturnal
emissions which cause excessive weakness in the
morning, drawing pains in the testicles, sexual desire.
is excited with lascivious fancies. Third dilution bis die.
Carbo Veget. is a most useful medicine in female
onanists; there is present a greenish corrosive dis-
charge from the vagina; itching, burning, soreness of
the vulva, and disposition to miscarriages; also great
excitability of the sexual system, and great weakness
on making the least exertion. The sixth dilution is
the best.
China or Merc. Sol. is often useful after Carbo
Veget. There is lascivious excitement with painful
nightly erections, nightly emissions of semen mixed
with blood. The penis is small, cold, and flabby;
dragging pain in the testes and spermatic cord;
emission is soon followed by icy cold hands, burning
or bruised pain in the back, with sensation of weak-
ness. Merc. Sol. 6.
Cantharis satyriasis; frequent and ready pollu-
tions; emission is followed by burning pain in the
urethra, with violent nocturnal priapism.
Sepia in discharge of semen during a difficult
evacuation or after urinating. In females, with
yellowish or green leucorrhoea, bearing down in the
ง
AI66
NATIONAL NAMES OF SYPHILIS.
1
uterus, with induration of the neck of the womb;
shootings in the vagina with excoriation.
Of the Names bestowed at Various Times upon
Syphilis.-As various as have been the opinions of
physicians on the nature of the disease, so propor-
tionately various have been the designations bestowed
upon it. Regarding it as many have done, as a form
of lepra derived from Asia, it became known as
Elephantiasis. Others saw in it a cutaneous disorder
known among the Arabs as sahafati. But the familiar
name bestowed upon it by the first physicians, after
its enormous spread, was derived from its remarkable
similarity to the small-pox. The following list gives
a fair outline of the various names thus employed to
indicate it:
167
Country or Nation.
Africans
...
American aborigines
Arabians
Aragonians...
Calcutta
Catalonians
Chinese
Dutch
English
Flemish
French
Genoese
Germans
Indians, East
Indians, West
Italians
Japanese
:
...
:
:
Name produced by
Common Name.
National Rancour.
Name produced by
Religious Impulses.
Pian. Yaws. Frambæsia.
Galel-ya.
Sahafati.
Las bubas.
Pockas Wallahs.
Las bubas.
Konang Tong Tchouang.
Spanse Poken.
Syphilis.
Les Poques.
Grose Vairole.
Lo male de le tavelle.
Grosse Blätter.
Pian. Yaws. Frambæsia.
Mal Frances.
Тереа.
Mal de St. Sementus.
Mal de St. Sementus.
Mal Portuguese.
French Pox.
Spanish Pox.
Mal de Naples.
Mal de Frances.
Franzosen.
Mal de Portugais.
Foul disorder.
Spaanse Pocken.
Mal de St. Roche.
Mal de St. Job.
Französische Pocken.
Mal de Frantzos.
Fire of lust.
Mal de St Job.
168
Country or Nation.
Common Name.
Name produced by
National Rancour.
Name produced by
Religious Impulses.
Latins
Lombards
Moors
Neapolitans
Persians
Lues Venerea.
Morbo Gallico.
Lo male delle Bozzole.
Mal de St. Job.
Mal de Espagnol
:
Mal Franks.
Mal de St. Job.
Mal de Turcos.
Picardians
...
Poles
Les poques.
Mal de St. Job.
...
Portuguese
Russians
St. Domingo
Savoyards
...
:
:
Mal de Allemand.
Mal de Castillan.
...
Scotch
Spaniards
...
Ospa, or Vospa.
Guaguara hipas, taybat, ycas.
Clavlée.
Sibbens, or Sewens.
Las Bubas, or Boas.
Mal de Polonais.
Mal de St. Job.
Swedes
Turks
Welsh
:
Radesy-ge.
Mal des Franks.
Y frech losg.
Yr hen Gi.
Y Clefyd drwg
169
PART X.
COMMENTS ON THE CONTAGIOUS
DISEASES ACTS.
AMONG all the diseases that weigh upon suffering
humanity, there are probably none which are more
extensively discussed by physicians, more dreaded
by some, more frivolously treated by others, and at
the same time less definitely determined, with regard
to their course, the multifarious phenomena they
assume, and the boundaries of their various forms
and destructive inroads upon the framework and
constitution of both sexes, than the motley group of
diseases designated as VENEREAL. According to
the views of Nicholaus Leonicenus and Gaspar
Torella in the fourteenth century; James Cataneus,
John Almener, Peter Maynard, Jerome Fraçastorius,
Nicholas Massa, John de Vigo, and Paracelsus in the
fifteenth century; Hartmann and others in the sixteenth
century; Petronius Cæsalpinus, the supposed discoverer
of the circulation of the blood, John Deraux, Fallopius,
Girtanner, Astruc, John Hunter, and others in the
seventeenth century-among the older authorities :
or Carmichael, Bell, Cazenove, Biett, Lancereux,
Diday, Ricord, Hutchinson, and many more among
recent physicians; there exists nothing more disgust-
ing, revolting, and insidious in the whole world than
these diseases. Fostered as they undoubtedly are, in
170
COMMENTS ON THE
1
the fatal bosom of a degrading passion, and conceived
at a moment of burning and illicit lust, they scatter,
according to some silently and mysteriously, their
poisonous seed, whose offspring, which at its first
appearance is but slightly regarded, and extirpated
from the sphere of observation as speedily as
possible by the criminal hand of indiscreet or igno-
rant practitioners; nevertheless continues silently to
unfold its manifold germs in the organism, until
they break forth anew in a variety of different
forms, and thus announce to every eye the presence
of the still raging malady. Again and again
repressed by external means, and again sprouting
forth in other parts of the body, they penetrate,
according to the assertions of recent observers, all
the tissues of the sufferer, who, far from suspecting
the hydra-headed monster that is gnawing at his
vital forces, but too often sees one organ after the
other invaded, tortured, and destroyed; his face
disfigured in the most horrible manner; his muscles
and bones perforated; his mind converted into a
moping idiot, or a madman gay; his nerves palsied;
his eyesight lost or bedimmed, and his once healthy
frame overwhelmed by the most horrid and excru-
ciating tortures, without knowing how his distress
can be alleviated, were it only in the most trifling
degree.
Whatever revolting and horrifying diseases are met
with in large towns, in the huts of misery, and in the
gloomy abodes of vice; all those miserable-looking
wretches who are covered with ugly scars and jagged
ulcers; whose faces are disfigured by pustules and
CONTAGIOUS DISEASES ACTS.
171
suppurating blotches; who are not unfrequently
deprived of their noses, their sight, their hearing,
their smell, and their power of swallowing; who are
emaciated to skeletons; whose livid, pustulous, and
shrivelled skin is dangling upon their fleshless
bones like some pestiferous shroud; and who,
spreading a pestilential fœtor all around, wander about
like half-rotten spectres from the gloomy recesses of
the tombs; or who, removed from all human society,
and avoided even by their own friends, are stretched
upon the torture-bed of hopeless despair, praying for
death as their greatest blessing: all these unfortunate
and miserable-looking objects, according to the
opinion of the greatest physicians of this and past
centuries, owe the whole sum of their sufferings to no
other cause than to syphilitic infection; which, having
been contracted in an unguarded moment, had been
neglected, disregarded, and afterwards but too often
mismanaged and badly treated throughout. Yet the
science of pathology has up to the present time
made such wonderful advances, that a whole army of
the most chronic, incurable, and deep-seated organic
affections, which assume a thousand colours, and the
most hideous and fantastic garbs, with which inhabit-
ants of large cities and towns, the soldiers of our armies
and the sailors of our fleets, and the youth of our
country are afflicted; emanates from this single CAUSE
as their true fountain-head; their true character, unless
they had reached the previously described fearful
height, being almost always misapprehended, so that
they are confounded with other and less dangerous
diseases, and the virus, even if, favoured by peculiar
172
COMMENTS ON THE
circumstances, it should not break forth in actual
disease in all cases, is transmitted to the offspring,
and entails upon them the distressing and irresistible
processes of destruction from which the guilty parents.
had luckily escaped, thus confirming the sacred
and solemn warning, that "the sins of the fathers"
are visited "on the children to the third and
fourth generation." It is the opinion of the more
advanced syphilographers of the present day, that
these diseases contain a poison which, if once intro-
duced into the system, germinates and sprouts after
the fashion of parasitical growths, at the expense of
its vital essence and strength, and continues to spread
and sprout until the body perishes by the poison.
And when nothing is done against these diseases
than merely to obliterate their sprouting growths by
outward applications, the roots remain in the organic
tissues, and may sprout forth again and again until
life is annihilated by this murderous destroyer.
The frightful prevalence and virulence of this
disease among the lower class of prostitutes in certain
seaports, garrison towns, and in the neighbourhood of
camps, had for many years attracted the serious at-
tention of the Legislature; and in 1862 a special
committee was appointed by the Government to
inquire into the prevalence of "venereal diseases" in
the army and navy. Their report, dated the 15th
December, contains, at its conclusion, the following:-
"Your committee have refrained from entering
into the painful details which have come to their
knowledge of the state of our naval and military
stations at home as regards prostitution.
