Practical observations on venereal complaints

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PRACTICAL OBSERVATIONS

O N

VENEREAL COMPLAINTSc

(Price Four Shillings /ewed.]

L^ V V ■ > .>■>»._, , V ^ -^ \

PRACTICAL OBSERVATIONS

O N

VENEREAL COMPLAINTS.

BY '

F. S W E D I A U R, M. D.
THE THIRD EDITION,

CORRECTED AND ENLARGED.

TO WHICH ARE ADDED,

An Account of a NEW VENEREAL DISEASE

which has lately appeared in C A n A d A ;"

AND A

PHARMACOPOEIA SYPHILITICA,

Scientise veros fines cogitent; nee earn aut animi caufa petant, aut ad con-

tentionem, aut ut alios defpiciant, aut ad commodum, aut ad famam, aut ad po-
tentiam aut hujufmodi inferiora; fed ad nieritum, et ufus vitK, eamque ifi chari-
tate perfic!g.nt, et regnent. Baco Je Vend. Prtf. c.d iwv. organ.

EDINBURGH:

Printed for C. ELLIOT, T. KAY, and Co,

Oppofite Somerfet-Place, N^ 332, Strand, London

And C. ELLIOT, Edinburgh.

MjDCCjLXXXYIII.

PREFACE.

H E intention, when I firft publifhed
this fmall Treatife, was to offer to
the public in a concife, but at the fame
time perfpicuous manner, my own obfer-
vations and difcoveries, together ^^;ith thofe
lately made by the firft medical men in
different parts of Europe, in that particu-
lar branch of medical fcience fo interefting
to mankind in general. I did not think
proper at that time to enlarge the^book
with any thing that did not immediately
relate to the improvement of real know-
ledge, either about the nature or cure of
thefe dreadful complaints, with which I
had myfelf the misfortune to be repeatedly
^ffeded. The refult of thofe obfervations

-^was

VI

PREFACE.

was thus dear-bought experience to me;
but for this very reafon perhaps the more
ufeful to my readers. The fecond edition
was printed ofF without any material alte-
ration. In this third, I have added fcveral
new ob'fervations, leading to the improve-
ment of the hiflory, nature, and cure of
thofe complaints. Whatever has been de-
rived from other fources, I thought it ho-
nourable and proper to acknowledge. I
fcorn the man who attributes to himfelf
what he owes toothers.- The Pharma-
copoeia Syphilitica, I hope, will not be un=
acceptable to young praditioners.

F. SWEDIAURc

Port-Seton, near Edinburgh,
Dec. 8,1787.

CONTENTS,

Ghap. I. Obfervatmis on the Venereal InfeBion^
and the different appearances of Syphilitic
Complaints in general, - - - ,i

Chap. II. On the Blennorrhagia or Clap, 22

Chap. III. On Blennorrhoea or Gleet, - 54

Ghap. IV. On the Venereal Swelling of the 'Tef-

ticles, - - - 73

Chap. V. Of the Inflammation and Induration of

the Projlate Gland, - - 88

Chap. VI. On the Venereal Ifchiiry and Stric-
tures, - , - - - 90
Chap. VII. On Venereal Ulcers, - 107
Chap. VIII. OfthePhymofts, - 126
Chap. IX. Of the Paraphymojis, - 130
Chap. X. On Venereal Buboes, - 133
Chap. XI. On the Syphilis or Venereal Difeafe

in particular, - - - 158.

Chap. XII. On the New^ Venereal Difeafe. which

of late made its Appearance in Canada, 17:^

Chap. XIII. On Mercurial Preparations in ge-
neral, with a fynoptical View of the differ-
ent Mercurial Preparations, - 178
Chap. XIV. On Mercurial Preparations in
particidar, - - - 187

I. On Crude Mercury, the Mercurial Ointment,

and on Mercurial Frictions, - ib^

II. 0?i Mercurial Fumigations, - 199

III. Of Saline and other Mercurial Prepara-

tions, - - - ib.

Chap. XV. On Pty all fm or Salivation y - 215

Chap,

vlii CONTENTS.

tihap. XVI. Oji particidar Venereal Com- '
plaints, which require a peculiar Method of

Cure, - - - - 222

\. On -the Venereal Ophthalmia, - ib*

li. On Venereal Deaf fiefs, , ■- - 226

III. Oji Venereal Sore Throat, ^ *•■ ib.

IV. On Venereal Complaints of the Skin, 230

V. On Venereal Excrefcences, , - 232
VI- On Venereal Weahiefs or Impotehcy. 233

VII. On Vefiereal Pains, Spafms, l^c> 234

VIII. On Venereal Complaints oj the Bo7ies, 236
Chap. XVII. On Complicated Venereal Co?n-

plaints, andfuch as have beenfufpeSted to be

of the Syphilitic Kindv, ~ - 238

Chap. XVIII. On Venereal Qoniplaints difgui-
fed ; fuch as, Confumption, Rheumatifm, Fe-
vers, l^c, - - _ 240

Chap. XIX. On Venereal Complaints incurable
by Mercury, - - ., - 243

Chap. XX* Of the Reafons why certain Vene-
real Complaints do not yield to Mercury, 248

Chap. XXI. On different other Remedies,- he-
fides Mercury, recommended for curing the
Lues, - "■ - - "^S^

Chap. XXII. Obfervations on fome dangerous
or unhappy Prejudices generally prevailing
about the Venereal JDifeafe, ^ - - - 261

Pharmacopoeia Syphilitica, - . - 265

J port Review of a late I'reatife on the Vene-
.f^eal Difeafe by John Hunter, - 279

PRACTI^

JPRACTlGAL OBS^RV-AtlONS

ON

VENEREAL COMPLAINTS.

Ad rcfte medendum omninO opus eft, ut remcdia, non folum generic
fed fpeciei cuique, et faepe etiam varietatibus quibufdam, apprime
fiiit accommodata. Cullen, Synop. Nof. Method.

G H A P- L

Olfervaiions oh the Venereal InfeBion, and the dif-
ferent Appearances ef Syphilitic Complaints in ge-
neraL

WE fay, in the common language, a per-
fon is poxed, injured, or infected with
the venereal difeafe, pox, or bad dii^
temper*, when the venereal poilbn has been
received into, oris difFufed through, the fyflem,
and there produces its peculiar effedls. Thefe
efFedls or fymptoms are ulcers of the mouth,
fauces \ fpots, tetters, and ulcers of the fkin^ pains,

A fwelling

* In Latin, this difeafe is called lues venerea, morlus Gallicux, ox fy-
philis. Whether the mmtfyphilis is derived ixom<r^-, porcus, and f'^'•'',
amor {amor pirdms), or whether it owes its origin to fome other de.
rivatlon, is uncertain. In French it is called la 7iialadie venerienne, l»
veriisi la. grands '-.'sro'e: in Gennan, die Lujifeiiche^ dk Franzofen.

2 Observations on the

fwelling, and caries of the bonesy &c. But as
long; as the effeds of the polfon are locals and
confined to or near the genitals, the diforder is
not called Syphilis, Lues Venerea, or Pox ; but
diftinguifhed by fome peculiar name, according
to its different feat or appearance 5 fuch as Clap,
Shanker, Bubo, &:c.

Concerning the nature of the venereal poifon,
we know no more than we do about that of the
fmall-pox or any other contagion; we know
only that it produces peculiar effeds, which yield
to a peculiar mode of treatment. It afteds,
like the fcrophula, the lymphatic fyllem and the
bones. Monkeys die fometimes during cold
weather in England of the fcrophula, but they
are never affeded with the fyphilis ; and the
reft of animals feem, as far as we know, to be
as little fufceptible of being affeded by the ve~
ilereal poifon as the monkeys. Baydford, how-
ever, thinks they may be in'feded, but mentions
ilo authority for his opinion. M. de Pauw^
likewife mentions, without naming his fource,
that dogs are liable to be affeded with the vene-
real dileafe in Peru, but not in North America.

The fmallell particle of this poifon is fufE-
cient to bring on the moll violent diforder over
the whole body. It feems to fpread and diffufe
itfelfbya kind of fermentation and affnnilation
of matter; and, like other contagions, it re-
quires fome time, after being applied to the hu-
man body, before it produces that effed. It is
not known whether it has different degrees of

acrimony

* Sere Recherches philofophlques fur les Americnins.

VENEREAL INFECTION. 3

acrimony and volatility, or whether it is always
the fame in its nature, varying only with regard
to the particular part to which it is applied, or
according to the different habit and conftitution,
or particular idiofyncrafy, of the perfon who
receives the infedion. We know that mercury
polfefies a certain and fpecific power of deflroy-
ing the venereal virus : but we are quite uncer-
tain whether it ads by its fedative, aftringent,
or evacuant quality ; or if not perhaps rather
by a chemical eledive attradion, whereby both
fubftances uniting with one another, are chan-
ged into a third, which is no more hurtful, but
has. fome new properties entirely diflind from
thofe which any of them had before they were
united.

The variolous miafma, we know, produces its
efFeds in about twenty or twenty-four days af-
ter the infedion is received from the atmofphere,
and eight or ten days if by inoculation^ but the
venereal virus feems to keep no particular pe-
riod. At fome times, and perhaps in particular
perfons, it requires a longer time to produce its
effeds than at other times, or in other perfons.
I have feen (hankers arife in the fpace of twelve
hours, nay in a ftill fhorter time, indeed I might
fay in a few minutes, after an impure coition ^
whereas, inmoft cafes, they make their appear-
ance only in as many days. The generality of
men feel the fir ft fymptoms of a clap between
the fecond and fifth day after an impure coitus;
but there are inftances where they do not appear
till after as many wrecks or months. About ten
years ago, I was confulted by a young man

A 3 who

4 OBSERVATIONS ON THE

who was feized with a violent difcharge from-
the glans (Blemiorrhagia halani), along with a
phymolis, but without any fhankers, four weeks
after coition j and during all the interval, he
felt not the leaft fymptom of the difeafe. Some
^ears ago, a gentleman went out from London
in feeiiiirigly perfect health to the Eafl Indies ;
but on his arrival in that hot climate, after a
voyage of four months, a violent clap broke
out before he went on fhore, though he could
have deceived no infedion during the voyage,
as there was not a w^oman onboard.

There are inftances which render it probable
that th^ virus may lie four, five, or fix weeks,
and perhaps longer, on the furface of the geni-
tals before it is abforbed \ and were it not then
to produce a fhanker, might probably not be
abforbed at alL We fee daily examples, where
common women communicate the infedion to
different men in the fpace of feveral weeks,
while they themfelves have not the leait fyphi-
litic fymptom, local or univerfal \ the poifon
lying all that time in the vagina harmlefs, and
generally without being abforbed.

How long the Venereal virus may lurk in the
body itfelf, after it has been abforbed into the
mafs of blood, before it produces any fenfible
effeds, is a matter of equal uncertainty. There
is fcarce a praditioner who has not obferved
infi:ances of its remaining harmlefs for weeks,
or even months, in the body. I had accefs
to obferve a cafe, where, after lying dormant
for half a year, it broke out with unequivocal
fymptomSb But the following inftance, if to be

depended

VENEREAL INFECTION. 5

depended upon, is flill more extraordinary. Some
years ago, 1 was coiifulted by a gentleman about
a fore throat, which I declared to be venereaL
My patient was aftoniilied^ and aflured me, that
for nine years pafl he had not had the leaft ve-
nereal complaint, nor had he any reason to be^
iieve he had lince received any infedion : but
at that time he had been in the Eafl Indies,
where he was afFeded with a violent clap. On
his return to Europe, being to appearance in
perfed health, he married, and continued per-
fedly free of any fuch complaint ever iince. By
a mercurial courfe, however, the complaint for
which he applied to me was completely remo-
ved *.

With regard to its effeds, the venereal poifoii.
follows no conftant rule : for though in general
it affeds firfl the throat or Ikin before it produ-
ces any fymptoms in the bones, we fee in many
inflances the bones afFeded without any fymp-
tom in the throat or fkin before or after. In
fome perfons it more particularly attacks the
throat, where it produces ulcerations ; while in
others its exerts its virulence on the ikin or
bones. Whilft the greatefl part of mankind are
thus eafily afFe6led by this poifon, there are
fome few who feem to be altogether unfufcep-
tibld of the infedion, and run every riik witli-
but fuifering in the fmallell degree; jufl as fome
are never infeded with the variolus contagion,

A 3^ though

* This, and fimilar other cafes, however, (lead me rather tp fufpedl
that an abforption of the venereal poifon may perhaps fometimes take
Tjlace v^flthout any previous external loca^l ai"e(9tJ,on of the gsnitals.

6 OBSERVATIONS ON THE

though they go into infed:ed places, and expofe
themfelves to inoculation or every hazard by
which the difeafe is generally communicated.
Some perfons are more liable to be infeded
than others feemingly of the fame habit ; nay,
the very fame perfon feems to be more liable to
be infeded at one time than at another^ and
thofe who have been once infeded feem to be
more liable to catch the infedion a fecond time
than thofe who never were infeded before with
the difeafe. The climate, feafon, age, Hate of
health, idiofyncrafy, are perhaps, as in other
difeafes, the necelTary predifpofing caufes. The
fame difference is obfervable in the progrefs
made by the difeafe after the patient is infeded.
In fbme the progrefs is flow, and the difeafe
appears fcarce to gain any ground ^ while in
others it advances with the utmofl; rapidity, and
fpeedily produces the moft terrible fymptoms.

At what time this dreadful malady (the very
idea of which poifons the fource of our moil
happy moments) was firil known among man-
kind in general, or in Europe in particular, is a
matter I cannot pretend to decide. Thus much
we may affirm from the accounts tranfmitted to
us by ancient writers, that the lues, with its
horrid and fatal fymptoms, fuch as we find it
firft defcribed by medical and other writers to-
wards the end of the fifteenth century, had
been unknov*^n amxong our Greek or Roman
anceftors, though undoubtedly as licentious
as their barbarous or refined pofterity. Lo-
cal complaints of the genitals, indeed, very
much like our prefent venereal complaints of

j:hofe

VENEREAL INFECTION. 7

th:6CG parts in both fexes, were known and ac-
curately delineated by many of the ancient wri-
ters : Such are the different complaints defcribed
by Aetius as well as thofe related by Paulus
GF ^GiN A, and more efpecially the corroding ul-
cers of the prepuce and glans ; the difcharge of thin
famous niatter from the pe?iis j the mortification and
cancer of the penis ; the phagedoenic nicer of the

fame ; the warts of the prepuce and glans ; condy^
lomata ad afium ; x.h.Q five lied tejlicles arifing with-
Qut external contifionj all mentioned and exadly
defcribed by Celsus^. But none of thefe we find
any where marked as contagious, as propagated
by coition, or as producing fymptoms like thofe
we now obferve produced by the venereal virus
when abforbed and diffufed through the fyftem;
which, if they had ever happened, there is
ereat reafon to believe we would have been in-
formed 6f by the medical, fatiricai, or hiitori-
.cal writers of thofe times; who were very careful
and fagacious obfervers, and otherwife far from

' giving us very favourable accounts of the cha-
flity of the Roman ladies.

