ORIGIN OF THE VENEREAL DISEASE.
Thereader will allow that it can not be for want of materials to produce a book, that this subject is introduced, as the multifarious nature of this work’s contents will readily testify; but it is briefly to explain certain probabilities and conjectures which the afflicted curious are generally desirous of being satisfied upon. Who ever suffered under syphilis but was solicitous to know how such a plague came into the world? Many moralists believe and insist that it is a specific punishment, sent for our physical transgressions. Philosophically speaking, such it is; because the infringement of any natural law always incurs a penalty. However, if it be a manifestation of divine displeasure, it certainly is most unequally apportioned; for it generally happens to the least licentious, instead of the most depraved—the timid, scrupulous, and nervous man, contracting it on the first loose intercourse, whereas the man of the town revels almost with impunity; and, lastly, he who exercises the greatest caution and cleanliness escapes it altogether, although he may be the most deserving of the infliction. In a state of timorous excitement, we are more apt to catch the latent mischief. The careless, thoughtless libertine, hardened against infection by indifference, free living, and probably strong health, often escapes scot-free; and the cool and calculating pleasure-hunter, who exercises those useful antagonists to disease, namely, ablution and selection, comes off triumphant with still greater certainty.
The point at issue is, when the disease first arose, and where. Medical historians give credit to America, Spain, and France, for its propagation; and controversies have been carried on by various parties, each disclaiming the honor. Now, as I do not propose to analyze the authorities, but simply to venture my own opinion, with the reasons for the same, I have no alternative but to refer the reader, if he be dissatisfied with my attempted exposition, to more comprehensive and elaborate conjectures than my own. Starting upon the proposition that nature’s lawsare unalterable, and believing that fever is, and has been fever since the creation of the world; that a cut finger has healed by the first intention, or hasfestered, and ever may do so—each condition being modified by the state of health of the party, and the nature of the wound; that a broken limb was attended with the same consequences in the year 1 as it will be in the year 1900; and that dirtiness generated itch, and does so still: I can not reconcile myself to any other belief, but that any violation of the laws whereupon sexual intercourse has been permitted, has been, is, and will be, attended with corresponding results; and as such violations most likely exist where numbers cohered together, I consider both gonorrhœa and syphilis to have been coeval with the origin of mankind. They both doubtlessly are much modified by climate, habits, and constitution; and therefrom ensue the many modifications we see in Europe, and the other large portions of the globe. The proofs that can be adduced in favor of this hypothesis are interminable.
It is said that, until the arrival of some British sailors at Otaheite, the disease was unknown in that territory. Possibly, in its present modification; but previously to this new intercourse, it is most probable that the sexual cohabitation was not so promiscuous or frequent, and that that very infringement entailed a new form of irritation. In married persons, of even temperate passions, and of most careful habits, local sexual disorders are of frequent occurrence, the slightest derangement of female health giving rise to vaginal disturbance, that unsuspectingly is increased by the marital embrace, and communicated to the husband; and only from its presence does it occur, that the coitus may have been the cause of it. By attending to the simple suggestion of nature, namely, abstinence, cleanliness, and rest, a cure is effected; but where neglected, or should either party be unfaithful to the marriage vow, the disease becomes magnified, and extended to, mayhap, innocent parties.
The next question is, are gonorrhœa and syphilis identical? Certainly not, any more than the very many modifications of generative sores. It is absolutely, now-a-days, a difficult question to solve, whether this or that be syphilis; so numerous and yet so closely in resemblance are the ulcers that ensue after sexual cohabitation. The eye is not to be trusted, because so different is real fromspurious syphilis that the French surgeons decide the point by inoculating a healthy portion of the body with the matter or discharge from what they suppose to be a syphilitic ulcer. If a corresponding ulcer be produced, the disease is decided to be syphilis. If, on the other hand, no result follow, the patient is proclaimed free from that malady, and stated to be laboring under merely common local irritation. What is still more curious is this: a patient will have ulcers, which every medical man will pronounce, on beholding, to be chancres; yet, upon this trial, the inoculation will not evince them to be so. A while after, supposing the chancres to be healed, secondary or other symptoms will show themselves—sore throat, spotted skin, glandular enlargements, or painful joints, follow. The same consequences oftentimes ensue after gonorrhœa. The primary diseases can not be identical, because the symptoms are vastly different, and the parts attacked are also unlike; and yet there is this anomaly, that the after-consequences frequently closely resemble each other.
