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Full text of "A popular treatise on the venereal disease: in which is
exhibited all the recent discoveries; and a certain cure. For that
terrible malady "
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A
POPULAR TREATISE
ON THE
VE NEREAL DISEASE:
IN WHICH IS EXHIBITED
ALL THE |
RECENT DISCOVERIES;
AND
A Eertain Cure
FOR THAT
TERRIBLE MALADY.
By ROBERT JOHN THORNTON, M.D.
‘MEMBER OF THE ROYAL LONDON COLLEGE OF
PHYSICIANS.
Wondon,
PRINTED FOR D. Cox, BALL-ALLEY,
LOMBARD.- STREET;
AND MAY BE HAD OF ALL BOOKSELLERS IN TOWN AND
COUNTRY.
1815,
Lh ae =<
a
\ E* SO,
} HISTORICAL
MEDICAL
Ve p AR
He eee ee ama aE a aa I DE TERT TI
J. M‘Creery, Printer,
Black-Horse-Court, Fleet-Street, Loudon.
A POPULAR TREATISE, &c.
CHAP. I.
THE MISERIES ARISING FROM
THE VENEREAL DISEASE.
ONE of the most dreadful of our diseases,
that scourge, with which in this life offended
Heaven chastens the indulgence: of - criminal
desire, appears to have: its original from. the
Americans.* By this retaliation on their con-
querors, they have not only amply avenged their
* Some poisons seem peculiarly to affect’ man; for
brutes have no measles, or small pox, nor has inoculation
of the venereal poison been found to have the least effect
upon them. This is said to have arisen from the eating of
human flesh. i xak
B
2
own wrongs, but have also perhaps more than
counterbalanced all the benefits which Europe
has derived from the discovery of the New |
World. Astonishment and terror accompanied
this unknown affliction in its progress, and men
began-to dread the extinction of the human race
by such a hard visitation. ‘The disease at first
was supposed to be propagated by the breath,
and those affected with this dreadful distemper
were exiled to the Borough by the laws of theland.
Its true nature, however, soon became better
understood, and the enemy by his frequent
visits appeared less formidable, and the power
of art was found at length able to overcome
this Proteus-monster.
Delicacy would have prevented me even
mentioning the venereal poison; but when I
consider that it belongs to a class of poisons
whose action is slow and deceiving—when I
3
see the country people, once so blooming and
robust, the proper stock for supporting the race
of men, through the more frequent connexion
with the city, from the greater facility of
travelling,—when I see them very generally eat
up by this most loathsome of all the poisons,
the bones of the nose and palate rotted, the
beauty of face and speech destroyed, the body
covered with copper-coloured ulcers, the period
of rest rendered to them the time of insufferable
torment from pains along the shin-bones, and
finally in the forehead. When see fine youths,
the darlings of their parents, the hopes of their
country, thus severely smarting perhaps for the
folly of one unguarded moment—when I see
it also sometimes insinuate itself privately into
the circle of domestic felicity, and the virtuous
wife a prey to a poison she does not understand,
and extending its influence at the same time to
B 2
4
the innocent offspring, I cannot refrain shewing
the means of diminishing SO Ero PINE an evil,*
nd * I might have also prodeced bore the ‘apology of
Sydenham. “‘ T have met,” says this illustrious physician,
“ with ‘several, who either with a good intent, in order
to deter the incontinent from their vicious practices, by
the apprehension of the succeeding punishment, or to
acquire the character of chaste persons, haye not scrupled
to assert, that the cure of the venereal disease ought to be
kept secret. But I cannot be of their opinion, because
I conceive that there would be very little room left for
charity, unless the misfortunes which the inconsiderate
bring upon themselves by their own fault were to be
alleviated with humanity and tenderness. It belongs to
Gop to punish the offence, hut it is our duty to assist the
‘distressed, and relieve the diseased to the best of our
power, ‘and not to make too strict an inquiry into the
cause of the evil, and irritate them ‘by our censures.
For this reason, therefore, I. will deliver what I have
. bserved and experienced. in this-disease ; not that I in-
tend to make men’s minds more. vicious; but to cure their
bodies, which is my province.”
C
It has long been my opinion, says. the. bene-
volent Dr. Buchan, that:much of the mischief
occasioned by the venereal disease might be
prevented, and that whoever effects this. purpose,
will be a great benefactor to society. . This im-
portant point can only be accomplished by en-
deavouring to advance the morals of the people;
and when the disorder is obtained, to. point out
the danger and the means by which its bad con-
sequences*may in general be obviated.
An attention to health, which ought to be a
primary object in the education of children, is
seldom considered as even a secondary one;
while trifling accomplishments, of little impor-
tance in the pursuits of life, generally engross the
attention both of father, son, master, and
scholar.
Young men are prodigal of life. They throw
6
it wantonly away at the very time it is most
worth preserving, nor do they know the value
of health till it is lost. Many a painful hour
might be prevented by a few cautions duly im-
pressed on the young mind. Early impressions
are seldom eradicated. They generally form
the conduct, and become the rule of life.
Were a young man taught to believe that the
paths of pleasure lead to destruction ; that if he
pursues them; he will never arrive at mature
age, but fall the early victim of a loathsome
disease, he would learn to consider pleasure as
his greatest enemy. The genuine consequences
of vice need only to be painted in their true
colours, 10 order to make it an object of horror
to the youthful mind.
As example has more influence than precept,
it might be of use to young men, were they
occasionally taken to places where the unhappy
7
sufferers, under the venereal disease, are con-
gregated. ‘They would there see the wretched
condition to which thoughtless youth may be
reduced by the act of one unguarded moment.
I have known the first mistake made by a
young man, in this way, cost him his life; and
have seen others, who, from a single unhappy
connexion, were rendered incapable ever after
of enjoying connubial happiness.
Though parents, tutors, and guardians, were -
to use every endeavour to keep youth from the
snares laid for them by bad women, yet, owing
to the want of Police in cast great cities, they
would find their efforts equally frustrated. It is
there the corruption of youth is almost unavoid-
able, and their destruction, alas! is but too
often the consequence.
Much might be done towards lessening the
8
ravages of. this baneful malady by the exertions
of the public magistrate. But to effect -this
purpose would require more skill and attention
than few magistrates would wish to encounter:
Improper interference in these matters does
mischief, and to put bad women under proper
regulations would require the most consummate
wisdom. ‘This, however, is no reason why
bad women should be suffered to prowl about
the most public streets without the least restraint.
‘Were men to be seen at the corner of every
street in a great city, armed with-swords and
bludgeons, to put every one in: fear of ‘his life,
who would not comply with their. demands ;
the public mind would be quickly roused, and
proper measures taken to suppress them: yet
the danger is nearly equal, from those unhappy
females who lie in wait to ensnare the unwary
youth as he passes along. The young man
9
must have uncommon resolution mdeed who
can always resist these temptations; yet -by
yielding in a single instance, he may be undone.
One step leads on to another, till the unhappy
youth, immured in vice, finds it impossible to
retreat. It signifies very little if a man is
robbed of his health, or property, whether it is
done under the influence of fear or lust.
Even the delicacy of modest women is hurt
by the number of common prostitutes which
they daily see plying in the public streets, and
their example must have an unfavourable in-
fluence on the younger part of the sex.
Were it my province here to dip into affairs
“of Police, I should think it an easy matter to
suggest a plan by which the public streets of
great cities might be freed from those women,
who by night and by day infest them, without
BS
10
laying any unnecessary or improper restraints on
the hberty of the subject.*
But the grand corrector of this evil are suitable
laws against seduction, which leads to all the after-
misery attendant upona life of pleasure, or rather
of misery, as it should be more justly called,
such as is well described in the following lines
by the late Enwarp RusuTown, of Liverpool.
In a cottage embosom’d within a deep shade,
Like a rose in a desert, oh! view the meek maid;
Her aspect all sweetness, all plaintive her eye,
And a bosom for which e’en a monarch might sigh. 4
Then in neat Sunday gown see her met by the squire,
All attraction her countenance, his all desire:
He accosts her, she blushes, he flatters, she smiles ;
And soon Blue-eyed Mary’s sedue’d by his wiles.
* The great public thoroughfares should certainly be
eleared from Prostitutes, and on this score the present
Lorp Mayor deserves great commendation.
li
Now with drops of contrition her pillow’s wet o’er,
But the fleece when oncestain’d can know whiteness no more;
The aged folks whisper, the maidens look shy ;
To town the squire presses, how can she deny?
There, behold her in lodgings, she dresses all gay,
Vauxhall she attends, always goes to the play,
Learns to squander, they quarrel, his love turns to hate,
And soon Blue-eyed Mary is left to her fate.
Still of beauty possess’d, and not yet void of shame,
With a heart that recoils at the prostitute’s name ;
She tries for a service, her character’s gone,
And for skill at her needle, alas! ’tis unknown.
Pale want now approaches, the pawnbroker’s near,
And her trinkets and clothes, one by one disappear ;
Till at length sorely pinch’d, and quite desperate grown,
The poor Blue-eyed Mary is fore’d on the town.
In a brothel next see her trick’d out to allure,
And all ages, all humours, compell’d to endure ;
Compell’d, though disgusted, to wheedle and feign,
With an aspect all smiles, and a bosom all pain ;
Now caressed, now insulted, now flattered, now scorn’d,
And by ruffians and drunkards oft wantonly spurn’d,
This worst of all misery she’s doom’d to endure,
For the poor Blue-eyed Mary is now an impure.
12
Whilst thus the barb’d arrow sinks deep in her soul,
She flies for relief to that traitor, the bowl;
Grows stupid and bloated, and lost to all shame,
Whilst a dreadful disease is pervading her frame.
Now with eyes dim and languid the once blooming maid,
In a garret on straw faint and helpless is laid! |
_ Oh! mark her pale cheek, see, she scarce takes her breath,
And lo! her blue eyes are now seal’d up in death!
Or, the after-wretchedness described in the
following
ELEGY.
WEEP o’er the mis’ries of a wretched maid, ©
Who sacrifiec’d to man her health and fame ;
Whose love, and truth, and trust, were all repaid
By want and woe, disease and endless shame.
Curse not the poor lost wretch, who ev'ry ill
‘That proud unfeeling man can heap, sustains ;
Sure she enough is curst, o’er whom his will,
Inflam’d by brutal passion, boundless reigns.
Spurn not my fainting body from your door,
Here let me rest my weary weeping head —
No greater mercy would my wants implore,
My serrows soon shall lay me with the dead.
13
Who now beholds, but loaths my faded face,
So wan and sallow, chang’d with sin and care?
Or who can any former beauty trace
In eyes so sunk with famine and despair?
That I was virtuous.once, and beauteous too,
And free from envious tongues my spotless fame :
These but torment, these but my tears renew,
These aggravate my present guilt and shame.
Expell’d by all, enfore’d by pining want, |
I’ve wept and wander’d many a midnight hour ;
Implor’d a pittance Lust would seldom grant,
Or sought a shelter from the driving show’r.
Oft as I row’d, while beat the wintry storm,
Unknowing what to seek, or where to stray ;
To gain relief, entic’d each manly form,
Each hideous form contemptuous turned away.