Though, however, thefe local complaints, fo
much refembling our prefent venereal ones,
were not marked or oblerved to be contagious
and propagated by coition at fo early a period,
they were a few centuries after, a long while
before the lues broke out, experienced and ob-
ferved to be fo, by feveral fuccefilve writers ;
and that thofe difeafes were the very fame with
our prefent local venereal complaints, every un-

A 4 prejudiced
^ — . ^ j„

* L. vi. cap. xviii. De obfcoenarum p^nium yitiis.

8 OBSERVATIONS ON THE

prejudiced reader may convince himfelf, by per-
ufing thofe ancient writers; ar> hiflory of which
has been lately colleded and publifhed by one
of the rnofl learned and ingenious phyf^cians ^
in Europe, whatever Friend, AJiruc, or otheir
modern writers may fay to the contrary.

Befides the law given in the manufcript ila-
tutes, De difciplina Lupa^aris publici Avenionenjis
(Avignon), made in the year 1347!, by Queen
Joanna I. we find Lmfrancus , and more efpecially
Salicetus, in the XIII. century, mentioning pu^
JiuleSy ulcers, cancer of the glans penis, arifing pofi
coitum cum focda muliere. In the XIV. century,
we find in Gordon, Arnoldus de Villanova, and par-
ticularly Guido de Chmdiac, one of the firft furgeons
who wrote in the middle of that century, excoria-
tions, burnings, corrofive, ^^n^ putrid ulcers, mention-
ed as SLiiiing propter decubitum cum muliere foeda : and

Becket

* prHcNSLER Gefchichte der Luflfeuch^ (I^iftoty pf the Lues
Venerea), Vol- 1. Altona, 1783; where he added, by way of a fup-
plementj excerpts of the different authors in their original Latin
language.

f After other regulations, the law proceeds thus : ** Jubet
*' Regina Sabbato quplibet a Bayliva una cum chirurgo a confu-
''« iibus propofito, mulieres meritoriasringulas luftrari; quotcun-
<^ que in lupanari proftant. Et fi qua fcortatione segritudinem
" ullam contraxerit, a caeteris feponi ut feorfim habitet, ne fui
*' copiam facere poffit; ut morbi prsecaveantur qui a juvenibus

*• poiTent concipi." The ^een further orders, that every one

of the xvomsn kept in that bawdy-hotife fhould be vifited every Sa'
turddy by the mother-abbcfs, together ivith a furgeon appointed by
the magijirates for this piirpofe ; and if there be any who havo
contraEled fome difccfe by fcortation, the fame ffjould be feparatcd
from the re/l, and be fhiit up in a private room, fo that fie may
not lie with any man: in order to avoid by ihefe ineans the difordcrs
■iihich might bo communicated by her to yoinig men. •■

'TENERE AX. INFECTION. g

Becket* fays, " In an old MS. I have by me,
" written about 1390, is a receipt for hremiing of
^.y the pyntyly yat men clepe ye Apegalle. Galle
-' being an old Englifb word for a running fore,
f^ .They who know the etymology of the word
^' aproUy cannot be ignorant of this. And in
" another MS. written about fifty years after,
" is a receipt for burning in that part by a wo-
" man.'*- He like\yife adduces two remarkable
paffages from Englifh ftatutes about bawdy-
houfes : One of 1 163 fays, no flewholder to keep
any woman that hath the perilous infirmity of burn-
ing. And that of 1 430, written upon vellum,
w^hich was preferved in the court of the bifhop
of Winchefter, begins thus : " Here begynne
" the ordinances, rules, andcufloms, as well for
*' the falvation of mannes life, as for to afchewe
** many mifchiefs and inconvenients," &:c. there
is 3. law, with a penalty of a hundred iliillingi
-fa great fum for the time), if any flewholder
keeps women in his houfe habentes nefandani in^
firmitatem; or, as it is afterwards tranllated,
having any ficknefs of brenning, I could ad-
duce a number of firailar inftances, but I think
it unneceffary to enlarge any further upon this
fubjedl here ', 1 rather refer my curious readers
to JDr HenJJer\ book, where they will find a com-
plete evidence from hiilorical fads. — But to fix
the precife year or time when that dreadful
epidemical diforder, with horrid exulcerations
and monitrous excrefcences on the il<:in, with

an

* See Philofoph. Tranfa6lians, Vol XSX. p. Scig. &c and
Vol. XXXI. , .

10 OBSERVATIONS ON THE

an intolerably fllnking ichorous difcharge from
the fame, fwelling and caries of the bones, tor-
menting the patients with the mofl: excrucia-
ting pains, called at the times the Gallic Difeafe
{morbus Gallicus), and which foon after obtained
the more proper name of Venereal Difeafe (^lues
venerea^ fyphilis)^ firft appeared in Europe, is
difficult and perhaps impoffible exadly to de-
termine : fo much is certain, that this new dif-
eafe broke out towards the end of the fif-
teenth century, between the years 1484 and
1494 ^ and from the feveral writers of thofe
times, and the critical inquiries made by the
late Dr Sanche%*-, and more particularly by the
laft mentioned ingenious Dr Henjler^ it is highly
probable that this difeafe had really exifted in
Europe feveral years before Columhus firft re-
turned from the Caribbee iflands.

It is, at leafl, undoubtedly wrong in us, to
conclude that the difeafe was brought to Europe
from the Weft Indies, becaufe it appeared and
became epidemic here at the time when Colum-
bus returned from his firft voyage 1493: or to
fay, that, becaufe it had been epidemic there,
it was brought from thence to us. I think it
might be equally reafonable to allege, that it
v/as brought into different parts of the globe by
the fame caufe, at the fame time. 'However, fo
far down as to the middle of the fixteenth centu-
ry, this difeafe was unknown altogether in

South-

* See Diflertation fur I'origine de la maladie venerienne, and
Exam-en hiitoriqiie fur Tapparition de la maladie venerienne en
Europe.

VENEREAL INFECTION. ii

South- weft America; and in fome parts of North
America, it was not yet known of late. Curi-
ous and remarkable it is, that the firft twenty-
years after the appearance of this new and pe-
culiar difeafe, it was afcribed to a peftilential
temperature of the air; and nobody, neither phy-
fician, or any other perfon, had the leaft idea or
fufpicion of its being ever communicated by coi-
tion, or in the leaft conneded with any difcharge
from the urethra or ulcers of the genitals.

Indeed no mention is made by any of the
earlier writers on the venereal difeafe, of the ge-
nitals being any way ever affected ; and the dif-
eafe was at that period looked upon as a kind of
plague (i^^ij". Morbus Pejiilentialis), Only, in
the beginning of the iixteenth century, PinBor,
^orella, and Almcnar, firft mention, that the ve-
nereal difeafe begins in the genitals, and from
thence is fpread and diifeminated; which, how-
ever, was at the time denied by others to be al-
ways the cafe.

Was this new^ cutaneous difeafe really a dif-
ferent difeafe at the time? and was it only after-
wards, by being united or blended w^ith the virus
that produced blennorrhagias and ulcers of the
genitals long before, that it transformed itfelf,
if I might fay fo, into our prefent fyphilis ?
Were the local difeafes of the genitals of former
ages, and the cutaneous epidemic plague of the
fifteenth century, two different difeafes ?

Whether the venereal poifon can be abforbed
into the fyftem, without a previous excoriation
or ulceration of the genitals,, or fome other
parts of the furface of the body, was, as I men-
tioned

12 OBSERVATIONS ON THE

tioned in the former editions of this book, ftlll
a matter of doubt. Several cafes, however,
which occurred to me and to others, rei^der it
highly probable, if not certain, that the poifon
really is now and then abforbed, without any pre^
vious excoriation or ulceration whatfoever, and
thus produces buboes and other venereal fymp^-
toms in the body.

It has been aflerted by the earlieft and even
by fome late writers, that it may be caught by
lying in the fame bed or living in the fame room
with or after an infeded perfon *. What may
have been the cafe at the commencement of this
difeafe, I cannot fay ; but, from the moil accu-
rate obfervations and experiments I have made
upon the fubjed, I have never been able to con-
firm this to be the cafe in our times. Nor do
wc ever fee nurfes infeded in the Lock Hofpi-

tal,

* The diTeafe, in its origin, muft have been very contagious
indeed, or, at leaft, been fufpefted to be fo ; becaufe, in the
year 1529, in November, when Cardinal Wolfey, King Henry
Vlllth's prime minifter, was accufed, amongll other articles of
charge brought againft him by the Houfe of Lords, the very re-
markable one is, his whifpering in the King's ear, knowing
himfelf to be afFefted with venereal diftempers. See Harness
Ifi^. VoLlY. p. 4^1, noteC.

Schelligy a German phyfician, the earlieft writer on this dif»
'eafe, who wrote in the year 1494 or I495> ^^Y^y that the poifou
is very fubtle, and eafily proves contagious, not only by the air,
^breath, or habitation in the fame room, but alfo by the cloatha
which had been worn by infected people.

The Sibbensin Scotland is now-a-days caught, not only by ly-
ing in bed with, but alfo on the (lighteft touching of the perfon
atfe6ted. But this diforder feems to be a difeafe compofed of
the itch and the lues ; and may therefore be eafily comtriuniu-
ti'-d by the touch

VENEREAL INFECTION. 13

tal, where they live night and day with patients
in all llages of the diflemper. The fad feems to
be, that patients in our times are apt to impof6
upon themfelves, or upon phyficians andfurgeons,
with regard to this matter; and the above opi-
nion eaSly gains ground among the vulgar, e-
fpecially in countries where people are more in-
fluenced by prejudices, fuperftition, fervile fi-
tuation in life, or other circumftances. Hence
we fometimes hear the moll ridiculous accounts
given in thofe countries, by friars and common
foldiers, of the manner by which they came tp
this diforder : Such as piles, gravel, colics, coa-
tufions, fevers, little-houfes, lying in fufpedeii
beds, or lying in a bed with a fufpeded perfon,
retention of the femen, coitus with a woman in
menftmation, the ufe of cyder, bad wine or
beer, &c.

Another queftion, which I am equally unable
to decide, is, Whether the venereal poifon ever
infeds any fluid of our body befides ^he mucous
and lymphatic fyftem. Hence I arri in doubt,
whether the venereal poifon in an infed;ed wo-
man ever afledls the milk; and confequently
whether the infedion can thus be conveyed to
the infant by the milk alone, without any vene-
real ulcers on or about the nipples. It is equal-
ly a matter of uncertainty to me, whether thq
venereal difeafe is ever conveyed from an infec-
ted father or mother, by coition, to the foetus,
provided their genitals are found : or, whether
a child is ever affeded with venereal fymptoms
in the uterus of an infected mother. Such in-
fe<ft€d infants as came under my own obferva-

tion,

14 OBSERVATIONS ON THE

tion, or that of my friends, whofe practice af-
fords . them frequent opportunities of feeing
new-born infants, feemed rather to militate
againft the opinion. Neither I myfelf, nor
any of them, have ever been able to obferve
ulcers or other fymptoms of a venereal kind up-
on new-born children ; and fuch as make their
appearance four, fix, eight, or more days after-
wards, on the genitals, anus, lips, mouth, &Ci.
may rather be fuppofed to arife by infection
during the paffage from ulcers in the vagina of
the mother ; the ikin of the infant being then
nearly in as tender a ftate as the glans penis
or the labia 3 and this is perhaps the time when
an abforption of the venereal poifon might ea-
iier take place without a previous excoriation
or ulceration of the ikin.

All the ways, therefore, by \Vhich we fee, in
our days, the venereal poifon communicated
from an unhealthy to an healthy perfon, may
be reduced to the following heads :

1, By the coition of an healthy perfon with am-
ther who is infe6led with venereal fymptoms of the
genitals.

2, By the coition of an healthy perfon with ano- '
ther apparently healthy, in zvhofe genitals the poifon
lies concealed, without havifig yet produced any bad

fymptoms. Thus, a woman who has perhaps re-
ceived the infedion from a man two or three
days before, may, during that time, infed, and
often does infed, the man or men who have to do
with her afterwards, without having any fymp-
tom of the difeafe vilible upon herfelf ; and,
vice verfa, a man may infed a woman in the
cj , fame

VENEREAL INFECTION. i$

fame manner. Such inftances occur in practice
every day.

3. By fucking. In this cafe, the nipples of the
wet nurfe may be infeded by venereal ulcers in
the mouth of the child ; or, vice verfa, the nip-
ples of the nurfe being infeded, will occalioix
venereal ulcers in the child's nofe, mouth, or
lips. I have mentioned above, that I was un-
certain, whether the venereal poifon was ever
propagated by means of the milk from the breaft.

4. By expofing to the contaB of the venereal poifon
any part of the furface of the body, by kifling,
touching, &c. efpecially if the parts fo expofed
have been previoufly excoriated, wounded, or
ulcerated, by any caiife whatever. In this man-
ner we frequently fee venereal ulcers arife in
the fcrotum and thighs ; and there are fome
well-attefted inftances where the infedion took
place in the fingers of midwives or furgeons, I
have likewife feen feveral inftances of venereal
ulcers in the noftrils, eye-lids, and lips, of per-
fons who had touched their own genitals, or
thofe of others, affeded at the time with local
venereal complaints, and then rubbed their no-
ftrils, &c. with the fingers, without previously
wafhins: the hands.