}
CONTAGIOUS DISEASES ACTS.
173
"These facts are so appalling that they feel it a duty
to press on the Government the necessity of at once
grappling with the mass of vice, filth, and disease
which surrounds the soldiers' barracks and the sea-
men's homes, which not only crowds our hospitals with
the sick, weakens the roll of our EFFECTIVES, and
swells the list of our invalids, but which surely, however
slowly, saps the vigour of our soldiers and our seamen,
sows the seeds of degradation and degeneracy, and
causes an amount of suffering difficult to over-
estimate."
The reports of Government committees are not, as
a rule, of a sensational description, more generally
they are dry and technical documents. Very terrible,
then, must have been the condition of matters, when
a Government committee concluded their report in
such terms as these. It, however, two years after-
wards (1864) resulted in the passing of an Act for the
prevention of contagious diseases at certain naval and
military stations; namely, Portsmouth, Plymouth, and
Devonport.
In the same year, a committee, consisting of some
of the most eminent physicians and surgeons in
London, was appointed by the Admiralty to inquire
into the pathology and treatment of syphilis and
syphiloidal diseases, and to suggest practical rules for
the prevention of those diseases, capable of being
adopted by the naval and military authorities. Such
inquiry lasted over a period of nearly two years; and
the result of this inquiry was that a mass of facts and
practical experience was accumulated, in reference
to the pathology and treatment, both hygienically
174
COMMENTS ON THE
and medically, such as had never before been collected
to elucidate the nature of any one disease. The
attention of the committee had been especially drawn
to the laws which had been enforced in Malta, in
which island the regular periodical examination of
all known prostitutes, and the detention in hospital of
any who were found diseased, had resulted in the total
extinction of venereal disease so far as the island was
concerned, all fresh cases being clearly traced to
fresh importation.
In 1866, a fresh Act was framed, entitled "An Act
for the better Prevention of Contagious Diseases at
certain Naval and Military Stations." This repealed
the Act of 1864, and with some alterations is now in
force. The benefits derived from the working of this
Act were so satisfactory, physically, morally, and
socially in the districts where it was extended,
that an association was formed in London, consisting
of some of the leading members of the medical, clerical,
and legal professions, university professors, eminent
statesmen and philanthropists, with the view of
petitioning Parliament for an extension of the Act to
the civil population of our large towns. In conse-
quence of the importance of this movement, a
committee of the House of Lords was in 1868
appointed to consider the subject. Their report con-
tains the following recommendation:-" The com-
mittee consider the the cautious extension of the Act
may be safely entrusted to Government, and conse-
quently recommend the introduction into Parliament
of a bill giving to her Majesty in Council power to apply
the Act of 1866 not only to all naval and military
CONTAGIOUS DISEASES ACTS.
175
stations, but also to any locality the inhabitants of
which may apply to be included in the operations of
the Act." The witnesses examined on that committee
consisted of some of the leading medical men in
London and other large towns. In 1869 a committee
of the Commons was appointed to inquire into the
working of the Act of 1866; and although the Act had
only been in operation two years and a half, and at
some stations only seven months, strong testimony
was borne to the benefits, both in a moral and sanitary
point of view, which had resulted from it.
Prostitution appears to have considerably diminished,
its most aggravated features to have toned down, and
its physical features considerably abated.
It was
further resolved that the Act should extend to other
places, viz., Gravesend, Maidstone, Winchester, Dover,
Deal, Walmer, Canterbury, Dartmouth, Ivybridge,
and Southampton: great stress was laid by the com-
mittee, as to whether it would not be advisable and
practicable to extend to the civil population the bene-
fits of an Act which had in so short a time done so
much to diminish prostitution, decrease disease, and
reclaim so many women from an abandoned and de-
based life.
The Acts of 1864 and 1866 passed with very little
opposition; but after the formation of the association
for promoting the extension of the Acts, and the
report of the committee of the House of Lords, a
general "hue and cry" was raised, with a most deter-
mined opposition to the further expansion of these
Acts.
In 1870 the first motion for the repeal of the Acts
176
COMMENTS ON THE
was brought before the House of Commons, the
debate being held with closed doors. The motion, as
it should be, was negatived by a large majority.
I have given these few details in order that a clear
insight may be obtained as to why these Acts of
Parliament were ever passed, and, having passed, why
they were continued.
The Act of 1866 was passed in accordance with the
recommendations of the highest medical authorities,
after a most laborious and painstaking inquiry,
extending over a period of two years. Moreover, on
the strength of such a report, both Houses of Parlia-
ment not only confirmed it, but strongly recom-
mended its extension, which was partly adopted in
the Act of 1869.
The different localities in which the Acts are now
in force are-
In England: Aldershot, Canterbury, Chatham,
Colchester, Dartmouth, Deal, Devonport, Dover,
Folkestone, Gravesend, Maidstone, Portsmouth, Ply-
mouth, Sheerness, Shorncliffe, Southampton, Walmer,
Winchester, Windsor, and Woolwich.
In Ireland: Cork, the Curragh, and Queens-
town.
From this it will be seen that the Acts at present
applied only to some garrison towns and certain
naval seaports; the large seaport towns of Liverpool,
Bristol, Hull, Swansea, Cardiff, Newport, Glasgow,
Edinburgh, Dundee, and Belfast; and our great
seats of learning, Oxford and Cambridge, where the
disease commits terrible havoc and disastrous results
amongst the undergraduates, being conspicuous by
CONTAGIOUS DISEASES ACTS.
177
their absence. It is most important that the list of
places here quoted should be carefully studied and
frequently referred to, as it is surprising how much
ignorance there is even amongst people whom we should
expect to find well informed on so grave a subject
and foul a disease—a disease which has for ages been
undermining and sapping to its very foundation the
constitution of man, and disseminating its destructive
and malignant seed to the second and third generation.
It will help us to understand how, on the one hand,
these Acts are TOO partially applied to have any
particular influence in reducing the frequency of
the disease beyond the very limited boundaries to
which they are at present applied; on the other
hand, however, these districts are sufficiently numerous
and expansive to enable us to judge of the marked
good effects produced by the careful and proper,
working of these Acts in a MEDICAL, MORAL, and
SOCIAL point of view, as fully confirmed by personal
inquiries and Governmental reports.
The Royal Commissioners, to whom this painful
and delicate subject was entrusted, were the Right
Hon. W. N. Massey; the Right. Hon. Viscount
Hardinge; the Right Rev. the Bishop of Carlisle ; the
Right Hon. Lord Hampton; the Right Hon. W. F.
Cowper-Temple; Sir J. S. Trelawny, Bart.; Sir W. C.
James, Bart.; Vice-Admiral Collinson; Charles
Buxton, Esq.; Major O'Reilly, M.P.; Peter Rylands,
Esq., M.P.; A. J. Mundella, Esq., M.P.; Professor
Huxley; the Rev. Canon Gregory; the Rev. J. F. D.
Maurice; the Rev. Dr. Hannah; Dr. Samuel Wilks;
Dr. J. H. Bridges; Dr. G. E. Paget; T. Holmes, Esq.,
N
178
COMMENTS ON THE
F.R.C.S.; H. Coote, Esq.; G. W. Hastings, Esq., and
R. Applegarth, Esq.
It will thus be seen that the clergy, the bar, the
medical profession, the army and the navy, were all
fairly represented on the Commission, which, as will
appear, comprised stern opponents of the Acts, sup-
porters, and others who may be fairly considered as
strictly neutral.
In December, 1870, the Commissioners sat to take.
evidence of the working of the Acts; some eighty
witnesses were examined, amongst whom were various
official personages and officers of high rank in the
public services; inspectors of police forces, inspectors
of certified hospitals, several surgeons engaged in the
administration of the Acts, various others officially
connected with different lock hospitals, refuges, and
reformatories, besides many clergymen of various
denominations.
A large amount of evidence was received on the
subject of venereal disease, its classification, different
forms, and diagnosis, and its effects on the constitution
of the sufferers.
!
Substantially, the authorities were agreed that the
disease is contagious; that even in its milder form it
frequently involves for a time painful and disabling
complications, which leave permanent local and con-
stitutional darnage behind them; and that many inno-
cent persons, married and unmarried, including
medical men and nurses, may and do often suffer from
the contagion; and further, that the posterity of a
diseased parent are liable to serious affection from
constitutional syphilis.
}
CONTAGIOUS DISEASES ACTS.
179
The voluminous statistics laid before the Com-
missioners, in the returns of the army and navy
medical departments, and the metropolitan police
returns, showing the number of brothels and public
women, and of the proportions of disease in the
protected districts, at various periods since the Act
of 1864, received marked attention from them.
They go far to prove a marked improvement in the
health of the army and navy under the new system.