Where were my virgin honours, virgin charms?
Oh! whither fled the pride I once maintain’d?
Or where the youths that woo’d me to their arms?
Or where-the triumphs which my beauty gain’d?
14
Ah! say, insidious Damon! Monster! where?
What glory hast thou gain’d by my defeat?
Behold the miseries I am doomd to bear, ©
Such as have brought me to my winding-sheet.
The law of the land for seduction, is a penalty
of money to be levied by the father for the sup-
posed incapacity of the daughter to earn. her
livelihood; and such a law may be instantly
seen to-be but the chicanery of law, a mere
subterfuge. Nothing short of imprisonment in
a solitary cell will ever restrain so licentious
a passion as that of lust.
The confinement of the woman should be
short, but still she should be so punished. ‘That
of the man should be longer. Or if the he-
wretch was to be pilloried,* there would be
* How ridiculous then would the seducer appear, and
the feats of gallantry would no longer be his unfeeling
sport. At present, owing to the punishment both for
seduction and adultery being money, little or no disgrace
15
few or no seducers ; and he merits it as much as
those she-devils who are ever prowling about,
seeking whom they may devour.
When a woman has had her fling of debau-
chery (vide the Life of Ann Bellamy), she then
sets up a regular traffic of sacrificing innocence
to the shrine of gold. She even in different
directions has her infants at school, and before
they know a passion, carries the iniquitous rich
old man to see her nieces, as she stiles them;
and before they are ripe, the virgins are de-
flowered by the villain. They are then brought
is attached to either, and plans are hourly laid to make
this the object of extortion, so easy is it for a nation to be
corrupted by bad laws.—To encourage an innocent
gratification of a proper and useful passion, every
bachelor should pay, besides taxes, an income tax in
proportion to his gains. This would prevent celibacy,
and the worst vices. A heavy tax should be laid on those
who have unmarried people of a certain age as servants,
16
forward to be the common sport of the world,
false debts are contracted with the old Jezebel ;
and when sickness. has eaten away the rose of
health, and the object of desire has become
but. little attractive, the. poor. wretches, are
turned. adrift to seek a worse fortune in the
streets. ‘They then-hire: clothes for: the night
at an exorbitant price—pay, to use the vulgar
expression, through the nose for every thing,
and soon after become almost naked patients of
some hospital, or perish unpitied, and for want,
Youth should especially be told, that these
women are almost certain of containing about
them the venereal virus. .These indeed are
scorpions of the worst kind. What_ person
would be so insensate, or mad, as to play with
the adder, or snake, forgetful of its power of
injury. Even as a child, although such are
fond of sweets, none venture to up-turn a bee-
hive for the honey, and for what reason? for
fear of the sting. But here is a more formi-
dable sting, and equally as certain.
Beware then, O youth! of being deceived
like a foolish bird into the snares set out to en-
tice thee. The pleasure (if such can deserve
the name, which is ever enjoyed with fear and —
trembling) is not worth the danger which ‘ac-
companies it; and to say nothing of thy im-
mortal soul, he must be a fool indeed, who
shall pursue vices absolutely certain of leading
to destruction; for although I have announced
a new and safe cure, [have seen often such quick
and decided ravages from the venereal virus,
that the whole powers of manhood have been
destroyed ina few hours, before any applica-
tion could be employed.
CHAP I.
CONSIDERATION OF THE QUESTION, WHE-
THER GONORRHGA AND LUES VENEREA
ORIGINATE FROM THE SAME POISON.
AN opinion has been generally received
among practitioners, that gonorrhea virulenta
and dues venerea are of the same nature, that
they originate from the same contagion, and are
only distinguished by the circumstance of go-
norrhoea being a local disease, while the other
is a general affection of the system. But as
there is cause to imagine that these diseases
arise from different specific contagions, and as
the establishing of one or other of these opi-
nions must undoubtedly influence the conduct
19
of the cure, it becomes, says Bell, in his ad-
mirable Treatise, a matter of importance to
institute an inquiry in to this part of the subject.
Both diseases are contracted in a similar
way; both, in the first instance, affect the same
organs; and they occasionally appear at the
same time in the same patient: hence it has
been concluded, that they have a common
origin, and one method of cure has been sup-
posed applicable to both.
The refusal of some patients to submit to the
distress and inconveniency, the frequent result
of a protracted mercurial course, and who
nevertheless recovered from the usual symp-
toms of gonorrhcea, first suggested a doubt of
the two diseases being of a similar nature. It
is well known that lues venerea can be certainly
cured by mercury only; and the opinion re-
20
specting the existence of a specific contagion
of gonorrhoea, arising from this obvious and
marked difference in the method of cure, ap-
pears to be fixed and established by the fol-
lowing: facts. a
The symptoms and consequences of ‘gonor-
rhoea are perfectly different from those. which:
take place in lues venerea. Both diseases have
appeared, at different periods, in the same
countries; and, in some instances, they have
remained distinct and uncombined for a great
length of time.
- That the symptoms of the two diseases are
different is universally known. .A_ particular
detail of such as are peculiar to each will be
given in the. ensuing sections. At present, it is,
only necessary to observe, that gonorrhoea con-
sists of a discharge of puriform matter from the
21
urethra; which, even by those who support a
contrary opinion, is now admitted to be, in
almost every instance, a local affection, and that
it never does: contaminate the general habit of
body: while lues venerea is a disease of the
constitution, arising from the absorption of
venereal virus from any part of the surface of
the body, but most frequently from those. only
covered’ with cuticle; by which are - pro-
duced buboes, ulcers in various. parts, parti-
ccularly’ in ‘the throat, pains and. swellings in
the bones, with a variety of other symptoms,
which it is not at present necessary to enu-
merate.
The first appearance of the lues venerea is,
for the most part, in the form of a chancre or
small ulcer, just as a pustule of the small-pox.
It is universally admitted, that even the slightest
affection’ of this nature is apt to produce the
22
pox, or a general affection of the system; inso-~
much, that no practitioner of experience will
trust the cure of this symptom to local reme-
dies. If the sore be left to itself, it almost
always becomes worse. ‘The matter which it
affords is taken up by the absorbents; and
buboes, with the other symptoms mentioned
above, very certainly ensue. ‘These are almost
the universal consequences of a sore produced
by the venereal virus ; but they also occur fre-
quently where the skin remains sound and entire;
that is, absorption of the venereal poison often
takes place where no vestige of ulceration is
perceptible. This, indeed, is denied by many,
but I have met with various instances of it, and
it will be admitted by every practitioner of ex-
perience. Now, this being established, in the
application of the venereal virus to every other
part of the body, if the matter of gonorrhcea
were of the same nature, why does it not, in
23
almost every instance, enter the system, and
produce pox? So far as we know, the urethra
is as plentifully supplied with absorbents as
other parts of the body; the same kind of
matter, when applied to them here, ought
therefore to be productive of similar effects:
and hence lues venerea ought frequently, per-
haps in every instance, to be the consequence of
gonorrhoea, were the matter, by which the two
diseases are produced, the same.
As this is a strong argument in favour of the
two diseases proceeding from different kinds of
contagion, much ingenuity has been exerted by
those who support the contrary opmion, in
endeavouring to account for it.
In the first place, it has been said, that
gonorrhoea sometimes terminates in pox, and
therefore, that this of itself is a sufficient proof
24
of the two affections being of the’ same
nature.
Were it certain that this ever happened, no
farther evidence would be required, as a few
well-marked instances would be conclusive;
but every unprejudiced practitioner will admit,
that no sufficient proofs of it have ever - oc-
curred.
In order to support this opinion, data must
be received, which we know to be inadmissible.
We must admit, that a person with chancres
only, communicates to another, not otly every
symptom of pox, but of gonorrhoea ;’ and that
another with gonorrhoea only gives to. all with
whom she may have connexion, chancres with
their various consequences. This ought,’ in-
deed, to be a very common occurrence, inso-
much that every practitioner should be able to
25
decide’ upon it with certainty, if this opinion
was well founded ; instead of which, it will be
admitted by all, that the one disease being pro-
duced by the other, is even, in appearance, a
very rare occurrence. I have paid much/atten-
tion ‘to the point in question; and in almost
every instance, ‘and where the most particular
inquiries were made, it has proved, from in-
quiry, that a person infected with gonorrhea,
has received it from another evidently labouring
under that disease, and that chancres have been
communicated by such as were distressed with
chancres only.
_ ,. This, I am convinced, will be very commonly
_ found to be clearly the case, so that a few in-
stances, bearing some appearances of the con-
trary, are much more readily explained on the
idea of the two diseases being produced by dif-
ferent kinds of contagion; and this may also be
C
26
said of the few solitary cases that may be met
with of chancre being supposed to terminate in
gonorrhoea, and gonorrhoea in chancre, and
Other symptoms of lues. We can more easily
perceive that the same person should, in some
instances, receive, and therefore be able to
communicate both kinds of contagion, than that
the incident we are considering should be so
seldom met with, were the opinion well
founded of the two diseases being originally of
the same nature.
However ill founded an established opinion
may be, if it has received the sanction of being
generally adopted, we know how difficult tt is
to overturn it. There are few who enter so
minutely into the consideration of such points,
as to be able to decide upon them; and of those
who do, there are very few who will take the
trouble of engaging in such discussions as are
27
necessary for the conviction of others. 'This
may be considered as the chief cause of the
point in question remaining so long in obscu-
rity, as well as of the explanation hitherto
usually given of various circumstances in go-
norrhoea and lues venerea having been uniformly
made to support it. It will also serve to ac-
count for circumstances being held forth as
matter of fact, which, on inquiry, are perceived
to be ill-founded; for, when once an opi-
nion is admitted, we are apt to give such an
explanation of whatever may seem to relate to
it, as can in any way tend to support it.
Thus, although few in the present age will
assert, that gonorrhoea often terminates in lues
venerea, yet by many we are told, that it is very
apt to do so when it is improperly treated.
Whatever puts a sudden stop to a severe or c0-
pious discharge from the urethra, is by many
c 2
28
supposed to do harm. Hence all, who con-
demn the use of injections in gonorrhea, affirm,
that they often convert a simple clap into a pox,
by throwing into the blood what -otherwise
would have been carried off. . This, however,
is by no means supported by experience. A
very stimulating injection will no doubt excite
pain and inflammation in the urethra ; .and this,
in some instances, will be productive of swelled
testes, and perhaps of sympathetic swellings in
the glands of the groin, but I have not known a
single instance of lues induced in this manner;
and as I have long been in the daily use of in-
jections, many cases of it must have occurred,
if the idea I have just stated were well founded.
Till of late, indeed, a patient who was so.un-
fortunate as to have a clap suddenly stopped,
was so certainly considered as poxed, that he
was immediately put under a very complete
course of mercury, by which he was made to
29
undergo a very hurtful, unnecessary, and: dis-
tressful confinement.
’ Although this practice, however, is now very
commonly exploded, yet there are some who
still adhere to it. I was called in, says Mr. Bell;
to visit a gentleman, who in a gonorrheea, at-
tended: with a good deal of inflammation, had
been so foolish as to live freely, and to ride
much on horseback. . This, with the un-
guarded use of a very stimulating: injection, ‘put
a sudden stop to the discharge, and at the same
time it excited a very considerable degree of
pain and inflammation along all the posterior
part of the urethra, towards the prostrate gland:
and neck of the bladder, attended with a painful
and frequent desire to make water.