We had a few years ago here in London, a
melancholy example of a young lady, who, af-
ter having drawn a decayed tooth, and replaced
it with one taken immediately from a young
woman apparently in perfed health, was foon
after affeded with an ulcer in the mouth. The
fore manifefted fymptoms of a venereal nature :
but fuch was its obflinacy, tfeat it j'efifted the

mofl

i5 OBSERVATIONS ON THE

moft powerful mercurial remedies, terminating
at laft in a caries of the maxilla, with a moft
fhocking erafion of the moiith and face; by
which the unhappy patient was deflroyed : du-
ring all this, however, we are informed, not the
fmalleft venereal fymptom was perceived in the
woman from whom the found tooth was procu-
red. :

5. By wounding any part oj the body with a lan^
cet or knife infeSted zvith the venereal virus. In
this inflance there is a limilarity between the
venereal poifon and that of the fmall-poxi We
have feveral examples of the latter being pro-
duced by bleeding with a lancet which had
been previouily employed for the purpofe of
Inoculation, or of opening variolous puflulesj
without being properly cleaned afterwards. In
Moravia, in the year 1577, a number of perfons
who^ being aflembled in a houfe for bathing, had
themfelvesj according to the cuftom of that
time, fcarified by the barber^ were all of them
infeded with the venereal difeafe^ and treated
accordingly. Krato the phyiician, and Jordan
who gave a defcription of this diflemper, are
both of opinion that it was communicated by
means of the fcarifying inftrument. And Van
Swieten relates feveral inftances where the lues
was communicated by a fimilar careleflhefs in
cleaning the inllrument ufed in bleeding or fca-
rification.

No branch of the medical art has, as far as my
knowledge extends, received fo many valuably
improvemencs from modern pradice as the treat-
ment of the different venereal complaints. Thefe

VENEREAL INFECTION. 17

improvements, I venture to fay, were prin*
cipally made, becaufe medical men themfelves
were ^s much fubjed: to thefe complaints as
any oth^r perfon 3 and I believe, that, amongft
the various diieafes to which mankind are fub-
jecS:^ there is none of which the cure is now
more eafy and certain than the venereal difeafe,
if properly and judicioufly treated : but if, on
the otlier fide, neglected, or unfkilfully treated,
we fee it often not only extremely obftinate, but
fomctimes incurable and fatal ^ and it is a well-
known truth, that many perfons have their cpn-
ftitution broken, and fuffer more by the prepo-
fterous treatment than by the difeafe itfelf.
Yet there is fcarce any difeafe in which more
people pretend to fkill than in this ; and among
the whole herd of quacks, there is hardly
one who does not pretend to fome fuperior
knowledge, or to the poiTeffion of fome parti-
cular nollrum, which he fets forth as the befi:
and moft infallible remedy for this diforder in
ail its various ftages. Thus, with coniummate
impudence, they impofe on fuch patients as have
the misfortune to fall into their hands, and who,
fooneror later, generally fuffer feverely for their
credulity^ whereas it is beyond, doubt, that the
cure of this diftemper in all its various ilages, re-
quires not only a great degree of judgment in the
choice and dofe of the medicines, but likewife
fuch an exacl knov,dedge of the conftitutlon of
the patient, as is not to be obtained but by atten-
tive experience and judicious obfer nation. Hence
more than common abilities are often requifite
perfectly and radically to cure a confirmed lues,

B , oj^

i^ OBSERVATIONS ON THE

or venereal complaints which have been pre-
pofleroully treated. The great number of un-
fortunate, vi(3:ims to ignorance and rapacity,
Avhich we daily fee, are but fo many confirma-
tions of the truth of this aflertion.

From the moll authentic accounts, it cannot
be doubted that venereal complaints were for-
merly much more dreadful, violent, and even
not unfrequently fatal. This is generally im-
puted to the more malignant nature of the poi-
fon at that time ; and it is imagined that it af-
terwards grew more mild. This may indeed
be true in fome refpeds ; though, on the other
fide, I have feen the difeafe, with all its differ-
ent fymptoms, in a number of inftances, as vio-
lent and inveterate as ever defcribed by any au-
thor of the fixteenth or feventeenth century.
We fee, however, in general, thofe dreadful com-
plaints now by far not fo often in Europe. This
may indeed be partly owing to the venereal poi-
fon having grown milder by its diffufion through
mankind > but greatly, I think, to the improve-
ments made in the treatment of this difeafe, and
more efpecially to the enlightened principles of
humanity fpreading all over Europe, and happi-
ly fucceeding the barbarous fuperftition and
cruelty of former times. We no longer abhor
or expofe thofe poor unhappy wretches on the
dunghill, or let them die, as the Kalmucks do
their brethren and children affeded with the
fmall-pox, without giving them the leafl allilt-
ance : both fexes, being in our times lefs expo-
fed to the prejudice of others, apply fooner for
relief, and obtain it more eafily from more hu-
mane

VENEREAL INFEGTiON. tg

mane and better inftru^ed phyjficiaris and fiir-
geons ; and I am perfuaded it is owing princi-
pally ta this, that the difeafe is not only lefs
frequent, but in all its different fymptoms lefs
violent, in London, than in any Other capital in
Europe; People of the lower clafs have not on-
ly fo many places where they obtain advice and
medicines from unprejudiced arid fkilful perfons
for nothing ^ but thofe of the female-fex, who
would perhaps be detained by iliame from ap-
plying to fuch a place, ealily find fome benevo-
lent perfon who will give them money to fup-
port themfelves during their miferable fituation;
and as eafily a medical man, who will undertake
to cure them without expeding any remuneration
whatfoever. I know this is no where the cafe
on the continent of Europe : befides, the gene-
rality of their phyficiaris and furgeons, not ha-
ving the advantage of fuch a liberal education^
have not feldom more confined notions of mo-
rality, and often but a very fuperficial know-
ledge of this difeafe; Our phylicians and fur-
geons, do not think themfelves authorifed to
reproach their venereal patients with th^ir
mifery in a rude and inhuman manner; nor
are they fo infatuated with fuperfl.ition^ as
to believe^ and look upon themfelves as the cho-
fen inflruments of heaven^ to punifli thofe poor
creatures for thofe imaginary crimes, rather
than to relieve them, as I have a thoufand times
heard even in feveral great capitals on different
parts of the continent; Oiir magiftrates and
police do not force thefe wretches into a prifon^
or into an hofpital not very different from a pf i--

B 2 fon ;

20 OBSERVATIONS ON THE

fon; but they are fatlsfied to put in their way
all pofiible means to procure relief for them-
felves. In other countries, where goverment
purfues a different plan, v/here poor venereal
patients h^.ve no place of refort, where they are
expofed to die of hunger during the cure, or
where they are even intimidated from applying
in time 3 in thofe countries I have frequently
feen the diforder in its moil horrid ftages, and
fuch as are almoil unknown in this country. In
fhort, let a perfon make the tour of Europe, and
only take notice of the venereal patients, as well
thofe who are confined in hofpitals, as thofe
who live or die unnoticed, under the moil hor-
rid fymptoms of this difeafe, in their private a-
bodes s and he will, in my opinion, be able to
form as folid a judgment of the comparative
progrefs of enlightened principles of govern-
ments in different countries, from thefe obfer-
vations, as from any other inquiry whatfoever.
He will be ailonifhed to find at this day fuch a
difference between the feveral governments with
regard to barbarity and humanity, as I found
wilh refped to fcience and learning, not many
years ago, between tv/o modern univerfi ties 3 I
mean Goettingen in Hanover, and Louvain in the
Netherlands. In the former, every inftitution
feerns calculated to inculcate upon th& minds of
young men every kind of ufeful knowledge, and
the moff liberal principles of philanthropy^
whereas, in the latter, every thing feems to
confpire to keep the youth in fuperflition and
ignorance, and to engrave in their hearts all the
pn^ciples of intolerance and hatred of true

learning

VENEREAL INFECTION. 21

learning of every kind, for which we now lb
juflly blame our forefathers.

I have at leaft hitherto found, in my difFer-
ent travels, the frequency and violence of ve-
nereal complaints in different countries, to be
exadily in proportion to the degree in which
knowledge and liberal principles are deiTemina-
ted among the different nations. From thefe
obfervations, I am led to believe, that if a ju-
dicious plan, with proper regulations and pre-^
cautions, was adopted by any government, in
whatever climate, all the violent fymptoms of
the venereal difeafe would not only be rendered
uncommon, but the difeafe itfelf might be, if
not entirely eradicated^ at leaft greatly dimi-
nilhed in its frequency : But fuch a plan, though
ealily conceived and executed, feems not yet
adapted to the tafte of the prefent age, but ra-
ther calculated for. our humane, lefs prejudiced,
and more enlightened pofterity.

^ CHAF,

:3 O N C L A P S,

CHAP. IL

On the Blennorrhagia or Clap,

THE Chp^ is a local inflammation, attended
. with the difcharge of ?ipuriform matter from
the lacunse or mucous glands of the urethra in
men, and from thofe of the labia or vagina in
women 3 accompanied with a frequent defire of
making water, occalioning a fcalding, or prick-
ing and burning pain, during the time of its

pafTage ;

* This difeafe occurs in the Latin authors under the different
denominations of Ganorrhcea^ G. Firulentat C. Venereai Fluor.
Jlbus Malignus. The name Gonorrhea is derived from the
Greek yv". genitiiray femeriy and f^'^^fluoy i. e. fiuxus feminis ,-
■which is a very improper name for the diforder in queftion, be-
caufe it conveys an erroneous idea. The name Gonorrhoea im-
plies a difcharge of femen, \vhich never takes place in this dif-
order. If a Greek name is to b>e retained, I would call it Blen-
norhagia, from /Jae »v@^, muciiSy and p^") fluo, i. e. Mucifluxus fa£li-
vusj i and thus diftinguifh it both from real gonorrhoeas and
from gleets ; to which latter I would give the name Bknnorrhoea,
Mucifluxus (pajfivus)y i. e. without phlogiftic fymptoms. In
Englifli, the difeafe is commonly called a Clapy from the old
French word clapiers ; which \yeEe public {hops, kept and in-
habited by fingle proftitutes, and generally confined to a particu-
lar quarter of the town, as we fee flill to-day in feveral of the
great towns in Italy ; in German, a Tripper ^ from dripping j
and in French, a Chaude-pijfey from the heat and fcalding in
making water : names derived from the principal fymptoms of
the difeafe. See the Nofological Table of this difeafe at the end
of the following chapter.

O N C L A P S. 23

pafl^ge^ which may arife from any acrid Hi-
mulus, but more efpecially and generally from
the venereal poifon applied to thofe parts.

This dill emper, we may obferve, i. Is a local in-
flammation 3 and therefore, like all thofe of the
fame kind, does but feldom affed the whole fyftem*

2. The difcharge, though the matter has a
purulent appearance, is not a real piu, much
\ek femen, as fome patients fancy. The mat-
ter difcharged is nothing elfe but merely the
mucus of the urethra or vagina fecreted in a
larger quantity than ufual, and changed in its
colour and confidence by the ftimulus applied
to thefe parts 5 like the mucous difcharge from
the nofe or lungs in a coryza, or cough from
cold, where the mucus aflumes nearly the fame
purulent appearance : for which reafon I gave it
the new, but I hope proper, name purifornu — It
is an erroneous notion, that this difcharge
arifes always from an ulcer in the urethra. In
ninety-nine out of an hundred claps, per-
haps there is no fuch thing as , an ulcer ; but
the difeafe is merely a fuperficial eryfipelatous
inflammation of the internal membrane of the
urethra, like that above-mentioned of the mu-
cous membrane of the nofe or lungs from cold*.

B 4 For

* This has been hitherto rather fuppofed, than proved by any
direft fafl:. Anatomifts, examining the urethra of men M'ho had
laboured during their lifetime repeatedly under claps, found, af-
ter death, no cicatrix in the urethra \ and thence the conckifion
Was drawn, that thofe difcharges were generally not accompanied
with an ulceration. This, however, would prove little or nothings
becaufe we fee daily, that (hankers on the prepuce or glans, though

fome-

24

ON CLAPS.

For in this laft cafe, though the difcharge has
much the appearance of purulent matter, we
know that it does not proceed from an ulcer iri
the nofe or lungs. Thus we may eafily account
for the quantity of the matter diicharged ^ and
have no reafon to he furprifed that fo large an
excretion as is frequently ohferved in violent
claps, fliould fo little aflecl the conftitution :
while if an equal quantity of femen, or real
pus, was difcharged, we fhould find the confti-
tution and flrength of our patients materially
injured; which, however, is hardly ever the
cafe, even in the moil virulent clap.

3. I have faid, that the difcharge, though
moil generally arifing from the venereal virus,
may proceed from any ilimulus fufficiently
flrong applied to the urethra. To. difcufs this
latter fubjecl more fully, 1 fliall conlider it un-
der the three following heads.

I. I am of opinion, that claps, " arifing froni
" an external caufe, are actually excited by

" the

fometimes pretty deep, go ofF, and are a fhort time after fo ob-
literated, as not to leave the leafl mark of a former ulcer or.ci-
catrifation behind To conclude thence that there has' never been
any ulcer, becaufe in fuch a cadaver we find no cicatrifation on
the prepuce or glans, would in this cafe be evidently wrong.
But what anatomifls have hitherto only fuppofed, is now made
evident by an obfervation of my friend Dr Stolly profeffor of the
praftice of phyfic at Vienna. He diffedted a man who died in
his hofpital while labouring under a virulent clap. On opening
the urethra carefully, he found its internal furface preternaturally
red; two of the lymphatics white and enlarged; and the puri-
form matter oozing out from the internal membrane,, efpecially
at the lacuna, where the feat of the diforder.wag, without ,the
ieaft appearance of an ulceration or excoriation.

O N C L A P S, ' 25

'"^ the flimulus applied to the cavity of the
" urethra itfelf^'* and that confequently, in
coition, the virulent mucus of the vagina is
driven, or, if I might fo fay, pumped or forced
into the urethra, and not, as fome writers have
imagined, abforbed by the lymphatics of the
glans penis, and thence depoiited at the lacuna
under the frsenum. — If fuch an abforption ac-
tually took place, we ihould every day obferve
virulent runnings originally feated low down in
the urethraj as well as under the frsnum^
whereas this is feldom or never the cafe. The
feat of thefe runnings is always originally in
the lacuna Morgagni, under the frsenum; and
thofe which are found to have their feat at the
curvatura penis, or lower down in the urethra,
are not fo at the commencement of the difeafe,
or arife from an internal caufe. What has been
faid of the impoffibility of fach an immediate
application of the virus to the iniide of the ure-
thra, becaufe its orifice is clofely Ihut up during
ere6^ion, and therefore admits not of any fuch
introduclion, appears to me o»ly to be reafon-
ing from an ill-grounded theory ^.

