be demonstrated by reasoning." The apparent anomaly of a woman infected with gonorrhoea only, being able to communicate venereal ulcers to one man and gonorrhea to another, is now, I believe, no longer put forward by the advocates of the identity of the two poisons; as in every institution an opportunity is afforded of demonstrating, by means of the speculum, that chancres may exist deep in the vagina, where no form of ulceration will be perceptible externally, and where the only symptom of disease is that which will give rise to the impression on the mind of the medical attendant, that the patient is labouring under the effects produced by a gonorrhoeal discharge. If the merits of the speculum vagina were only appreciable, as far as assisting to explode this paradoxical idea, its use as a valuable boon to our means of diagnosis, must be hailed with pleasure by all engaged in the study of syphilitic diseases. That a considerable portion, however, of the cases of secondary symptoms which have been supposed to result from simple gonorrhoea, owed their existence to a concealed urethral chancre, can now be no longer doubted; such instances are alluded to by Hunter, and have been clearly pointed out by M. Ricord, Mr. Parker, and others, and to no other explanation can we refer in proof of the success which followed the mercurial treatment, as prac * Remarks on Ulceration of the Genital Organs, p. 78. tised by the late Dr. Wallace of this city, in cases where he was unaware of this complication. My attention was next directed to the inoculation of the matter of buboes; two classes of which, the sympathetic, usually consequent on gonorrhoeal inflammation, and those produced by the absorption of the syphilitic virus, presented themselves to my notice. As regards the experiments which I had an opportunity of instituting upon the former, which were characterized for the most part by tumefaction of the deep-seated glands, I was unable after repeated trials to elicit any effect beyond slight irritation of the cuticular surface, results so far coincident with the experiments of M. Ricord; but I have been convinced from frequent observation, that even here a mild form of constitutional symptoms, as a papular eruption, an erythematous redness of the fauces, has often resulted on this affection. In the latter, the virulent bubo of M. Ricord, I have succeeded in several instances in producing the characteristic pustule by inoculation. These enlargements of the inguinal glands were distinguishable from the former, by being generally confined to the superficial ganglions. I must, however, confess, that although my experiments were performed in strict accordance with the rules laid down in those cases for the operator by M. Ricord, I was not unfrequently disappointed at finding that inoculation did not give rise to the pustule which makes its appearance after the in troduction of the venereal virus. While, thereapplied to en fore, I admit that this test, when largement of the inguinal glands, will in many cases serve to distinguish the nature of the cause that produced this secondary effect, I cannot concur in the conclusion at which M. Ricord arrives when he states, that inoculation in bubonic enlargements must be relied upon as forming an unexceptionable and pathognomonic sign. Moreover, I am inclined to think that, from his own experiments, this deduction is of too sweeping a nature; as, even in cases where buboes resulted on chancre, he was not always successful in producing positive resultsthese effects not being elicited at all in some instances; and in others, not till after a repetition of the experiment. It is true that, in these unsuccessful attempts, M. Ricord has endeavoured to point out the causes of failure; the pus being sometimes taken from a gland too near the surface, at other times from a mixture of that contained in a superficial and deep ganglion, and occasionally from the pus contained in the surrounding cellular tissue. Further, he observes that in order to produce a specific pus, it is not only necessary that the bubo shall have been consequent on chancre, but that the virus shall have been transmitted to the gland by the process of absorption, and not by any sympathetic irritation. But admitting that to one or other of these circumstances, want of success can be always attributable-points which may perhaps be satisfactorily made out in the mind of an expert and experienced manipulator— it must nevertheless be sufficiently obvious that, to an operator of less practical knowledge of the cautions required and the difficulties to be avoided, conflicting statements and contradictory results must frequently ensue; which, in a medico-legal point of view might be attended with unhappy consequences. Thus, Dr. Wallace informs us, that although he inoculated some hundred times with the matter discharged from buboes, he only succeeded on three occasions in producing any specific effect. On these occasions, the ulcers that resulted presented during their entire course the characters of the primary syphilitic ulcer. On the other hand, Mr. Hamilton, whose experiments were performed at the Richmond Hospital, in this city, states that the facts which he has observed in his own trials of inoculation, bear out in every par ticular the truth of M. Ricord's researches, and that this is the surest test in determining the virulent or non-virulent character of buboes. There is another form of bubo alluded to by M. Ricord, of which he admits the existence, though he states it is of rare occurrence: this he calls the primary non-consecutive bubo (bubo d'emblée). The existence of this species of inguinal enlargement was likewise attested by Fallopius, Astruc, Swediaur, Bertrandi, and Gibert; and it is said to present itself after impure sexual intercourse, without the intervention of any antecedent form of disease. As I have never met with a decided example of this affection, (the existence of which my experience would lead me to deny) I shall transcribe from M. Ricord's work the passage which bears upon its history:-"If (he says) the patients be closely and minutely questioned, one will soon be convinced that the reputed primary buboes are very rare; for most frequently, in those which were supposed to be such, we find the cause so evident, that we are surprised that the patients themselves did not perceive it. Thus, patients who have only become aware of their disease by the development of a more or less painful tumour at the anus, will only speak to you of this tumour, which they only perceived the day previous, or even that day. If you interrogate them, they state the last coition to have been a fortnight, a month, or more, previous; if they be then examined, a chancre will be found, often pretty extensive, upon the penis, prepuce, or some neighbouring part. Yet, after an unclean connexion, the engorgement of the ganglions situate near the sexual organs becomes, though rarely, primarily diseased. There are some circumstances in which it is impossible to find any suspicious antecedent or concomitant, and we are then obliged to admit the existence of the primary non-consecutive bubo (bubo d'emblée). If these engorgements be attentively examined, without being led into error by those which may resemble them, it will |