They go to prove a marked reduction of the
disease among the lower class of prostitutes, as well
as improvement in their morals and mode of con-
ducting themselves; soldiers and sailors, under the
influence of drink, being no longer importuned and
seized upon by filthy and degraded prostitutes, as they
were in former days. The Contagious Diseases Acts
have in one sense acted as a SANITARY SCAVENGER,
by purging the towns and encampments to which they
have been applied of miserable creatures who were
reeking masses of rottenness, and pestiferous vehicles.
of disease; and moreover they have provided those.
unfortunate "outcasts of society " with asylums where.
their sufferings could be temporarily relieved, even if
it were not within the pale of science to eradicate the
rank poison from the system.
But the alleviation of the physical sufferings of
these unfortunate and frail sisters is not the only
good that has accrued to them from these Acts; and
although the reclamation of fallen women seems
hardly to have entered into the original conception of
the Acts, it very soon became recognised as a
prominent section of the system. A chaplain is
180
COMMENTS ON THE
attached to each of the certified hospitals. The
matrons are mostly of a superior class, qualified by long
experience for the performance of their duties, and
animated by a benevolent zeal for the work in which
they are engaged; and such is the influence which has
been brought to bear upon the inmates, that many
have returned to the bosom of their friends, others to
homes and refuges always open and ready for their
reception, and some have emigrated to other climes
and are doing well.
The good moral effects which these Acts have
already produced may be thus briefly stated :—
A. Religious and sound moral influence has been
brought to bear upon large numbers of women; a
large portion of whom had been from infancy
familiar only with scenes of debauchery and vice.
B. Many towns and camps have been cleared, or
nearly so, of the miserable women who were formerly
to be found in their streets and thoroughfares, their
only places of rest at night being hedges and
ditches, railway arches, bridges, and reeking sewers.
C. A considerable number of these unfortunates
have been reclaimed and restored to respectable life,
and in many instances married.
D. The number of loose women has been greatly
reduced, and those who remain have been rendered
more decent and decorous in appearance and conduct.
E. The practice of clandestine prostitution, which
too often degenerates into open professional vice, has
been materially checked by fear of the consequences
of such illicit indulgence which are rendered proba-
ble under the Acts.
CONTAGIOUS DISEASES ACTS.
181
F. The sad spectacle of juvenile prostitutes of
tender age, so rife in localities heretofore, has been
greatly diminished, and in some instances almost
entirely removed.
G. The temptations by which young men of all
classes have been hitherto assailed have been to a
great extent taken out of their way, and a higher
tone of morality has thus been promoted.
The Commissioners who drew up the report,
concluded by saying: "We are of opinion that the
total repeal of these Acts would be, as was said by a
Devonport witness, 'disastrous in the extreme.' We
object to attempting a compromise, which would
probably be unsuccessful, by retreating on an
imperfect measure discredited by grave and obvious
faults, and we desire to see the Acts of 1866 and
1869 fully maintained in substance and in principle."
In 1871 a memorial, signed by two thousand five
hundred of the leading members of the medical
profession, was presented to 'Parliament in favour of
the continuance of the Acts.
In 1870, 1873, and 1875, motions were moved in
the House of Commons for the total repeal of these
useful and benevolent Acts; an amendment was on
each occasion proposed and carried by a large
majority, that these Acts should not be repealed,
which was fully confirmed by the House of Lords.
The Right Hon. Dr. Lyon Playfair, M.P. for the
Universities of Edinburgh and St. Andrews in 1870,
in a speech which was marked by profound learning
and deep antiquarian research on the subject, referred
to the rules and ordinances of eighteen houses of bad
182
COMMENTS ON THE
repute (stews) situate on the Bankside, Southwark, as
far back as 1430, which were under the jurisdiction of
the Bishop of Winchester. In the year 1497 the
Aberdeen magistrates caused all women who were
diseased to abandon their evil courses and shut
themselves up in their houses till they were cured,
branding on the cheek with a red-hot key those who
came out too soon. Six months later the Privy
Council ordered the authorities of Edinburgh to
collect all diseased women, with their doctors, on the
sands of Leith, boats being provided to transport.
them to the island of Inchkeith, where they were to
remain till cured, on pain of being branded in a
similar manner. In 1529, Parliament arraigned
Cardinal Wolsey for daring to go into the presence
of his sovereign while he was suffering from the foul
disease, when he ought to have isolated himself from
all in whom the State was interested.
This enforced isolation of DISEASED PERSONS we
have now mentioned extends to those gallant men who
are kept for the protection of the State both by sea and
land; and it is fervently to be hoped that the time
is not far distant when these beneficent Acts will
throw their protective powers over the whole of
England and her far-distant and extensive colonies;
for no one except those who have paid more than
ordinary attention to venereal disease can for a
moment conceive the
the frightful and loathsome
ravages it inflicts upon the human body, or the
appalling mortality from the same cause. Dr.
Frederick W. Lowndes, of Liverpool, to whom I
am indebted for a copy
of a well-written
CONTAGIOUS DISEASES ACTS.
183
pamphlet on this subject, gives us some valuable
statistics relative to the ratio of mortality in Liver-
pool and other large towns from venereal dis-
eases, also the extent of prostitution:-
Liverpool in 1871 had a population of 493,346
"
""
""
brothels
prostitutes
668
1,722
At the present time the number of these unfortunates
has increased in proportion to the increase of popu-
lation.
Deaths from syphilis from 1860 to 1875, a period
of sixteen years, have been as follows :—
Males
Females
Infants under one year
900
700
2,016
It must not, however, be supposed that these are by
any means the total number of deaths from this terrible
disease, as many deaths doubtless have been set
down to other causes than syphilis, more particularly
in infants.
Dr. Lowndes, whose able treatise I have freely
drawn upon, being anxious to see something of the
practical working of the Acts, visited Aldershot,
Chatham, Plymouth, and Devonport in 1875. As
Plymouth resembles Liverpool in being a seaport and
a great maritime highway, Dr. Lowndes was specially
interested in seeing the stipulations of the Acts being
carried out. When the Act of 1864 was first put
into operation, in the following year, there were 356
brothels and 1,770 prostitutes in Plymouth and Devon-
port. The number of beds available for diseased
184
COMMENTS ON THE
!
females in the Royal Albert Hospital at that time.
was only 38, quite inadequate for the purpose. In
February, 1866, the number was increased to 50
April
January, 1868
February
>>
""
62
86
>>
")
96
March
I 12
")
""
"
April
128
""
"
May
وو
154
>>
162
July
With this INCREASED accommodation the disease
proportionately DECREASED, and the character of the
disease became materially changed, becoming much
milder and more amenable to treatment. The reduc-
tion and diminished virulence of the disease, however,
is not by any means the only good which has been
effected in Plymouth and Devonport. The number
of prostitutes, as we have seen, at first 1,770, has
been since reduced to about 400; and the number of
brothels from 356 to 98. At one time it was impossible
to walk the streets without being solicited and insulted
by the lowest of women, whose language and de-
meanour were shocking. Now, crowds of drunken
seamen and shameless and abandoned women round
public-houses are never seen; and even those streets
still inhabited by those unfortunates are quiet and
orderly. Chatham, Aldershot, Windsor, Dover, Can-
terbury, and Portsmouth, showed results equally as
satisfactory.
The following extract of a letter from Dr. Gram-
shaw, the visiting surgeon under the Acts, and medical
CONTAGIOUS DISEASES ACTS.
185
officer of health at Gravesend, which appeared in a
recent number of the British Medical Journal, shows
very clearly the excellent results in that town :-
"The tables of statistics put forward both by pro-
moters and opponents of the Contagious Diseases
Acts are frequently so bewildering to ordinary minds.
that they are cast aside without examination, and the
statements of those who frame them are taken for
granted, whatever may be the opinions they are wanted
to produce.
"A statement of facts with regard to the working
of the Acts amongst us in Gravesend, if unencumbered
by tables, may perhaps be interesting to some, and
may also be useful in the present unsettled state of
public opinion.
"We have on the books here a number of women,
varying from thirty-five to forty, somewhat under
one-half of whom are required to come up weekly for
inspection. This of course represents the number of
public prostitutes only. The behaviour of these
women has been uniformly good. There has never
been the slightest repugnance shown by any to
examination. During my two years of office I have
known girls come into the district from Warley and
elsewhere to present themselves for examination,
but I never once heard or saw any unwillingness to
submit to it on the score of modesty from a single
patient. A few object to the trouble it gives them
of getting clean clothes, and of regularity of hours,
but never from any other cause. No officer has ever
been found overstepping the limits of his duty. In
the last four months I have been obliged to send only
186
COMMENTS ON THE
one woman to hospital for decided disease, and either
three or four others as doubtful cases, whose detention
has only been for a short period.
"In private practice here I rarely see a case of
syphilis, either in men or women, certainly not con-
tracted in the town. In conversation with other
medical men I hear their experience is nearly the
same. At all events, the amount in the last few
years is very much lessened. The chemists, who
used themselves to treat a great many venereal
diseases, make a similar statement.
