LUES VENEREA. 



crmllitution more difpofed to inflammation than natural. If 

 the pain is great, it (lievvs a itrong difpulitioii to irritation. 

 A llroniT tcncU'iK-y tr> mortilication is aUo fometinies be- 

 trayed by chancres beginning in an early ftage to form 

 doughs. 



According to Mr. Hnnter, venereal ulcers have no dlf- 

 pofition to heal, which, generally fpeaking, is undoubtedly 

 true. We may add, that the edges of a chancre are com- 

 monly jagged and vertical, inllead of fhelving, like thofe of 

 moll other fort's ; and its furface, before the adramiftration 

 (if remedies, is fmeared with a greyilh vifcid matter, which 

 1^ in very fmall q'laiuity, and faid to have a peculiar fmell. 

 If a bit of lint is applied to the fore in this Hate, it becomes 

 adherent to the part, the matter fecreted not being enough 

 to moillen and loolen the connettion. 



When there is a confiderable lofs of fubftance, either from 

 jloughing or ulceration, a profiife bleeding is no uncommon 

 circumltance, more efpecially if the ulcer is on the glans, 

 the blood efcaping from the corpus fpongiofum urethra:. 

 The ulcers, or lloughs, often go as deep as the corpus 

 cavernofum penis, and give rife to ftill more copious bemur- 

 rhaj'es. 



A furgeon fliould never be too hafty in pronouncing fores 

 to be chancres ; the genitals, the common feat of a chancre, 

 are, " hke every other part of the body, liable to difeafes of 

 the ulcerative kind, and from fome circumllances raiher 

 more fo than other parts, for if attention is not piid to 

 c'eanlinefs, we have often excoria'ions, or fuperficial ulcers 

 from that caufe ; alfo, like every other part that has been 

 injured, thefe parts, when once they have fuffercd from the 

 venereal difeafe, are very liable to ulcerate anew." Hunter, 

 p. 215-. 



Until fome of the virus has been abforbed from the fur- 

 face of a chancre, fuch fore is to be regarded as entirely a 

 local afFedion. Unfortunately, the time when this abforp- 

 tion happens can never be exaiflly known, fo that, in the 

 earliett ilage of the ulcer, moft praiftitioners are fearful of 

 acting, altOt;ether, as if there were no pofllbility of the con- 

 ftitution being already contaminated. 



Some confequenccs of chancres will be hereafter fpoken 

 of. 



Of Buboes, — A venereal bubo is an inflammation of an 

 abforbent gland, and arifes from the abforption of the fyphi- 

 litic virus, which, in being conveyed from the furface to 

 which it was firll applied, towards the trunk of the lym- 

 phatic iy.lem, has to pafs through glands, and in doing this, 

 it often makes thele parts inflame and fuppurate. Venereal 

 matter may be taken up by the abforbents under various 

 circumftantes. The leall frequent way is where it has only 

 been applied to fome found furface, without having pro- 

 duced any local efi"eft on the part, but has been abiorbed 

 immediately upon its application. Accorduig to Mr. Hun- 

 ter, another mode of abiorplion is where fome of the matter 

 of a gonorrhoea is taken up by the lymphatics, and carried 

 into the circulation. A third mode is the abforption of the 

 matter from an ulcer, and is bv far the moft comtr.on. A 

 fourth way is the abforp'.ion from a wound. Mr. Hunter, 

 ■perhaps, with great propriety, ufed to call every ablcefs in 

 the abforbiiig fy flem, ariiing in conlequence of the ablorptioii 

 of venereal matter, a bubo, whether in the veflels or the 

 glands themfelves. 



As thefe veffels and glands are immediately irritated by 

 the fpecific virus before it has undergone any change in its 

 paffage, the confequent inflammation mull, therefore, have 

 the tam.e fpecific quality, and the matter fecreted in the 

 fvvelling be venereal. 



