LUES VENEREA. 



before it has made its attack on the firft order of parts. 

 Mr. Hunter, however, had feen a few cafes which were ex- 

 ceptions to this obfervation, the malady affefting the bones 

 before any complaints of the lliin or throat had happened. 



When the deeper-feated, or fecond order of parts become 

 affefted, the progrefs of the difeafe is more gradual than in 

 the firft. The complaints produced bear a great refem- 

 blance to fcrofulous fwelliiigs, and the effefts of chronic 

 rheumatifm, excepting, however, that the joints are lefs 

 fubjedt to be affedted. At a time when there has been no 

 poilible means of catching the infedion for many months, a 

 fwelling will be formed on a bone, and having given little 

 pain, will not be taken much notice of till it is of confider- 

 able fize. In other inftances the pain may be fevere, and 

 yet no fwelhng occur at all, or be perceptible for fome time 

 afterwards. The fame remarks are equally applicable to 

 fwellings of the tendons and fafcix. As it is the charafter 

 of nodes to increafe by (low degrees, tlwy are not attended 

 with much inflammation. When they attack the periolleum, 

 the tumour being clofely connected with the bone, fcems in 

 id&. to arife from it. 



The malady continuing to grow worfe and worfe, fup- 

 puration takes place in tlie node ; but the matter which is 

 produced is not good pus. Some nodes, both of the ten- 

 dons and bones, laft for years, before they form any matter 

 at all. Thefe cafes, Mr. Hunter fufpefted, might not in- 

 variably be venereal. 



In cafes of nodes the pain is fometimes very confiderable, 

 while at other times it is hardly fuch as to deferve notice. 

 In certain inftances, the tendinous parts, when inflamed, 

 occafion a heavy kind of pain ; and in other examples, they 

 will fwell very much, and yet excite no pain worth men- 

 tioning. 



The pains arifing from a fyphilitic affeftion of the bones, 

 are ufualiy periodical, having exacerbations moftly in the 

 night. Rheumatic pains, which the venereal much refemble, 

 are alfo generally worft in the night. See Hunter on 

 Venereal Difeafe, p. 328, 329. 



Having defcribed the fecondary fymptoms of lues ve- 

 nerea, as occurring in the firft and fecond orders of parts, 

 k remains for us to notice a few other difeafes frequently 

 fuppofed to be fyphihtic. 



Warts, Excrefcences, l^c. — Parts acquire, from the irrita- 

 tion of venereal matter, a difpofition to form excrefcences, 

 or cutaneous tumours, called warts. Thefe are moft prone 

 to grow where chancres have been fituated, which fores, 

 indeed, not imfrequently heal into warts. Such excref- 

 cences are liable to be hurt by bodies rubbing againft them, 

 and often a fimilar caufe will make them exceedingly painful, 

 and bleed very profufely. They are confidered, by the 

 generality of furgeons, mjt Amply as a confcquence of the 

 venereal poifon, but as poflefled of its fpecific difpofition, 

 and, therefore, have recourfe to mercury for the cure of them. 

 Mr. Hunter obferves, however, that he never faw mercury 

 have fuch an erfeft, although given in iufficient quantity to 

 cure, in the fame perfon, recent chancres, and fometimes 

 fecondary fymptoms. We cannot fay that our experience 

 is in fupport of this laft obfervation, though we join in the 

 belief, that warts are never venereal. In St. Bartholomew's 

 hofpital, it is the common praftice to give mercury for the 

 cure, and it is done with unequivocal fuccefs. But then 

 the fame excrefcences might be cured much more judi- 

 cioufiy either with the knife, ligature, or efcharotics, ac- 

 cording to the ftiape, fize, and fituation of them. In all 

 thefe ways we have feen a lafting cure accompliflied, with- 

 out any employment of mercury. On the whole, therefore, 

 we think with Hunter and Dr. Adams, that fuch complaints 



2 



never partake of the fpecific nature of the venereal difeafe. 