"Our barracks contain a variable number of soldiers;
I believe the average number to be about 400. Since
June 17, 1875, there have been in the Military
Hospital no more than three cases of the disease, one
only of these as ascribed to Gravesend; the other
two were contracted before the men came here. When
we take this last statement into consideration, and
recollect that, though not exactly a port, vessels are
always passing and re-passing on the river, and that
they are often detained here for a day or two, we
may fairly give credit to the Acts, and to their
REPRESSIVE and PROTECTIVE POWERS for much of
this freedom from a foul and horrible scourge.
"To those who would accuse us, as they often do,
of bringing up for examination women who are only
suspected of prostitution, we reply that nothing of
the sort ever takes place. It is necessary to be certain
of their character before they are summoned to attend;
and though there are now and then cases where the
suspicion is very strong, yet the Acts are never put
in force against them till certainty exists. To such as
CONTAGIOUS DISEASES ACTS.
187
1
1
publicly commit themselves we say, we are power-
less to prevent you exercising your calling if you will
persist in doing so; but we can, and will, to a certain
extent, prevent your becoming the source of irre-
parable mischief to infants and unoffending victims.
All this takes place quietly and decorously, in a secluded
part of every town where the Acts are in force; and
if any part of the system can possibly be called
objectionable, it is well and fully counterbalanced by
ITS GOOD RESULTS."
..
188
REMEDIES.
THE remedies recommended by many authors, and
referred to throughout the pages of this work, con-
sist of a solution of Alum, Arnica montana, Calen-
dula officinalis, Bichloride of mercury, Carbolic acid,
Condy's fluid, Sulphate of zinc, Nitrate of silver, and
Nitric acid.
The Carbo-sulphuric paste of Ricord.
The Chloride of zinc paste of Diday.
The Potassa fusa vel Potassa c. calce of Parker.
The Nitric acid of the author.
The Opiate cerate of Lancereux.
The internal remedies chiefly recommended by
French physicians consist of Bazin's syrup, of the
following proportions.-Take—
Biniodide of Mercury
Iodide of Potassium
Syrup of Saponaria
wards increased to four.
0'15 parts,
10'15
""
•
500'00
""
Two tablespoonfuls are given daily at first, and after
Belloste's pills.—Take—
Metallic Mercury
Aloes
}
aa 0.75 grains,
1
REMEDIES.
189
Rhubarb
Scammony
Black Pepper
Mix for one pill.
Sédillot's pills.-Take-
Strong Mercurial Ointment
Medicinal Soap
Powdered Marsh Mallow
For one pill.
aa 0·30 grains,
O'15
1'5 grains,
}
aa 1'5
Van Swieten's drops.-Take—
Bichloride of Mercury
Corn Spirit
12 parts,
1,000
A tablespoonful to be taken morning and evening.
Mialhe's formula.-Take-
Bichloride of Mercury
Chloro-hydrate of Ammonia
The whites of two eggs
Distilled water
15 grains,
75
"9
30 ounces.
From one to three tablespoonfuls to be taken daily
Cullerier's pills.-Take-
Bichloride of Mercury
•
I part,
Wheat Flour
15 parts,
Powdered Gum
2
""
Distilled water sufficient to make into a mass, of
which 2 grs. to be taken morning and evening.
Dupuytren's pills.—Take—
Bichloride of Mercury
•
O'18 grains,
Extract of Opium
O'22
"
Extract of Guaiacum
For one pill, two of which to be taken daily.
0'75
")
190
REMEDIES.
Ricord's formula.-Take-
Proto-iodide of Mercury
Extract of Lettuce .
Extract of Opium
Confection of Roses
•
}
aa 45 grains,
15
•
90
دو
""
For sixty pills, one, two, or three to be taken daily.
Puche's Syrup.—Take—
Iodo-hydrargyrate of Potash . . I part,
Iodine
•
Iodide of Potassium
Syrup of Wild Poppies
I "
20 parts,
•
473
""
This syrup is well suited for persons of lymphatic
constitution, who have reached the end of the second
stage.
J
J
i
!
:
191
INDEX.
Acts of Parliament, "Sanitary Scavenger "
African origin of syphilis
...
Aldershot, Contagious Diseases Acts applied to
American origin of syphilis
Analogous diseases to syphilis
in Africa
Scotland
...
">
Sweden
""
""
Norway
Jutland
Amboyna
Canada
...
...
Anatomical views of venereal diseases
Antiquity of syphilis
China
India
...
...
...
Biblical references
...
Persia
...
Greece
Rome
Judea
Auxiliaries in treatment of syphilis
Turkish baths
Hydropathy
...
Mineral waters
Biblical references to syphilis
Buboes
Definition of
Forms of
Symptoms of each form
Treatment
...
Can syphilis arise without contagion?
...
...
...
PAGE
179
I
176
...
I
00 со со со со со а
18
18
18
18
18
18
19
1.2
19
!
25
I
I
2
3.
334
4
5
Ja post pont j
156
156
...
157
157
3
106
106
...
...
107, 108
...
...
•
ΟΙΙ
111-113
20
192
INDEX.
:
Can syphilis arise without contagion ?—Authorities
...
PAGE
20-22
Canterbury, Chatham, and Colchester, Contagious Diseases Acts
applied to
Chancroid and its complications
Statistics of chancroid
Statistics of chancre
Complications
Suppurating bubo
Phimosis and paraphimosis
Gangrene
Diphtheritic deposit
Cases illustrative of
Treatment
China, Syphilis in
...
Comments on the Contagious Diseases Acts
Views of ancient authorities
Middle age and
Recent authorities.
...
Different Acts of Parliament
Reports of committees
...
...
...
...
176
71
72
72
73
73
73
74
:
...
74
75
79
I
169
169
169
169
172
173
...
175
117
118
...
160
Beneficial working of the Acts in various camps and garrison
towns
Diagnosis of syphilitic and syphiloidal diseases
Tabular arrangement
...
Dietetics in treatment of syphilis, Ancient and modern
Early appearance of syphilis in England
Authorities and manuscripts of
...
15
15-17
Endemic origin of syphilis
Epidemic phase of syphilis
Geography of syphilis
Gonorrhoea of the glans, Balanitis
Symptoms of
Causes of
Treatment
Gonorrhoea, Syphilitic
Treatment
Gonorrhoea virulenta
Symptoms
Causes
Treatment
Preventive
Therapeutic
...
...
...
...
...
:
...
Gonorrhoea, Complications of
Chordee Canth., Caps., Puls., Nux v., Camph.
Hæmorrhage: Acon., Acid r., Canth., Ham.
Phimosis: Merc. sol., Thuja, Can.
Paraphimosis: Can., Merc. s., Sabin.
:
Prostatitis Lotio plumbi, Acon., Bell., Merc. s., Puls.
To hasten suppuration : Hep. s., Sil.
Chronic form: Merc., Biniod., Kal. hyd., Sulph.
I
24
...
22
222
23
26
26
26
26
30
32
33
34
37, 38
39
39
40-42
48
48, 49
49
49
51
52
52
53
INDEX.
193
Gonorrhoea, Complications of. Dysuria: Acon., Canth., Merc.
sol., Nux v.
Buboes: Puls., Can. s., Merc. biniod., Kali, Sulph.
To hasten suppuration : Hep. s., Sil., "Surgery
:
PAGE
445500
Orchitis Acon., Bell., Aur. m., Clem., Merc. s., Puls., Sulph. 57
Cases cured
Ophthalmia: Acon., Bell., Merc. s., Merc. corr., Lotion of
alum, Zinc. sulph., Carbolic ac., Condy's fluid, Arg. nit.
Chronic stage: Sulph.
Rheumatism: Acon., Puls., baths, sea voyage
Gonorrhoea in women
Vulvitis
Urethritis
Vaginitis
Uteritis
...
Symptoms of each
Diagnosis
Treatment
Greece, Syphilis in
History of syphilis
Hygiene of syphilis
India, Syphilis in
Judea, Syphilis in
...
...
...
...
...
...
Kreuznach waters in constitutional syphilis
...
Lowndes', Dr., pamphlet on Contagious Diseases Acts
Names bestowed on syphilis by different nations
Onanism in the male
Symptoms
...
Constitutional effects
Local effects
Treatment
in the female
Symptoms
Treatment
Persia, Syphilis in ...
...
Prognosis of syphilitic and syphiloidal diseases
Rome, Syphilis in ...
...
•
...
...
...
58
62
63
65
65
66
...
66
67
67
66-68
68
68-70
4
I
24
506
2 59 m
159
183
167
162
162
163
163
164
163
...
163
...
168
3
118
Sycosis
History of
Anatomy of
Different forms of
Treatment of
Symptoms, Early, of syphilis
Syphilis, True
Definition of
Authorities
...
...
...
Syphilis, Congenital
Different forms
Symptoms of
Prognosis
..
...
...
4
... 120
I21
121
121
123
6,7
84
85
85-87
...
...
126
127
128
129
194
INDEX.
Sypilis, Congenital. Diagnosis
Treatment of different forms
...
Syphilis, Constitutional, secondary stages
Different forms
...
...
...
Tertiary stages
Different forms
Different forms
Treatment of
Quaternary stages
...