On the idea of these being symptoms of lues,
he was immediately put under a course of mer-:
cury; and when [ first saw him, he had been
using it for the space of six weeks. The sur-
geon in attendance acknowledged, adds Mr.
Bell, that no advantage had been derived from
it; and the patient himself said, that his dis-
tress was daily increasing. ‘They were both,
therefore, easily persuaded to lay the mercury:
aside; and by the repeated application of
leeches to the perineum, of fomentations, and
opiates, to allay the pain, the inflammation
soon began to subside, and in a short time he
was perfectly well.
In December, 1788, a young man called
upon me, with a painful hard swelling in his
groin, of an oblong form, nearly an inch in,
diameter, and reaching from the ring in the.
external oblique muscle down to the top of
the testis. It appeared suddenly about four
months before, and seemed to be the conse-.
3k
quence of a clap being too hastily stopped. He
was at first attacked with severe pain at the
neck of the bladder, which stretched to the
groin, and down to the testis of the same side.
This, together with a constant and painful in-
clination to void urine, rendered his life miser-
able. Nor was his distress in any degree
abated by a course of mercury which he was
immediately put under. On the contrary, the
swelling, which at first was not thicker than a
common quill, was now very considerable. My
idea of the swelling was, that at first it had been
“merely an inflammatory affection of the vas
deferens, which by degrees had spread to the
rest of the spermatic chord; but, what was un-
usual, it had never affected either the testis or
epididemis. As a considerable quantity of
mercury had been taken, and as, instead of
proving useful, it had rather appeared to do
harm, the surgeon whom he employed was
easily persuaded to trust the cure to other re-
medies. Local blood-letting with leeches was
frequently repeated, both in the perineum and
groin. The parts were regularly fomented
with a solution of saccharum saturni. His
bowels were kept easy with gentle laxatives,
and he was put upon a mild diet of milk and
vegetables. Ina few days the pain abated, and
the tumour gradually lessened; till. at last, in
the course of five or six weeks, it was entirely
_ gone.
In the course of oleae I attended two
different patients, with alarming symptoms about
the neck of the bladder, evidently induced by
the improper management of gonorrhoea. ‘The
parts in both were not merely pained, but con-
siderably swelled; and, at the same time, al-
most a total suppression of urine took place.
Although in both the discharge from the
33
urethra had been suddenly stopped, I did not
advise mercury. ‘The patients being both ple-
thoric, were plentifully blooded, first at the
arm, and afterwards repeatedly with leeches in
the permeum. This; with fomentations,. and
opiates to allay the violence of the pain, as-
sisted by a cooling regimen and gentle laxatives,
very soon completed the cures.
These instances’ are given out of a great
number that might be adduced, merely to shew
that’ the symptoms; which supervene on the
sudden stoppage of a clap, are local, and not
connected with any affection of the’ constitu-
tion, which ‘they necessarily would be if they’
were of the same nature with Ines venerea.
Tt will perhaps be said, that although this
may have happeried-in a few cases, yet that in’
others there has been cause to suspect that lues’
c 5
34
venerea has been the consequence of a clap
disappearing in this manner. In answer to this,
it is sufficient for me to shew, that this is at
least a rare occurrence; as I think I am entitled
to do, from my never having met with an in-
stance of it. It has been supposed, that the
sudden check given to the discharge in cases of.
clap, must necessarily throw the matter into
the blood, and that pox must accordingly ensue
from it. Were the matter of the two diseases
the same, this would happen in every instance ;
so that when we can shew that it seldom happens
even in appearance, we are entitled, from. this
argument alone, to conclude that they are pro-
duced by two different kinds of contagion; and,
where pox has appeared at the sudden termi-
nation of gonorrhea, that the two kinds of in-
fection had either been communicated together,
or, what may more frequently perhaps be the
case, the patient will be found to have received
39
the pocky contagion by communication with a
diseased woman, at the very time he laboured
under gonorrhoea. I have already remarked,
that lues venerea is sometimes produced by ab- ~
sorption, while the skin remains entire, and
where no chancre or excoriation is perceptible ;,
there is therefore much cause to imagine, that
in long continued cases of gonorrhoea, many
may be infected with lues.venerea by commu-
nication with others labourmg under it; and as
this may happen without any external mark of
it taking place, it is not surprizing that some
fallacy should arise from this circumstance.
The abettors of the opinion, that the matter
of the two diseases is the same, admit that
gonorrheea very seldom terminates in pox.*
* This is even granted by one who keenly supports
the opposite doctrine in every other point. In speaking
And they attempt to account for this, that is,
for the two diseases not being produced more
of gonorrhoea and chancre not terminating so frequently
as might be expected, in the production of each other,
he says, “ Although it does not often happen, yet it
sometimes does, at least there is great reason to believe ..
so. I have seen cases where a gonorrhea came on, and
in a few days after in some, in others as many weeks,
a chancre has appeared : and I have also seen cases
where a chancre has come first, | and in the course of its
cure a running and pain in making water have suc-
ceeded.” V. Treatise on the Venereal Disease, by John
Hunter, page 16.
This is what every practitioner has seen; but by admit-
ting so clearly that it is a very rare occurrence, Mr.
Hunter tends rather to strengthen the contrary opinion ;
for, were the two diseases produced by the same kind of
matter, the one would clearly'and necessarily often ter-
minate in the other. In the few cases which Mr. Hunter,
in the course of extensive practice, has met with, there
is more cause to imagine, either that the two diseases were
communicated at once, or that the one was given while
37
frequently by the application of the same
matter, by saying, that this depends upon the
difference of parts to which the matter is
applied.
They divide the different surfaces of the body
chiefly into two kinds, what they term secreting
surfaces and non-secreting surfaces. By the
first they mean all the passages for extrane-
ous matter, including also the ducts of glands,
such as the mouth, nose, eyes, arms and ure-
thra; and by non-secreting surfaces, the exter-
nal skin in general. To which they add a third
kind of surface, leading from. the one to. the
other, as the glans penis, prolabium of the
the patient laboured under the other, than that Nature
should deviate so much from her ordinary course, as to
produce them in a few instances so very differently from
what obviously happens in the course of general obser-
vation. |
38
mouth, the inside of the lips, and the female
pudendum ;. which surfaces, partaking of the
properties of each of the others, but in a less
degree, are capable of being affected both
ways, sometimes by being excited to secretion,
and at other times to ulceration.*
Upon this their theory or opinion of the
point in question, is attempted to be established:
when the contagion, either of gonorrhea or
pox, and which they consider to be the same,
is applied to any part of the external skin, par-
ticularly to the glans, where the skin is very
thin, chancre, or ulceration, they observe, will
most readily ensue, as these are not secreting
surfaces; while the same kind of matter applied
to the urethra, must necessarily excite gonor-
rhoea, from this being a secreting surface, and
* Vide John Hunter on the Venereal Disease.
39.
therefore not so easily affected with ulceration
as with irritation, by which an increased dis-
charge, attended with some change in the
mucus of the part, must accordingly be pro-
duced.
This idea, however, is more ingenious than
solid. It might answer the purpose of giving
a specious appearance to an ill-founded opi-
nion, but it will not stand the test of inquiry.
In the first place, on the supposition of the
matter of gonorrhoea and lues venerea being the
same, the latter ought to be a much more fre-
quent occurrence than the former, from the
greater ease with which the matter of infection
must, in every instance, be applied to those
parts on which it can produce chancres, than to
the urethra, where, instead of chancre or ulce-
ration, it almost always excites gonorrheea. It
40
is difficult to conceive how the matter by which.
the disease is communicated, should find access:
to the urethra; while, on the contrary, all the:
external parts, particularly the glans, must be:
easily and universally exposed to it; and yet
gonorrhoea is a much more frequent disease
than pox. Cases of gonorrhoea are in propor-
tion to those of chancre and pox, so far as my*
observation goes, of about seven to one; while:
it is obvious, that the very reverse should: happen:
if the two diseases were produced by the same
kind of matter.*
Again, were this the case, should we not |
_* Mr. Hunter supposes, that. the proportion the cases.
of gonorrhoea, bear to those of chancre, is as four or five
to one. Vide Treatise on the Venereal Disease, p. 217.
This is surely a weighty argument against the opinion he
endeavours to support, of gonorrhea and cliancre pro-
ceeding from the same contagion.
4}
find gonorrheea in almost every instance termi-
nating in pox, and chancre in gonorrhoea; for
every one knows, that in gonorrhoea the matter
is at all times passing from the urethra over the
glans and prepuce; and in chancre, that it is
passing from the glans into the entrance of the
urethra. It happens indeed, in a few instances,
(Mr. Hunter, we see, has met with some cases
of it) that the one disease supervenes upon the
other: but we have also seen that these are
rare occurrences, and where they have not been
communicated by subsequent connexion with
an infected person, that the two diseases have
probably been given at one and the same time:
Tt is no argument against this suggestion to say,
-that mstances. have been’ met with of a go-
norrhoea appearing during the continuance of
chancres of several weeks duration, and vice
versa; for every practitioner must have met
with instances of these diseases both appearing
42
at the distance of two or three months. from any
exposure to infection. ae ae
I have at this moment a gentleman under
cure, for a deep foul chancre, altogether within
the urethra. It was of several weeks duration
before I saw it, and yet no gonorrhoea took
place. He is now getting well fast by the
use of mercury. I have met with various
cases of this, as every practitioner must have
done.
Mr. Bell relates the following case. I was
called in to a gentleman with a painful chancre on
each side of the urethra. The sore extended
about the eigthth part of an inch up the passage ;
and the parts being much inflamed, I hesitated to
apply caustic. This rendered the cure tedious,
but still no gonorrhoea took place. At last,
after having taken a considerable quantity of
43
mercury, and when the chancres were looking
clean, and in a healing state, he was seized
with all the symptoms of a severe clap, with heat
in making water, and a plentiful discharge of a
thin green matter. ‘This, however, bore all the
appearance of a recent infection. I at once
said so to my patient, and he candidly acknow-
ledged that he had imprudently exposed himself,
by having connexion with a girl of the town.
three or four days previous to the accession of
these symptoms.
We may also remark, that the discharge from
gonorrheea frequently becomes so acrid as to
excoriate the glands and preputium, and even
to excite a very plentiful formation of matter;
but every one knows that this is materially dif-
ferent from chancre. It is altogether different
in appearance, and so materially different in its
effects, that scarcely any practitioner of expe-
Ad
rience will trust the cure of chancre to any
thing but mercury; while in the other, mercury,
T imagine, is seldom employed. However ex-
tensive the excoriations may be, they are easily
removed by local remedies, and I have never
known an instance of pox succeeding to this kind
of treatment. Nay, I have met with various
instances of such affections, where mercury had
been given in considerable quantities. with no
advantage whatever, and where the cure was:
effected by the use of an astringent injection.