11. I fliall prove, both from well-eftablifhed
principles, and from pradical obfervations,
" that claps not only may, but moft fre-

" quently

^ What is faid here relates only to thofe claps which arife
from a caufe externally applied. But though venereal biennor-
rbagias do generally arife from an external caufe, it is highly
probable to me, that they may fometimes be excited by the ve-
nereal or any other acrid matter depofited from the mafs.

20

6 ONCLAPS.

" quently do, arife from the fame venereal poi-
" fon which, applied to other parts of the body,
" produces Ihankers, or other fymptoms of the
'' lues." — It has of late been afierted, even by
fome phyiicians of eminence, that the poifon
which produces a clap is different from that
which produces the lues }, and feveral fpecious
arguments have been brought in favour of this
paradoxical opinion. This difpute concerning
the nature of claps, leads me into a difcuf-
fion the more agreeable, as it is of confider-
able importance in practice; and as experi-
ments and obfervations will, I think, enable me
to prove not only the contrary, but perfedtly to
reconcile the different opinions, and thus fet
the matter in a clear light, and free it from that
obfcurity in which it has been hitherto invol-
ved. I enter therefore into the difculiion of
this fubjed; with the coniideration of the differ-
ent reafons alleged for that favourite do6trine.

Fir/l, It is faid. That tbe poifon which produces
the clap does never, like that of fhankers, pro-
duce any venereal fymptoms in the mafs, or the lues
itfelf. To this I reply, that though a lues is
feldom produced by a blennorrhagia, yet we are
by no means to look upon this as univerfally
true. The reafon why claps do not, like
Ihankers, conftantly produce the lues, is, that
moft of them, if not ill treated, excite only
a fuperficial inflammation in the internal mem-
brane of the urethra, without any ulceration.
Hence abforption cannot eafiiy take place, the
poifon being out of the courfe of the circula-
tion. But I have feen claps, through in-
judicious

ON CLAPS, 27

jadicious treatment, or where the dlfeafe had
been originally accompanied with an ulcer of
the urethra, foUov/ed by the moft unequivocal
fymptoms of the lues itfelf. The reafon why
the venereal poifon indeed, when applied to the
urethra, does not fo frequently produce ulcers
as when applied to the glans, prepuce, and
other external parts, is, that the internal mem-
brane of the urethra is defended by a large
quantity of mucus, the fecretion of w^hich is
moreover augmented, fometimes to a furpriling
degree, by the prefent flimulus. As long as
this niucus is fecreted in fuch abundance, the
poifon is inveloped, the urethra defended, and
tjius the formation of ulcers effedually pre-
vented : but if, either from the violence of the
irritation, or from any other caufe, this fecre-
tion is diminifhed, or if by improper injedions
the mucus be waihed away while fome of the
poifon remains ; I am of opinion, from more
than twenty inflances which occurred to me,
thst£ in nine inch cafes out of ten, an excoria-
tion or ulceration of the urethra, and fubfe-
quent pox, will be as certainly the confequence,
as from venereal ulcers in any other part of the
body. If there was the fame quantity of mucus
between the prepuce. and the glans, as there is
in the cavity of the urethra, we fhould as fel-
dom fee ulcers there as we do in the urethra in
cafes of fimple blennorrhagia. We obferve, that
when the poifon meets there with a large quan-
tity of mucus, as is fometimes the cafe, it then
produces no ulcers, but only a great fecretion
Qf puriform mucus, which is commonly called a

gonorrhoea

28 O N C L A P S.

gonorrhoea fpuria, but which with more propriety
may be termed 2i Bknnorrbagia bala?iiy i. e. an ac^
tive difcharge from the glans or corona glandis.
The reafon why this kind of running is lefs fre-=-
quent than thofe from the urethra, appears to me
to be, the fmali quantity of mucus which in moft
people is fecreted in thefe parts ; whence the vi-.
rus, not beingfuffxciently diluted, commonly pro-
duces thefe erofions, or venereal ulcers, called
ihankers.-— This iikewife receives a conliderable
confirmation from the w^ell-known fadt, that
women very feldom have {hankers in the vagina,
though very frequently in the labia pudendi
and nymphsB. The mere want of a fufEcient
quantity of mucus on the latter, accounts, in my
opinion, fufficiently for this effed.

Secondly y They maintain, That the poifon of the
clap never produces JhankerSy and that the poi-
fon of fhankers never produces a clap.-r^ln con-
firmation of this allertion, it has been faid, that
a p^rfon who has fhankers will never comiiju-
nicate any other complaint but fhankers, aiid
that a perfon who has a clap cannot com-
municate any thing but a clap, I will
not deny that this is frequently the cafe; but
repeated and attentive obfervation authorifes me
to fay, that, like too many other medical wri-
ters,, they have drawn a general conclufion from
a few obfervations favourable to their own pre-
conceived opinion. For in many cafes where I
had occafion to examine both parties, I have
been convinced, that fhankers were communi-
cated by a perfon affeded with a fimple clap 3
and, vice verfa, that a virulent clap had been
. - the

^ O N . C L A F S. 29

the confequence of an infedion from a perfon
having limple Ihankers only. But there is a
more ftriking proof than this, which has not
been taken notice of, viz. if a patient afBided
with a venereal running does not take care
to keep the prepuce and gians perfectly clean,
fhankers will very often be produced^ the caufe
of which may evidently be traced to the matter
of the clap. This is one of the principal
reafons why, in cafes of blennorrhagia, we
inlift fo much on the parts being kept clean ;
experience having taught us, that ihankers
frequently arife from negligence in this par-
ticular, even fometimes after the running
has confiderably abated. For the fame rea-
fon, I conftantly order thofe patients to keep
their hands clean; having feen repeated inflan-
ces of venereal ulcers in the nofe and eye-lids
being the confequence of this negled;. But be-
fides this, will any man of the medical profet
fion doubt, that matter taken from a ihanker,
and applied to the urethra, would not produce
a clap ? This is an experiment which I
certainly fhould not venture to try on myfelf,
I mull conclude, therefore, that though the
writers who have alligned this fecond reafon,
may be right in a few cafes which fell under
their own obfervation, they are wrong in dedu-
cing a general rule from a few fa61s ; as I roy-
felf would be, in concluding from feveral con-
trary inftances which I have obferved, that
a clap always communicates Hiankers, and
fliankers always a clap. Some cafes of this
kind I have feen, as already mentioned^ where,

-^o O N C L A P S.

J)

in the fourth or fifth week of an Ill-treatei
clap, or from a negled of external cleanli*
nefs, ihankers have been produced in places
that had been perfedly well before : but this
fureiy would be a very flender reafon for avert-
ing that fuch is always the cafe. Thefe
ihankers arifing from the matter of a clap,
were, to my obfervation, conftantly as virulent
and infetflious as original ones ; and, like thefe^
when left to themfelves, produced the fame per-
nicious fymptoms in the body ; and if a perfon
who has fuch ulcers was to believe that they are
not venereal, nor capable of bringing on the
lues, becaufe they fo plainly originated from
the matter of a clap, he certainly would find
himfelf moft difagreeably miftaken.

thirdly ^ The lafl, and in their opinion the
mod unanfwerable, reafon for ■ believing that
the virus of a clap and of a confirmed lues
are materially different, is, as they fay. That
mercury never contributes to^ or accelerates ^ the cure of
a clap; but that, on the contrary, every hlennor-
rhagia may be certainly cured without mercury, and
without any danger of leaving the lues behind.-— -To
this I reply, That it is indeed a certain and au-
thenticated fad, that a great many claps
may be, and are, cured without mercury. I
have feen many inftances, where water, drunk
for a confiderable time, has cured the clap
fully as well as any medicine whatever. Na-
ture is very often able to effed a cure in
acute diftempers, if we would allow her to pro*
ceed undifturbed in her operations. Nature,
when irritated by the poifon, will excite a
2 greater

O N C L A I^ S. 31

greater fecretion of mucus than ufuai, In the
fame manner as the lachrymal gland pours out a
larger quantity of watfer when a grain of fand
falls into the eye. This larger quantity of mu-'
cus anfwers the purpofe of diluting the poifon
as efFe(3:ually as any medicine artificially injedl-
ed. Befides, the poifon is hy this means not
only diluted, but carried off in part by the run-
nings and the modern pradice of curing
claps, by injeding fweet oil, or other mucila-
ginous liquors, into the urethra, does nothing
but affifl nature in this falutary work.

But though I allow that claps may gene-
rally be cured without mercury, yet repeated
experience has fhown me, that it is not always
poflible to accomplilh a cure in fuch an agree-
able manner. In thofe cafes where the blennor-
rhagia is of a milder kind, without any ulcer or
excoriation in the urethra, it may certainly
be radically cured without ufing a grain of
mercury : and though mercury Ihould be given
in fuch cafes internally, it cannot have the leall
effedt ; not becaufe the difeafe does not pro-
ceed from a venereal poifon, but becaufe it lies
out of the reach of the circulation.

To what is further alleged, that mercury
never fhow^s any powder in accelerating the cure
ofa blennorrhagia, I reply, That they not only
confound the runnings which arife from the
venereal virus, with thofe w^hich are occafioned
by other caufes ^ but that they do not make a
proper diftindion between the internal ufe of
mercury and the topical application of it. I
readily allow, tliat mercury given internally can-
not

32 0 N C L' A P Si

not cure fimple claps, as the caiife of tlie
difeafe lies out of its reach. But the fame con*
fequence cannot be drawn concerning its topi-
cal application. 1 am indeed perfedly convin-
ced, not only that mucilaginous injedions, com-
bined with mild mercurial preparations, contri-
bute to the cure, but that they are the fafeft,
fpeediefl, and beft of all methods for that pur-
pofe : though I do not deny^ that in fimple
claps mercury applied in this way does not
always produce beneficial elFeds ^ which, how-
ever, is often owing, I think, to the ufe of im-
proper medicines or injedions.

It muil alfo be obferved, that in this difpute,
the contending parties feem to have entirely
overlooked the diftindion between the fimple
venereal blennorrhagia and that combined with
an ulceration of the urethra : and of fuch im-
portance is it to attend to this diftindion, that
daily experience fhows us, that runnings of the
latter kind are not only cured more fafely and
expeditiouily by the ufe of mercury, but that
they are very often, if not always, totally incu-
rable without it; and that the gleets remain-
ing after thefe claps, though they obfiinately
refill all other remedies, yet frequently very
readily yield to the ufe of mercury, either ex-
ternally or internally applied. I can even affirm
with certainty, that a gleet of this latter kind,
of any fi^anding, can never be radically cured
v/ithout it.

1 now proceed to examine the lafb part of
this objedion, viz. That a clap never leaves
a lues behind. This they have, no doubt, very

frequently

ON C L A PS. 33

frequently obferved^ but here they fall into the
fame miftake as formerly, by not diftinguifh-
ing fimple claps from thofe accompanied
with an ulceration of the urethra. Indeed it
muft be allowed, that an abforption cannot ea-
iily take place in fimple blennorrhagias : though
I confefs it to be yet a matter of doubt with me,
whether even in this cafe an abforption and con*
fequent lues do not fometimes happen ; at leafl
we have not a fufhcient number of obfervations
to determine this point with certainty.

But whatever may be the cafe in fimple blen-
norrhagias, it is certain, that when the difeafe is
accompanied with an ulcer of the urethra, the
parts are then difpofed to an abforption of the
virus. In thefe circumilances, I never met with
a fingle cafe where this abforption did not
take place ^ and, if early recourfe was not had
to mercury, the lues moil certainly was the
confequence. I have alfo met with feveral in-
flances, where, from the accidental woundii^g
of a fmall blood-veffel in the urethra by the un-
ikiiful application of the fyringe or catheter,
the virus of a fimple clap has been abforb-
ed, and produced unequivocal venereal fymp-
toms in the fyftem ; v/hich, notwithflanding
their origin, yielded very readily to mercury.
We may therefore afibrediy conclude, that there
are fome claps which cannot be cured with-
out merfcury^ though there are others which
may be removed without the ufe of that reme-
dy, and without any bad confequence enfuing.
An account of fome infiances which came under

34 O" N C LA P S-

my obfervation, will {et this matter in a clearer
light.

A young man of about twenty-three years of
age, in perfed health, happened to be infeded
with a fimple blennorrhagia, without any other
venereal fymptom. The running had been in-
judiciouily flopped; the confequence of which
was a total fuppreffion of urine. A furgeon
was called y and the patient being unable to
bear any. longer the pain from the diflention of
the bladder, recourfe was had to the catheter.
But on approaching the neck of the bladder, a
great reliilance was found, which prevented the
rnilrument from being further introduced, tho'
every poffible method was tried. After waiting
a little while, a fecond attempt was made, but
without fuccefSo As the pain increafed, and
from the accumulation of urine there was great
danger of a rupture of the bladder, a paiTage
fbr the catheter was at lafl forced with as little
violence as poffible ; which was fucceeded by
Tome drops of blood from the urethra, and fol-
lowed by a large difcharge of urine. By proper
treatment the patient recovered in a few days
from this dreadful fymptom; the running came
on again; and, in a ihort time after, he v/as,
as we imagined, thoroughly cured. But foon
after, although there had not been the leall ap-
pearance of a flianker throughout the whole.
courfe of the difeafe, an exoltofis, with a vio-
knt pain about the middle of the flernum, made,
its' appearance. Mercury was adminiftered; in
a few days the patient found himfelf better, and
in -five \YQcks was perfedly cured. — Now from

an

O N C L A P S, ■ ^^

an attentive conlideration of this cafe, I would
afk any unprejudiced perfon, Whether it is not
reafonabie to fuppofe, that by forcing the ca-
theter fome vefTel had been wounded, in g:on-
fequence of which the abforption took place;
that the patient v/as from that moment infeded,
and afterwards cured in the fame manner as if
he had received the infedion from a flianker *.
A gentleman of about forty years of age, who
formerly had laboured under diiferent claps
within thefe lail five or fix years, got one, which-
he found, as he faid, rather mild, without much
pain in making water, and hardly any pain in
eredion the firfl five or fix days 3 when, after
violent exercife, he felt the whole urethra, and
morfe efpecially the neck of the bladder, much-
irritated p for which, however, he took no-
thing but a mercurial purgative, and rubbed
into the perinaeum fome mercurial ointment
every day. Thefe fymptoms, together with the
running, were nearly gone in eight days time,:
leaving only a little forenefs in the perinseum
behind. But the complaint for which he now

C 2 confiilted

* The different period of time at which the venereal difeafe
and the blennorrhagia firft appeared, has alfo been urged as
an argument for the difference between the virus of the one
and that of the other. But it is abfurd to oppofe uncertainty
to uncertainty: we are, I think, as ignorant of the precife period
when the lues firft appeared, as we are of that of the clap. It has
been afferted, that the inhabitants of the South-fea Iflands, though
affli£led with the lues, are yet free from the blennorrhagia.
But Captain King, who made the late voyage round the world
with Captain Cook, affured me that this was falfe, and that he
himfelf had feen many of them v.-ith the matter dripping from
their urethrji.