Syphilis essentially a constitutional disease
Primary lesions
...
Secondary lesions
Tertiary lesions
Quaternary lesions
Incubative stages
PAGE
129
130
133
134
...
136
1
...
...
137
...
...
...
138
139
143
87
88
88
88
89
со со со со со со со
88
Table of relative period of incubation of other febrile diseases 89
Period of local eruption
Different forms of chancre
Symptoms of each
...
Indurated or Hunterian sore
Gangrenous sore
Treatment by ancient physicians
By modern physicians
Complications of chancre
Syphilis in Middle Ages
Authorities
...
...
Theory of American origin of syphilis
Áfrican origin
Authorities
...
...
...
...
...
...
...
92
92
...
93
94
...
95
96
100
104
5
5,6
...
ΙΟ
...
::
II
12,13
Modern Works on the Principles and Practice of
HOMOEOPATHY.
For the use of the Professional Student, the Clergyman, the
Missionary, the Colonist, Heads of Families, etc.
I Text-Book of Modern Medicine and Surgery,
ON HOMOEOPATHIC PRINCIPLES.
By E. H. RUDDOCK, M.D., L.R.C.P., M.R.C.S., L.M. (Lond. and Edin.), &c.
Demy 8vo., pp. 1032, 21s.; half-morocco, 25s.
Extracts from Reviews.
"All articles are characterized by extreme lucidity, and hints and instructions are marked by thought-
fuluess. and common sense.' - Chemist and Druggist.
"Dr. Ruddock's writings have always been favourably received, and this book-perhaps the most
important of all of them-cannot fail to meet with the same attention."-Public Opinion.
LA
Very clearly and pleasantly written, and on matters of hygienic rule and habits contains a
vast amount of common-sense advice, which even the non-medical reader may find it to his advantage
to consult."-Graphic.
4
It does not require recommendation, being the exponent of its own merits."—Church_and
Home.
"As a volume of general utility, containing a large and varied amount of information concerning
the nature of a considerable proportion of diseases, and the remedial measures requisite for their
cure and palliation, it possesses strong claims to our commendation."- Homœopathic Review.
"The student will find it a work of great value in the preparation of his cases, and the busy
physician a work of ready reference in his arduous labours."-Medical Union.
This splendid volume of 1032 octavo pages is, altogether, the most complete text-book for the use
of the layman, student, and physician which has ever been published for our School. Next to Bæhr
it is the best work on Practice, but its value is not confined to this department alone." From the
American Observer, by Dr. E. M. HALE.
66
Valuable for laymen and young practitioners, written in a plain, pleasant, off-hand style.
Our author gives concisely in a few pages the essence of large volumes. We feel more
pleased with the book the more we read it, and we can recommend it in good faith to all
our readers of high or low degree, strict Hahnemannians or otherwise."-North American
Journal of Homeopathy.
Although this volume is got up very much in the style of the author's 'Vade Mecum,' it is by
no means a reprint of that work. Very much new material has been added in all the departments
and the whole character of the work has been changed, while its value has been at the same time
greatly increased. For junior practitioners (and seniors as well) it will certainly prove of con-
siderable service. It is handsomely printed with clear type on good paper, and presents a very
attractive appearance. We recently had the pleasure of meeting Dr. Ruddock, and were as much
pleased with the man as with the book."-Hahnemannian Monthly.
"Dr. Ruddock has again placed the profession under obligations to him for another valuable work
on Homeopathic practice.
The most liberal as well as the most exclusive Homeopath will
find within its covers food for his mind of the most solid character. The first pages of the book
are devoted to the sadly ignored field of Dietetics, and the proper method of cooking and selecting
food for invalids and healthy persons as well. These chapters are exceedingly valuable, and may
be read with advantage by many physicians, old as well as young.
Then follows an admi.
rable series of short chapters on Hygiene. The doctor evidently helieves in the old saw of an
ounce of prevention being worth a pound of cure. The Clinical Directory is one of the most
valuable yet published.
For a comprehensive work, one for ready reference for the busy
physician and the student, we can heartily and conscientiously recominend Dr. Ruddock's.
Luytie's St. Louis Monthly Homœopathic Circular,
+
·
"We believe that there is nothing equal to it in England or America for its precise descriptions
of diseases and their symptoms, for full and specified indications of remedies, copious and
valuable professional experience gathered in a Clinical Directory, and for complete index to
the contents of the volume.”—Colombo Observer.
"Dr. Ruddock, author of several well-known works on Homeopathy, has just published
this handsome volume of 1032 pages, which we recommend to all our confreres to whom the
English language is familiar. Dr. Ruddock being intimately acquainted with the progress of
Homœopathy, has introduced in his book most of the recent acquisitions of the science,
particularly concerning the new American remedies."-Revue Homeopathique Belge.
HOMEOPATHIC PUBLISHING COMPANY, 2, Finsbury Circus, London, E.C.
2
HOMEOPATHIC PUBLICATIONS.
NEW PUBLICATION. Feap. 8vo., pp. 252, handsomely bound, gilt lettered
and side, price 3s. 6d.
ESSENTIALS OF
OR,
DIET;
HINTS ON FOOD IN HEALTH AND DISEASE.
By the late Dr. HARRIS RUDDOCK.
Corrected and Revised by E. B. SHULDHAM, M.D., M.R.C.S., M.A. Oxon.
RECENT REVIEWS.
"In homœopathic literature diet has hitherto been considered solely as among the causes of disease,
and as presenting antidotes to medicines. So our homeopathic dietaries have been generally a
mere list of articles of diet likely to be prejudicial to sick persons, or such as would blunt the
sensibility of the system to medicine. We have also a good homeopathic cookery book to aid in the
carrying out of these two principles, but little attention has been paid to diet as especially applicable
to particular diseases, or even as a means of cure in itself. This book supplies that want, and gives
us in a handy form the essentials, as it professes, in these particulars. We cannot say that the
theoretical views are quite up to the day, for they savour too much of the chemical theories of
physiology, but this is of little importance, as we think the practical directions are extremely well
chosen, and, in the main, in accordance with the best authorities on the subject. In fact, this book
supplies what, as regards diet, we would be disposed to put into the third section of the therapeutic
part of the Hahnemann Society's Repertory, if that much-wanted work ever comes to completion. We
cannot give it greater praise, and cordially recommend it in the meantime."-The British Journal of
Homœopathy.
One last work from the pen of the late Dr. Ruddock, lately published under the editorial care of
Dr. Shuldham, will not be found the least useful of the books prepared by that prolific author. It is
entitled Essentials of Diet; or, Hints on Food in Health and Disease.' The subject has been
treated somewhat abundantly of late years, and there is little excuse now for any well-read person
to torment his stomach with food not suitable for it. The danger is, that a course of this kind of
literature may lead one to torment his imagination with distorted pictures of the frightful effects of
almost any meal he may happen to take; and we are inclined to think that dyspepsia is almost as
closely dependent on the imagination as on the stmach. Dr. Ruddock's small treatise, like all his
works, is simple and practical. It gives no elaborate chemical tables of analyses, nor does the author
treat his invalid clients like criminals in a prison, weighing out to them the exact amount of nitro-
genous, carbonaceous, and mineral foods which they are to take in each twenty-four hours. Half the
book is devoted to a consideration of the qualities of the various kinds of foods, and the rest is occupied
with chapters on the diet most desirable in the various disorders resulting from dyspepsia, and under
special circumstances. A series of useful recipes is added, which tell how to prepare in the best way
any of the ordinary household forms of diet, suitable,especially to the sick-room."- Chemist and
Druggist.
เ
"A melancholy interest attaches to this little volume. It was at the time of its author's death
nearly, if not quite, complete, when he was suddenly called away, as, in a prettily-written preface
Dr. Shuldham remarks, to enjoy that one thing he had ever denied himself, and that was, Rest.
"A successful caterer for the many wants of the sick-room, we doubt if Dr. Ruddock ever more
usefully endeavoured to provide for them than in this simple and-because simple-valuable brochure
before us.
"Some serviceable hints on the regulation of diet are followed by a few pages pointing out the
physiological connection between food and its digestion.
Brief notes on the special properties of the many varieties of animal and vegetable food occupy
the next four chapters. The sixth directs attention to the special forms of food most desirable in
some of the more prominent morbid conditions. The seventh and concluding chapter enters into
details respecting the best methods of preparing food. Alarge amount of really useful information
is contained in Dr. Ruddock's last contribution to popular medical literature, and we feel sure that
our readers will find its perusal of service to them in the many dietetic difficulties which surround
efficient nursing. Dr. Shuldham has, as we can see, carefully revised the MSS., and done all that
could be done to render the book pleasant and easy reading."-Homœopathic Review.
66
This work, which has been corrected and revised by Dr. Shuldham, will prove valuable to all
readers alike, Allopath and Homoeopath. The nutritive qualities of every kind of food are commented
on, pointing out in clear and intelligible language what is best to partake of, not only in health but
in disease. The truth that a stricter attention to diet-what to eat, drink, and avoid-will, to a great
extent, dispense with the doctor's visits, is daily becoming more known and appreciated, conse-
quently the value of this comprehensive yet compact,diet guide, by an acknowledged authority,
cannot easily be overestimated."- Brighton Times.
