friend and the mistress were healthy. In course of time the ulcers healed, and nothing more came of his sores. The patient yielded to temptation a second and even a third time, with a like result on each occasion. This, Abernethy supposed not to be a case of syphilitic contagion, because mercury was not necessary for its cure; but unfortunately for his reputation as a discoverer, Abernethy included cases of undoubted syphilis in the list of pseudo-syphilitic affections, because they recovered without mercury, and when left to themselves.

Though not staying to enumerate many other authors who wrote on venereal diseases in the eighteenth century, we must not omit John Hunter. In 1786 he published his celebrated "Treatise on the Venereal Disease," a work so far surpassing its contemporaries, that it has scarcely ceased to be a text-book. It contains proofs of the truth of many doctrines at that time undreamed of in syphilitic pathology. Of these may be mentioned; contagion from secondary infection, and the incubation period of the syphilitic poison. Though these facts were not recognised by Hunter himself,1 they can be easily discovered in his accurate descriptions of the course of the disease.

After Hunter, B. Bell increased our knowledge by separating gonorrhoea from syphilis and chancre.

In the present century Rose, Hennen, and other English writers, pointed out that the majority of venereal ulcers heal by simple non-mercurial treatment, and are not followed by any general eruption, without, so far as can be learned from their writings, indicating that such local affections have a separate origin from syphilis.

In 1814, Carmichael, perceiving that general disease did not always follow contagious ulcers, subdivided venereal affections into four chief classes, each of which had a dis

1 Palmer's edition, vol ii., pp. 471 and 475. 1835.

tinct excitant poison, a peculiar primary manifestation, and a separate series of constitutional affections. Further, while attributing the different series of symptoms to particular kinds of venereal ulcers, he decided that many were not syphilitic, because their primitive ulcers were not the Hunterian chancre. His doctrines, which were completely refuted by Bassereau's careful observations published in 1852, are somewhat like those supported by Diday in his "Histoire Naturelle et Thérapeutique de la Syphilis," published in the "Gazette Hebdomadaire," June 21, 1861.

During this long period many theories of the nature of this disease have been set up at different epochs-theories of most various and contradictory kind, among the most paradoxical of which, was, perhaps, that of Broussais and his school, who maintained, during the early part of the present century, that what is called syphilis is an artificial collection of a number of distinct diseases, there being no such thing as a syphilitic poison. This doctrine was, for a short time, supported in this country, and lately has been again advocated without success by a retired army surgeon, Dr. Macloughlin.

Forms of unrecognised Syphilis called by different names. -Several endemic maladies, limited to certain districts, were, in the seventeenth and eighteenth centuries, supposed to be peculiar affections; but they are now generally believed to be syphilis. Among the difficulties that prevented earlier recognition of these affections as syphilitic, was the absence of suppurating chancres, buboes, and gonorrhoea, affections at that time considered parts of syphilis, but which are only accidental complications. Again, these diseases were commonly propagated by kissing, suckling diseased infants, using spoons employed by syphilitic persons, as well as by the ordinary one of sexual intercourse. These modes of contagion do not favour the production of suppurating

ulcers and discharges. Syphilis, like small-pox or measles, when introduced into a new district, spreads rapidly and acquires a somewhat epidemic character. Hence the peculiarity of the disease in the Bay of St. Paul, where it rapidly spread among a fishing population. Some of these affections were localised in secluded districts, and, spreading among individuals of similar habits, acquired special characters, somewhat varying from ordinary syphilis, or they became confounded with other diseases, like the radezyge of Norway, which consists of syphilis and leprosy.