3,6 ' O N C L, A P S.

confulted me was a pain in the xyphoid carti-
lage, lo violent indeed that he even conld not
bear the touch. I adviled him to rub in fome
more mercurial ointment into the perinaeum
for tv/o days. When I faw him again, the pain
was not milder; but it had left its former place,
and occupied now the middle of the fternum,,
which troubled him much, efpecially laft night.
I adminiilered him a courfe of mercury 3 by the
nfe of which this complaint diiappeared in a
fliort time after.

Thus far I have anfvvered the arguments
which were adduced to prove that the clap is
never of a venereal nature; or, in other words,
that it never proceeds from a poiibn of the fame
mature with the lues. But though I have lliowns
that this do<ftrine is exceptionable, yet I am far
from maintaining, that all claps arife from the
venereal virus. On the contrary,

III. I am convinced, from experiments made
on myfelf, and from obfervations made upon
others, " that hlennorrhagias fometimes arife from
*^ other acrimonies^ orfiirnuli, applied to the urethra^
*' with nearly the fame fy rapt oms as we obferve in a
*^ venereal one s""^ nay, I am now even inclined
to believe, that flich claps may fometimes be
propagated as well as venereal ones. Whe-
ther the gonorrhoeas, of which we have an ac-
count in fbme ancient writers, were of that na-
ture, I am unable to determine ; and thei^efore
forbear to enter upon the fubjed. I iliall only
juft obferve, that the hlennorrhagias I am here
fpeaking of, are very different from the flux of
veal femen, or from the flux of mucus from the

pro.

O N C L A P S„ 37

proilate glancL Thefe latter complaints, ariling
chiefly from a weaknefs of the excretories of
thefe parts, occafioned by an abufe of venery,
.and efpecially by nianuftupration, do not ccme
.within my prefent plan.

I proceed, therefore, to the main point, fiz.
to prove, that local inflammations of the ure-
thra, accompanied with a running, common-
ly called Gonorrhcea, are not always, either
in men or women, of a venereal nature.
This idea firfl occurred to me from having fre-
quently obferved in ftone-horfes a kind of run-
ning of a greenifh yellow matter from the ure-
thra. This running, which arifes from caufes
ilill unknown to me, I have feen lail only for
a few days, and then go ofiTpontanecuily. The
fame, and that more frequently, I have obfer-
ved in dogs, without perceiving that they feem-
ed to fuffer much pain from it ; and though in-
deed they continued to lick the part almofi con-
ilantly, they were never affeded with any plcer
of the mouth. I have beiides, for thefe many-
years pafl, been confaked, by a variety of pa-
tients, for runnings very much fimilar to venereal
blennorrhagias, but often fo mild in their fymp-
toms, and fo ihort in their duration, that I began.
to doubt of their venereal nature. I have feen
married people, who lived together in the raofl
perfeel harmony and friendihip, where the one
v/as afFed:ed with fuch a difcharge for leverai
days, without communicating the leait fymptom
to the other. With fome of them I have been
mofl intimately acquainted ^ and convinced be-
yond any doubt, that they w'ere faithfully at-

G 3 " tacjied

38 ON CLAP S.

tached to each other; and that therefore the
difeafe mull have been pwing to fome other
caufe.

Allthefe obfervations taken together, led me to
behevcj that fome kmds of thefe runnings might
perhaps owe their origin, not to the venereal poi-
fon, blit to fome different caufe, either external
or internal. I began to fufped, that a difcharge
might be produced by any ilimulus applied to
the urethra, whether venereal or not, provided
it was fufficiently acrid to excite an inflammation,
and confequent preternatural fecretion of mucus
from the urethra; juft as coryzas, accomipanied
with a large preternaturaliy coloured fecretion
from the mucous membrane of the nofe, arife
from other caufes. Having revolved thefe ideas
in my mind for feveral years, I determined at
laft to try an experiment upon myfelf, which
fliould either confirm the theory I had laid down,
or entirely overthrow it. With this view, I
took fix ounces of v/ater, and dropped into it as
much of cauilic volatile alkali as gave the mix-
ture a very fharp fiery tafle. -This liquor
I injeded into the urethra, comprefling the
canal with the fingers of my other hand below
the fraenum, that it might be prevented from
going further, and thus be applied to the
very part which is generally the feat of the
clap. The moment it touched the infide of the
urethra, I felt fuch an infupportable pain,
that I could not retain it for a fingle fecondj
but withdrew the fyringe, much againfl my
will, almofl at the inftant of the injection, and
tl^e injeded liquor ran out. But though tlie

pain

ON C L A P. S. 3.9

pain continued very fevere for half a quarter of
an hour, I refolved to make a fecond trial. It
occaiioned a more fevere pain than I ever re-
member to have felt in my life before, yet I re-
tained it for very near the fpace of a minute ;
when the pain became fo excruciating that I
could bear it no longer, and therefore withdrew
the fyringe. I inllantly felt a flrong defire to
make water ; but having taken this precaution
before I made the experiment, I fupprelfed the
inclination. I lay down on my fopha, and
waited the event with patience ; but fo violent
was the pain, that it was near an hour before
I was able to move. I then amufed myfeif with
reading during the remainder of the afternoon,
eat my dinner as ufaal, but went early to bed,
I was now obliged to make water, v/hich I had
not done iince the time of iDJeding the liquor.
When the urine came to the place to which the
injedion had been applied, 1 felt a very fevere
pain, but lefs violent than what I expeded.
Having llept well during the night, 1 examined
the part as foon as I awaked next morning, and
found a pretty large difcharge of purifprni
matter, of the fame greenilh-yellow colour
with that in virulent claps. ' The pain in ma-
king water was now greatly increafed, and the
following night my reft was interrupted by
painful involuntary eredions. The morning
after, the difcharge was much more plentiful,
nearly of the fame colour, only perhaps a little
more greeniih ^ the pain in making water, how-
ever, was now fo violent, that i refolved to miti-
gate it by injeding fome lukewarm oil.of alv

C 4 ' iifionds.

4©

ON CLAPS.

inonds. By this it was greatly abated; the
tunning continued five days, the pain all the
while growing remarkably lefs in the part af-
fected. But 1 now obferved very diftindly a.
new inflammation taking place, lower down iu
the urethra, where 1 had felt nothing before,
and where none of the injedion had touched.
This new inflammation began, as it feemed to
me, at the very border of the former, extend-
ing itfelf lower down in the urethra ; and was
followed by a copious difcharge, attended with
the fame fymptoms as before, and continued foi'
iix days; at the end of which all the fymptoms
were greatly abated. But now, to my furprife,
1 felt difl;in(5lly the fymptoms of a third inflam-
mation taking place, extending from the border
of the former about the caput gallinaginis to the
very neck of the bladder, and attended by an
ardor uringe, and copious difcharge like the pre-
ceding. At this 1 was ferioufly alarmed ; for I
had conltantly injecled the warm oil of almonds
three times a-day. I perceived that the inflam-
mation firll; excited by the caufl:ic alkali was
mofl: evidently communicated from one part of
the urethra to the other ; whence I was afraid,
that an inflammation of the whole internal fur-
face of the bladder might at length enfue, and be
attended perhaps with dangerous confequences.
In this fituation I continued betwixt hope and
fear for about feyen or eight days; when I found
at lafl, to my great fatisfadion, this inflamma-
tion gradually abate, together with the dif-
charge, w^ithout pafling the limits of the ure-
thra; and I was perfedjy freed from every fymp-

tom

O N- C L APS 41

torn of thefe three diftind blennorrhaglas, as I
might call them, at the end of the fixth week.

I fince have feen feveral convincmg inflances
of blennorrhaglas, accompanied with a difchargc
of yellow-greenhh matter and ardor urin^,
which undoubtedly were not venereal, becaufe
they di (appeared in three, four, or eight days
time without any remedy, and without leaving
any fymptom behind,

A particular friend of mine, a phyfician, being
radically and perfedly cured of venereal com-
plaints which he was formerly afFeded with, mar-
ried, and enjoyed for ^hree or four years a per-
fed flate of health ; when one morning he found
himfelf aifeded with a running iimilar to that
above mentioned. He lived, as may be ealily
imagined, for feveral days in the greatefl agi-
tation of mind, having no other perfon to fuf-
ped but his wife ; with whom he at laft infix-
ed upon ocular demonftration. He found her
fo as ilie told him, perfedly healthy, which
compofed his mind^ but to his great furprife,
four or five days after, the running flopped, and
he was perfedly well. The fame accident, with
the fime fymptoms, happened to him afterwards
in the courfe of many years marriage with the
fame woman feveral times, always lafling from
two to three, or five days, and conflantly then
difappearing of itfelf.

From this experiment upon myfelf, together
with the feveral obfervations mentioned, and
from a very curious cafe related in a difler-
tation publifhe,d by Dr Oettinger of Tubingen,
where a difcharge from the urethra, apparent-

42

ON CLAPS.

ly fimiiar to that of a virulent clap, was produ-i
ced by the internal ute of olive oil, which had
been wrung out of red Turkiih yarn, on which
it had been poured fome days before, the reader
may judge, whether acrimonious fubftances, of
a different kind from the venereal virus, fuch
as cancerous ichor, or perhaps other ftimuli, ap*
plied to the urethra, may not fometimes pro-
duce the fame fymptoms as the cauilic did in
my experiment, and the oil in Dr Oettinger's
obfervation. I certainly believe, that runnings
fimilar to a clap excited by the venereal virus,
are fometimes produced from other caufes, only
perhaps with milder fymptoms, and of ihorter
continuance^ though on myfelf I could not per-
ceive any difference either in the colour and con-
iiflence of the matter, or other circumflances.
And I now look upon the following fads as tho-
roughly eft ablifhed. viz, I. That blennorrhagias
frequently arife from the fame Venereal poifon
applied to the infide of the urethra, which, when
applied to the glans, prepuce, &c. produces {han-
kers ', or when abforbed into the fyftem, produces
the lues: and, 2. That there are blennorrhagias
which owe their origin either to acrimonious fub-
ftances introduced into the urethra ab extra, ^ or
perhaps fometimes to a more violent mechanical
ftimulus arifmg during coition, or from fome
other caufes hitherto unknown to, us. Hence I
divide the hknnorrhagia at leaft into two fpecies,
effentially diftindt from each other, viz. that ari-
fing from the venereal virus, which I call hkn-
norrhagia fyphilitic a; and into that arifmg from
other acrid fubftances, to which I give the nam^

Blen^

ON CLAP S.' 43

Blennorrhagia ah acri, autjlimuh mechanico. By at-
tending to this difference, our pradice'mufl be
regulated as long as we are not thoroughly ac-
quainted with the nature of other caufes. It is
owing to the negledt or ignorance of this difiinc-
tion, that we hear quacks daily extolling the
pre-eminence of their noitrums or fecret in-
jections for curing the clap in a few days,
while patients fometimes complain of being
kept by the moil experienced phyficians for
weeks together, though affeded with what they
imagine to be the fame complaint.

The running which a gentleman of my ac-
quaintance got fome years ago, notwithftanding,
as he faid, he made ufe of the bell preventative
of all, was undoubtedly not from a venereal
caufe ; and he may be equally aifeded in time
to come with the fame complaint, though
he now thinks himfelf fafe, by what he calls
doubling his precaution.

Thefe fads, which I do not recoiled of ha-
ving been afcertained by any writer before or
after my publication, feem to me to be of im-
portance to mankind in general. By a proper
and. due confideration of thefe fads, the happi-
nefs of many married or unmarried couples
will be for the future not fo eafily ihaken or
diilurbed by imaginary and groundlefs fufpi-
cions; and many people will be preferved from
falling a prey to ignorant praditioners, who,
following the common routine of treating all
claps by a courfe of mercurials, not only plague
the patient with a heap of ufelefs or hurtful
3 , drugs.

44

ON CLAPS.

drugs, but thereby often lay the foundation to
a number of very diiagreeable complaints.

To the ignorance or negled: of this diftinc-
tion between Blennorrhagias excited by the ve-
nereal poifon, and thofe arifing from other fti-
muii, we are iikewife t^ afcribe the great differ-
ence among praditioners with regard to the
mode of treatment. Some advife aftringents,
while others are laviih in their prailes of emol-
lients. Hence, even fome practitioners of emi-
nence, having -"^bferved that aftringent injec-
tions hac' been of fervice in fome cafes, even in
the ilage' of inflammation, recommend them to
every patient affefted with that complaint, but
by no means with the fame fuccefs in all cafes.
For, belides violent pains in the whoje courfe
of the urethra, fwelied teillcles, an acute fup-
prelTion of urine, &c. which are the frequent
effeds of thefe jnjedions, if the difeafe is of a
fyphilitic nature, and efpecially in its inflam-
matory flage; fl;ri6tures in the urethra of the
moft troublefome and obftinate kind are often
the confequence. By overlooking this neceffa-
ry diftinClion, which applies to men as well as
to women, the ftate of the patient is fome-
times not only endangered, but the happinefs
of married people, and the friendfhip betwixt
the two fexes, without jufl caufe, frequently
deftroyed. I have certainly feen more than
one inftance of this kind.

The fmiple fyphilitic Blennorrhagia ought further
to be diftinguilhed from the cornplicated, or that
accompanied with an ulcer in the urethra : the

latter

• , O M . C L A I^ S. ,. 4J

latter admits no radical cure without the inter-
nal ufe of mercury 3 whereas the former feldom
or never requires it.

Sometimes, by the violence of the irritation^
the fecretion of mucus feems to be totally fuf-
pended, or at leafl conliderably diminifhed, fo
that no difcharge, or only a very fmall onej
takes place though the other fymptoms rage with
the utmoft violence. In this cafe, the difeafe
has obtained the very improper name o? goiicr-
rhoeajiccay as if we we were to l-^^j ,fluxiis femitiis
fine fluxu. Another fymptom is a vii ent pain,
during eredion, from the tenfion of the fraenum,
which has obtained the peculiar name of Chordee;
but as thefe diftindions denote only the vio-
lence of fome particular fymptom, there is no oc-.
calion for retaining them.