About eighteen months ago, a gentleman
came to town from a considerable distance,
with an extensive excoriation, attended with a
discharge of a large quantity of thin offensive
matter.. The quantity of matter indeed was so
considerable, that at first sight it appeared to
be the discharge from a very inveterate recent
case of gonorrhoea; but on farther examination,
45
it was found to proceed entirely from the pre-
puce, the clap by which it was produced being
entirely gone.
He had taken mercury for the ‘space of six
weeks, and the parts had been regularly bathed
an milk and water, but with no advantage. ‘The
discharge continued as plentiful as ever, and the
preputium was beginning to acquire some de-
gree of thickness, and to be difficult to retract.
In the space of a week he was completely
cured, merely by bathing the parts from time
to time with brandy and water, and applying,
during the night, a poultice strongly impreg-
nated with saccharum saturni.
This, as, well as a variety of similar ‘affec-
tions, which, were it necessary, I might enu-
-merate, clearly evince not only that the matter
of gonorrheea, when ‘confined to. the urethra,
46
does not terminate in pox, but that it proves
equally inoffensive to the constitution, where it
is even so sharp and acrid as to excoriate the
surrounding parts. This points out a very
marked difference between the matter of the
two diseases. In pox, even the slightest sore
never fails to throw matter into the system,
while the most extensive affections proceeding
from gonorrheea are so seldom found to injure
the constitution, that I have never met with an
instance of it.
By those who wish to support the opposite
doctrine, it is said, that the matter of gonor-
rhoea would more frequently terminate in pox,
were it not for the mucus of the urethra with
which it is blended, and by which they suppose
it to be rendered not only milder in its nature,
but not so apt to be taken up by the absorbents.
This, however, is merely ideal, and no proof
fr
A7
can be advanced in support of it. Besides, the
force of the argument is entirely done away,
when we see, from what has been observed
before, that “even where the matter of gonor-
rhoeais more acrimonious than almost ever occurs
im cases of chancre, so as in some instances
to produce very extensive excoriations, that still
no affection of the constitution ensues from it.
Nay, we see, even in such diseases as are
found to proceed from what-is termed a trans-
lation of the matter of gonorrhcea to other parts
of the body, and which we suppose to happen
through the sympathy of parts, as swelling of
the testes, that still no affection of the consti-
tution proceeds from them. I have seen some
instances of ophthalmia proceeding from gonor-
rhoea, and in which a considerable discharge
took place of a puriform matter from the evye-
lids, very similar to the matter of a recent
48
clap. I have also met with instances of patients
labouring under gonorrhoea, being seized with a
similar discharge from the membrane of the
nose, but in none of these have I ever known
lues venerea ensue. A considerable number of
examples might be adduced of each of these,
but the three following will be sufficient.
Not long ago, a young man applied to me with
a very ‘troublesome painful disease affecting
both eyes. The eye-balls were not much
inflamed outwardly; but as he experienced an
intense degree of pain from the admission of
light, I concluded that the retina, or other
deep-seated parts of the eye, were in a state of
inflammation ; and the membrane of the eye-lids
was not only inflamed, but a constant and co-
pious discharge took place from them of a
greenish yellow matter, bearing much the ap-
pearance of the matter of a recent clap.
49
The account I received of his disease was
this: That he had for eight or ten days laboured
under gonorrhoea, the symptoms of which, how-
ever, were not more severe than usual ; when,
after. being heated with drinking port wine, the
discharge from the urethra, which had pre-
viously been copious, disappeared almost entirely.
His eyes, almost immediately thereafter became
painful, and in less than twenty-four hours the
discharge of matter had taken place from the
eye-lids.
The disease was at first treated with blisters,
slight evacuations of blood, and the usual applica-
tions of ointmentsand collyria. These not proving
successful, a course of mercury was prescribed ;
but although different attempts were made with
it, mischief always ensued from it. It did not
lessen the discharge, while it obviously increased
the inflammation, and rendered the eyes more
D
50 - .
irritable. I therefore advised this remedy to be
laid aside. A quantity of blood was taken from
the temporal artery of one side; such vessels
as were turgid upon the eye-balls were divided ;
scarifications were made in the inflamed parts
of the eye-lids ; poultices were applied over the
eyes, in which opium and saccharum saturni
were dissolved ; and gentle laxatives were pre-
scribed. By these means the pain soon abated,
the inflammation and discharge of matter lessened,
and in the course of a fortnight no symptom of
the disease remained, but a degree of irritability
on exposure to much light, with which both
eyes continued to be distressed for five or six
months afterwards.
In the course of the following year, on being
attacked with gonorrhoea, but of a more violent
nature than the former, he was again seized,
after exposure to much cold, and riding on
a1
horseback, to a similar affection of his eyes.
In this. instance too, blood-letting, and the
other remedies formerly prescribed, proved
successful, and he has not since that period had
any return of the disease.
About two years ago I was desired to visit a
patient, who, during confinement from a
swelled testis imduced by a gonorrhoea, was
suddenly seized with a profuse discharge of
matter from one of his nostrils, very similar to
the running of aclap. The membrane of the
nostril appeared tender, and somewhat inflamed,
but little or no pain occurred fromit. The dis-
charge from the urethra had diminished con-
siderably previous to the testis becoming in-
flamed, and on this taking place from the nose,
it disappeared entirely. This suggested the
propriety of attempting to excite a return of the
discharge by the urethra: but no advantage
dD Qg
52
being derived from this, I advised the affection
of the nose to be treated with injections similar
to what we use in cases of clap. An astringent
solution was thrown up, sometimes with a
syringe, and at other times by inserting a_bit of
sponge, immersed in it, up the nostril; and in
the course of a few days the running ceased
entirely.
Since that period, the same patient has been’
twice affected in a similar manner, and the
same kind of treatment proved equally success-
ful. . No mercury was given, and no symptom
of pox ever appeared.
In the course of a few weeks after the re-
covery of this patient from the first attack of
the disease, I was desired to see a friend of his,
who for several years had been distressed with a
similar discharge from both his nostrils. ‘The
DD |
rumning had occurred during the continuance of
a clap; and although it had frequently di-
minished in quantity, yet at all times it was so
considerable as. to. be productive of much un-
easiness. No ulceration appeared on the mem-
brane of the nostrils, but it was of a deep red
colour, and tender over its whole extent. A
variety of remedies had. been employed ; and at
last, after the disease had gone on for upwards
of three years, although no other symptom
appeared, he was advised to undergo a course
of mercury. This was done in the most at-
tentive manner, but no advantage ensued from it.
In this situation, I expected that the same
plan of treatment which proved successful in
the preceding case, and which had also done so
in others, would likewise answer here. In
this, however, I was disappointed; for al-
‘though every variety of injection was used
a4
that I ever employed, yet no material advantage
ensued from them. ‘The running was some-
times indeed lessened by them, but it always
returned equally severe as before; and although
it has of late, even when no remedies were em-
ployed, become considerably less, it still con-
tinues in such quantities as to prove highly dis-
tressful, No other symptom of the disease,
however, has ever occurred.
As a farther:proof of the: difference of the
contagions of syphilis and gonorrhoea, it may
be remarked, that no stage of pox has ever
been known to induce gonorrhoea, which surely
would: occasionally happen if the two diseases
were of the same nature. We may also remark,
that in numberless instances, people have been
poxed by the matter of syphilis being by acci-
dent applied to acut or a scratch, as oftenhappens —
with surgeons in the dressing of chancres and —
595
buboes ; but no one ever heard of a pox being
got in this manner from the matter of gonorrhcea.
It has indeed been said, that chancres may be
produced by insinuating the matter of gonorrhoea
béneath the skin. But experiments upon this
subject are productive of such anxiety and dis-
tress, that they never have been, nor ever
probably will be repeated so frequently as the
nature of it would require. Nothing, therefore,
can be admitted from this argument; for in
order to avoid fallacy, and to give support to
the opinion, these experiments would not only
require to be conducted with accuracy, but to
be numerous, and to be repeated on a variety
of patients under every possible variety of cir-
cumstances; whereas we have heard of only a
single experiment or two being made by any in-
dividual, and even these seem to have been made
under the management of such as were strongly
36
and obviously. biassed. in favour of one side of
the question.
In opposition to these too, I may mention,
that, induced by some late publications. upon
this subject, two young gentlemen of Edinburgh
have made some experiments upon themselves,
with a view to ascertain the point in dispute,
but the result was materially different from what
appears to have happened in the experiments to
which I allude. By the introduction of the
matter of chancres, as well as of buboes, into
the urethra, some pain and irritation were ex-
cited, but no gonorrhoea ensued; and, by
fretting the skin of the prepuce and glans with
a lancet, and rubbing the parts with the matter
of gonorrhcea, slight sores. were produced, but
they never assumed the appearance of chaneres,
and they healed easily without the use of mercury,
o7
-
For the reasons mentioned above, however, we
cannot place much dependence upon these, or
any other experiments that have yet been made
upon this subject; we- must trust therefore to
experience and observation in the ordinary
course of practice, for means to ascertain it.
The other fact, on which the doctrine we
attempt to establish, rests, is, that gonorrhoea
and syphilis have appeared at different times in
the same countries, and in some instances have
remained distinct and uncombined for a great
length of time.
If these two diseases were of the same nature,
and proceeded from the same contagion, they
ought to have appeared nearly at the same time
in every country to which the infection was
carried. This does not appear, however,: from
the history of the disease, to have been. the
pas
va
58
case. From the earlier writers upon this sub-
ject, it is evident that the lues venerea was
known in Europe at least forty years before the
gonorrhoea virulenta. Dr. Astruc, whose ac-
' curacy and minute attention to this subject has |
not been equalled by any one, asserts, that in
his time, gonorrhoea had not been long .known
in China, although we know that the ues
venerea had long prevailed in that: country;
and it would appear, notwithstanding any
thing that has been said to the contrary, that
the lues venerea was imported to the Island of
Otaheite a considerable time before gonorrhoea,
It seems to have been carried to that and other
islands in the South Seas by the very first
European navigators who touched there; and
to have remained distinct, without being con-
nected. with gonorrhoea, for a very considerable
time ; for when Captain Cook visited these
islands in his second voyage, we have authority
59
for saying that gonorrhoea had not then appeared
amongst the natives.
These historical facts all tend to prove, that
- where only one of these diseases has been im-—
ported to any particular district, it has always
remained distinct, without producing the other ;
and which we cannot suppose would have hap-
pened, if both were formed by the same con-
tagion. And, in addition.to these, I may add
another, not less remarkable, the truth of which
may be ascertained by all who incline to inquire
concerning it, as the scene of it lies in our own
country.
In various parts of the country of Scotland,
particularly in some parts of the Highlands, in
Galloway, and in Dumfries-shire, the common
people have, for a great length of time, been
afflicted with the /wes venerea, under the deno-
60
mination, as they termit, of Szbbens ; and which,
from those distressed with it having no commu-
nication with those infected with gonorrhea, has
still retained its original unmixed form, without
a single instance, so far as I know, of gonorrhea
having been ever produced by it.*. There is
evidence in some of these districts of this dis-
ease having prevailed among them for upwards
of seventy years. Nay, in some of them, it 1s
said, from tradition, to have been left there by
* This must have happened from the disease in these
districts prevailing almost entirely among poor county
people, whose manners do not expose them to the hazard
of being infected with gonorrheea. None, however, can
escape the sibbens who are much in company with those
labouring under it; and so-much are they convinced of its
being the same disease with lues venerea, that even those
who get it in the most innocent manner, are so ashamed
of it, that they never speak of it as long as it can possibly
be kept secret.
