LUES VENEREA. 



is not fo confiderable as to prevent the poifon from having 

 any aftion at all. The fame matter appears to affeft very 

 differently different people ; ami the diverlity of the fymp- 

 toms is, therefore, attributed to caufes exilUng in the con- 

 ftitution and habit. 



In treating of GoNOltliHCEA, we have adverted to the long 

 difputed queilion, whether the virus of that diieafe is of the 

 fame nature as that which gives rile to lues venerea ? 

 We have there explained Mr. Himter's reafons for believing 

 in the identity of the two poifons, and niciilioned the 

 motives which have hitherto kept us from givin.; eredit to 

 thedoftrme. Mr. Hunter declares that he has fcen all the 

 fymptoms of lues venerea originate from gonorrhiea only ; 

 that he had even produced venereal chancres by inoculat- 

 ing with the matter of gonorrhosa ; and that he had repeated 

 thefe experiments in a manner in which he could not be de- 

 ceived. (On the Ven. Difcafe, p. 293, &c.) He has re- 

 ferred the different effefls of the virus, in thefe cafes, to 

 the difference in the nature of the parts affefted. He main- 

 tains that the matter of a chancre will produce either a go- 

 norrhoea, a chancre, or the lues venerea. Suppofing the 

 poifon to be the fame both m the chancre and gonorrhaa, 

 why do not thefe complaints always happen together in the 

 fame perfon ? For one would naturally think that the gonor- 

 rhoea, when it has appeared, could not fail to become the 

 caufe of a chancre ; and that fuch fore, when it happens 

 firll, muft produce a gonorrhoea. Mr. Hunter believes that 

 this fometimes really occurs, although he confeffes it is only 

 feldom ; and he fufpefts that the prefence of one irritation 

 in general becomes a preventive of the other. 



The experiments made by Mr. Hunter with the matter of 

 gonorrhoea and chancre, have been repeated with a different 

 refult. (See B. Bell on Lues Venerea, chap, i.) On the 

 other hand, the defenders of Mr. Hunter's opinion contend, 

 that we cannot wonder at this contrariety, when we coniider 

 from how many caufes gonorrhoea may arife, and how im- 

 poffible it is to diftinguilh the venereal from any other. See 

 Adams on Morbid Poifons, p. 91, edit. 3. 



Having already touched upon this controverted fubjeft, 

 in fpeakiugof Gonoirhma, we Ihall here refrain froin comment- 

 ing on the arguments adduced againft the identity of the 

 virus, from mercury being requifite for the cure of chancres, 

 and not neceffary in the treatment of gonorrhoea. Neither 

 fhall we expatiate on the afferted experiment, that venereal 

 matter, applied to the urethra, will produce a chancre in 

 that canal, and not fimply a difcharge. We wifh, however, 

 in this place, to call the reader's attention again to the circum- 

 ftance of gonorrhoea not being defcribed as a fymptom of 

 fyphilis, till nearly half a century after the other fymptoms of 

 the venereal difeafe were known. Fallopius was the firll who 

 fet down a clap as an effeft of the fyphihtic virus. The faift of 

 gonorrhcea not having been remarked as a fymptom of lues 

 venerea till fo long a time after this laft difeafe had been 

 known, has been brought forward as another argument 

 againft the identity of tlie poifons from which thefe difor- 

 ders arife. *^ late writer endeavours to place this matter in 

 a very different point of view, remarking;, that if the vene- 

 real gonorrhoea remained unnoticed till fifty years after the 

 other forms of the difeafe were defcribed ; what does this 

 prove, but that confagious gonorrhoea was fo common, as 

 to be difregarded as a fymptom of the new complaint? Can 

 there be a doubt (lays Dr. Adams), from the caution given 

 by Mofes, that gonorrhoea was conlidered as contagious in 

 his days ? During the claffical age we find inconveniences 

 of the urinary paffages were imputed to incontinence, and 

 the police of feveral ftates, before the Cege of Naples, made 

 laws for preferving the health of fuch as would content them- 



felves with public ftews, inllead of difturbing the peace of 

 families. 