HOMEOPATHIC PUBLISHING COMPANY, 2, Finsbury Circus, London, E.C.
HOMEOPATHIC PUBLICATIONS.
3
Seventh Edition. Thirty-eighth Thousand, thoroughly revised, wide margins,
price 10s. 6d.; half-bound, suitable for presentation, libraries, medicine chests,
&c., 14s. Cheap abridged edition, Fifty-third Thousand, without Clinical
Directory, 5s.; superior binding, 7s.
THE HOMEOPATHIC VADE MECUM
OF
MODERN MEDICINE AND SURGERY.
With a Chapter on Poisons, a Clinical Directory (containing the personal experience
of many Physicians), an Appendix of Formula, Table of Dilutions of the
Remedies prescribed, and copious Index.
NOTICES.
·
•
"A work which has been called for so frequently by the public as this, and within so short a time
since its original publication, must be possessed of more than ordinary merit.
We shall
only add that we know of no volume on the subject better calculated to suit the requirements
alike of the popular investigator and the professional student than that of Dr. Ruddock.”-
Edinburgh Daily Review.
"Dr. Ruddock has so fully and clearly filled in the design, that his work well deserves the
unusual success it has gained."-Chemist and Druggist.
"From preface to index it wears the aspect of a text-book, suited alike to the professional
student, the clergyman of a parish, and the head of a family."-Church Standard.
44
Any one who has desires to be acquainted with the homoeopathic system of medicine
should purchase Dr. Ruddock's Vade Mecum. It is deservedly the most popular work of its
sort."-Belfast Weekly Observer.
Revised Edition. Price 5s.; or interleaved, 6s., post free.
THE CLINICAL DIRECTORY;
CHAPTERS ON POISONS, Etc.,
Being Parts V. and VI. of the "Text-Book of Modern Medicine and Surgery."
Very convenient as a pocket repertory.
This repertory is brief, simple, and based on clinical experience. Dr. Ruddock is known as a
very candid and reliable author."-The American Homœopathic Observer.
Crown 8vo., handsomely bound in cloth, gilt lettered, price 1s. 6d.
DOCTOR
LOWE'S
SACRIFICE;
OR, THE TRIUMPH OF HOMEOPATHY.
i
'DOCTOR LOWE'S SACRIFICE' is a tale written to set forth the general facts, combat erroneous
opinions and prejudices, and controvert objections which are raised against Homœopathy. This
sort of thing has generally been done in medical works and pamphlets, but we see no reason
why it should be confined to such works. The style is interesting, and may make the mere reader
of stories thoughtful. It is, however, just as well to tell would-be readers that the work represents
in a narrative form the objections to the law of similars, and the manner in which they can be
met. It points out the prejudice that exists, and the method by which it may be overcome. If
we drive our friends away from reading it by this candid statement, surely we must be held blame-
less. Dr. Lowe, the hero, gains a charming wife at the end of the book according to the orthodox
fashion, which, perhaps, has something to do with the law of similars after all."-Public Opinion.
"This is a capital little story, in which the advantages of the homeopathic system of medical
treatment are considerably displayed, to the disadvantage of all other systems. It is in itself a
remarkable work, and possibly unique in its method of explaining the scientific mode of treatment
of disease. But, though it is admittedly written in advocacy of the special mode of medical treat-
ment, it is nevertheless a most excellent story, most ingeniously worked out, and full of very amusing
and interesting incidents."-Southport News.
HOMOEOPATHIC PUBLISHING COMPANY, 2 Finsbury Circus, London, E.C.
4
HOMEOPATHIC PUBLICATIONS.
!
NOW
READY.
TENTH EDITION (130,000 Copies) price, lettered, good binding, toned paper,
with a CLINICAL DIRECTORY, price 1s. 6d.; ditto, elegant binding, gilt
edged, for Presents, 3s. 6d.; Cheap Edition, without Clinical Directory, &c., ls.
THE STEPPING-STONE TO HOMEOPATHY
AND HEALTH.
Opinions of the Press on previous Editions.
"The present issue is both an enlargement of, and an improvement upon, its predecessor.
Its use is not intended to supersede the attendance of the properly qualified practitioner, but only
as a guide to the treatment of trifling but painful ailments, or the prevention of more dangerous ones
by prescribing precautionary treatment." – Public Opinion.
"Contains all that is essential to a domestic work, in an easily accessible form, and in more
explicit and satisfactory language to the non-professional than many a larger and more pretentious
work."— United States Medical and Surgical Journal.
"He who has never opened the book before is able to find the remedy he wants."-
Homœopathic Record.
Sixth Edition, 26th Thousand, thoroughly revised and improved, with new
Sections, toned paper, handsomely bound in patent morocco, bevelled boards,
burnished edges, price 5s. Cheap edition, in cloth, 3s. 6d.
By E. H. RUDDOCK, M.D., L.R.C.P., M.R.C.S., L.M. (Lond. and Edin.), &c.
THE LADY'S
MANUAL
Of Homœopathic Treatment in the various Derangements incident to her Sex.
44
+
Written in clear language.
་
woman needs, and contains infor-
Women's diseases are here treated as clearly as the most
exacting student could require."-Chemist and Druggist.
The work of Dr. Ruddock is precisely what every
mation for the want of which she often suffers permanent loss of health. The whole range
of functions and diseases incident to women is treated with care and precision."-New England
Medical Gazelle.
"We do not hesitate to say that 'The Lady's Homeopathic Manual' is the best book of its kind we
ever examined. The author knows what to say, how to say it, and how to stop when it is said.”—
United States Medical and Surgical Journal.
แ
The Lady's Manual' is a work which should be in the hands of every lady in the land. The
remedies prescribed are mainly homoeopathic and hydropathic, and are extremely judicious. We
nerer examined a medical work which pleased us so well." – Western Rural.
4
C
The fact that this is the Sixth Edition' shows the estimate placed upon it by the public, and the
estimate is a just one, for the work is in every respect meritorious. As a book to be placed in the hands
of married women it stands unrivalled, and yet it is full of just such information as the general
practitioner should possess, and will here find easily and quickly. We have seen nothing of the
kind that pleases us so well."-Cincinnati Medical Advance.
7th Thousand, 12mo., pp. 228, 3s. 6d.
THE DISEASES OF INFANTS AND CHILDREN.
and their Homoeopathic and General Treatment
By E. H. RUDDOCK, M.D., L.R.C.P., M.R.C.S., L.M. (Lond. and Edin.), &c.
"A very valuable contribution to the pathology and therapy of the diseases of children. It contains
for physicians much interesting matter, and also not a little that is new.”— Allgemeine Homœop.
Zeitung.
+
Admirabie hints on the general management of children, hygienic and medical prescriptions bemg
intended for preventive as well as for curative treatment."-Public Opinion.
"The Doctor traverses the entire domain of therapeutics."-- Daily Review.
"It is a work worthy of commendation, for while written in plain language, so that all may
understand its teachings, it preserves a sound pathology and diagnosis throughout, and its treatment,
which embraces the new remedies as well as the old, is in accord with the experience of most
practitioners, and is thoroughly sale.
"This volume is in keeping with the handsome style in which other volumes by the same prolific
author have been presented."-Hahnemannian Monthly.
HOMOEOPATHIC PUBLISHING COMPANY, 2, Finsbury Circus, London, E.C.
HOMEOPATHIC PUBLICATIONS.
5
من
Crown 8vo., handsomely bound in half-calf, pp. 840, price 15s.
THE VETERINARY VADE MECUM,
A Manual on the Horse, Cow, Dog, and Sheep; their Diseases, Homœopathic
Treatment and General Management.
Edited by R. P. G. LORD, M.R.C.V.S.L.; also by J. RUSH and W. RUSH,
Veterinary Surgeons.
REVIEWS.
"There are so many valuable publications on this subject that it seems invidious to
draw attention to one particular work, but we can safely say that the work under review is one
that every breeder and others having cattle will find of great service. Homœopathy has
worked a radical change in the system of treatment of the human body, and in a like manner
has a different method of treatment for the animal-a system, we venture to say, more in
accord with our humanitarian ideas than the former one. Looking at the subject in an
economic point of view, we find homeopathy claims advantages worth recording. Thus the
author, Mr. W. C. Lord, veterinary surgeon of the cavalry depôt, Canterbury, when stating
his reasons for preferring homeopathy to the old system, says that the remedies act quicker,
safer, and better in many ways, particularly in not reducing the strength of an animal after
drugging, as is frequently the case under the old system. In reference to colic or gripes, he
says:-The average time it takes to cure colic homeopathically (as taken from sixty-four
consecutive cases in my official record of treatment) is 77 min., but some cases I have cured in
from 10 min. to 14 min. with ten drops of the appropriate remedy. The longest of my cases
under treatment was 6 hours, the shortest 5 minutes."-Melbourne Weekly Times.