61
the soldiers of Oliver Cromwell; and to have
been given, since that period, by one generation
to another: and although I have had opportu-
nities, says Bell, of seeing many hundred people
labouring: under it, with ulcers in the throat,
nodes” of the bones,’ fungous excrescences,
blotches over the body, with alrhost every other
symptom of ‘syphilis; yet not an instance has
occurred,to me, as I have observed above, nor
have I heard. of any, where. gonorrhea took
place in it.. Whether it is from those infected
with it, concealing it longer than ‘usually hap-
pens in towns, or what may be the cause of it,
I shall not at present pretend to determine; but
certain it is, that the symptoms produced by it
are more inveterate than we usually find them to
be in the ordinary form of ‘this disease.. They
appear to be more particularly infectious, the
slightest communication with those labouring
under the disease being apt to produce it. The
62
symptoms spread more rapidly, and a greater
quantity of mercury is, for the most part, re-
quired to remove them ; but still gonorrhea is
never produced in any stage of the disease.
*
A disease very similar to this broke out
among the country people of Canada some
years ago, Owing, as is imagined, to commu-
nication with some of the soldiers quartered
among them, who were infected with lues
venerea. It is attended, as is the case with
the sibbens in Scotland, with all the symptoms
of syphilis in the most virulent form of that
disease ; and it is so infectious, as to be often
communicated by eating or drinking out of
the same vessel, or employing the same cloth
that has been used by those labouring under it.
It often enters the constitution by absorption
from the surface, without any previous ulcera-
tion, in which case it afterwards breaks out in
63
buboes, nodes, ulcers, and other symptoms of a
confirmed lues; but not an instance, I am in-
formed, has happened of gonorrheea being pro-
duced by it.
®
This, as well as what has occurred in the
progress of sibbens, is precisely what happened
with the lues venerea when it first appeared in
Europe, as well as at a late period in the South
Seas; and there cannot be a doubt of the same
circumstances taking place wherever the syphilis
only is communicated. We have seen, in all
these instances, that gonorrhoea has never been
produced by it, which surely could not have
happened if the two diseases were of the same
nature, and produced by the same contagion,
They could never, in that case, have remained
for any length of time so distinct and precisely
marked, for the one must necessarily in almost
every instance, have soon been productive of
the other. 5
64.
As a farther support of this opinion, I may
add, that if the two diseases were of the same
nature, and produced by the same infection, —
the remedies proving useful in the one might.
be expected to prove likewise so in the other. |
Instead of this, we find that those upon which
we depend with most certainty in gonorrhoea,
have no effect whatever in the cure of syphilis ;
while. mercury, which is the only. remedy, as
we have observed above, upon which any de-
pendance can be placed for the cure of syphilis,
does not in gonorrhoea produce any advantage.
Nay, that in most cases it evidently does harm.
We also know, that gonorrhcea will often
terminate whether any remedy be employed or
not, merely by moderate living, and keeping
the parts regularly clean. ‘The disease by this
alone will, in most instances, become gradually
milder, till at last it will disappear entirely.
No such thing, however, happens in- lues ve~
65
nerea. In this, as we have already remarked,
even the mildest symptom becomes daily worse,
unless. mercury be employed; nor: will any
practitioner of experience trust the cure even
of the slightest chancre to any other remedy.
_ Upon this evidence alone, of the method of
cure of the two diseases being so essentially
different, we might, I think, conclude that they
are different in their nature, and that they pro-
ceed from different contagions. Were they of
the same nature; and proceeding from: the same
cause, it is not possible to conceive that any
medicine would act as a certain cure for the
one, and do harm in the other; and yet every
practitioner will admit, that mercury is the only
remedy hitherto known, upon which we -can
depend for the cure of lues venerea, while it
evidently often does harm, as I have. already
observed, in gonorrheea.
66
If the subject now under discussion was merely
of a speculative nature, I should not have en-
tered so minutely into it; for in that case it
would have been a matter of indifference both
to practitioners and patients, whether these dis-
eases were of the same nature or not; but as
the treatment of gonorrhoea must depend much
upon this circumstance, I judged it proper,
to enter fully into this, very curious controversy.
For the above arguments for distinct dis-
eases, we rest chiefly upon. the authority of
Bell; and thinking the subject of that import-
ance, I procured some young men,. induced by
money, and under the promise of cure, to sub-
mit to some experiments made upon them.
But in six trials, the matter of chancre never
produced gonorrhea, or the matter of gonor-
rhea, chancre. They are, therefore, distinct
diseases.
CHAP. Il.
OF THE CURE OF GONORRHGA.
‘Tsu of late years this disorder was confounded
with the Lues Venerea, and treated in the
same manner with mercury; and mavy have
been the martyrs to this error im practice,
which, I am sorry to say, yet exists, notwith-
standing our advances in science.
Whenever a smarting heat or scalding accom-
panies making water, with a purulent discharge
staining the linen, appearing a few days or
_ weeks after impure connexion, we should imme-
diately judge that the reckoning is come, and
endeavour to ward off the impending evil.
68
The time of danger is arrived. That aw-
ful command, “increase and multiply,” was
never intended by Providence for the inter-
course, without love and affection, with the
most abandoned of wretches, whose faces belie
their manners, being ‘ whitened sepulchres,
but inwardly full of all manner of uncleanness.”
Happy should the youth be, if with gonor-
rhea, he has not also dues wvenerea, the itch,
body and other lice, which are the common’
attendants on this class of degraded beings, who
live in a state of prostitution.
Behold in every street the name of surgeon
over the door; and young men would do well
to consider, that this numerous tribe flourish
from this disease alone.
Can any one of the slightest understanding,
but perceive, that from a disease, which exists for
69
months, and years, in men of unprincipled cha-—
racter, but that the same must be communi-
cated to females of bad morals; who, had they
the power, would not have the sense to. undergo
a cure: so that this disease, so awful in its
visitation, keeps on increasing in the land.
But it is for ingenuous youths that I write;
who deplore their condition; who feel a sense
of shame; who resolve never to deviate from
the right path again; and who should not,
therefore, fall early victims: to so dreadful a
calamity.
One great misfortune attending those who
are afflicted with this malady is the necessity of
disguise. In many situations of life, a man
may be ruined by its being known that he la-
boured under the venereal disease. ‘The peace
of many a family has been broken by the mis-
70
take of an unguarded moment, when all the in-
jury might have been repaired, and the matter
kept an absolute secret, had the unfortunate
person known how easy a thing it is to remove
this malady. on its first appearance. Were any
apology necessary for extending the knowledge
of this disease, the above would be more than
sufficient.
In all diseases it is of importance, as soon
as possible, to know the nature and tendency
of the complaint: but in none more so than
in the venereal. ‘This dreadful malady, which,
in its advanced stages, commits such ravages
on the human system, as to destroy even its
most solid parts, may be disarmed of all its vi-
rulence. by some gentle applications on its first
appearance. ‘To negligence, or to trifling with
the first symptoms, we owe all the mischief
arising from the venereal disease.
71
Other diseases often attack men unawares ;
but this is seldom the case with the venereal
disease. It is generally the effect of an overt
act, of which the patient must have been con-
scious, and has consequently reason to ex-
pect it.
When the unhappy sufferer by this disease
perceives his situation, the same inclination to
conceal it, too often induces him to apply to
those pests of society, the advertising quack,
who, while he promises a sudden and secret
cure, generally disappoints him. Every man
conversant in the cure of this disease, will rea-
dily own, that the most deplorable cases he
meets with are those which have been under
the care of quacks; till the patient, convinced
of their ignorance, had recourse to proper
advice.
The quack not only holds out the lures of
72
expedition and concealment, but of cheapness.
To some patients this is a matter of great im-
portance: in this expectation, however, they
are sure to be disappointed. When the quack
finds that the patient’s pocket will hold out no
longer, he generally dismisses him, telling him
he is cured, or leaving him to find a remedy
where he can. No doubt the most ignorant
pretender may sometimes succeed; but as un-
toward circumstances will frequently occur, it
is safer to be in the hands of one who knows
how to treat them, than of him who practices
at random, and looks at nothing else but getting
of money. ‘These make a prey of the unwary,
who ashamed to acknowledge the imposition to
their friends, submit to be plundered of all
they can by any means scrape together.
If there needs any apology for writing on
this disease, the above would be a sufficient
one; when we so often see the fairest blossoms
73
of hope, thus untimely nipt, and becoming the
early dupes of the most unprincipled of mankind.
The disease in question is an highly inflam-
matory disease; and hence the patient should
avoid every thing which has the least inflamma-
tory tendency. He should avoid, as much as
possible, animal food and beer ; and drink toast
and water, or barley water; all excesses now
are attended with considerable risk. Drinking
only a few glasses of wine, or violent exercise,
has renewed the disorder, after it had ceased.
His breakfast and supper should be milk
porridge, and he should drink plentifully of tea.
If to this was added the occasional use of
linseed tea, by putting half an ounce of linseed
to a quart of boiling water, and drinking a cup
of this: warm, it would be of service; and all
immoderate exercise must be avoided. The less
exercise the better. Fruits are desirable.
E
74
With respect to medicine, it must be a saline
purgative, only of a mild kind, as
. Magnes. vitriolat. dr. 3.
Confect. Amygdal. dr. 1.
Infus. rosze unc. 7.
Pt. mist. capt. coch. larg. ii. hora somni, et
primo mane, sing. diebus.
That is, take of
Vitriolated magnesia, three drachms.
Almond confection, one drachm.
Infusion of roses, seven ounces.
Make into a mixture; of which take three large
table-spoonsful night and morning.
To this must be added the following in-
jection. 7
R. Hydr. muriat. gr. 14.
Aq. font. unc. 8.
Ft. injectio ter die utend. |
75
That is, take of
Muriated mercury, a grain and a half.
Water, eight ounces. v
This injection is to be used three times a
day.
In case of great pain attendant upon its use,
it may be lowered, by the addition of water,
but so as to excite some degree of pain. From
an experience of twenty years, I have found
this the most effectual of all injections. In
case of chancre in the urethra, which some-
times happens, as well as gonorrhoea, both dis-
eases will yield to this remedy at the same
time; and it acts in the following manner. The
part assailed being accustomed to a stronger
stimulus than the venereal, ceases to be acted
upon by the latter, or it has some specific ope-
ration over the virus itself.
E Q
76
I have had cases of some months’, nay years’
continuance, which resisted all the common
means, yet were cured by this application in a
very short period; and at the same time we
are using the means, we should be thankful to
Providence, that his anger is of short duration,
and He has furnished us with the means of re-
moving so dire a disease.