Another surprising result from loose intercourse is, that one female will convey to this individual gonorrhœa, to another syphilis; a third will escape scatheless, and a fourth will have a modifiable affection of both diseases. A satisfactory exposition of the why and wherefore such things should be, or are, is I fancy beyond the skill of pathologists. It is enough to know that they happen; and it is better to use those means which past and daily experience furnishes to get rid of them, than to ponder and wonder in the vain endeavor to explore their origin.
In giving an opinion that we have always been liable to fever, to cut fingers, and to syphilis, I am ready to admit that these several conditions depend upon the varied states of health of the parties. The fevers (ensuing upon the ill-ventilated places) of olden times, compared with those of the present day, differ in intensity and frequency, because the causes are neither so numerous nor severe. The cut finger of a drunkard, and one of otherwise feeble health, is more likely to fester, and even mortify, than should the accident befall a temperate and healthy individual; and the syphilis (or diseases simulating it) at the present time is less severe than formerly, owing to greater attention being paid to personal cleanliness, and the simplicity and earliness of the treatment.
A question worthy of inquiry is, why gonorrhœa andsyphilis should be infectious?Contagionis a word that many medical men would expel from worldly usage, not believing in its existence; that is to say, the extension of a fever or epidemic, for instance, is not traceable to the disease seizing the individual, but to the peculiar aptitude of the party to become the recipient of it. Consumption is of the most extensive prevalence; but it only occurs in the delicate—those peculiarly formed, or rendered apt for it, from the circumstance of their lungs being hereditarily feebly constructed, or disordered through inflammation following a cold, and which effects are traceable to an infraction of some of nature’s laws. Sickly children owe their condition to their sickly parents, or to their physical mal-education, or some other positive violation of nature’s regulations; and in like manner, where the fire rages or the wind blows, the feeblest and least protected become the earliest victims. Both gonorrhœa and syphilis furnish a remarkably irritating purulent fluid, which, applied to delicate surfaces, produces certain effects. Experiments have not been made to multiply these effects, beyond those incurred by sexual freedom; and the one of inoculation by the French surgeons, as quoted; but accident has proved that the eye, for instance, puts on, after contact with the discharge of gonorrhœa, the same kind of inflammation as follows its contact in coition with the antagonist generative organs.
The rectum has also been the seat of venereal affection; and instances have been known of the mouth being also the recipient of disease communicated by a deposition of the poison. If there be such a thing as contagion, it certainly exists in the venereal disease; for, although I admit it (the disease) may occur spontaneously, or be generated by half a dozen of each of the sexes herding and cohabiting together, and neglecting the duties of cleanliness, or committing excesses, those very circumstances imply that the disease can be extended, notwithstanding a majority of the careful and hardy may escape, after a risk of the same. The fact of its contagious properties is not upset, because escape is owing to the non-susceptibility of the parties, and the caution they exercise to prevent a lodgment of, or contact with, the poisonous matter.
John Hunter observes, that it is only the developed disease that is communicable, and for the propagation of venereal affections thepoisonous secretionmust be deposited.So confident was he of this, that he even permitted married men having gonorrhœa to cohabit with their wives, to save appearances; care being taken first to clear all the parts of any matter, by syringing the urethra, then making water, and,lastly, washing the glans. Such, however, is my belief of the rapidity of the formation of the secretion, that, aided by the excitement of the generative act, the deposite of the same would necessarily take place with the seminal emission, especially in persons of full temperament, and in the plenitude of the sexual appetite, and thereby be liable to communicate the disease.
It is becoming a prevalent fashion to give new names to the several forms of venereal disease, such as substituting “urethritis,” “blenorrhagia,” &c., for gonorrhœa; and even to syphilis are added “tertiary symptoms;” the names quoted being selected to express more symptoms than the old ones conveyed. I consider that this circumstance tends to support my opinion—that gonorrhœa and syphilis are not identical, and that each disease (the former being distinguished by urethral discharges, and the latter by ulcers and other cutaneous disfigurements) has innumerable varieties. I hold them both to be but modifications of inflammation from a poisonous source, and its consequences common to the structures in which they respectively become seated, and differing in degree according to the severity of the attack. Another proof in support of the last assertion is, I think, the time of the appearance of the particular disease. There is certainly a more usual time for a clap to manifest itself, such as from the seventh to the ninth day; but it very often occurs within twenty-four hours after connexion, and syphilis sometimes as early; and instances occur where weeks elapse before either of the forms shows itself.