Lucidly arranged and well treated, sufficient for the guidance of non-medical readers,
and not overloaded with technical information; we cordially recommend the book."-British
Journal of Homœopathy.
"Those who desire to treat the diseases of the horse, cow, dog, and sheep on homeopathic
principles cannot have a better manual for their purposes than The Veterinary Vade Mecum,'
and even those who are inclined to abide by the older fashioned and more generally practised
'heroic' treatment of diseases will find much valuable information in the work. The editors
are veterinary surgeons of large experience in the army as well as in country practice, and
evidently know their business thoroughly."—Irish Farmers' Gazette.
"The section devoted to the consideration of horse ailments appears to have been done with
much care.
Taken as a whole, this book will be found useful alike in the stable, the
kennel, and the eow-shed."-Homœopathic Review.
•
"The authors know their business thoroughly. They treat the various diseases concisely,
but completely. We know of no book where we could turn so readily for an exact statement of
the symptoms in the several animals which indicate the complaint; and as far as hygienic
treatment is concerned we admit also the usefulness of this volume."-Chemist and Druggist.
"The law of similars, similia similibus curantur, having been found beneficial to mankind,
is to be extended to the diseases of the lower animals. The dumb creation has suffered much
in times gone by at the hands of ignorant cow-leeches' and farriers, and though the veteri-
nary surgeon is now no longer a brutal, ignorant practitioner, yet, at times, his treatment is
far too heroic. If homeopathy can provide simpler but not less effective means of cure than
animals have hitherto been subjected to, we cordially wish it success in the experiment. The
present volume describes in a simple manner modern scientific methods of detecting disease
and observing symptoms, also the best modes of treating animals in sickness. Special attention
has been paid to the disorders of the horse, very full descriptions of their causes, pathology,
and symptoms being given, together with the remedies which extensive experience has proved
to be most applicable. The administration of remedies is based upon homeopathic principles,
and is indicated not only by an acquaintance with those principles, but also by diversified ex-
perience in the use of the remedies. The instructions on feeding, and housing, and the best
course of treatment to aid in restoration to health, are very useful, and hence farmers and
others who keep animals may refer to the work with profit."-Public Opinion.
HOMEOPATHIC PUBLISHING COMPANY, 2, Finsbury Circus, London, E.C.
6
HOMEOPATHIC PUBLICATIONS.
New Series.-Enlarged and Improved.
THE HOMEOPATHIC WORLD:
A Popular Journal of Medical, Social, and Sanitary Science.
Edited by E. B. SHULDHAM, M.A.,
Trinity College, Dublin; M.R.C.S., M.A. Oxon.
Elegantly Bound, Bevelled Edges, Gilt Lettered, price 7s. 6d., post free.
HOMOEOPATHIC WORLD VOLUME FOR 1876.
Specially suitable for presentation to Libraries, Reading Rooms, &c.
Monthly Parts, 6d. ; by Post, 7d. ; or prepaid 6s. per annum, post free Monthly.
An idea of the Contents may be gathered from the Index in the December part. Each Volume
furnishes profitable reading, and will be found very useful for reference.
The YEARLY VOLUMES from 1866 to 1874, inclusive, well bound in cloth, gilt lettered, price 5s.
each, post free.
Covers for binding for 1873 and 1874 and previous years, price 1s. each. Covers for 1875 and 1876,
1s. 6d. each.
"A welcome addition to ordinary reading."-Public Opinion.
44
"Fills a void in homoeopathic literature.
•
•
We can commend this Journal as the best our School ever published."-New England
Medical Gazette.
The cheapest journal published.
Filled with well-written articles. - Boericke and Tafel's Quarterly Bulletin.
"Ranks much higher than any other popular homoeopathic journal."--American Homeopathic
Observer.
MATERIA MEDICA AND SPECIAL THERAPEUTICS
OF THE NEW REMEDIES.
By Dr. E. M. Hale. Fourth Edition, revised and enlarged. In two Vols.,
half-bound, 558.
From a personal interview with Dr. E. M. Hale, when on a visit to England, we learn that the
fourth edition of his New Remedies differs from previous editions in this, namely:-
Vol. I. contains the characteristic and special symptoms of all the American remedies
mentioned in the first, second, and third editions, together with many other new drugs from the
mineral kingdom.
"Vol. II. is made up of matter nearly new, being mainly Dr. Hale's lectures on the Materia
Medica and Therapeutics of New Remedies, delivered before the class of Hahnemann Medical
College, Chicago, during the last four years. This volume gives, therefore, his latest and
ripest experience with those medicines which he was so instrumental, in bringing before the
homœopathic profession."-Homœopathic World, November, 1876.
Second Edition, enlarged, fcap. 8vo., price 1s. 6d.
ON CONSUMPTION
OF THE
TUBERCULOSIS
AND
LUNGS:
Their Diagnosis, Causes, Prevention, and General Treatment, embodying the
Modern Views on these Diseases, with cases treated by the Author.
"Treated fully and intelligently. We gladly wish Dr. Ruddock's work a wide circulation, and
we trust it may prove useful in enabling 'delicate' persons to ward off Consumption."-Homeo-
pathic Review.
"We admire the precision and clearness with which the Author unfolds the questions and matters.
of which his book treats, and the depth of knowledge he displays within such narrow limits,
in order to place before the public the preventive and curative measures in cases in which
they are possible. This work may be consulted with advantage by the faculty."-El. Criterio
Medico.
"We are surprised at the amount and clearness of the information given in so small a work.
It should be on sale in every city; and those who thoughtlessly place themselves in the way
of this remorseless malady should take warning from its lucid pages."- New England
Medical Gazette.
HOMEOPATHIC PUBLISHING COMPANY, 2, Finsbury Circus. London, E.C.
HOMEOPATHIC PUBLICATIONS.
7
HOMOEOPATHIC MISSIONARY
MISSIONARY TRACTATES.
Fifth Edition, much improved.
I. Fallacies and Claims. Being a word to the world on Homœopathy.
"It is the clearest and most comprehensive little treatise we have in our litera-
ture."-Dr. Hering.
Fourth Edition, revised and enlarged.
2. Ministers and Medicine: An Appeal to Christian Ministers on the
subject of Homoeopathy. By Rev. THOMAS SIMS, M. A. (late Rector
of St. Swithin's-upon-Kingsgate, Winchester), Author of "Letters on
the Sacred Writings," &c.
3. Principles, Practice, and Progress of Homœopathy. (Fourth
Edition.)
4. The Practical Test of Homœopathy; or, Cases of Cure by Homoeo-
pathic remedies, in the practice of various physicians. (Second Edition.)
5. Measles; its Complications and Fatality prevented by Homœo-
pathy. Being contributions from more than twenty medical men.
(Second Edition.)
6. Homœopathy Explained; a Word to the Medical Profession.
By Dr. JOHN WILDE.
7. Constipation; its origin and Homœopathic Treatment, and the
use of Enemeta. By Dr. JOHN WILDE.
8. Scarlet Fever: Being an attempt to point out how the ravages of this
very fatal disease may be limited. By Dr. JOHN MAFFEY.
The above Tracts are published at One Penny each, or for enclosure in
letters, &c., post free, 25 copies for 15 stamps, 50 for 26 stamps, 100 for 48
stamps.
Catalogues of Homeopathic Publications post free on Application.
A SYSTEM OF SURGERY.
By WILLIAM TOD HELMUTH, M.D., Professor of Surgery in the New York
Homeopathic Medical College. Illustrated with 571 Engravings on wood.
Price 40s.; superior binding, 45s.
"The author is no mere theoriser, but is well known as a bold, skilful, and successful surgeon,
who has made a high mark amongst the best surgeons of the country; and into this book
he has put the experience he has gathered within the past twenty years. We are able to assert,
from a very careful examination of the work, that as a text-book of surgery, or as a work especially
adapted to the requirements of a homeopathic practitioner, it has no superior."-Hahnemannian
Monthly.
"Perhaps no surgeon's success bas reflected more credit upon Homeopathy than that of
Prof. Helmuth. Nearly twenty years ago he had felt the want to which we have alluded, and
he had barely entered his profession before he made this a subject of special study, and
compiled a work on surgery of 650 pages, which was published in 1855. Eighteen years have
added greatly alike to his experience, his reputation, and his ability for such a task; and now
we have this splendid volume of 1,228 pages from his pen, carefully illustrated in all essential
points. The advent of such a volume is indeed an epoch both in surgery and in our school.
He has collected, summarized, and condensed the experience of the homeopathic school for
more than half a century-from Hahnemann to the present time. In this he has left little to
be desired, and has written what no homeopathic physician can afford to be without."-New
England Medical Gazette.
All British and American Homœopathic Medical Books.
Price Lists on Application. Special terms to Shippers and large buyers.
For further particulars address THE HOMEOPATHIC PUBLISHING COMPANY,
2, FINSBURY CIRCUS, LONDON, E.C.
3
со
HOMEOPATHIC PUBLICATIONS.