But although such be the general, and I had
nearly said constant effects of this remedy; yet
some constitutions are so framed, that all our
endeavours prove abortive, and the following
symptoms arise; a chordee, which is a painful
and involuntary erection, accompanied with an
incurvature of the penis downwards, and ex-
quisite pain.—The adjacent parts sympathizing
with those already affected, the bladder becomes
irritable, and incapable of retaining its urine for
77
any length of time;—this gives the patient a
frequent inclination to make water, and he feels
an uneasiness about the scrotum, perineum, and
fundament.—Sometimes the discharge is more
copious from the external surface of the glans,
or from the membrane of the prepuce, when
phymosis or paraphymosis are not unfrequently
produced.—Often there is an enlargement of
the glands of the groin, which however is to be
considered as depending merely upon irritation
of the lymphatics, and not as a syphilitic bubo.—
The inflammation sometimes extends along the
whole course of the urethra, and even to the
bladder itself, producing actual cystitis——In
other instances it happens, more. especially in
the protracted state of the disease, that, owing
to the rupture of a small vessel, a hemorrhage
arises. —Spasmodic stricture, with retention of
urine, are likewise at times the effect of the
great irritability of the parts; or a stricture
78
arises, when the bladder evacuates its contents
with great difficulty, the ureters dilate, and the
urine is thrown back upon the pelvis 6f the
kidneys, which enlarge also; the symptoms are
now very distressing to the patient; his spirits
sink, the stomach sympathizes, nausea, frequent
retching, rigors, considerable exacerbations of
fever, and a long train of miseries afflict him.
The stricture then sometimes inflames, or mor-
tifies, or ulcerates; or suppurating, causes an
-abscess in the corpus spongiosum, or perineum,
ic. Occasionally the bladder partakes of the
inflammation; coagulable lymph may then be
thrown out, which, fillmg up its cavity,
destroys the patient by the most dreadful
sufferings.
Here Providence points out, what prevails in
the benignity of our laws, making examples of
afew in order to deter the larger mass; and
79
happy ought the youth to be, if he has escaped
with but a few scars in his first dangerous en-
counter, in what the ancients have styled the
wars of Venus.
Where this disease has not been attended at
first, it is apt to run on for years, and terminate
at last in a troublesome gleet, whichis a serous
discharge from the urethra, exhausting the
frame, and laying the foundation of consump-
tion, or a long train of nervous diseases, which
destroy by inches; and sometimes even ends in
madness itself.
This disease is to be treated. by tonics, as
bark, air, and exercise, and the cold-bath ; and
fortunate will the youth be, if in the course
of time he gets rid of so dreadful a sequel to a
disease, so loathsome in its nature, and which is
only certainly curable in its early stage.
~
ae a
CHAP. IV.
OF THE CURE OF THE LUES VENEREA.
Tus disorder is at first local, like the inocu-
lated small-pox, and begins with a sore of a
peculiar form, having a hollow crater or exca-
vation, with a prominent rising surrounding it,
or as medical writers style it, a chancre is a sore,
with a thick, red, and hardened basis.
Now is the time to take alarm, and imme-
diately think of getting rid of the horrid poison.
The bite of a venomous serpent, or a mad dog,
excites immediate consternation, but here is a
81
more alarming poison; for these kill with
speed, the other consumes by slow degrees.
In the next stage, the poison is arrested, by
one or more glands in the groin, which are
denominated buboes. ‘These usually appear six
weeks after the chancre, and this last after a
week from the time of impure cohabitation.
Four or five months after this, copper-coloured
eruptions break out over the surface of the
body, which dry over in scales; or the throat
becomes ulcerated, with a jagged-edged deep
ulcer, having a brown slough in the center.
All sore throats, which have a duration beyond
a month, ought to be suspected.
The last scene is horrible to name.. The
bones become affected. Excrescencies arise,
especially over the shin-bone. Sleep, which
comes to all, is then denied. At last the hu-
E 3
82
man face divine loses its chief ornament the
nose. ‘The bones of the forehead decay, and
the miserable being, perhaps from one un-
guarded hour, pays away a life of torture, to the
law which Nature always avenges, and which
thoughtless youth disregards.
But Heaven in its mercy has granted a re-
medy, MERCURY.
The best method of applying this is by une-
tion: .
R. Unguent Hydr. fort. unc. 2.
Toungr. dr. 2, hora somni sing. noet.
That is, take of the
Strong mercurial ointment, two ounces.
Rub into the inner part of the thigh two
drachms, until the mouth becomes sore; then
omit it for some time, so as to keep the mouth
tender for a month or six weeks. If it purges,
683
ai graimoropiam may be taken at bed-time:: or
two grains of calomel, and half a grain of
Opium, may be taken each night; and one
grain of calomel in the morning, with the same
intention; but rubbing in the ointment is the
safest method for the constitution.
Sometimes a discovery, highly injurious to the
party, would be made by using friction, then pills
must be had recourse to. ‘The method now ta
be employed is as follows:
R, Calomel. ser. 1.
Cons, Rose q: 8.
P. pil: 20.
Cap. pil. duas hora somni, et pil. unam primo
mane.
That is, make twenty grains of Calomel
with conserve of roses into twenty pills; of
which take two at bed time, and one early: -
the following morning.
If they purge, take twenty five drops of lau-
danum, in some liquid, at bed-time.
84
@
The chancre should be drest with strong mer-
curial ointment spread on lint, doubled, and
placed between the skin and prepuce, by means
of a slip of card.
Medicines are daily advertised as contaming
not a jot of mercury, for the cure of this dis-
ease ; and the evils produced by mercury are
aggravated by reporting its bad effects, if such
happen, upon certain constitutions, as general.*
Not only quacks of this description, now un-
dertake to cure this disease; but every idle fel-
low who does not chuse to follow some useful
employment, sets up for doctor, assumes some
fictitious name, and advertises an infallible spe-
cific for the venereal disease. Some have even
the effrontery to advertise an infallible preven-
tative. ‘The apothecary’s man, or even the
* See Mercury Stark-Naked, a recommendatory
pamphlet for De Velno’s vegetable syrup, which, as
Dr. Buchan affirms, never cured a single venereal case.
85
apothecary’s man’s man, often passes for an
adept in curing this malady. Nor is it un-
common for the fellow who brushed the sur-
geon’s coat, or cleaned his shop, to step into
his master’s shoes, and sometimes into his cha-
riot, by his pretended skill in curing the lues
venerea.
The credulity of the sensible part of man-
kind in regard to medicine, is truly astonishing.
Even those who affect to be sceptical in other
matters, are the easy dupes of every pretender
to a secret medicine: they will neglect the
advice of the most skilful physician, and run
after the ignorant quack, because he promises
them a cure, and without mercury; but, alas !
this cure, nine times out of ten, turns out to
be no cure at all, and the disease is, by this
means, trifled with, till it becomes nearly in-
curable.
86
The most frequent dupes to quackery, how-
ever, are the young and thoughtless. They
credit the contents of every puff that 1s put into
their hands as they walk the streets, and swal-
low with eagerness. the drugs it recommends.
I would beg leave just to hint to such inexpe-
rienced youths, that the advertising quack is ten
to one more ignorant of medicine than them-
selves; that his sole aim-is to take their money,
and when he has got that, he cares no more
for the patient. I am warranted to say this
from daily observation, and’ am sorry to add,
that too many, from woful experience, know it
to be true. So great, however, is the influence
of quackery over the young mind, that I have
seen one of those unfledged gentlemen, while I
was writing a prescription for him, take up a
newspaper, and casting his eye on an advertise~
ment, which promised to do in a few days what
I had told him’ would require weeks, if not
87
months, to complete, put my prescription in his
pocket, and haste away to the performers of
quick and easy cures,
From the prejudice raised against mercury,
by the hue and cry of these legal murderers,
the disgrace and pest of civilized society,* it is
now become a difficult matter to persuade pa-
tients to continue mercury a sufficient length of
time. The wish to be soon well is natural,
but it is productive of much mischief. The
victims to quick cures are innumerable: yet
men will run after those who make such pro-
mises, though to their own destruction. Few
days pass in which I do not see instances of the
danger arising from imperfect cures of the lues
venerea; and I have reason to believe, that
* Is there no Member of the House who has courage
to stem this torrent ?
88
those which are not seen, nor regarded, are still,
more numerous.
Nor is the difficulty much less in getting men
to take mercury in sufficient doses. Mercury ;
may be taken for any length of time, but if it
is not administered in such quantities as to
produce sufficient effects on the system, it will
not subdue the poison. ‘This, however, is not
an easy matter to estimate. The difference of
constitutions is such, that two persons can
hardly be treated exactly in the same way, and
our conduct must be regulated chiefly by its
effects on the system. Every symptom of this
dreadful disease should be overcome at least a
fortnight before mercury be discontinued, and
even here we must admit of calculation rather
than of certainty.
The great art in administering mercury 1s to.
89
regulate the dose in such a manner as to keep
the system fully saturated, without forcing it off
by any of the outlets. This may generally be
done by gradually increasing the dose till the
mouth is sore, and then keeping it so by
smaller doses. But it is difficult to persuade
patients to let mercury be employed with due
energy. A sore mouth and fever is an evil too
great to be endured! I am poisoned with
mercury, they exclaim. But what is this. to
the devastation of so foul a disease? and what
is this poison in comparison to the other? but.
not yet feeling it invall its horrible effects, they
choose often to desist before a sufficient. trial
has been made, and thus bring themselves and
mercury into disgrace. If a man could keep a
medium he would be perfect; but this is not in
his nature: he flies from one extreme to an-
other, and is equally wrong in both. This
has been strictly the case with regard to the
90
exhibition of mercury. ‘Many. constitutions
were ruined by pushing it too far; and now
effects equally hurtful are produced, from its
being too sparingly administered. We are,
therefore, to follow a middle path, and, if pos-
sible, to avoid the bad consequences arising
from either of the extremes. I do not mean
to recommend the old and justly exploded
practice of exhibiting mercury, so as. to raise
a violent salivation. ‘This was productive of
many bad consequences, and is by no means
necessary. All the purposes of mercury
may be answered in a much milder way:
I mean, by a gentle salivation; or a moderate
degree of soreness of the mouth being kept up
for a considerable length of time.
Another great evil is the want of precaution
whilst employing mercury. The quack not
only holds out the lures of expedition, se
91
crecy, and cheapness, but also that of em-
ploying a remedy that will not oblige a man
to take any peculiar precautions, or make any
change in diet. With regard to expedition,
there is no great difficulty in healing a chancre,
and this is expeditiously done, for sake of the
pay. The object is to touch the cash, and the
poor deluded wretch is dismissed; and we
are not surprised at the appearance afterwards
of a sore throat, obstinate ulcers, and carious
bones. The wish of following the usual mode
of free life is great, and the greatest risk is
incurred, and the dead tell no tales. The
true science of medicine, however, teaches
that the natural stimuli must be at first mo-
derated, whilst under the influence of mercury,
and catching of cold most anxiously avoided,
as the effects of mercury are lasting, and the
abstraction of stimuli difficult under the ope-
vation of mercury, which wears down excite-
92
ment, and requires supporting, although this
is not to be done until tewards the conclusion
of the course, when tonic medicines, a gene-
rous diet, and the benefit of country-air, are
absolutely necessary. ‘
It would be happy for mankind, if some
preparation of mercury, milder than those forms
now in use, or some other remedy could be
discovered for this disease. ‘The danger in the
use of mercury must be acknowledged on all
hands; and in the ensuing chapters, the public
will judge how far such a desideratum is near its
accomplishment.
