LUES VENEREA. 



Mr. Hunter thinks it doubtful, whether the application 

 of mercury fhould be continued through the whole fuppura- 

 tion. He was inchned to conliiuie it ; but in a fmaller quan- 

 tity. 



There has been much difpiitc, whether a bubo (hould be 

 opened, or allowed to burft of iifclf, and whether the open- 

 ing (hoiild be made with a cutting mftrument, or caullic. 

 On this fubjeft, Mr. Hunter remarks, that there is no pecu- 

 liarity in a venereal abfcefs to make one practice more eli- 

 gible than another. The furgcon, he fays, fliould in fome 

 degree be guided by the patient. Some patients are afraid 

 of cauftics ; others, of cutting inllruments. But when 

 the furgeon has the choice, Mr. Hunter exprofles a prefer- 

 ence to opening the bubo with a lancet, in which method no 

 (kin is loft. But, he obferves, that when a bubo is very 

 large, and there will be a great deal of loofe flcin, after the 

 difcharge of the matter, lie thinks that cauftic may, per- 

 haps, be better, as it will dcftroy fome of the redundant flcin, 

 and occafion lefs inflammation than what is caufed by an 

 incifion. The kali purum, with the calx viva, is the cauftic 

 commonly employed. 



After the bubo has been opened, furgeons ufually poultice 

 it as long as the difcharge and inflammation are confiderable, 

 and then they employ dreflings, which mull be of fuch a 

 quality, as numerous undefcribable circumftanccs may indi- 

 cate. The ufe of mercury, in the mean while, is to be con- 

 tinued, both to make the bubo heal, and prevent the bad 

 effefts which might otherwife arife from the matter conti- 

 nually abforbed. The mercury (hould alfo be fo rubbed in, 

 as to pafs, if poffible, through the difeafed groin. 



The mercurial courfe is to be purfued till the fore is no 

 longer venereal. But, in general, fmce this point is difScult 

 to afcertain, the mercury mult be given till the part has 

 healed, and even fomewhat longer, when the bubo has healed 

 very quickly ; for the conftitution is afterwArds very apt to 

 become contaminated. 



However, mercury is not to be continued thus long in all 

 cafes ; for, as Mr. Hunter explains, buboes often affume, 

 befides the venereal, other difpofitions, which mercury can- 

 not cure ; but will even exafperate. 



Ccnfequcncts of Buboes. — Sometimes the fores, when they 

 are loliBg, or entirely deprived of the venereal difpofition, 

 become changed into ulcers of another kind, 'and, moft pro- 

 bably, of various kinds. How far it is a difeafe arifing from 

 a venereal taint, and the efTefts of a mercurial courfejointly, 

 fays Mr. Hunter, is not cfrlain. This writer fufpedled, 

 however, that the nature of the part, or conftitution, had a 

 principal (hare in the malady. 



Mr. Hunter obferves, that fuch difeafes make the cure 

 of the venereal affeftion much more uncertain, becaufe, 

 when the fore becomes ftationary, or the tncrcury begins to 

 difagree, \\e are ready to fi\fpeft that the virus is gone; 

 but this is not always the cafe. Perhaps the aftion of the 

 venereal poifon is only fufpended, and will commence again 

 as fooa as the other difeafe ceafes. 



In thefe cafes, Mr. Hunter recommends attacking the 

 predominant difeafe ; but he allows there is difficulty in af- 

 certaining its nature, and finding out vi hether it is venereal, 

 or not. 



The fame author alfo acquaints us, that he has feen fome 

 buboes exceedingly painful and tender to almoft every thing 

 that touched them, and the more mild the dreflings were, 

 the more painful the parts became. 



In fome inftances, the fl<in only feems to become difeafed. 

 The ulceration fpreads to the furrounding integuments, 

 while a new fkin forms in the centre, and keeps pace with 

 the ulceration, fo that an irregular fore, which Mr. Hunter 



compares with a worm-eaten groove, is formed all round. 

 It appears only to have the power of contaminating the 

 parts which have not yet been affefted ; and thofe which 

 have readily healed. 



When buboes become ftationary, and feem little inclined 

 to fprcad, attended with a finus or two, hemlock, joined 

 with bark, is, according to Mr. Hunter, the medicine moft 

 frequently ferviceable. It is beft to ufe it both externally 

 and internally. The fame author alfo fpeaks favourably oi 

 farfaparilla, fea-bathing, and fea-water poultices. He 

 ftates, that at the Lock Hofpital, gold-refiners' water has 

 been found a ufeful apphcation ; that, in fome cafes, drink- 

 ing large quantities of orange-juice, and in others taking 

 mezereon, have been found ferviceable. 



Treatment of fecondary Symptoms. — Before treating of thi« 

 fubjeft, it may be as well to recapitulate a fevr of the leading 

 points in Mr. Hunter's doftrine. 



1. Syphilitic matter, after being abforbed into the fyftem, 

 circulates with the blood, and is thrown out by the common 

 emunftories ; but in its progrefs it may contaminate other 

 parts of the body, and give them a difpofition to difeafe. 



2. When this difpofition is given, the difeafed aftion does 

 not follow till a certain time, which varies according to the 

 conftitution and other circumftanccs ; but never happens while 

 the conftitution is under a mercurial irritation. 



3. When the difpofition has taken place, the aftion may 

 be fufpended by mercury ; but the diipofition will remain, 

 and the aftion ihew itfelf at fome period after the mercurial 

 irritation has ceafed. 



4. When the aftion has begun in an order of parts it may 

 be cured, and will not return in the part, or that order of 

 parts from the fame flock of infeftion. 



5. But the difeafed aftion may take place in another or- 

 der of parts, if that other order has been contaminated ; 

 and, in this order, it muft be treated as in the former. 



6. When the difeafed aftion has taken place and been cured 

 in the part firft infefted, in the throat and fauces, the fl<in, 

 and the bones or periofteum, the fubjeft may be faid to be 

 free from the difeafe, as far as our knowledge has hitherto 

 traced it. 



7. The ufual time of the flcin or fauces taking on the dif- 

 eafed aftion is, on a medium, fix weeks after the mercurial 

 irritation that cured the firft fymptoms has iubdivided ; and 

 in the bones about twice that time. 



8. Whatever doubtful appearances may arife on the /kin, 

 throat, or bones, during the mercurial irritation, under 

 which chancres, or buboes are giving way, they are certainly 

 not venereal : and even if fuch fecondary fymptoms appear 

 after that mercurial irritation has ceafed, but earlier than the 

 period fpecified in the preceding propoCtion, they are to be 

 regarded with doubt. 



9. If no fecondary fymptoms appear for three months 

 after the mercurial irritation has ceafed, and the conftitution 

 has not in the mean time been occupied by any other difeafe, 

 we have for the moft part no reafoii to apprehend any thing 

 in the flcin or throat from that ftock of inh-dtion. 



LalUy, there are uncommon inftances, in which the fe- 

 condary fymptoms occur fooner or later than the periods 

 above ftated. See Hunter's Treatife, and Adams on Mor- 

 bid Poifons, p. 159, 160. 



The treatment of fecondary fymptoms confifts almoft 

 entirely of the judicious employment of mercury. Frittions 

 with the ointment are generally the moft preferable ; but 

 fometimes the pill hydrarg. oxydi rubri, the folution of the 

 oxymuriate, or the adminiftration of mercury by fumiga- 

 tion (fee Fumigation), may be proper and advantageous. 

 The continuance of the mercurial eourfe muft always be 



fufpended, 