In the opinion of the foregoing author, this is enough to 

 leffen our furprife that gonorrhoea ffiould be urnoticed for 

 fome time after the appearance of the venereal difeafe. But, 

 according to his fentiments, fo far is it from proving thi.- dif- 

 ference of the two contagions, that the faireft inference we 

 can draw is in favour of their identity. For, if fifty years 

 after the breaking out of fyphilis, this difeafe began to be 

 (o far underllood, that fecondary fymptoms were found to 

 be the confequence of primary ones in the genitals, it is molt 

 probable that the lirft fufpicion of venereal gonorrhoea arofe 

 from the occurrence of Inch fecondary appearances, where 

 no other primary fymptoms could be traced. Adams on 

 Morbid Poifons, p. 95, edit. j. 



We are glad that this gentleman does not mean thefe ob- 

 fervations to afford any material fuppiTt to an argument, 

 which, as he acknowledges, refts on the bafn of experiment. 

 Every one will coincide with him that gcrorrhoeas muft 

 have prevailed from time immemorial, and hence, perhaps, 

 were not regarded as a novelty, or even fiifpefted of being 

 fyphilitic for many years after the firft breaking out of 

 lues venerea in Europe. Nor fhall we difpuie the probabi- 

 lity o Dr. Adams's conjecture, that the occurrence of fe- 

 condary venereal fymptoms, w here no primary ones could 

 be traced, excepting a gonorrhcea, caufed this lall complaint 

 to fall under the lufpicion of being itfelf lyphilitic. In 

 thefe points we rather agree with the anther ; but we can- 

 not perceive how they at all wa.rant an inference in favour of 

 the identity of the virus of the two difeafes. The antiquity 

 of gonorrhoeas certainly v. eighs againft fuch opir.ion, inaf- 

 much as it proves that fome fpecies of claps prevailed when 

 the venereal difeafe was unknown, and could not pofilhly 

 have any fliare in their ori>)in. The filence of medical writers 

 for fifty years after the venereal difeafe was known, in re- 

 gard to gonorrhoea being a fymptom of it, undoubtedly mi- 

 litates againft the identity of the virus producing thele afr 

 feCtions, fince it tends at leaft to prove that pradti'ioners 

 were unable all that time to difcern any evidence in proof of 

 the gonorrhoea depending upon the fame poifon as lues Tene- 

 rea. And when the occurrence of fecondary fymptoms, ap- 

 parently unpreceded by any primary ones, excepting a go- 

 norrhoea, firll gave rife to t!ie fuppofition of this lall affedion 

 being itfelf fyphilitic, the notion might be erroneous, and the 

 fecondary venereal complaints admit of explanation in another 

 way. Among the received doftrines concerning lues venerea, 

 the poffibilityof the fypliihtic virus being abforbed from the 

 furface of the body, without any ulceration of the (]<in, 

 feems to have gained the general affent of modern prafti- 

 tioners. In this manner buboes, fore throats, nodes, erup- 

 tions, and other fecondary venereal fymptoms, may be occa- 

 fioned. Such ablorption is the more likely to occur where 

 the cuticle is moill and thin. Many cafes, where ni-ither 

 gonorrhaea nor chancre has exifted, can be explained in no 

 other way ; unlefs, indeed, we fuppofe the fore to have been 

 fo trivial, and to have healed fo quickly, as to have efcaped 

 the patient's notice or recollection. Secondary venereal 

 fymptoms may be produced in either of thefe modes, and 

 yet, though no chancre can be traced, and a gonorrhcea, as 

 happening to be a previous maladv, falls under fufpicion of 

 being the original caufe of the conllitutional complaints, the 

 notion may be on the above account entirely erroneous. 



We are aware of the fentiment entertained by Dr. Adams 

 and many other prattitioners, that it is the nature of a chan- 

 cre to increale in all diredlions till mercury is exhibited. 

 However true this may be as a general obfervation,, few fur- 

 geons of extenfive experience will be perfuaded that there are 



no 