CHAP. V.
OF THE CURE OF SYPHILIS BY OTHER
SUBSTANCES THAN MERCURY.
GiRTANNER was the first who alleged that
the effects produced on the human body by the
different preparations of mercury were entirely
owing to their combined oxygen ; and that it was
on the disengagement of this principle, which
had a powerful action on the system producing
the mercurial disease, that their anti-venereal
effects depended.
We do not find, however, that Dr. Girtanner
had ever put this assertion to the proof, by ex-
hibiting other substances, containing a large
94
proportion of oxygen, in the place of mercury,
in the lues venerea.
Mr. Scott, surgeon in the East India Com-
pany’s service at Bombay, was the first whe
attempted to verify this doctrine by actual ex-
periment. ‘The nitric acid,* containing about
four parts of pure air and one of azot, was the
first substance that occurred to him as being fit
* The acid of nitre is obtained in various degrees of
oxygenation. _ When the proportion of oxygen to that of
azot is less than three of the former to one of the Jatter,
it is termed nitrous acid, and, in this state, fames of a red
colour are very freely emitted. But when there are four
parts of oxygen, by weight, combined with one part of.
azot, the acid is transparent and colourless, emits no
vapour, its constituent parts are more firmly united than
in the other species, and it is denominated nitric acid.
So that nitrous acid, is the acid of nitre containing a
smaller proportion of oxygen, whereas, the nitric acid is
super-oxygenated, or surcharged with that principle.
95
for a course of experiments in the venereal
disease: he tried this acid also in some other
complaints, the result of which it is not my
present business to notice.*
Mr. Scott’s first letter is dated April the 30th,
1796; at which time, he alleges, that the nitric
acid had been tried so fully as to satisfy him
of its efficacy. His words are as follows: “ I
have now had a pretty extensive experience
* The following observations of Mr. W. Scott are ex-
tracted from a small pamphlet which was sent to Sir Joseph
Banks, entitled, Some Letters upon the application of the
Nitric Acid to Medicine, first published in the Bombay
Courier, 1797. And it is curious to observe, that Sir
Joseph gave these letters to Dr. Pearson, who was so
laughed at by the different medical men to whom he
mentioned their contents, that he returned them to Sir
Joseph Banks, reporting his total want of success in the
cause of science and humanity.
96
of the good effects of the nitric acid in syphilis,
and I have reason to believe that it is not in
general less effectual than mercury in removing
that disease, in all its forms, and in every stage
of its continuance. {[ think that, in some cases,
it has even superior powers, for I have suc-
ceeded completely with the acid, when mercury
administered, both in this country and in Europe,
for years together, had failed of success.
q
A mass of mercury in the circulation, pro-
duces many disagreeable ‘effects, that make it
often necessary to give over its use before it has
answered its intention; but the nitric acid may
be taken a long time without any material injury
to the health ; nor are its effects on the mouth,
in producing inflammation and a flow of saliva,
so disagreeable as from mercury.
As the acid I distil is not strong, and is of
97
unequal strength at different. times, I am regu-
lated chiefly by the taste in giving it. I make
two pints of gruel as acid as it can well be
drunk. This quantity is finished every twenty-
four hours, taking about a Madeira glass full
- only at a time.
‘¢ [ have sometimes removed syphilitic symp-
toms with the acid in five days; more com-
monly, I think, they give way in a fortnight;
but sometimes, though seldom, they continue
for twenty days without any apparent relief.
I have cured syphilis with the acid under a
variety of forms, where no other. remedy had.
ever been employed, and for two years I have
seen no relapse in those cases. I have ad-
ministered it against the primary symptoms ox
the disease, and I have given it for exostoses,
for carious bones, for nocturnal pains, for
eruptions and ulcers of the skin, and for
FE
98
all the train of misery that is attendant on
dues.”
This respectable writer concludes by hinting,
“ that several of his friends had begun to use
the nitric acid in syphilis, and that an account
of their experience should make the subject of
a future paper.” “1 hope,”. says he, “ this
slight account will induce medical practitioners
to try the effect of the nitric acid in syphilis;
a'disease which, in this climate, (viz. the East
Indies,) is so frequently the disgrace of their
2a
e
art
The second letter of Mr. Scott is dated June
the 11th, 1796. He therein endeavours to
obviate an objection which might be made
against the nitric acid, on account of its de-
composing the teeth. His method is, to mix
the congee of rice with it, or to sweeten it with
99
sugar, or liquorice root. Although these ad-
ditions may deprive the remedy of some of its
oxygen, he has not found that they diminish its
effect.
Mr. Scott also notices, that when the acid
has been united with the earth of alum, it had
the advantage of not acting in the same way on
the teeth. From this nitric clay he obtained the
same effects as from the nitric acid. .
He concludes thus, ‘‘ In a few years, I think
that mercury, as a remedy for lues venerea, will
be banished by this acid; and in some of my
dreams for the improvement of the condition of
man, I even imagine that the poison of ‘syphilis
may, ina great measure, be extinguished over
the face of the earth, not by the doubtful efforts
of the magistrate, but by an agent like this, safe,
simple, and efficacious.”
r@
100
With a view, says Mr. Cruickshanks,* Sur-
geon and Chymist to the Orduance, to satisfy
ourselves of the antisyphilitic property of the
nitrous acid, and, at the same time, to discover
how far this might be owing to its oxygen, the
following trials were instituted :
The first substances employed were acids,
such as are known to contain much oxygen, and
which part with it readily ; as yet we have only
used the nitrous, oxygenated muriatic, and citric
acids. It is well known that the bases of these
are different, and the only thing which. they
have in common is oxygen; if, therefore, they
should all produce the same, or nearly the same,
effect on this disease, as well as on the consti+
tution, the natural inference. to be drawn is,
* Vide Dr. Rollo’s most excellent work on the Diabetes,
with the appendix by Mr. Cruickshanks, who is univer-
sally acknowledged to be the first chemist in this
country.
101
that this must depend upon their common
principle.
The only other substance which we have yet
tried, is the oxygenated muriat of potash, a
neutral salt, containing likewise: much oxygen,
and which parts with it very easily. We mean,
_ however, to extend our researches farther, when
a proper opportunity shall offer, and to make
trials with some of the other acids, the black
oxyd of manganese, Xc.
In detailing the following cases, we shall
satisfy ourselves with describing the symptoms
at the commencement, and any remarkable
change which afterwards occurred during the
cure; with enumerating the doses of the dif
ferent medicines employed, and their effects in
general on the disease and constitution; and
with giving the final result and duration of the
treatment. A more particular, or daily, ac-.
102
count (although such. was regularly kept,)
would be tiresome, and could not afford any
additional information, or satisfaction.
It may be proper to observe, that most of
the patients, whose cases are here related, were
kept in a ward set apart for the purpose ; and
where it was impossible, from the nature of a_
military hospital, they could procure any medi-
cines but such as were given to them. ‘The
cases were also selected, being primary affec-
tions,* and such as were strongly and distinctly
marked, and where no mercurial remedies had
been employed.
* Primary cases, according to John Hunter, are the
best criterions of venereal infection. His words are:
“ Of the symptoms of the second stage of the lues.
venerea, it must be observed, that this stage of the disease
is not so well marked as the former, aud as it is of more im-
portance, it requires all our discernment to determine
what the disease is.”—Vide page 527.
103
GENERAL ABSTRACT
Of the Patients admitted in the Royal In-
Sirmary at Woolwich, dividing ther Cases
into the Primary and Secondary Nature of
the Venereal Hs aoe specifying the. par-
ticular Remedies employed, and the respective
Numbers who have been treated.
1st. PRIMARY DISEASE. Number
of
Remedies employed. Patients.
NTEFOUS AEN ra a tee tre ler atte Oe
Oxygenated muriat of potash . . . . . 54
——_—_—__—_——-manganese .
a ee,
3
muriatic acid” Ss ee
Lemon-juice SAY Ab. 1 wee Ge ef aid
Nitrous acid and oxygenated muriat of pot-
GE Se a ag ge ee et eee I
Ditto and oxygenated muriat of manganese
Mercury and the new remedies combined . 16
reat
a ee
Total 142 cured.
24d. SECONDARY DISEASE.
PEO CAG a See a a APNG ht AE LU
Oxygenated muriat ofpotah .... . 5
—_—_____——_——-manganese and potash 1
Nitrous acid and oxygenated muriat of potash 2
Total 13 cured...
104
It would appear from the cases just related,
that the nitrous, citric, oxygenated, muriatic
acids, and, more particularly, the oxygenated
muriat of potash, are capable of removing the
primary symptoms of the lues venerea, and that
too without producing any thing like mercurial
salivation. How far these cures may be per-
manent, or whether the secondary symptoms
may not hereafter supervene, can only be de-
termined by further experience and observation ;
as the primary symptoms, however, have not
yet returned in any one instance, we should
suppose that these have been completely re-
moved; the only doubt therefore which can
reasonably remain, must relate to the secondary
ones; and if, ina Es cases, should even these
make their appearance at some future period,
it can form no solid objection to this mode of |
treatment, as similar consequences frequently
follow the use of mercury.
05
In our first trials, it, was thought proper to
confine ourselves to cases of primary affections,
these being always less equivocal and doubtful ;,
we intend, however, when an opportunity shall
offer, to employ the same substances inthe more
advanced states of the disease, particularly where
mercury has either failed, or had little effect.
Before we attempt to explain the modus
operandi of these remedies, it may be proper to
take a review of the effects they were observed
to produce on the constitution in general.
The general effects from the acids were, an
increase of appetite, an augmentation im the
quantity of urine, more or less thirst, white
tongue, and an increased action of the whole
system, most generally accompanied with sizy
blood. The oxygenated muriatic acid ap-
peared to be the most active, and the citric
°
_B OO:
Z 106
acid the least so. The nitrous acid, in a few.
instances, likewise affected the bowels. The
oxygenated muriat of potash produced thirst,
the white tongue, and the increased action of
the system, in a more remarkable degree than
the acids, but there was less alteration perceived
in the quantity of urine, and on the appetite.
The effects, therefore, induced in common by
these different substances, appear to be a
general increased action of the whole system,
accompanied for the most part with sizy blood.
That this mcreased action is occasioned by
the disengagement of oxygen, is rendered highly
probable from the following considerations : —
Ist. It is now sufficiently known that
oxygen 1s the substance which imparts to the
different acids their activity, their tendency to
combination, and other characteristic properties :
107
their radicals being all different, and possessed
of powers either opposite, or in no respect
similar to those of the compounds, or acids.