I fliall only add here one remark more. It is
by moll people imagined, and feveral medical
writers have even publicly afferted, that the
malignity, as they call it, or the 'virulence, of a
clap, is always in proportion to the colour
of the matter difcliarged; and that as fooii
as this colour changes into a whiter one, the
difcharp-e is no more infedious,. But this ap-
pears to me by far too general a conciuiion: for
in fome perfons I have feen the matter retain
its original brimltone colour to the very laft day.
The more certain figns of the abatement of the
virulence of the difeafe are, the ceilation of the
ardor urines, and a capability of retaining the
water as when in health 3 the matter becoming
lefs, and of a thicker coniiflence, fo that it
grows ropy, and may be drawn into threads

be^

4^ O N C L A P S;

between the fingers ; and the abfence of pain or
titillation during eredions. The only certain
ligns, however, of a radical cure of this difeafe,
and of a perfed: fecurity of not being able to
communicate the infection, are, the entire cef-
fation of the running ; eredions and excretion
of femen without any kind of pain, titillation,
or heat in the urethra : And though in general
we may afliire our patient, that the change of
the greeniih yellow colour to a white one is not
an unfavourable lign of the difeafe growing
better, he ought to be cautioned, that it is by
no means a certain one of the venereal virus
being entirely eliminated.

Having thus finifhed my coniiderations about
the nature and the different kinds of blennor-
ihagias, we now proceed to

I'he Method of Cure,

Here we muft take notice of what has been
eftabliflied before, that every kind of clap or
blennorrhagia, is a local inflammation with a
mucous difcharge, excited by a peculiar poifon,
acrid matter, or ftimulus. Hence the follow-
ing indications will naturally prefent themifelves
for all the different kinds of blennorrhagias, viz.

1. To remove the acrid matter or poifon.

2. To defend the tender parts from its viru-
lence or irritating nature. ^^^^

3. To allay the irritation occafionedc^ViV the
virus j or, if poillble, to change its natu^ii.

The fir it point nature provides fufHciently

foi>

ON CLAPS. 47

for ; and there remains little to do for the phy-
fician, but only not to difturb nature in this fa-
lutary attempt.

The fecond and third points will be moll ef-
fedually anfwered by lukewarm oily or mu-
cilaginous injedions *, together with the inter-
nal ufe of fome mucilaginous drink ; or (what is
perhaps preferable) by the fole internal ufe of
the folutio Arabica, emulfio amygdalina, infu-
fum of hemp-feed or malva, &c. cold or luke-
warm, taken in as large quantities as the pa-
tient can bear without loading the ftomach, with
an anodyne draught at night, according to cir-
cumftances. Thefe remedies are always ufeful;
and for patients who have ah averiion to injec-
tions, abfolutely neceflary.

If fymptoms of an inflammatory fever ap-
pear, bleeding may fometimes be ufeful ; but
in general, more fervice will be derived from
topical evacuations by means of leeches, and
from emollient and fedative fomentations and
poultices. The poultices are to be applied
in the manner mentioned hereafter under
the article Phymofis.— — —On the other hand,
when the patient is of a weak and irritable ha-
bit of body, the difcharge very thin and copi-
ous, attended with violent pain and a quick
pulfe, I have found the Peruvian bark, givea

in-

• * If we meet with patients who are prejudiced againft the ufe
of inje-^'ons, and wifh to be treated by internal medicines, we
ought cquaint them, that the difeafe may be cured equally
•well w lOut any topical app!ic;'t!on ; but that it will then re--
quire, perhaps, a little longer time, and the obfervance of a more
€xa6l regimen.

48 O N C L A P S.

internally, according to circumflances, with or
"Without opium, more ufeful than the whole
tribe of antiphlogiilics ; and opium given ia
emollient glyilers is fometimes particularly life^
ful in fuch cafes. By the ufe of this medicine,
the frequent painful eredions are alfo much
mitigated } but their return ought, as much as
poffible, to be prevented, by tying the penis
down, lying on a matrafs on the fide, and not
in a warm, feather-bed on the back. If the e-
redion be attended with a flrangulation of the
glans, the treatment laid down under the ar-
ticle Parapbymofis will be neceflary.

In order to avoid the more violent fymp-
toms of this difeafe, the patient ought, during
its inflammatory flate, to ufe as little exercife
as poilible, to wear a fufpenforium fcroti from
the beginning of the difeafe, and to keep the
part affeded as much as poilible from the cold
air. The fufpenforium fcroti, or trufs-bag, may
perhaps feem fuperrluous : but being fo little
troubleforiH when well applied, and fo well cal-
culated to prevent a fwelling of the tefticles, I
never negled to recommend it, efpecially to
thofe who have once laboured under this latter
difeafe. To prevent any of the difagreeable
confequences of a clap, fuch as painful erec-
tions, chordee, parapbymofis, fwelling of the
teflicles, or complaints of the inferior parts of
the urethra, the beft method perhaps would be
to wear a proper bandage or bag round the penis
united to the trufs-bag^ by means of which the
penis might lie, if I may ufe the expreflion, like
ia a cafe or fhell, defended at the fame time
3 againft

b N C L A P S. 49

againft all external injuries, fuch as cold, fric-
tion in walking; and may be conflantly kept
clean by renewing lint frequently ; the beil
means to prevent fhankers, and likewife to avoid
dirty linen. When the patient is obliged to
make water, there is a hole left at the end of this
cafe, and he has nothing td do but to loofen the
llraps or to draw the ring of it backwards, and
to take out the lint forwards.

With refped to the regimen to be obferyed
during claps, exercife, external cold, high
living, drinking fpirituous liquors, and efpeci-
ally the frequent touching the part affected,
ought carefully to be avoided by all patients ^
but efpecially by thofe of a phlogiflic ha-
bit of body, as they geherally fuffer more,
and for a longer time, from this difeafe than
others. Such patients ihould coii€ne them-
felves td a low diet, rather of the farinaceous
than of the animal kind ; they fhould eat no
fupper, and drink nothing but cooliu'^ mucila-
ginous liquids ; whereas thofe of a Cerent
conftitution are not to be reftrained fo much.

Neutral falts have been formerly recommend^
^d to cool the bldod, and to promote the fecre-
tion of urinCj by which it was thought td miti-
gate the inflammation, and afliil nature in the
expulfion o£ the virus. But I have conflantly
found them to be hurtful. They increafe the
fecretion of urine, render it fharper, and thus
augment the irritation, without producing any
of the good effeds afcribed to them. However,
in fome cafes, the pulvis ad Blennorrhagiam men-
tioned beloWj may have its good efFeds»

D A

eo ON CLAPS.

A prejudice in favour of purging in claps lias
alfo long prevailed. For this purpofe, feme
have ufed the mild, and others the more dra-
llic, kinds of purgatives; and calomel efpeci-
ally has been recommended to be given every
two or three days. Neither of thefe medicines I
ever law do any good, but frequently much
harm^ Beiides their tendency to promote the
abforption of the poifon into the fyftem, like
improper injed^ions, they often give rife to
fwelled tefLicles, difeafes of the proflate gland,
fuppreflion of urine, ulcers of the urethra or
bladder, &c. However, though purging is al-
ways improper, the body ought to be kept open,
fo that the patient may have a ilool regularly,
which is beil efFeded by the mixtiira laxans or
pilulcE laxantes ; and I have no doubt that it is
partly owing to this improvement of ourpradice,
that we now fo feldom obferve fymptoms of the
lues, or ulcers of the bladder, following a clap.

Thus far with regard to the more general run
of the diforder; but venereal Blennorrhagias
are not aiv/ays fo limple. Sometimes the poi-
fon feems to be of a more exalted acrimony, or
rather meets with conftitutions of a more irri-
table nature > or, as is frequently the cafe, the
fymptoms are exafperatedby improper treatment,
or by negleding the above-mentioned rules.
In thefe circumftances, the patient feels a more
violent heat and pain in maidng water, accom-
panied with a teniion of the urethra along its
whole length 3 a perpetual defire of making wa-
ter, without being able to pafs more than a few
fcalding drops at a time 3 frequent eredions,

with

d N C L A P S. 51

witli moft exquilite fhootlng pains throughout
the whole length of the urethra, but more elpe-
cially at the fraenum. Sometimes ilreaks of
blood, or real blood, are difcharged with the
urine ; and evident marks of an ulceration of
the urethra make their appearance; In this
cafe, befides the above-mentioned remedies, the
ufe of mercurial fumigations or fridions on the
perinaeum, and inlide of the thighs, I have
found to be one of the moil efficacious reme-
dies.

The fame treatment will prove ferviceable, if^
by any caufe \vhatfoever, the difcharge of the
venereal Blennorrhagia, during its inflammatory
ilage, be fuppreffed or flopped, either by acrid
or aflringent injedions, or even by the m-oft
proper injections applied in an improper man-
ner, by draflic or repeated mild purges, by the
premature ufe of turpentine or balfamics, by
violent exercife, and efpecially by catching cold
in the part afFeded. The virus, in thefe cir-
cumllances, feems to leave its natural feat^ the
lacuna Morgagni under the fraenum, and to fettle
lower down, where the excretory duds of the
feminaf velfels and proflate gland open into the
uretltra, and there excites a fwelling in one
er both tefticles ; or^ if it has been driven
Hill lower down to the neck of the bladder,
the patient has a continual defire to make wa-
ter, without being able to pafs any, or only a
few drops at a time. He is then often unable
to Hand upright for a quarter of an hour ; and
a total fuppreflion of urine is in this cafe fre-
quently the confequence. In all thefe different

D 2 places^

52 0 N C L A F S,

places, the poifon generally produces only a
luperficlal inflammation 5 though not unfre-
quently alfo, hj its virulence, or want of a fuf-
ficient quantity of mucus to dilute it, an exco-
riation and ulceration in the urethra, which
then never fails to end in an obflinate gleet,
and to be followed by a general infedion of the
mafs.

In {peaking of the dreadful confequences of a
fuppreffed or ftopped venereal Blennorhagia, I
mull not omit to mention a difeafe, perhaps the
moil: melancholy of all venereal complaints
whatever y I mean, that kind of inflamma-
tion in one or both eyes, frequently accompa-
nied with a difcharge of puriform matter, en-
tirely fimilar in colour and confifl:ence to that
of a clap, and generally terminating in perfect
blindnefs ; or in other cafes, infl:ead of an
ophthalmy, a more or lefs perfed deafnefs.
Though I am not able to account for the ori-
gin of thofe complaints fuddenly following the
fuppreffion of a clap, efpecially from fevere
cold (for I have never obferved them but in ve-
ry cold climates and feafons), to which the pa-
tient had been previoufly expofed, I am convin-
ced of the fad, and fhall fpeak of it more fully
hereafter, under the head of Venereal Ophthal-
my.

The only reihark more I have to make here
is, that all thefe complaints from repelled ve-
nereal Blennorrhagias, being often attended
with fuch dreadful confequences, a medical man
of charader ought not to mind the opinion of
others, but be guided in his condud by juftice

and

O N C L A P S. . S3

and confcience, and do every thing that pofli-
bly may be done to cure or relieve his patient
labouring under thefe unhappy circumftances.
I therefore have tried, in four cafes of fwelled
tefticles and fuppreffion of urine, arifing from
a retropulfed clap, the inoculation of the vene-
real poifon, by means of a bougie previouily
applied for about half an hour to a perfon af-
flicted with a clap, and then introduced int©
the urethra, with unexpeded fuccefs. Thi$
I do not recommend from fancy^ as has
been faid by a late writer: it is not my cu-
ftom, as the reader may judge from the whole
tenor of this work, to indulge in fanciful theo-
ries ^ which I think hurtful both to the patient
and to the young pra(9:itioner. The method
propofed has been tried many years ago in one
of the firft military hofpitals in Europe with
conftant fuccefs, and has been iince confirmed
by Dr Lange in a treat ife on Ophthalmia. Was
I lefs cautious in drawing concluiions, and more
ignorant of the obfervations made by other me-
dical writers, I might probably be ealily indur
ced to fweli my book by ufelefs and fanciful
theories into alargue quarto. — We are confulted
for giving relief; and confequenfiy fulfil our
duty, at leaft, by offering a remedy, which the
patient has always in his power to accept or re-

fllfCy

3 ■ CHAP,

54 O N G L E E T S,

CHAP. III.
On the Blennorrkoea, or Gleet.

Y the name Gleet ^ we commonly under-
Hand a continued running or difcharge after
the inflammatory fymptoms of a clap have for
fome time difappeared. A Gleet or Blennorrhoea,
however, is properly, a preternatural difcharge
of puriform or limpid mucous matter, or of real
pus, from the urethra in men, and from the ori-
fice of the vagina in women, without p^in, heat
of urine, or any other fymptom of inflamma-
tion.

Gleets arife chiefly from two caufes : i/?. From
fimple relaxation of the mouths of the vefllels,
which had been irritated, inflamed, and thereby
lofl: fomewhat of their contradile powers or,
2dly, From an ulceration, or an erofion in fome
part of the urethra. The former may^ with

more

* This difeafe, which occurs in the Latin authors under the
difFerent denominations oi Gonorrhoea bcnignay G. non viruknta,
G. inveterata ; Leucorrhxai Fluor alhusy Fluor albus benignus^ I
gave the more proper name Blennorrhcen^ as if you were to lay,
Fluxus muci [paffivus), or a difcharge of mucus without any phlor
giftic fymptoms : which name diftinguiilies it as well from the
clap, to which I gave above the name Blennorrhagia^ {Fluxus muci
a5livus)y or a difcharge of mucus with fymptoms [of inflamaoa*-
tion, as from the real difcharge of femeni which dUeafe alone is
properly 9alled Gonorrhoeae

O N G L E E T S. , 55

e propriety I think, be called Blennorrhdea
/implex, and the latter Blennorrhoea complicata^
See the Nofological Table.

In the former kind, after the rnflammation
and irritation occafioned by the acrid matter
have fublided, the vefTels, from which that dif-
;charge proceeded, continue to pour out either
matter of the fame puriform appearance, or on-
ly a clear kind of mucus, but fomewhat thicker,
in a preternatural quantity.-^Sometimes a gleet
begins to appear after coition, exercife, or free
living, though the difcharge from the prece-
ding clap had entirely difappeared fome days or
weeks before.

