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by the sailors of whaling ships, to be very little subject to it. Travellers among savages, mention syphilis to be spread wherever Europeans have reached them, while there is no doubt that it is widely disseminated among the old civilised races of China, India, and Japan.

Data respecting the proportion syphilis bears to general disease, are not easy to obtain; as, even where statistics are procurable, they do not show how much the amount of venereal disease varies if the conditions be only slightly changed. Nevertheless, there is no doubt that a very large proportion of sickness in the human race is occasioned by the ravages of this disease.

SUMMARY.

Venereal diseases are three: chancre, gonorrhoea, and syphilis. The two first have immemorial antiquity, being described in Chinese systems of medicine 4,500 years old; also in Hindoo, Arabic, Greek, and Latin literature. There is much reason for attributing to syphilis an equally remote origin, though the proof is not incontestable. In the middle ages a general eruptive disease called lepra was often propagated by sexual intercourse with local venereal disorders. This was probably syphilis. In the years 1490-6 a disease spread rapidly through Europe, which was also possibly syphilis. At the time, it was called the "Great Pox," was contagious, and communicated most readily during sexual intercourse. As this disease had extended to several countries of Europe before Columbus's return, there is no foundation for supposing he brought it from America. Sixty years after this outbreak, its description by Fracastor and others shows that syphilis was then what it is now. About the same time, or in the middle of the sixteenth century, authors began to attribute all venereal disorders to one source, having previously drawn a distinction between syphi

lis and other venereal disorders. This confusion reigned until the present century, when Benjamin Bell demonstrated the non-identity of gonorrhoea with syphilis; and further researches show that syphilis and local chancre are distinct diseases. Ignorance of this fact, and also of the capability of the secretions of the general eruptions to convey the disease, helped to mislead physicians of the eighteenth century respecting the true nature of various endemic forms of syphilis, namely, yaws in the West Indies, sibbens in Scotland, radezyge in Norway, scherlievo in Dalmatia, and similar affections in other parts of the world.

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INTRODUCTORY.

CHAPTER II.

Doctrines of recent Date-The Unicist Theory, there is one exciting Virus for all forms of Venereal Disease-The Dualist Theory, Gonorrhoea is distinct from Syphilis-Bassereau's Demonstration that the Syphilitic Virus does not cause the suppurating local Ulcer-Clerc's Chancroid Theory unenable-Summary.

Doctrines of recent Date.-If we pass from the opinions. of our ancestors to those held by contemporary authorities, we find the majority hold syphilis to be a specific disease produced solely by contagion, and never spontaneously, though this hypothesis is even still upheld by some surgeons. Beyond this, there is no general agreement; creeds of every conceivable phase have yet their followers. Happily, all but one or two theories are rapidly falling into oblivion.

There may be said to be two main schools of syphilitic writers. The Unicist theory, or, the one holding syphilis to commence by a chancre, or a urethral discharge (gonorrhea), or a bubo, or as a constitutional affection without any local or so-called primary manifestation. According to those who hold this doctrine, between the moment of infection and the outbreak of the disease, whatever form that may take, an incubation of the poison, of varying length, occurs. Every chancre therefore appears after infection is incurred, and its cauterisation is useless to prevent future disease. The poison of the disease is contained in all the secretions, however late the eruption is in the course of the disease. The blood also is a vehicle of contagion. Devergie, Velpeau, and Casenave, more particularly represent this school.

Dualist theory; the opposite school, allows that one virus exists for all forms of syphilis, but it separates from syphilis certain varieties of venereal disease that are included by the unicist school as part of syphilis. This school, far more numerous than the other, and daily adding to its strength, is itself split up into groups of advocates of theories on points respecting the relation of the syphilitic virus to different contagious venereal ulcers. Ricord, Rollet, Cullerier, and others, all belong to this school.

Ricord, nearly thirty years ago, completed Benjamin Bell's proof that gonorrhoea had no connection with syphilis. In 1858 he acknowledged himself convinced by the arguments of his former pupil, Bassereau, that there are two kinds of contagious venereal ulcer: one of necessity a part of general or constitutional syphilis; the other but a local disorder, without any general action on the system.

Bassereau,1 in seeking the cause of the different results that follow venereal contagion, for several years examined the sources of infection whenever it was possible to trace them. These researches convinced him that bodily temperament, good or bad hygienic condition, age, or sex, the size, situation, multiplicity, and duration of the chancre, have all no influence in determining whether general syphilis does or does not follow contagion. The only ruling condition is this if the infected person has constitutional syphilis, the infecting person is similarly affected; and conversely, if the infected person escape general disease, the infecting person is also free from any but local disorders, incapable of affecting the constitution. The views of Bassereau have received attention in all countries, and are pretty generally adopted.

While admitting the truth of Bassereau's conclusions, it must be observed that at present we do not know the whole of the connection between venereal ulcers and constitutional

1 Bassereau: Traité des Affections de la Peau Symptomatiques de la Syphilis, pp. 197, 198. Paris, 1852.

syphilis. But, when acknowledging this incompleteness, it is not necessary to refuse to believe in the essentially distinct nature of the principle exciting local chancres, from that of the virus of general syphilis.

In 1853, and the following years, Clerc of Paris published his hypothesis to explain the different effects of inoculating venereal ulcers. He has also quite recently (1866) in the first part of an excellent treatise on venereal diseases, explained his opinions with the arguments in his favour.

Clerc considers that the principle exciting the local ulcer, is a hybrid of the virus of syphilis; he likens it to abortive vaccine, or abortive variola (varioloid); and believes that it has been generated thus: the pus of a primary syphilitic ulcer, when implanted on a healthy person, first passes through a dormant incubation, then produces the infecting ulcer, and subsequently the general disease. If the same ulcer be resorted to for a second supply of matter, which is inoculated on a person who has previously suffered from syphilis and recovered, a different result is attained; the matter now makes no delay, but at once irritates the point of introduction to inflammation, producing a vesicle in forty-eight hours, and shortly after, the ulcer known as the soft chancre. The matter of this sore, taken to a person who has never had syphilis, produces a similar result in him, namely, an immediate ulcerative inflammation, and usually no subsequent general disease. Usually no general disease, because Clerc admits, and, for the perfection of his theory, even requires that it shall sometimes confer general disease, plus the immediate ulcer. Thus, by his reasoning, the principle of the local contagious ulcer is established as a separate entity, and shows its connection with the parent virus of general syphilis, by occasionally propagating that malady.

Clerc endeavours to establish his peculiar form of "unity of the syphilitic virus," by comparing this bastard syphilis with "varioloid" and "vaccinoid." He assigns to these

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