NEW
WORK ON HOMEOPATHY.
Just published, crown 8vo., 264 pp., price 3s. 6d.,
THE LIVER,
Historically, Anatomically, Physiologically, Pathologically
and Therapeutically considered.
BY WILLIAM MORGAN, M.D., ETC.
REVIEWS.
"This work, which treats on perhaps the most prolific source of human suffering, will
prove not a little interesting to students of Chemistry, whether followers of the homoeopathic
or allopathic schools. Not only does every line bear witness to the practical acquaintance
the author has with his subject, but it marks him as an anatomist of a very high order. He
goes exhaustively into the question of the liver and its ailments; quotes all the diseases,
slight or acute, to which it is heir; and describes minutely what, in his opinion, are the most
efficacious remedies; comparing the means taken by allopathic as opposed to homoeopathic
practitioners. Of course, as one of the leading homoeopathic physicians, his leanings to the
method so forcibly described by the maxim, similia similibus curantur, are very plainly
marked, but in no passage that we have been able to select do they approach anything like
bigotry. The work is forcibly and earnestly written, and were it not for a too free use of
technical terms, which render many simple passages somewhat obscure to the superficial
reader, it would be found of inestimable service to ninety-nine persons out of every hun-
dred. The perusal of it by a student of surgery or anatomy would inevitably lead to the
procuring of some of the other numerous works by the same author. The book is handsomely
got up, and well printed on toned paper."
"This volume gives, in a chatty, pleasing style, an outline of the functions of the liver,
and of the pathology and treatment of those disorders to which it is most prone. Many
persons are painfully conscious of possessing a liver, or at any rate generally trace to some
disturbance of its functions the ill-health from which they suffer. Dr. Morgan has, in the
pages of his little book, endeavoured to gratify the thirst for knowledge respecting their
particular ailments such persons usually evince. So far as the brief examination we have
alone been able to give to it enables us to judge, the descriptions of disease are fairly accurate
and the treatment which is advised is, under skilful guidance, such as would probably prove
useful. One feature in the book is somewhat novel. Dr. Morgan gives an outline, in con-
sidering the therapeutics of each disease, of the allopathic treatment ordinarily pursued
The book is interesting, and will doubtless be found useful in directing attention to the clas
of remedies from which the practitioner has to select when prescribing."-Monthly Homeo
pathic Review, July, 1877.
"A carefully written book of over two hundred pages, in which the various disorders of the
liver are treated historically, anatomically, chemically, and under other heads. One feature
of the book is that a short account of the allopathic treatment is given with each disease."
Chemist and Druggist, June, 1877.
"This work, by a local medical gentleman, treats of a veryimportant organ of the human body
in a popular form, so that it may be readily understood by the ordinary reader. The history
anatomy, chemistry, and treatment of each disease of the liver are here given in a clear and
concise form. Although the author is a distinguished member of the Homeopathic School of
Medicine, he nevertheless, taking a wide and liberal view of things, appends the allopathic
method as well as the homeopathic system of treatment. The work, which is very neatly
got up, will thus be found to be of genuine service to those of either school who wish to
possess accurate views on one of the most important parts of the human organism.”—Brighton
Times, June 2, 1877.
เเ
This is a philosophical book, based on sound principles, and not at all illiberal. In fact,
the book will be alike useful to the orthodox practitioner, to the homoeopath, and to the
general pathologist. We might suggest that there is an apparent printer's error on the four-
teenth page, in which the well-known word 'officinal' has been printed twice over 'official.'
This can easily be altered in the second edition, which is sure to be required of this useful and
convenient little manual of hepatic diseases."-Public Opinion, June 23, 1877.
LONDON:
HOMEOPATHIC PUBLISHING COMPANY, 2, FINSBURY CIRCUS, E.C.
HOMEOPATHIC PUBLICATIONS.
9™
NEW
WORK
ON HOMEOPATHY.
Now ready, crown 8vo., 200 pp., price 3s. 6d.,
DIABETES
MELLITUS:
Its History, Chemistry, Anatomy, Pathology, Physiology,
and Treatment.
Illustrated with Woodcuts and Cases.
BY WILLIAM MORGAN, M.D., ETC.
This Work forms an Historic Record of the Pathology and Physiology of
Diabetes, from the Era of Hippocrates to the startling discoveries of Claude,
Bernard. As the edition is a limited one, early orders for copies are requested
Dr.
"Dr. Morgan's treatise is philosophical and exhaustive. The author gives a perspicuous
and practical exposition of the nature and causes of the complaint, and we hope that a
disease which for so many centuries has baffled the skill of the faculty may be alleviated by the
application of the rules contained in the complete and systematic work before us.
Morgan points out that since 1848 our knowledge of the whole subject has been revolutionized
by the experiments of Claude Bernard, Chauveau, Bence Jones, Harley, and Pavy. His own
researches have further revolutionized our ideas.”—Public Opinion, July 7th, 1877.
Handsomely bound, price 2s. 6d.,
The Signs and Concomitant Symptons of Pregnancy,
Their Pathology and Treatment.
To which is added-A Chapter on Delivery; The Selection of a Nurse; and
The Management of the Lying-in Chamber.
Third Edition, Parts I. and II. now ready.
A Manual of Pharmacodynamics.
By Dr. RICHARD HUGHES, L.R.C.P., &c.
Part I. containing the Remedies from Acids to Guaiacum; Part II. containing the Remedies
from Hamamelis to Zincum, may now be obtained from the Homœopathic Publishing Comnang,
who have purchased all the above books lying in the printer's hands, cousisting of 2,000
copies, which they are prepared to offer on liberal terms.
Price for each Part, in Cloth binding, 7s. 6d. ; Paper Covers, 6s.; or handsomely bound
in one volume, 14s.; and with Clinical Index, 15s. 6d.
Export Orders promptly attended to.
Third Edition, cloth, 1s. 6d.,
THE PHILOSOPHY OF HOMOEOPATHY.
(See Opinions of the Press.)
LONDON:
HOMEOPATHIC PUBLISHING COMPANY, 2, FINSBURY CIRCUS, E.C.
10
HOMEOPATHIC PUBLICATIONS.
NOW READY, TENTH EDITION.
ONE HUNDRED AND THIRTY THOUSAND COPIES,
IMPROVED AND ENLARGED,
Price, lettered, good binding, toned paper, with a CLINICAL DIRECTORY,
ls. 6d. ; ditto, elegant binding, gilt edged, for Presents, 3s. 6d.; Cheap
Edition, without Clinical Directory, etc., 1s.
THE STEPPING-STONE
ΤΟ
HOMŒOPATHY & HEALTH.
BY
E. H. KUDDOCK, M.D., L.R.C.P., M.R.C.S., L.M., (Lond. & Edin.)
ETC.
Opinions of the Press on previous Editions.
"The present issue is both an enlargement of and an improvement upon its predecessors.
Its use is not intended to supersede the attendance of the properly qualified practitioner, but
only as a guide to the treatment of trifling but painful ailments, or the prevention of more
dangerous ones, by prescribing precautionary treatment."-Public Opinion.
Contains all that is essential to a domestic work, in an easy accessible form, and in more
explicit and satisfactory language to the non-professional than many a larger and more pre-
tentious work."- United States Medical and Surgical Journal.
"He who has never opened the book before is able to find the remedy he wants."—
Homœopathic Record.
"A perfect manual on a vital subject, and a copy should be in every home."-Wesleyan
Times.
แ
Nolens volens, we physicians have to give in, for laymen will, without our permission,
try their hand on doctoring; and the best we can do is to instruct them to do it in the right
manner; and, after all, it pays even to the doctors, for there is no better proselyte-maker
than a lay woman who has performed some 'miraculous cure' with Aconite and Chamomilla.
May this and similar works be spread broadcast over the land. May they sow the seed, aud
the bomœopathic fraternity will enjoy the fruit, So may it be!"- North American
Journal of Homœopathy.
"The issue of 100,000 (now 130,000) copies of one of Dr. Ruddock's books indicates the
number of those who are inquiring into, if not practising, Homœopathy-for he is not the only
homeopathic writer, although he holds a high place among his compeers. An epitome of
the homœopathic system-exceedingly useful for learners." From Dundee Advertiser.
"This is a very comprehensive manual, on a very interesting subject. They who wish to
obtain a clear bird's-eye view of the system will find the volume reliable."- British Standard.
"The volume contains a great amount of information on the symptoms, causes, and treat-
ment of diseases of most frequent occurrence. It also treats of the diet and accessory
measures connected with the practice of domestic Homoeopathy."-Halifax Observer.
"It is devoid of all medical technicalities, and is written in a style so simple that the most
inexperienced can understand it."-National Standard.
"Clever, clear, and simple guide to Homeopathy and Health.'"'-Weekly Record.
HOMOEOPATHIC PUBLISHING COMPANY,
2, FINSBURY CIRCUS, LONDON, E.C.
AND ALL HOMEOPATHIC CHEMISTS AND DRUGGISTS.

UNIVERSITY OF MICHIGAN
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