LUES VENEREA. 



contrafted by a cut, or fore upon tlie finger, the bubo 

 takes place a little above the bend of the arm, upon the 

 iniide of ihe biceps mufde ; and that, when fiich bubo has 

 occurred, none is, in general, produced in tiie arm-pit, 

 whichMs the moft common place for the glands to be af- 

 fected by abforpfion. This celebrated furgeon, however, 

 mentions two rare exceptions, in which buboes occurred 

 as well in the arm-pit as above the elbow. 



Mr. Hunter once fufpedted, that the reafon of the fecond 

 and third fcries of glands not being afTc(Sed, might be 

 owing to a change produced in the matter by the firft 

 glands, through which the virus pafles. Reflecting, how- 

 ever, that the matter of a bubo is infeftious, like that of a 

 chancre, and that fome of it can hardly fail to be taken up 

 bv the abforbents, he perceived that the above explanation 

 failed. He therefore altered his fentimeut, and concluded, 

 that the internal fituation of the glands, more remote from 

 the feat of abforption than the hrll order, might prevent 

 the venereal irritation from taking place in them. We may 

 remark, that this reafoning will not account for the occa- 

 fional production of a bubo in the arm-pit above another at 

 the bend of the arm. It is pofTible, however, that, in this 

 laft kind of cafe, fome of llie virus from the chancre on 

 the finger may arrive at the axiUa, without being conveyed 

 at all through the abforbent glands, which are iituated 

 at the inner fide of the arm, a little above the internal 

 condyle. 



In men, buboes from a venereal complaint on the penis are 

 fituated in the groin. Mr. Hunter, we know, compre- 

 hended gonorrhoea among the caufes, and, in this cafe, he 

 thought, that both groins were equally expofed to bubo. 

 When the fwelling in the groin originates from a chancre, 

 it is generally on that fide of the body to which the fore is 

 neareft, though cafes happen which are exceptions to this 

 cbfervation, and admit of explanation by the anaftomofes 

 of the lymphatics. 



Mr. Hunter apprifes us, that the inguinal glands are not 

 conftantly arranged in one exa£t manner, and that, there- 

 fore, the courfe of the abforbent vefiels mull be fubjetl to 

 variety. Hence a bubo, from a venereal fore on the penisj 

 has been a confiderable May down the thigh, or in front of 

 Poupart's jigament, or near the pubcs. 



As, in men, chancres are almoft always caught upon the 

 penis, fo buboes in them are commonly fituated in the 

 groins ; but we have already noticed, that chancres occa- 

 fionally form in other parts of the body, and, of courfe, bu- 

 boes are not necefiarily confined to one fituation, the neareit 

 external glands, between the heart and the feat of abforp- 

 tion, every where in the body, being liable to (hare the lame 

 fate as thofe in the groin. 



When buboes arife in women, unprecededby any chancre, 

 it is more difficult to find out whether they are venereal or 

 rot, than jn men. For, in the latter examples, when they 

 arife without any local complaint, it is know-n that no fuch 

 complaint exifts, and, therefore, that the bubo cannot be 

 venereal, except by ir.micdiate abforption from a found fur- 

 face. But, fays Mr. Hunter, in women, it is often difficult 

 to difcover v^'hether any infedtion is prefent or not ; and 

 the nature of the bubo can only be made out by paying, 

 attention to the way in which it began, its progrels, and 

 other circumftances. 



When chancres are fituated near the meatus urinarius, 

 nyraphjE, clitoris, labia, or mons veneris, the abforbed mat- 

 ter is carried along one or both of the round ligaments, and 

 the buboes are formed in thofe ligaments, juft before they 

 enter the abdomen. Mr. Hunter believed that they never 

 extended further, and he fuppofed them to be inflammations 



of veflels, and not of glands. When chancres are fituated 

 far back, near or in the perineum, the abfi)rb'.'d matter is 

 carried forwards, along the angle between the labium and 

 the thigh, to the glands in the groin. "M^hroughout this 

 courfe fmall buboes may occur ; or th; virus, entering 

 the inguinal glands, a bubo in the groin is frequently 

 produced. 



The bubo, fays Mr. Hunter, commonly begins with a 

 fenfe of pain, which leads the patient to examine the part, 

 where a fmall hard tumour is to be felt. This increafes, 

 like every other inflammation that has a tendency to fup. 

 purate ; and, unlefs prevented, it goes on to fuppuration and 

 ulceration, the progrefs of the matter to the Run being very 

 quick. 'J here are, indeed, fome cafes whii'h are flow in 

 their progrefs : in thele, Mr. Hunti-r thought the inflam- 

 matory prcceiswas kept back by mercury, or other means ; 

 or clfe retarded by a fcrofiilous tende :cy, fuch a difpofition 

 in the parts not fo readily admitting the true venereal 

 a£lion. 



At firft, the inflammation is confined to theg'and, which 

 is moveable in the cellular membrane ; but as the fwelling 

 increafes in fize^ or as the inflammation, and, r'ore efpeci- 

 ally, the fuppuration advarcv, the fpecific diliance is ex- 

 ceeded, the furroundmg cellular membrane becomes more 

 inflamed, and the tumour is more difiufed. Sorre buboes 

 become eryfipclatous, by which means they afL' r -ndered 

 more diffufed and (Edematous, and do not readily luppurate. 



The following is then, according to Mr. KuuIlm, the true 

 charadler of a venereal bubo : it is coniined to one gland ; it 

 keeps within the fpecific difiance, til! fuppuration has taken 

 place, and then becomes more difTufed. It is rapid in its 

 progiefs from inflammation to fuppt-ration and ulceration. 

 In general, the fuppuration is copious, confidering the fize 

 of the tumour, and the abfcefs is fingle. The pain is very 

 acute, and the inflamed fkin exhibits a florid red colour. 



Where no local difeafe has exifted, the nature ef a bubo 

 will always be attended with more uncertainty, than when 

 there has been fome difeafe on the penis. As, however, 

 every inflammation of the inguinal glands is fu)ped\ed, the 

 patient runs but little riflv of not being cured if his cafe is 

 venereal ; but, (continues Mr. Hunter,) " I am all aid, that 

 patients have often undergone a mercurial courie, when there 

 has been no occafion for it.'' P. 266. 



The fame diftinguiihed praftitioner thought, that> there 

 were two forts of butjoes arifing without any vllible caufe. 

 One kind inflame and fuppurate brifl<ly, as thole buboes 

 ufually do which arife from chancres, or gonorrhoea. The 

 manner of their progrefs made him always fufpect them to 

 be venereal, 



'I'lie fecond kind are generally preceded and attended 

 with flight fever, or the common fymptoms of a cold, and 

 they are generally indolent and flow in their progrefs. If 

 they are more quick than ordinary, they becom.e more dif- 

 fufed than the venereal, and probably are not confined to 

 one gland. When very flow, they give but little fenfation ; 

 and though the fenfation is more acute when they are 

 quicker, yet it is not fo (harp as in the true venereal 

 bubo. Befides, they do not commonly fuppurate ; but be- 

 come flationary. When they do fuppurate, it is (lowly, 

 and often in more glands than one, the inflammation being 

 more diflufed, and yet not very fevcre, confidering the fize 

 of the fwelling. The matter makes its way to the fkin 

 flowly, unattended with much pain, and the colour of the 

 fwelling is fomewhat purple, inftead of the florid rednefs 

 which the furface of the venereal bubo difplays. Sometimes 

 the abfcelTes are very confiderable ; but then they are not 

 painful. 



In 