In conlidering tiie fubjefl of buboes, Mr. Hunter di- 



vided the abforbent fyftem into the veniU themfelves, and 

 into their convolutions, or lymphatic glands. 



The abforbent vedcls are not fo often inflamed as the 

 glands, but when they are thus afiected, in confequcnce of 

 a chancre upon the glans, or prepuce, they generally appear 

 like a hard cord, runnin,; from tke fore along the dorfum of 

 the penis. Such inflammations of the lymph.-.tics fometimes 

 ariit! from a thickening of the prepuce in cafes of gonori 

 rhtea, that part being ufually at the time in a llate of exco- 

 riation. Thefe cords often terminate infenfibly near thi 

 root of the penis, or the pubes. In other inllances they 

 extend further to a lymphatic gland in the groin. 



The lymphatics, thus inflamed in confequcnce of imbibing 

 venereal, or, at leall, irritating matter, often fuppurate, 

 and this fometinies in feveral places, fo as to produce as 

 many buboes, or fmall ablcefles, on the body of the penis. 



Inflammation of the lymphatic glands is much more fre- 

 quent than the foregoing afleCtion, and is caufed by the 

 venereal matter being carried into them. The llruclure 

 of thefe parts appears to coiifift of the ramifications of 

 lymphatic veffels, which, after branching it, re- unite again. 

 We may infer, from this kind -jf arrangement, that the fluid 

 abforbLd is, in fome mealure, detained in the glands, and 

 thereby has a greater opportunity of communicating the 

 difeafe to them, than to the lymphatic veffels, through whicb 

 its courfe is probably more rapid. 



Since the lymphatic glands are liable to inflame from 

 many different caufes, furgeons fliould be careful to dif- 

 criminate fucli fwellings as arife from the venereal poifon, 

 from others of a divcrie nature. They fliould firll enquire, 

 whether there is any venereal complaint at a greater dif- 

 tanc« trom the heart, as chancres on the penis, or, whether 

 there has been any preceding difeafe in fucli lituation. They 

 fhould enquire, whether any mercurial ointment has been 

 rubbed on the leg or thigh of the affcfted iide, as mercurial 

 friclions, thus praCtifed for the cure of a chancre, will 

 fometimes give rife to a glandular fwelling in the groin, 

 that may be erroneoufly taken for a venereal bubo. We 

 are alfo advifed by Mr. Hunter to obferve, whether there 

 has been any previous dileafe in the conilitution, as a cold, 

 fever, &c. He direfts us, moreover, to pay attention to the 

 quicknefs, or llownefs, with which the tumour has formed,, 

 and warns us of the pofllbility of miftaking a rupture, lum- 

 bar abfcels, and an aneuriim of the crural artery, for 3 

 bubo. 



Some cafes feeni to evince, that a bubo fometimes does not 

 begin till feveral days, and even longer, after the virus has 

 been abforbed, thechancris having been healed this length 

 of time, before the gland begins to inflame. 



The gl.inds nearell to the leat of abforption are, in gij. 

 neral, the only ones attacked. Thus, when -lenereal matter 

 is abforbed from a fore on the penis, the glands in the 

 groin are in danger of being affcctud. When the matter is 

 abforbed from the vulva in women, the glands liable to be 

 inflamed, are thole lituatid between the labium and thigh, 

 and tlie round ligament. 



Mr. Hunter believed, that, commonly, only one gland is 

 affeifed at a time by the abforption of venereal matter, and 

 he fuggells this circumftance as a dillinguilhing mark be- 

 tween venereal buboes and other difeafes of the lymphatic 

 glands. 



The abforbent vefTels and glands, fituated beyond the firfti 

 order of glands, or fuch as are neareft to the feat of abforpi. 

 tion, are never affefted. Hence, thofe near the iliac veffe'i 

 and back always eicape the effetls arifing from the ab- 

 forption of venereal matter from the genitals. It is alfo 

 cbl'ervcd by Mr, Hunter, that when the duealk has been- 

 I contracted- 



