M E DI 



of gonorrhoea, the inflammation with which it i* attend- 

 1 ed nas the power of extending itself along the urethra, 

 the ducts connected with it, thus producing tu- 

 i of the neighbouring glands, and especially of the 

 The tumours thus formed, unless the inflam- 

 action be subdued by proper applications, may 

 J to suppuration ; but the matter thus generated 

 i not appear to be capable of contaminating the sys- 

 tem at large : at least this i* the opinion of those who 

 regard the poison of gonorrhoea to be different from that 

 of chancre, or the proper Lues venerea. 



This very general outline of the leading features of 

 Syphili- wiil be sameient to prove, that many difficul- 

 ties attach to the pathslugy of the disease, and we shall 

 find that there is not less obscurity with respect to it* 

 treatment. And this doe* not arise from the same 

 circumstances which we meet with in the management 

 of other diseases, depending upon the obstacles that 

 present themselves to our researcht* into the operation 

 of medicines on the living body ; but here we have to 

 cncounur the OK^ direct contradiction of evidence, and 



we are 





nion* of thoae who might 



CINE. 29 



cases and tho^ of genuine Syphilis ; for not only wa P 

 the Pseudo-syphilis curable without mercury, but it ~* 

 seemed to be even aggravated by the use of this sub- 

 stance. A* the investigation continued to be pursued, 

 opinions arose that were still more remote from those 

 that had been formerly adopted ; it was now advanced 

 that mercury is not essential to the removal of Syphilis 

 itself, and farther, that a considerable part, if not the 

 whole of the constitutional symptoms, are really the ef- 

 fect, not of the disease, but of the deleterious operation 

 of mercury. We state these points, not as article!) of our 

 own faith, for we confess our scepticism upon the sub- 

 ject, but as what have received the sanction of great 

 authorities, and this not of mere theorists, but indivi- 

 duals who have been actively engaged in the details of 

 practice, whose testimony, had it not counteracted all 

 our former experience, and opposed some of the opi- 

 which seemed to stand upon the most incontro- 

 vertible evidence, we should have been the most dis- 

 posed to receive without hesitation. It seem.s that we 

 must regard the public sentiment on this question aa 

 now in the progress of a great revolution, the result of 

 which it i* impossible to predict ; after various oscilla- 

 tions of opinion, we shall perhaps finally settle in a 



identity ut the ...f, 

 the disease 



a question which is ob- 



rr.y r.|x-i<in,j t.'ir 

 the two varieties of 

 r to the proper *y- 

 al symptoms, under 

 salve*, there was, 

 yasta very lately, but one opinion, that the only remedy 



in !ut *A\ thi. innl .;r:.- .noui I ! <-!i;h.t,-,l ....1,1?, 



produce the least injury to the constitation Every 

 one agreed that mercury go J a specific power 



i,and to its i 

 form they i 



agreed 



over the venereal poison,* that no other medicine pas- 

 eased the same power ; and so firmly was this opinion 

 that it was esteemed a suSoent diagnostic 

 of the disease, where the M '"HqiTH 

 I a doubtful aspect, that they yielded to the ac- 

 tion of this remedy. But, notwithstanding the supposed 

 invaluable property of mercury as aa anti-syphilitic, 

 practitioners were aware that it is a sahsUnce which 



used in to* large a quantity, and it was aihiatted that, 

 in certain cases, it was a question of extremely difficult 

 eolation, whether certain morbid appearances were to 

 he ascribed to the Assail itself or to the remedy. 

 however, no one thought of calling in question t 1 

 mspcnsaole necessity of mercury lor the cure 



wnally to produce, were attributed eith, 

 idiosyncracy in the constitution of the individual, to 

 the injurious limiaastialiuu of the remedy, or to the 

 of the patient while under its 



cure of Sy- 



' 



|.r.titi..nrr. ..f ,-nn. 

 to take a different view of the s. 

 they conceived that there were certain affections, which 

 had always been riasird aa syphilitic, in consequence 

 of the mode in which they were communicated, and 

 aspect of their symptoms, but which were 

 of being cared without mercury , from this 

 rirramstinre: they concluded that they muu necessari- 

 ly be of a different nature, and they accordingly term- 

 ed them pseudo-syphilitic. It then became a point 

 of great importance to form a diagnosis between these 



we shall probably find that there are 

 either different kinds of venereal infection, or that it 

 undergoes certain modifications, which cause it to be 

 differently acted upon by the same remedy, or to re- 

 quire different remedies for its removal. The gene- 

 rml and indiscriminate use of mercury we may aafe- 

 h pronounce to be improper; and when we consi- 

 der the quantities in which H ha* been given, with 

 so little regard to peculiarity of constitution, or dif- 

 ferences of temperament, we can scarcely doubt that 

 its effects have been almost as injurious as those which 

 would have resulted from the ravage* of the disease 

 which it was intended to cure. Yet we should be act- 

 ing in opposition to the concurring testimony of the 

 whole medical profession for some ages, were we not 

 to allow of the specific effect of mercury over that form 

 of Syphilis which usually presents itself to our notice, 

 so that we may venture to assert, that if we are to give 

 up this point, there is no one position in the practice 

 of medicine * hi> h must not be regarded as disputable. 

 Fur reason* which have been already stated, we shall 

 not enter upon the consideration of the various local 

 forms of the disease ; and while such a schism exist* 

 respecting the effect of mercury, it would be prema- 

 ture to enter upon any pathological speculation* re- 

 specting the mode of it* operation. We shall only ob- 

 serve, that, independent of it* anti-syphilitic power, its 

 action on the various organs seems to be that of a sti- 

 mulant, increasing their natural powers, whether of 

 absorption, secretion, or excretion, as well a* the vital 

 functions of contractility and sensibility. We know 

 not how this stimulating property can have any in- 

 > over the neutralisation or expulsion of the sy- 

 philitic virus; we see no connexion between the two 

 elects, nor can we conceive of the nature of the rela- 

 tion which they bear to each other. 



SECT V 1 1 1 . ScorfmtH*. Sea Scurry. 



This disease is characterized by general muscular Scurrr. 

 debility, by livid spots on various pans of the body, 

 spongines* of the gums, and hemorrhage from the ali- 

 mentary canal. It is one of those diseases in which 

 the soft part* of the body seem to have experienced a 



