LUES VENEREA. 



In judging of the nature of a bubo, Mr. Hunter re- 

 •ommends us lirlt to conlider, whether or not there are any 

 venereal complaints exilling. If there are none, this is a 

 prefumptive proof, th.at the glandular fwelling is not vene- 

 real. If the tumour is only in one gland, very flow in 

 its progrefs, and gives but little pain, it is likely to be fcro- 

 fulous. If the fvvclling is coniiderable, diffufed, and at- 

 tended with fome inflammation an(T pain, then, in all pro- 

 bability, a conditutional aftion prevails, attended with 

 laflitude, lofs of appetite, want of fleep, fmall quick pulfe, 

 &c. Such fwcllings, (adds Mr. Hunter,) are flow in their 

 cure, and are not afFefted by mercury, even when it is ap- 

 plied very early. 



This gentleman likewife adverts to other cafes, which he 

 terms mixed, when the venereal matter, like a cold, or 

 fever, has only irritated the glands to difeafc, producing in 

 them fcrofula, to which they were predilpofed. In thefe 

 examples, the fwellings commonly arife llowly, give but 

 httle pain, and feem rather to be haftened in their progrefs, 

 if mercury is given with a view of dellroying the venereal 

 difpofition. Some fuppurate under fuch treatment, while 

 others, which probably had a venereal taint at firft, be- 

 come fo indolent, that mercury has no effedl at all upon 

 them, and in the end, they either get well of thcmfelves, 

 or by other remedies. See Hunter on Ven. Difeafe. 



AVith refpeA to the bubo which arifes from gonorrhoea, 

 we believe it is only fyinpathetic, or the con fequencc of ir- 

 ritation, though, as we have already ftated, Mr. Hunter 

 looked upon fome of thefe cafes as aftually venereal, 

 and originating from the abforption of the gonorrhoeal 

 matter. 



Dr. Adams avers, that he is unacquainted with any in- 

 ftance in which the conftitution has become affefted in con- 

 fequence of a bubo, without a previous chancre, or go- 

 norrhoea ; for the reader (hould underlland, that even a 

 venereal bubo does not imply a general contamination ; the 

 virus is only on its way towards the circulation, when it 

 gives rife to the fwelling in the groin. Dr. Adams more- 

 over alfures us, that he has never feen reafon to repent the 

 not having treated fuch buboes as venereal. " If," (fays 

 this gentleman,) " a bubo has been the confequence of an 

 ulcer on the penis, which healed fpontaneoufly, we may be 

 certain that it is not venereal. It may be the effecl of a 

 morbid poifon, as probably many of Celfus's were ; it may 

 be afilfted by, and even heal under, the ufe of mercury ; 

 but thi^ will be no proof of its venereal origin." On 

 Morbid Poifons, p. 1 28. 2d edit. 



Some additional remarks on buboes will be introduced 

 when we conlider the treatment- 



Of Secotidtiry; or Conjlkutlonal Symptoms. — By fecondary, 

 or conftitutional fymptoms, are commonly underltood thofe 

 effefts which arife from the fyphihtic virus being abforbed 

 and carried into the common circulation. It is moft likely, 

 that in cafes of chancre, the contamination of the fyilem 

 takes place about the beginning of the local complaints ; 

 for, in moft inilances, the chance of fuch infeftion hap- 

 pening afterwards is greatly lelfened, by the patient having 

 fpeedy recourfe to the ufe of mercury, which generally afts 

 as a preventive. 



The abforption of venereal matter into the fyftem raoftly 

 arifes from a chancre, and Mr. Hunter joined in the belief, 

 that it nay alio foifietimes originate from a gonorrhoea. We 

 have already adverted to the opinion, that the virus may 

 poffibly be obferved, in fome inftances, without there being 

 any fore at all produced in the feat of abforption, that is, where 

 the matter is applied. Mr. Hunter thought, that this might 



Vol. XXI. 



happen upon a half-internal furface, like that of the glans 

 penis, though, perhaps, not on the found /kin. Venereal 

 matter may likewife be received into the conftitution by 

 being applied to common ulcers, although not neceffarily 

 rendering thefe ulcers themfelves venereal. Wounds alfo 

 afford a furface for fuch abforption, but Mr. Hunter be- 

 lieved, that ulceration was always firft produced. 



Some parts of the body are much lefs fufccptible of luc* 

 venerea than others ; and many parts, as far as prefent evi- 

 dence extends, feem quite incapable of being affefted. 

 Mr. Hunter never faw tlie brain, heart, llomach, liver, kid- 

 nies, S:c. thus difcafed. This celebrated writer divides 

 the parts which are capable of becoming contaminated, in 

 confequence of the abforption of the virus into the circulation, 

 into two orders. The firft order confifts of the fkin, tonfils, 

 nofe, throat, infide of the mouth, and fometimes the tongue. 

 Thefe are the parts commonly affefted at an early period, 

 after the paftage of the virus into the conftitution. The 

 fecond order confifts of the periofteum, fafcix, tendons, aad 

 bones ; parts which become difeafed lefs early. 



Mr. Hunter, with much appearance of reafon, has endea- 

 voured to account for this feeming greater fufceptibility in fome 

 parts than others, by the manner in which the former are 

 expofed to cold. Thus, he obferves, the fl<in is continually 

 fubjefted to more cold than the internal parts are ; and the 

 venereal difeafe always more readily affefts parts fo expofed 

 than others. This may be the reafon why the mouth, nofe, 

 and fliin are affected with particular freauency, and alfo why 

 the periofteum, and moft fuperficial furfaces of the bonts, 

 are moft liable to be difeafed. .The diftemper, however, 

 feems to fliew fome preference to fuch bones as are pai^ 

 ticularly hard. 



In treating of chancres and buboes, we had occafion to 

 obferve, that the matter, in both thefe cafes, partook of the 

 fpccific quahty, and, of courfe, was capable of communi- 

 cating the difeafe. We have now to notice, that this is not 

 the cafe with the matter of fecondary venereal ulcers, or 

 fuch as arife in confequence of the introduftion of the viru* 

 into the fyftem at large. Indeed, none of the fecondary 

 fymptoms are infeftious. As Mr. Hunter has ftated, thif 

 form of the difeafe has not the power of contaminating 

 parts, not already under its influence, even in the fame confti- 

 tution. Probably, the poifon only irritates juft after it» 

 abforption, and is foon expelled with fome of the fecretions, 

 inftead of circulating with the blood during the whole time 

 of the difeafe. 



Mr. Hunter has concluded one of his moft interefting 

 chapters with the follovving inferences. 



Firft ; that moft parts, if not all, that are affefted in the 

 lues venerea, arc afi'efted with the venereal irritation at tlie 

 fame time. 



Secondly ; that parts expofed to cold are the firft that 

 admit the venereal aftion ; then the deeper parts, according 

 to their fufceptibility for fuch adion. 



Thirdly ; vhe venereal difpofition, when once formed 

 in a part, muft neceflkrily go on to form the venereal 

 action. 



Fourthly : that all parts of the body, under fuch difpO' 

 fition, do not run into aftion equally faft, fome requiring 

 fix or eight weeks, others as many months. 



Fifthly ; in the parts that come firft into aflion, the dif- 

 eafe goes on increaiing, without wearing itfelf out ; 

 while thofe which are fecond in time, follow the fame 

 courfe. 



Sixthly; mercury hinders a difpofition from forming ; or, 

 in other words, prevents contamination. 



4 E Seventhly ; 