2d. The oxygenated muriat of potash ap-
pears to be, in fact, nothing more than the
common muriat, combined with nearly. half its
weight of oxygen; for if this substance be ex-
posed to heat in a retort, a very large quantity
of the purest oxygen gas is disengaged, what
remains being the common muriat of potash,
amounting to a little better than half the weight
of the saltemployed. Now it must be allowed,
that the common. muriat, at mee in the. doses
given upon the present occasion, could. not
have produced the remarkable effects which we
have ascribed to the oxygenated muriat. This
difference of effect must, therefore, be owing
to its combined oxygen, a circumstance rendered
the more probable, when we reflect, that a
108
similar action is produced by the union of the
same substance with the radicals of the acids.
Sd. When oxygen gas has been inhaled into
the lungs, a general increased action of the
whole system has succeeded, and that some-
times to a very remarkable degree. (See
Doctor THorRNTON’s work on the Nature of
Flealth and Disease, and the Laws of the Animal
Qiconomy.
From these ‘considerations, therefore, we
would infer, that. the general, or constitutional
effects, which have been observed to follow the
use of these remedies, must be ascribed to the
disengagement of their oxygen.
How then does this increased action cure the
local sores produced by the venereal virus? Is
it true, that all general affections of the system
109
suspend for a time the local ones, proceeding
from this poison, or must we have recourse to
some specific powers, as has generally been the
case In explaining the action of mercury? We
are inclined to adopt.the first hypothesis, and to
suppose, with Mr. Hunter, that mercury, as
well as the remedies under consideration, cure
this disease by exciting a new action in the
system, in consequence of which, the syphilitic
one is suspended ; and this suspension being
continued for a sufficient length of time, the
whole of the virus, from the change which the
fluids naturally undergo, is at last completely
expelled from the body.
With regard to the last hypothesis, we would
observe, that there can be little or no doubt if
oxygen could be applied directly to this poison,
it would destroy it specifically, in the same
maimer as it destroys many others; but it is ex-
110
tremely difficult to conceive how this substance,
so prone to combination, should, when taken
in by the mouth, be applied in its pure state to.
a remote, local sore, ina quantity sufficient to
produce any sensible effect ; and this objection
applies still more strongly to mercurial remedies,
because in some of these, as the mercur.
muriat. corrosiv. and mitis, the quantity - of
oxygen disengaged must be extremely small.
From these considerations, therefore, we are
inclnmed to adopt the opinion, that these
different remedies produce their effects by ex-
citing a new disease, or action, in the system;
and that this action, for the reasons already
given, is produced by the disengagement of
their oxygen. Should this’ theory be correct,
we have no more reason to expect relapses
after a course of these acids, &c. than after one
of mercury ; nay, if we conceive the virus to. be
absorbed, and carried into the general mass‘ of
111
circulation, where it must be exposed to the
action of the disengaged oxygen, the patient,
upon the whole, may be considered as. more
secure, for there will be a greater chance in
this case of its complete destruction and era-
dication.. This is a point, however, which ex~-
perience alone can determine.
If these remedies should be found, from fur-
ther experience, to be adequate to the cure of
this disease in all its stages, the advantages
which they possess over mercury are so great
and important, that they must, in a great mea-
sure, supersede its use. ‘They require no par-
ticular regimen, no confinement, are not ac-
companied with any disagreeable consequences
during their operation, and they seem, in ge-
neral to produce their effects more quickly and
certainly, particularly the oxygenated muriat of
potash. But what we consider to be of far
112
greater importance is, that they do not appear
to excite, in any sensible degree, the action of
other diseases, especially inflammations, one of
the greatest inconveniences attending a mercu-
rial course, and by which many have lost their
constitutions, and several their lives. Mer=
cury, besides its occasionally bringing other
diseases into action, has also very deleterious
effects upon some particular habits; and this
has been so remarkable in certain cases, that
from the necessity of occasionally leaving it off,
cures have not only been protracted, but the
complaint has had an opportunity of running
through all its different stages, by which the:
constitution has too often suffered an irrepar-
able injury. No disagreeable consequences of
this kind are likely to follow the use of these
acids, or the oxygenated muriat of potash; for
although they were given in several weak
habits, the health did not suffer in the least ;
113
on the contrary, it, in general, seemed to have
been improved,
Although we suppose that mercury and the
acids, &c. cure the venereal disease by exciting
some peculiar action in the system, the nature
of these we, nevertheless, conceive to be per-
fectly different. The mercurial action must, no
doubt, be owing in part to the metal, and not
to oxygen; for all the mercurial preparations,
whether oxyds, or combinations with acids,
produce salivation, ulceration of the tongue and
mouth, &c. very much alike; effects which,
we have shewn, are not occasioned by oxygen
disengaged under different circumstances. The
mercurial action is also accompanied with an
impaired appetite and general wasting, the re-
verse of which takes place during the action of
the new remedies, Indeed, the white tongue
and sizy blood appear to be the only circum-
114
stances common to both, for in all other re-
spects they differ essentially. We know it has
been said, that the nitrous acid produces sali-
vation, but this is certainly a mistake, which,
has probably arisen from confounding the local
and temporary sorevess in the gums and teeth,
occasioned by the acid, with the inflammation
and ulceration produced by mercury; for in no
one instance, even where the common concen-
trated acid was given to the quantity of three
drachms daily, did we perceive any thing like
mercurial salivation. ‘The mercurial action we,
therefore, conceive, must be owing to the metal
rendered active by its union with acids, &c. ;
but that of the acids and oxygenated muriat of
potash, to the disengagement of their oxygen.
Of the different substances. which we have
yet employed, we would prefer the nitrous acid
and the oxygenated muriat of potash; the first,
115
_ because it may be readily procured, and seems
in most cases sufficiently active; and the last,
on account of its being the most efficacious and
certain, producing, in most instances, an almost
‘immediate effect upon the disease, without in-
juring the constitution. The nitrous acid
which we have hitherto used, has never been
perfectly pure, nor highly concentrated; in
short, it was nothing more than the common
fuming acid of the shops. The nitric acid has
not been tried, nor do we conceive that it
would possess any superior advantages. ‘This
medicine for the most part produces a sensible
effect in six, or eight days, and frequently ac-
complishes a cure in fifteen or sixteen. We
_ have generally begun with a drachm im the day,
diluted with about a pint and a half of gruel;
but where the acid is only of the usual strength,
and free from any metallic impregnation, a
drachm and half, or evea two drachms, we be-
116
believe, will seldom be found too much. We
have never exceeded three drachms in the day,
but we do not by any means suppose this to be
the greatest quantity which can be taken with
safety and advantage. Of the oxygenated mu-
riat of potash, we have generally begun with
three, or four grains, although in general six,
or eight may be given, at first, four times a
day; where it produces sickness, or griping
(which is sometimes the case) the dose should
be diminished. We have never yet exceeded
the quantity of fifteen, or. sixteen grains four
times a day, not but that more might have been
given had it ever been found necessary.
One of the greatest objections to the oxy-
genated muriat is, the difficulty of preparing
and purifying it; nor is there any process yet
known, by which it can be manufactured and
sold at a low price; for these reasons we have
117
no doubt that a very impure kind will be of-
fered for sale, the consequences of which
must be, want of success and disappointment
to those who employ it.
Its purity may be judged of by attending to
the following circumstances: the crystals should
be shining flat rhomboidal scales, or tablets,
without any mixture of cubes; they should have
little, or no taste, and when thrown upon red-
hot coals, should detonate rapidly, with a very
vivid flame, and without any decrepitation; but
when the crystals feel rough, have a bitter
saltish taste, and decrepitate much when thrown
upon: live. coals, we may be certain that they
contain a considerable proportion of the com-
mon muriat of potash, which is always formed
in great quantity during the process. ‘This
salt, when perfectly pure, does, not decompose
the nitrats of silver, or mercury. But this de-
118
gree of purity is not necessary when it is to be
employed as a medicine; only when completely,
or nearly freed from the common muriat, a
smaller dose will be sufficient, and much less
thirst excited.
The oxygenated muriatic acid appears like-
wise to be a very inefficacious remedy in this
complaint; but in the way in which it is usually
prepared, it always contains manganese, and
not unfrequently lead, particularly when’ the
-manganese employed has been procured from
Bristol; for the manganese from the Mendip
Hills very generally contains, more or less of
this metal. In every case where either. the
oxygenated muriat of potash, or oxygenated
muriatic acid are prepared in a medicinal point
of view, nothing but the purest crystallized
manganese should be used; that upon Upton-
pine, near Exeter, is the best. The acid given
119
in the four cases related above, was procured by
adding the common muriatic acid to the oxyge-
nated muriat of potash; by this, means a very
large quantity of the purest oxygenated acid
may be quickly obtained ; and it is this process
we have been in the habit of using for some
time, where a very pure acid for delicate che-
mical experiments has been required.
Instead of making the gas pass through
water in the usual way, the oxygenated salt
-was sometimes simply added to the common
‘muriatic acid, diluted with about an equal bulk
of water; in this. case: the salt was slowly de-
-composed, and the acid converted into. the
oxygenated acid. About a drachm of the salt,
when pure, was found to be sufficient for three
ounces of the dilute acid: of this we have given
to the extent of half an ounce in the day, al-
ways beginning, however, with a much smaller
quantity.
120
The philanthropic Dr. Beddoes at this time
took up the question with his accustomed zeal
and liberality, and through him we have copious -
accounts of trials made in the Royal Hospital
at Plymouth, by Mr. Hammick’s son,. with
similar success, authenticated by the late Dr.
Geach.
To DR. BEDDOES.
“& Sir,
Royal‘Hospital, July 26, 1797.
“‘ I do myself the honour, agreeably to your
request, of writing to you, and assuring you
that the patients, whose cases Mr. Hammick,
junior, lately transmitted, were regularly at-
tended by myself; and every circumstance was
remarked as minutely as possible, and is strictly
true. So great, indeed, has been the success
of this nitric medicine in the venereal disorder,
121
that many patients, who had been broken down
by an antecedent use of mercury, under which
the disorder gained ground, recovered their
health and strength without the assistance of —
diet-drinks, change of air, the bark, or any
other tonic medicine whatever. We have had
but few imstances where the stomach and
bowels have been affected by it; but the pre-
_caution of taking it through a narrow glass tube
has prevented the acid from affecting the teeth,
and the medicine has been rendered more pa-
latable by mixing simple syrup with it; and
this addition, as far as we have hitherto noticed,
has been effectual enough to prevent both
mawkishness and pain. But although these
circumstances have now and then succeeded the
use of the nitrous acid, it does not affect the
mouth, or produce-a ptyalism. Jt does not
impair the appetite, it does not require any
dietetic regimen, or confinement. Indurated
G
o
buboes have yielded to it without: suppurating 5,
phagedenic buboes. have. healed after unsuc-
cessful trials with mercury. _ In chancres, how-
ever large or sordid, and in excoriations of the
scrotum, however fetid and extensive, the cure,
by its use, goes on more rapidly than by.a mer-
curial process. -Such chancres and excoriations
have been dressed only with simple omtment,
that the patient might not be mcommoded by,
the friction. of thelinen, and that the effect of
the medicine might be. better ascertained when
there was no local application. ...We have not
found, after the chancres. have been cured by:
this medicine, that the throat has been affected;
a circumstance not. unusual, especially when
such ulcers have been dressed with :any mercu=:
rial preparation. . ‘The cases sent by Mr. Ham-
mick were the worst that were. received