Gleets of this kind are for the moft part only
a local complaint, the fimple remains of a clap
not perfectly cured; but thofe of the fecond
kind may be confidered as the remains of a very
violent or, complicated and ill-treated or neglect-
ed clap, and are generally acQompanied with an
infection of the mafs.

Hence it appears, that the nature and feat of
gleets may be as various as thofe of claps ; but
according to the place where they are lituated,
the time they have continued, and the caufe by
which they are produced, the method of cure
mufl be different, aijd becomes more or lefs dif-
ficult and complicated.

Thofe gleets are moil eafily cured which have
their feat in the urethra under the fraenum, in
the lacuna mucofa Morgagni : thofe originating
from ulcers of the urethra, and which have con-
tinued for fome time, are much more obflinate ;
and thofe ariling from erolions of the excretory

P 4 duds

S6 O N G L £ E T S.

dads of the femlnal veficles, or from a difeaw^
proflate gland, or from ulcers of the bladder,
are the moft ftubborn of any. In general, the
further back m the urethra gleets are iituated,
the more apt they are to produce a difficulty in
making water, or ftridures and fuppreilion of
urine ^ and the more difficult, in general, is the
cure.

I have always found thofe gleets which fucceed
a fimple clap to be merely a local difeafe, and
to owe their exiilence folely to a relaxation of the
fmall vellels after the inflammation has fubfided,
exadly fimilar to the difcharge of thick puri-
forrn mucus after the inflammatory fyniptoms
of a coryza or catarrhus are gone off. But
fuch gleets as arife after violent, ill-treated, or
negleded claps, are often accompanied with an
excoriation or ulceration of the urethra. In
this cafe, generally the venereal poifon has been
abforbed, and the mafs is of confequence more
or lefs infeded.

As it is of the utmoft importance, though
fometimes extremely difficult, to afcertain thefe
points, I fball endeavour to enumerate the mofl
remarkable fymptoms by which it may be known
whether there is any ulceration in the urethra.
They are ihortly as follow : i. Streaks of blood
in the mucus, or real blood difcharged, during
the inflammatory ftage of the clap, as above
mentioned, but more efpecially when conti-
nuing after the violence of the inflammation
has abated. 2. Real pus, or a thin ichorous
matter, difcharged in a greater or lefl^er quan-
tity from the urethra: 3. A pain confined to
' ' ' pne

^R

O N G L E E T S. 57

3re part of the urethra ; but felt more particu-
larly upon introducing the catheter, or prefiing
on thie urethra externally. 4. An acute pain in
one particular place of the urethra, felt efpe-
cially in palling the lail drop of urine, or in the
emiiiion of feme n.— Though all thefe fymptoms
pretty plainly indicate an ulcer, its exiflence will
be much more confirmed, if the preceding fymp-
toms of infiamm.ation have been very high 3 if
the patient has neglected or hurt himfelf, or has
been improperly treated^ or even, as I have
fometimes feen, if the urethra has been wound-
ed by a mifmanagement of the fyringe, or a
rude application of the catheter, during the in-
flammatory ftate.

By not attending to thefe marks, which fuffi-
ciently point out the exiltence of an ulcer in
the urethra, we fhall be ctften difappointed in
the cure. Whenever, therefore, we are confulted
about gleets, our firft bufinefs ought to be, to exa-
mine whether they arife merely from relaxation,
or from an ulceration in the urethra 3 and in
this latter cafe, whether the difeafe is univerfal
or only local. If there is an ulcer, it will be
neceifary, in order to form a proper prognolis,
.to afcertain the place of that ulceration in the
urethra.

When the difeafe is merely local, it may be
cured either by external topical applications, or
by internal remedies, or by both united. The
befl topical remedies I have found, are injec-
tions made of a folution of verdegris in volatile
alkali, or of white vitriol difTolved in water,
and mixed occalionally with fome grains of fu-

58 ONGLEETS, J

gar of lead \ or of a folutlon of blue vltriol^Jcr
alum j each of which may in certain circumftan-
ces be ufeful. In many cafes, 1 have found a large
dofe of calomel, prepared according to Mr
Scheele's procefs, fufpended in a fmall quantity
of fimple water or any mucilaginous fluid, injedl-
ed five or fix times a-day, preferable to any other
remedy. See the Formulas. Of the internal remedies
for the fame purpofe, I fliall fpeak hereafter.

If the difeafe be univerfal, viz. accompanied
with an infedion of the fyftem, as is almoft
always the cafe where there is an ulceration of
the urethra, we mufl, beiides topical remedies,
have recourfe to thofe appropriated to the cure
of the lues itfelf. In this cafe, it is impof-
lible to cure the gleet till we have purified the
mafs. After this is done, or while it is yet do-
ing, I have found a folution of fublimate and
litharge in vinegar, or a folution of verdegris in
volatile alkali, diluted with a fufhcient quantity
of water, and injeded two or three times a-day,
a mod excellent remedy.

With regard to injedions in general, in Blen-
norrrhagias as well as Blennorrhosas,I rnufl make
two material obfervations^ the negled of which
may fometimes occafion our being difappointed
in the cure, even though the befl remedies are
ufed. The fyringe made ufe of for this pur-
pofe fhould have a fhort but wide pipe, jufl fo
large that its orifice may go into the orifice of
the urethra, but not further^ and the piflon
ought to apply clofe to the fides of the tube.
If the pipe of the fyringe be fmaller than

the

O N G L E E T S. 59

tlie orifice of the urethra, it is always attended
with two confiderable difadvantages. The firfl
is, that with a 'fmall pipe, efpecially if not per-
fectly fmooth, the patient eaiily hurts or wounds
the infideof the urethra; and thereby renders
himfelf liable to an ulceration of that part, and
confequent abforption of the poifon. The fe-
cond is, that the liquid injected, inftead of go-
ing into the cavity of the urethra, will, in pro-
portion as the patient preiTes the pifton, run out
fideways through the orifice of the urethra. If
the pifton itfeif does not apply clofely to the
fides of the fyringe, even if the pipe be fuffi-
ciently large, fo that it perfedly clofes the ori-
fice of the urethra, the liquor will regurgi-
tate between the pifton and fyringe, inftead of
going into the urethra ; and thus the patient
may imagine that he has injeded the liquor pro-
perly, when perhaps little or nothing has en-
tered the urethra. But though the fyringe be
properly made, and at the fame time the moft:
careful inftrudions be given, patients do often
perform the operation in fuch an aukward man-
ner, that no good efFed is obtained.

The fyringe, properly made, ftiould be applied
clofely and exadly to the orifice of the urethra;
fo that, by the conic form of its pipe, all paf-
fage may be denied to the liquid betwixt it and
the fides of the urethra. If the feat of the dif-
order be in the ufual place of claps, viz. in the
mucous lacuna, juft under the fr^num, the pa-
tient ftiould, with one hand, comprefs the ure-
thra at the firft curvature of the penis, where
the fcrotum begins ; \vhile he holds and mana-
2 ges

6o ONGLEETS.

ges the fyringe with the fingers of the other.
The pifton, which fhould always fit clofe, but
flide eaiily, ought then to be prbfTed very flow-
ly and gently, till he feels the urethra gently
diflended ^ and thus keep the liquid injeded for
a minute or two in the urethra, repeating the
fame operation three or four times. By a ralh
or longer-continued preffure of the pifton, the
irritation thereby produced in the urethra often
will do more harm than the injedlion does
good.

By attending to thefe diredions, a double ad-
vantage is obtained. The liquid is properly
applied to the part affed:ed, the urethra not vio*
iently diftended^ and at the fame time no dan-
ger is incurred of driving fome of the poifonous
matter lower down the urethra along with the
injedicd liquor^ but if the feat of the diforder
be lower down, the precaution of compreifing
the urethra behind is fuperfluous.

With refped to the liquid itfelf, it fhould al-
ways, in cafes of claps, be made lukewarm; but
in gleets this is unnecefTary. In the former, if
the liquid be too cold or too warm, it may ea-
fily hurt the patient, either by driving back the
matter, or increafing the inflammation. In
many inflances alfo the liquid ought to be well
fliaken before jt is injeded. It may eafily be
made warm, by putting a tea-cup full into
a bafon of hot water. At all times, before any
injedion is applied, the patient fhould attempt
to make water.

The other obfervation I have to make is, that
young men labquring under gleets, after ha-
ving

O N G L E E T S. 61

ving for fome time ufed injedions, and find-
ing themfelves coniiderably better, fequent-
iy grow carelefs in the application, and even
fometimes negled the injection altogether for a
day or half a day. The confequence of this ne-
gled is fometimes very difagreeable. For I have
feen feveral inftances, where, by a negled of
this kind for a lingle day, the running has the
day after fo much increafed, as if it had
been a frefh gleet 3 and the relapfe being more
obftinate than the original difeafe, the patients
were thereby obliged to continue the injedions
for more weeks than they would perhaps have
required days to cure the diflemper, had they
continued the ufe of them without interruption.
In general, in order to prevent any danger of a
relapfe, I order my patients to apply the injec-
tions three, four, or, according to circumftan-
ces, fix times a-day during the difeafe, and to
continue the fame regularly for ten or twelve
days after the running has entirely ceafed.

Syringes of a different kind are required for
women, if we wifii to fee any good effeds pro-
duced by the injedions adminifi;ered to them, as
I fliall mention below, under the article of Ve-
nereal Ulcers.

Befides injedions, bougies will be often of
great fervice, nay, abfolutely necefi^ry for
curing the gleet, efpecially when there is an
ulcer in the lower part of the urethra. They
may be ufed either alone, or in conjunc-
tion with proper injedions. They ftiould be
kept in, for the firft three or four days, on-^
ly for a quarter or half ani hour at a time^

until

62 0 N G L E E T S.

until the patient be accullomed to thern, fd
that he can bear them longer^ and then they
may be kept in for feVeral hours in the morning
and evening, or during the whole day and night.
It mufi; be left entirely to the judgment of the prac-
titioner to determine whether the bougies to be
employed fhould be perfedly fimple or of an
irritating or fedativ(^ quality ; the circumflances
of the cafe will point out whether thofe of the
former or latter kind are neceffary. It ought,
however, to be remembered, that before the ap-
plication of bougies, as well as injedions, the
patient ought always to attempt to make water,
in order to give the remedy time to produce
its efFeds on the part afFeded. If the applica-
tion of the bougie produces, as I have fome-
times obferved, a tenfion and pain in the fper-
matic cord, or a fwelling of the tefticle, it ought
to be difcontinued for a few days. This effeO: I
have fometimes alfo found to be produced by
the ufe of too large a bougie, and to be remo-
ved by changing it for a fmaller one. In gene-
ral, hxiall bougies fhould be preferred to large
ones in the beginning. See Formulas, article
Cerei medkati.

Should we be difappointed in our expedations
of a cure, either by the ufe of bougies or injec-
tions of the above-mentioned kind, it will be
proper to injed fuch liquids as may excite an
irritation and inflammation in the urethra, efpe-
cially in the part affeded. Thefe have often
been attended with fuccefs after the belt aftrin-
gents have failed. For this purpofe, we may ufe

the

O N G L E E T S. 6

>

the injeBio ad Bknfiorrhocam ^tia made ftronger^
or a fimple folution of fublimate in water, or a
large dofe of calomel fufpended in water.

It has been obferved by Dr Cullen, that obili-
nate gleets have fometimes been cured by vio-
lent and long-continued exercife on horfeback;
fuch as a journey from Edinburgh to London :
and it is probable that this cure is produced by
exciting an inflammation in the parts, as the in-
jedions jull now recommended are apt to do.
Gleets have fometimes been cured by coition ;
which may be accounted for on the fame prin-
ciples : but this is a remedy which can never
be recommended by any praditioner ', be--
caufe gleets are often infedious, and the vene-
real difeafe is by thefe means certainly com-
municated to an healthy woman ^ or, if fhe
be not healthy, the man would not only run the
rilk of getting a freih clap, but even the lues it-
felf, if his gleet was owing to an ulcer in the
urethra.

Befides the above-mentioned remedies, fome
others may be tried in gleets of the more ob-
ftinate kind ; fuch as the tindura cantharidum
internally, or injedions made with oil of tur-
pentine, or with a decodion of tormentilla, or
an ii^fulion of galls ; a bliiter to the part af-
fede(i, or to the perinseum. Mr Birch has found
gentle eledrical flrokes pafled through the part
aiFeded in fome cafes effedually to produce
a cure; and I have been informed by a friend,
that he once faw a defperate gleet cured by in-
jeding the tindure of ipecacuanha. I can, how-
ever.

64 O N G L E E T S;

eveiv fay nothing with regard to the efFeds of
thefe remedies, having never had occafion to
try them. I mention them only, becaufe we
may be fometimes at a lofs for medicines in very
obllinate complaints of this kind*

Bathing in cold water has alfo been recom-
mended in obftinate gleets, and I have feen
fometimes very good effects from it ; but, in
two or three cafes, it rather increafed the run-
ning. The fame has alfo been obferved by
others. — Sea-bathing is very beneficial j as like^
wife wafhing the genital parts with cold water,
by itfelf or mixed with vinegar.

There are three kinds of internal remedies
made ufe of in gleets; each of which may be
iifed, either alone or joined, as circumflances
may require, with the local applications above-
mentioned. Thefe are,

1. A CGurfe of 7ntrcurials. This is always ne-
ceffary where the difeafe arifes from an ulcer of
the urethra, efpecially Cff a- long flanding, or
where a general infedion has taken place. In
fuch cafes, pills made of turpentine and mercury
are often very proper.

2. Balfamics, Such as balfamus Canadenlis^
Tolutanus, Peruvianus, copaivse, e mecha, oliba-*
num, terebinthina, or the aqua picea. Of thefe
the moil commonly ufed is the copaiva balfam ;
of which the patient may take from fifty to ari
hundred drops in a draught of cold water once
a-day at noon, or twice a-day morning and
evening. Immediately after the balfam, from
twenty to fifty drops of Mynlicht's elixir of vi-
triol fhould be taken, in the fame quantity of

3 water.

O N G L E E T S. 65

water, to render the former lefs difagreeable to
the ftomach. Half a drachm of pure turpen-s-
tine, or a drachm of balfamum traumaticum,
often anfwers the fame purpofe as the copaiva
balfam. 1 knew an mftance, where a very large
quantity, from one to two ounces, of copaiva
balfam was fwallowed at once by a young man,
who was thereby radically cured of a molt in-
veterate and obfiinate gleet.