Briefly to recapitulate, I consider, then—1. That the generative organs have ever been liable to disease from misuse; that the disease is variable and modifiable by many circumstances, such as have been before stated—namely, climate, age, constitution, and cause. 2. That it is contagious; mild cases usually producing mild consequences, but those depending much upon the treatment and health. 3. Newly-indisposed and severer cases, establishing a worse form of disease, alike modifiable by circumstances. I am not prepared to insist that the syphilis of the present time assumes the aspect as it did with theancients, any more than I would affirm that it will be the same centuries hence: but I contend that all abuses of sexual pleasures will be surely followed by sexual disturbances, and that the most likely form of ailment is marked either by discharges or ulceration; that these diseases are simple or complicated, and all are separate in themselves. There is no fixed order in which what are called secondary symptoms occur. It may more usually happen that a sore throat will follow the healing of a bubo, as swelled testicle is more commonly subsequent to the occurrence of a gonorrhœal discharge; but in very many cases neither occur, or not in the succession stated. The anomalies in the disease I shall consider in describing the symptoms and treatment, when the reader will judge how far the view herein entertained, as to the origin and character of the disease, facilitates and simplifies its management and control.
In conclusion of this part of our subject, I may state, that I believe the form and severity of any syphilitic disease depend more upon the state of health and other aptitudes of the party receiving, than of the one communicating the disease.
Of the Character of the Syphilitic Poison.—“The venereal poison is only known by theactionwhich follows its application.” It has been observed, that it is only communicable by deposition; and that certain parts are essentially prone to its reception: these are the generative apparatus of both sexes. The poison is conveyed in the form of a purulent fluid; that of gonorrhœa from inflamed vessels with corresponding morbid action; that of syphilis, also from a purulent fluid emanating from the surface of an ulcer. The disease prevails only in the human race; it is impossible to transfer it to animals of a lower kind. John Hunter soaked lint in matter from a gonorrhœa and chancre, and introduced it into the vaginæ of bitches and asses without producing any effect. The same experiment was tried by interposing the purulent matter within the prepuce of dogs and male asses, and also by inoculation, but with no other effect than that of producing a common sore. The venereal poison attacks the human body in two ways, locally and constitutionally; the latter by absorption of the poison secreted by the patient himself. We can only suppose the local form of the disease to arise from absorption, and so altering the local action of partsas to produce specific results. The constitutional form is generally an after-occurrence, although instances are known where it has not been preceded by any apparent previous form; albeit, no doubt suchhasexisted without exciting observation. Gonorrhœa shows itself without abrasion of surface; but syphilis is marked by another action—an ulceration of the solids whereon it is found.
In Hunter’s Work on the Venereal Disease, there is an interesting chapter respecting the source of the gonorrhœal secretion, in which it appears that it is produced from the vessels investing the mucous membrane of the urethra, by their becoming altered in their action; and that ulceration is seldom found within the urethra, and when so discovered, it is not from the gonorrhœal poison; and that where ulceration occurs, it must be ascribable to an accession of inflammation of a distinct character. Both gonorrhœa and syphilis are conditions assumed by the human frame in self-defence, and are processes set up to cure the previous one; and unless the constitution be much impaired, the disease gets well. Such impediments, however, exist in the form of moral and social arrangements, occupation and variable health, that the end, without assistance, is seldom accomplished. Gonorrhœa may cease of its own accord; but, according to the belief of Hunter, syphilis never; and certainly every day’s experience proves the fact. We see gonorrhœa cured by the most ignorant persons and by the most empirical measures; but syphilis often defies the most skilful treatment. The first attack of venereal affections, especially gonorrhœa, is the most severe; from which it is presumed that a habit of reconciliation takes place between the disease and the generative organs; so that after a recurrence or two of the complaint, the same party may almost bid defiance to a new infection. Yet, if a man lose the habit obtained by frequent intercourse, through abstinence from venereal pleasures, he will be very likely to contract the disease even on the first re-essay, with the very same parties, who may preserve precisely the same condition of health that formerly was innocuous to him. Cases innumerable can be adduced in support of this statement. In the first part of this book, statements have been made, proving that the difference in the symptoms of gonorrhœa are almost endless. The same may be anticipated with regard to syphilis.