ON SYPHILIS AND GONORRHCEA 213 



organisms and toxic debris resulting from the growth and 

 discharge of their repeated generations, the same condi- 

 tions entail very much the same consequences in coccygeal 

 elimination. 



Such seeming coincidences as these latter occurrences 

 display are, therefore, due to the progress of this fell 

 disease along definite lines, anatomical, histological, patho- 

 logical, and clinical, and represent the natural history and 

 evolution of a morbid entity as clearly and as explicitly 

 as that of any disease to be found in the whole family of 

 the exanthematous affections. We, consequently, claim 

 that the etiology, morbid anatomy, and clinical phenomena, 

 of this disease find a clearer explanation along these lines 

 than along any other lines with which we are acquainted. 



Gonorrhoea, although usually classed from its manner of 

 causation with syphilis, is a disease of an entirely different 

 character in manner of .attack, symptoms, complications, 

 and clinical behaviour. Instead of beginning with a 

 primary chancrous sore or sores, it is usually ushered in 

 by urethritis with more or less consequent painful mic- 

 turition and muco-purulent discharge, which, after running 

 a more or less acute course for a somewhat indefinite 

 period, eventuates in complete recovery without the occur- 

 rence of secondary or consequential symptoms or compli- 

 cations. 



This, however, does not always characterise the course, 

 behaviour, and decline of the disease, as there are cases 

 where it is usually accompanied or followed by affections 

 of a rheumatoid character, involving the limbs and joints, 

 which run a more or less acute or continued course, and 

 terminate, in many cases, in synovitis, which may display 

 the presence of the gonococcus or microbe of gonorrhoea. 

 It may further be remarked that it is a disease of a much 

 less malign character than syphilis, and that in a large 

 percentage of cases it terminates without leaving any 

 wreckage behind, but, nevertheless, it is one which, if not 

 arrested by what may be called "nature's police" on its 

 entrance of the system, will give rise to severe and well- 

 defined morbid processes : these latter, as we have said, 

 are generally of a rheumatoid character, and evince them- 

 selves in the manner customary to those affections by the 