Yaws (framboesia, pian) is the best known and described of these diseases. It prevailed among the negroes of the coast of Guinea; and by the transport of negroes to the West Indies, it also spread among those islands and through the Southern States of America. Many authors, chiefly English, Dutch, and French, wrote on this disease in the eighteenth century. Sir Hans Sloane describes what he saw in a voyage to Madeira, St. Kitts, and Jamaica. John Hunter,1 writing "on diseases resembling the lues venerea, which have been mistaken for it," describes a case of yaws that was clearly syphilis, for the very reasons he advances to prove it could not have been that disease. Lancereaux 2 has made an excellent abstract of the literature on this subject, including, with many others, the essays of James Thomson, Paulet, Rollet,5 and Boeck, on these unrecognised forms of syphilis. Both Thomson and Paulet practised in the West Indies, having medical charge of the negro labourers of different estates. Boeck, at the direction.

3

1 Hunter's Works, Palmer's edition, vol. ii., p. 471.

2 Traité Historique et Pratique de la Syphilis, p. 27. Paris, 1866.

3 Thomson Edinburgh Med. Surg. Journal, vol. xv., p. 321, and vol. xviii., p. 32. 1819.

Paulet Archives Générales de la Médecine. 1848-1849.

Rollet Recherches sur la Syphilis. 1860.

6 Boeck Traité de la Radezyge. 1860.

of the Swedish Government, investigated radezyge among the fishing population of certain parts of Norway and Sweden. Rollet has digested the writings of various authors on these obscure diseases. These investigations show how completely they are identified with syphilis.

The first symptoms of yaws are lassitude, malaise, and even fever; presently little buttons (papules) or pustules follow, which ulcerate under the scab. The papules are scattered over the body, often becoming prominent and vascular, and bleed easily; in this state they resemble the wild raspberry, whence the name framboesia. Yaws is contagious. Paulet inoculated an infant with the matter of yaws. The punctures healed, and retained the appearance of light scratches for three weeks, then became hard, unequal ulcers. Seven weeks after the inoculation, an eruption broke out on the body which lasted nine months. Children inherit the disease from their parents, and communicate it to those who suckle them. Again, this affection occurs but once, and its most effectual remedy is mercury. There are other points showing its identity with syphilis, such as ulcers of the throat, and pains in the bones. Though both James Thomson and Paulet were aware of the good effect mercury had in this disease, they seldom employed it, as they feared the mischief salivation caused among the negroes. They separated the sick from the healthy, fed and housed them well, and found that the disease often subsided altogether in seven months, though it was sometimes prolonged for two or three years by relapses of various kinds.

Sibbens, or Sivvens, was a disease confined to the southwest of Scotland, Dumfriesshire, and Galloway. It was very prevalent through the seventeenth century, and was popularly supposed to have been introduced by the troops of Charles the Second's army in their campaigns. It much resembled

yaws in its eruption, and has long ceased to be distinguished as a separate disease.

Radezyge, which first attracted attention in the eighteenth century, is a variety of syphilis endemic in certain fishing towns of the north of Norway and Sweden. Boeck shows it. differs in no way from syphilis, though often confounded with elephantiasis grecorum or leprosy, which is very prevalent in the same district.

Scherlievo. On the coast of the Adriatic, Dalmatia, and Croatia, where the people are ill-fed, very dirty, and ignorant, syphilis, at the beginning of the present century, again assumed some distinguishing peculiarities which obscured its real nature, and procured it a local name before its true character was discovered.

Mal Anglais, Mal de la Baie de St. Paul.-In the middle of the eighteenth century syphilis invaded the upper part of Canada. Several tribes of Indians, hitherto strangers to the disease, were rapidly and widely infected by it. The sudden increase and extent of the evil diverted men's attention from its real nature, and it was variously described. It spread also among the fishing population of the Bay of St. Paul, whence it has received its various names.

Several other local names have been given to various other outbreaks of the disease, of which Amboyna Button, Maladie de St. Euphemie, &c., are examples.

GEOGRAPHICAL DISTRIBUTION.-With one or two exceptions syphilis is met with throughout the world, being most general among communities on the coast, where there is much communication with ships from foreign parts, whose sailors spread the disease among the population. Throughout Europe, especially in all large cities or thickly populated districts, it is rife. Out-of-the-way country places are still almost free from it, but none absolutely so. Iceland is said, notwithstanding the frequent introduction of syphilis

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