SYPHILITIC DISEASES, THEIR PATHOLOGY, DIAGNOSIS, AND TREATMENT. SECTION I. CHAPTER I. PRELIMINARY OBSERVATIONS. IF, in ordinary scientific researches, it be considered necessary, previous to entering upon the elucidation of a given subject, to afford a clear definition of the terms employed in designating the object under consideration; it is, I conceive, infinitely more incumbent on the author who ventures upon the description or treatment of disease, to state, beyond the possibility of doubt or cavil, the signification which he proposes affixing to the different affections of which he purposes to treat. But, unfortunately for the advancement of medical science, disputes, misunderstandings, and misinterpretations, have been severally the lot of the very names adopted to denote the characters of disease; symptoms have been multiplied, ideas mystified, and the patient investigator after truth retires from the scene of laborious research, with a mind enriched with a copious vocabulary, burdened with B innumerable and discordant opinions, and perplexed amidst the difficulty of diagnosis, and the consequent uncertainty of determining upon a safe and judicious line of treatment. To those who have devoted attention to the study of venereal diseases, with a view of arriving at clear and accurate conclusions as regards their history, pathology, or treatment, the applicability of the foregoing remarks must be in a more especial manner recognised; and, in proportion to the expenditure of time and labour in collecting the published records and opinions of authors, will they be compelled to exclaim, with one whose recent investigations have thrown considerable light upon this branch of special pathology : "What is syphilis? What are its symptoms?" Thus, for example, one class of writers describe all the forms and varieties of the disease as modifications of one specific virus, the different phases having been eliminated by peculiarity of constitution, mode of living, climate, treatment, &c.; while another, not inferior in ability, or deficient in opportunities of observation, contend that to a plurality of poisons alone can symptoms so diversified in their character, yet so uniform in their succession when once produced, be attributable. Again, the nomenclature by which these affections were formerly designated has, in conformity with more modern usage, participated in the revolution to which all things human are subjected; blennorrhagia has been substituted for the more objectionable term, gonorrhoea, while, in the very description of the stages of that disease, a confusion exists calculated to embarrass the mind,—at least of the student; virulenta being employed by most English authors to designate the second and more aggravated stage of the affection; while, by continental authorities especially, the appellation is confined to the disease when accompanied with ulcers in the urethra. The mode of treatment has been no less varied, in accordance with the peculiar views of the writer; by some, mercury being employed in every form of the disorder; by others, in certain selected cases only; and, by a third, its use being completely discarded. Preparatory, therefore, to entering upon the subject designed by the following pages, I think it requisite to premise that, by venereal diseases I mean all those affections either directly or indirectly consequent upon impure sexual intercourse a definition which must naturally include within its range gonorrhoea, and its consequences, primary, secondary and tertiary syphilis, properly so called. The history of venereal diseases has formed so large an item in the various publications which for the last few years have issued from the press, that I should think it an unpardonable intrusion were I to swell those pages, by raking up from the oblivion to which they have been long since con signed, the detailed opinions of antiquated and by-gone authors. At the same time, I find that in order to obviate any misunderstanding, and guard against the possibility of confusion or misconstruction in further allusions to the subject, I cannot pass on without taking a cursory glance at some points which I conceive have a practical bearing upon the views which will be found embodied in the present treatise. In doing so, however, I shall endeavour to be as concise as possible, compatible with perspicuity. Since the time of Astruc, whose treatise contains by far the most elaborate history of venereal diseases which we are acquainted, (with inferences very different, however, from those which we might expect from such an extensive fund of information,) authors have been divided in opinion as to the precise origin assignable to those affections. Thus, after a critical and chronological review of those writers who have made mention, either directly, or what has been construed into indirect allusion to the subject, Astruc arrives at the following conclusions: "That the venereal disease was at that time, [towards the end of the year 1496] first seen in Europe; and from thence was propagated into other European countries. That this disease was so far different from any of the diseases of the ancients, that all persons at that time were unacquainted with it; insomuch that the physicians, astonished at the novelty of the disease, and find |