 With refpeft to other excrefcences, thofe called rhagades, 

 fici, and condylomata, were defcribed long before lues vene- 

 rea was ever heard of. The firft arc common in warm cli- 

 mates, particularly about the ends of the fingers, and are 

 never venereal. " There are (fays Dr. Adams) a number 

 of foft excrefcences about the anus, to which various names 

 have been given. They arife fometimes in confequence of 

 a difcharge from the redtum, ftimulating the neighbouring 

 parts to ulceration. If fuch ulcers are prevented from 

 healing by the difcharge continuing, or by the frittion of 

 the parts, they muft either ulcerate deeper and wider, or the 

 cuticle will fend out proceftes to defend them. Thele, on 

 account of the preffurc they receive, grow in various Ihapes, 

 from which they have acquired their names. 



" They will arife from a venereal origin in two ways. 

 If a fecondary ulcer is featcd in thefe parts, that ulcer 

 having no power of healing itfelf, will take the cliaradter 

 above defcribed, from the nature of the parts. Sometimes, 

 alfo, the matter cf gonorrhoea, by falling from the vagina 

 along the perineum, will produce ulceration, and the fame 

 confequenccs follow. In eittier of thefe cafes, the remedy 

 which cures the firft difeafe will cure thefe local complaints;' 

 or, if they afterwards remain, they will no longer retain 

 their fyphilitic property, and may readily be cured by topi- 

 cal remedies." (On Morbid Poifons, p. 173, edit. 2.) On 

 this fubjedl we muft obferve, that we have never feen more 

 reafon for confidering fuch excrefcences about the anus, as 

 really fyphilitic, than for regarding warts on the genitals in 

 the fame light. We fpeak of the excrefcences alone, and 

 not of any ulcers which may exift with them. Thefe tu- 

 mours may always be extirpated without any bad confe- 

 quenccs, and mercury is unnectlfary in the cure. 



Among the fecondary fymptoms of fyphilis, the venereal 

 ophthalmy might be confidered ; but as we fhall have an 

 article exprefsly on the various fpecies of inflammation 

 affedting the eye, we lliall poftpone this fabjedt till a future 

 opportunity. See Ophthalmy. 



General Olferval'wns on the Treatment of Lues Venerea 



From the remarks already delivered, the reader muft be ap- 

 prifed, that mercury is the grand remedy for all complaints 

 unequivocally venereal. This is fo much the cafe, that this 

 medicine is ufualiy regarded as a fpecific, and the only one 

 to be depended upon for a cure. That mercury is power- 

 fully efficacious in checking and curing fyphilitic affections, 

 is a truth as well eftablifhed as any in the pradlice of furgery. 

 But whether there may not be other fubftances which poffefs 

 anti-venereal qualities fiifficiently to be of fervice, and even 

 preferable to mercury, under particular circumftances, and 

 whether fuch remedies alone can ever be confided in for a 

 permanent and radical cure, are queftions of more difficulty 

 and uncertainty. As long as many difeafes prefent them-' 

 felves, having nearly the fame appearance as iyphilitic com- 

 plaints, and as long as mercury cures not one, but a hundred 

 diforders, there will always be obftacles in the way of an 

 eafy fettlement of thefe contefted points. All men muft 

 firft agree, that the cafes in which the trial of any medi- 

 cine is made, are decidedly venereal, or elle the experiment 

 will avail nothing. 



If it be fuppofed that mercury is the only medicine to be 

 trufted in the treatment of the venereal difeale, of courfe 

 we can have httle more to do than relate the various plans of 

 ufing this renowned remedy, and explain the principles by 

 which its adminiftration ought to be regulated. We mean, 

 ho.vever, to be more impartial, and not totally iilent re- 

 fpedting otlier medicines. 



When lues venerea firft invaded Europe, towards the con- 



clufion 