3. Corroborants. Among thefe the tormentilla
root, in powder or extrad:, the Peruvian bark
in powder, or infufed in red wine, or, which is
fometimes better, infufed in lime-water, united
according to circumflances, with iron, balfa-
mics, or fome other powerful ailringent, fuch
as refina kino, relina draconis, &c. will fome-
times prove effedual when all other remedies
have failed. After all, however, our utmoll
endeavours to cure an inveterate gleet will
fometimes be in vain ; and there have been in-
flances where Nature has effeded a cure in time,
after the unfuccefsful and tedious exhibition of
the moll powerful remedies.

Obfiinate gleets fometimes originate, as men-
tioned above, from a lingular caufe^ of which we
have fome examples in anatomical colled:ions»
This is, when two ulcers of the urethra happen
to be nearly oppoiite to each other. In this
cafe, fome parts of them will inofculate with
each other, producing a kind of bands acrofs the
urethra, with a fmall ulceration below* Thus
not only a mofl oblllnate running, baffling ail
medicines, is produced v but a difEculty of ma-^
king water frequently takes place, and an im-

E poflibility

6-6 ' O N G L E E T S.

poflibility of making it but in a very fmali
fbream, or not at all. The only remedy in this
cafe, if we have fome reafon for fiifpeding this
caufe, is the chirurgical operation 3 though in
fome cafes, where the bands are not too flrong,
they might perhaps be broke by applying a
probe or catheter. Whether or not the follow-
ing cafe of a very troublefome and obflinate
gleet belongs to this clafs, I leave my readers to
judge.

Some years ago I was confulted by a noble-
itian concerning a gleet, with which he had been
affeded for about ten years, and for which hq
had confulted the phylicians and furgeons in fe-
veral countries'. Sometimes it Hopped for feve-
ral days 3 then it came on again of itfelf, efpeci-
ally after riding on horfeback or coition. At
fuch times he always felt fome uneafinefs, and
the next day a little running, which went off
till the fame caufe was repeated 3 which ren-
dered him very uneafy, efpecially as he intend-
ed to marry. Upon examining the patient,
I found the diforder feated down in the ure-
thra, about the place called the Capta gallina-
ginis. Every internal and external remedy that
I knew of was applied without effeding a radi-
cal cure, I took the difeafe to be a callous
ulceration^ and, on this fappofition, applied
bougies for eight or ten weeks without the leaft
effeS. Being obliged to continue my travels, I
left him very little the better for what I had
done y at the fame time advifing him, as he in-
tended to go to Paris, to confult there whomfoever
lie could expecl; any benefit from. The refult,

as

ON GLEETS. 67

as he afterwards informed me by letter, was as
follows. " After my arrival at Paris, I con-
" fulted, according to your advice, all the me-
" dieal men of eminence in that city, who ren-
" dered me more uneafy about my diforder than
" I had ever been before, by their diiferent
" opinions of the caufe, nature, and cure of it.
" Some advifed me to a new mercurial courfe ;
** others prefcribed different internal and exter-
" nal medicines. I fhowed them all the pre-
" fcriptions fucceffively tried by you ; they feem-
•* ed rather aftonifhed, that none of them, after
" a fair trial, had fucceeded. However, fome
" new injedions and internal remedies were
" ordered, rather 1 think to fatisfy me for my
** money, than in hopes of doing me aliy real
" fervice 3 indeed 1 was for three or four
" months entirely in the fame condition as when
" I firfl came to Paris. But, furprifing it may
" feem to you ! the laft perfon whom I confulted
" upon recommendation, feemed to me the mofl
" ignorant I had applied to. He laid he was
" obliged to examine the palTage of the urethra
" with a catheter, in order to afcertain th^
" place, &c. He accordingly applied it. It went
" in as ufual very readily, till it came to the
" feat of the diforder, where it met with the
" fame obflacle it had always done, which I
" had before told him of. Notwithftanding
'* this, he endeavoured to pufh it further. I
" told him it gave me excellive pain : but he
" prefTed it imprudently on, and it went through >
" upon which fome blood immediately run out
** of the urethra. This, as it feemed, much

E 2 frightened

6t ON GLEETS.

((

<c

iC

friglitened him : he afked my pardon, with-
drew his inftrument, took his fee, and de-
parted ; but left me much dilTatisfied for em-
ploying him. I expecled I iliould be worfe
the next day, and fuffer much from his un-
fkilful condud : but quite the reverfe ^ I have
been free from any diforder thefe two months
pafl. I ride on horfeback, and enjoy a wo-
man, without finding any ill effects from
them; and therefore think myfelf radically
cured. The friendfhip.I owe you, for the
trouble you took on my account, obliges me
to ilate to you this particular cafe^ which may
be of ufe to you, and which you perhaps can
'* better account for than thofe I have fince
" confulted."

Gleets, ariling from deep and large erofions of
the mouths of the feminal duds, or excretories
of the proilate gland, as alio thofe which ori-
ginate from a difeafed proilate gland, or from
ulcers of the bladder,^ are often incurable.

In all inveterate and obftinate gleets, which
have their feat low down in the urethra, we
fliouid carefully examine the proftate gland;
for to a difeafe of this part they frequently owe
their origin. If the gland fnall be found pi;e-
ternaturally fwelled and hard after a mercurial
courfe, repeated blifters applied to the perinae-
um, with large dofes of the inlpilTated juice of
conium maculatum, or a decodion of meze-
reum, I have {ten in fome inftances attended
with fuccets where all other remedies had
failed.

• Of the treatment of gleets combined with
H^'-- - , - ilridures,

O N G L E E T S. 6g

ftridures, viz. with more or lefs difficulty in
making water, I muft refer to the chapter on
Ifchury,

Gleets which arife either from a weaknefs,
relaxation, or fometimes perhaps from too great
an irritability of the ducAs of the feminal vef-
fels, are properly called by the name of Gonor-
rhoea (fluxus Jeminis)> In thefe cafes, a real fe-
men is difcharged, fometimes without eredion
or any fenfation of pleafure : and is either con-
tinually dripping off, or evacuated at times by
debilitating nodurnal or diurnal pollutions.
Sometimes it is difcharged only on going to
ftool, when the hard faeces, during their paffage
in the rectum, prefs on the feminal velicles and
proftate gland, and thus force the relaxed ori-
fices of their excretory duds. This diforder,
however, does not arife from any venereal in-
fection, and but feldom from the abufe of ve-
nery. The mofl general caufe of it is manuflu-
pration, and therefore comes not within my plan
at prefent. It requires a mofl prudent and careful
treatment; otherwife the patient will fall a vic-
tim to that kind of confumption which we call
with Hippocrates T^abes dorjalis.

E ^ N O S O.

7©

NOSOLOGICAL TABLE, illuftratlng
the two preceding Chapters.

Claf, Locales,

Ord. Pblogofes, or Mticifliixus.

Genus, BLENNORHAGIA. AngUs, Clap;

Ge7^matiis,lLXi^^cXy G^//ij", Chaude-pifle^ Italis^

Gonorrhea.

Cbaracler in Viris. Titillatio, prascipue in urethras
parte anteriore in lacuna Morg^gni fub fr^enulo ; fub-
fequente poft biduum aut quatriduum, phlogoli locali,
cum ardore et dolore in mingendo ; accedente ftilli-
cidio materiel purulentae vel puriformis ex urethra;
corpore cavernofo urethrae praeternaturaliter turgef-
cente, plerumque cum eredtionibus membri virilis fo-
lito frequentioribus, dolorificis.

In Fceminis. Titillatio ad oriflcium vaginae externum;
fubfequente poft biduum aut quatriduum dolore,
rubore et tumore praeternaturali, praecipue (ad ra-
pham) prope commiffuram labiorum vulvas inferio-
rem ; accedente ardore et dolore ejufdem partis in
mingendo ; cum ftillicidio materiel puriformis ex
vulva.

Gonorrhoea

— , virulenta

venerea

Fluor albus venereus, f. mallgnus
i/<^^corrhcea venerea

}

Ya^^iat

NOSOLOGICAL TABLE. 71

Variat ratione fedis.

Materia JIuente ■
Blennorrhagia balani [ ex glande,

— urcthralis ' j ex ur^hra,

— : — veficalis e vefica,

_ —^ labialis \ ' e labiis vulvje,

,; -_ — vaginalis I e vagina,

. uterina ex uterOj

;^ nafalis 1 e naxibus.

Species funt,

Blennorrhagia fyphilitica,

«. Simplex,

fi. Complicata, f. ulcerofa.
Blennorrhagia a manuftupratione.

, ab acri externa applicato.

,: a ftimulo interne applicato.

^ arthritica.

.r. a calculo veficoe.

'. — , a cancro uteri aut vaginie.

Sequela Blennorrhagise eft,

BLENNORRHOEA. Jnglis, Gleet; Germa-
nis, Nachtripper, weifler Flus^ Gallis, Go-
norrhee inveteree.

CharaBer. Stillicidium humoris puriformis, aut muci
limpidi, ex urethra in viris, ex orificio vaginae in
feminis, praeternaturalis, line libidine aut dyfuria«

Gonorrhoea benigna ~\

• inveterata f „„ r^.^^,,^

_,,,,,. >. auctorum,

Fluor albus benignus f

Leucorrhoea J

Varlgt ratione fedis ut Blennorrhagia.

E 4 Spscieg

72 NOSOLOGICAL TABLE,

Species pradlico notatu necefTariae funt,

In viris : Blennorrhoea fimplex, a relaxatione vaforum,

— ; complicata:

a.. Cum ulcere urethrse ;

g,. Cum ulcere aut fcirrhoiproftatac.

Infosminis: Blennorrhoea a relaxatione aut debilitate vaforum
uteri aut vaginse.

r ■ ex Blennorrhagia pr^grefla.

ex diseta laute et vita fedentaria.

a manuftupratione.

- — ■ ■ — ab ulcere aut cancro uteri vel vaglnsp.

Sequelae Blennojrrbagiae fyphiliticse retropulfae
funt :

Tumor teftlculorum.

Ifchuria urethralis.

Bubo ? -

Ophthalmia.

Dyfecoea.

Fluxis puriformis ex oculisj

ex auribus,

e naribus.

Syphilis.

Genus, GONORRHOEA.

^ Character. Excretio feminis aut muci proflatae prg^-
"ternatiiralis, potiffimum line ereclione et libidine ;
accedente dolore lumborum et atrophia. ,

Gonorrhoea vera ^

Pollutio no6lurna debilitans > auClorum,

Excretio feminis involuntaria j

Species funt :

Gonorrhoea a debilitate aut relaxatione vaforum.

ab ulcere aut crofione ducluum excretoriorum

proftatse et veficularum feminaHum.
• a nimia irritabilitate, potiffimum per manuftu-

prationem indudta.

CHAP.

OF THE TESTICLES. 73

CHAP. IV.
On the Venereal Swelling of the 'TeJI'icles*

'HEN a Clap has been treated either bj
improper medicines, or the patient labour-
ing under it ufes violent exercife, or efpecially
if he catches cold in the part afFeded, by expo-
ling it to a ilream of cold air, or by wafhing it
with cold water, one and fometimes both tefti-
cles begin to fwell, often to an enormous fize,
attended with all the fymptoms of a local in-
flammation^ to which an irritation of the whole
fyftem and violent fever not unfrequently fuc-
ceed. This difeafe is called a Swelled Tefli-
cLe, and by fome writers, though very impro-
perly, Hernia humoralis.

Previous to the fwelling, the running of the
clap partly or entirely ceafes; but, fometimes,
this will only happen, at leail to an obfervable
degree, a day or two after the fwelling has ac-
tually taken place.

That the fwelling and fymptoms of this in-
flammation are produced, in this cafe, merely
by the irritation of the poifon lodged lower
down in the urethra, at the place where the ex-
cretory duds of the feminal veficles open, and
not (as was formerly fuppofed) from an abforp-
tion and tranfpQiition of the poifon to the tefti-

cle

74.-^ VENEREAL SWELLING

cle itfelf, is now generally admitted; and will
perhaps be more evident from the obfervations
which I fliall lay down upon the nature and feat
of this diibrder, and from the new method of
treatment which I found the moft fuc<:efsful for
this complaint.

There is another fpecies of this diforder
mentioned by fome writers, viz. an inflamma>r
tion of the tefticle, arifmg from the venereal
poifon being depolited there from the mafs.
This kind of difeafe never came under my ob-
fervation, and I therefore can fay nothing about
it. We are alfo told, that a fwelled tefticle ari-
fes fometimes from venereal ulcers of the glans
being dried up : but neither do I recoiled to
have obferved any cafe of this kind 3 though I
have feen a patient, who, two years ago, was
affeded with a fwelled tefticle, which being imr
properly treated, brought on a fiftula in ano.
This was operated, and nearly healed up, when
a fwelling of the tefticle appeared again ; for
which I was confulted. I fucceeded in difper-
iing the fwelling, by bringing on a running from
the urethra, and in completing the cure by a
courfe of internal remedies.

It has been hitherto the general opinion, that
the tefticle itfelf is always the feat of this difor-
der. But, upon a more clofe attention and in-
quiry, I found,

Firjl, That the tefticle itfelf is never fwelled,
or in the leaft afteded, in the beginning of this
complaint; and that the only part affeded and
fwelled is the epididymis; of which every patient
may eaftly convince himfelf by a careful exami-
nation.

OF THE TESTICLES. 75

jiation. I faid, the tefticle is never in the leaft
aiFedied in the beginning, or for the firfl five or
iix days; and if it becomes afFed:ed afterwards,
it is entirely owing to a prepofterous treatment.
2dly, I have conftantly obferved, that the fever
which frequently attends this complaint, efpe-
cially in irritable conflitutions, is never a pri-
mary diforder, but only concomitant to, or the
confequence of, this local irritation; and that
for this reafon, by the method mentioned here-
after, it is almoil generally in the power of the
phylician, if he be called in time, to prevent
any fever from taking place in this complaint.

In what manner this fwelling of the epididy-
mis and fpermatic cord is produced, is difficult
to explain. Some think it is owing to fympa-^
thy; others, to a certain quantity of poifon ab-
forbed and depofited to the tefticle; and others,
to the inflammation flowly extending down-
wards to the neck of the bladder, and thus ob-
fl:rud;ing the courfe of the femen. If it were
owing to fympathy, why does the fw^elling never
happen as long as the difcharge of a. clap goes
regularly on, though the fymptoms of inflam-
mation and irritation run ever fo high ? The
fecond caufe afcribed is a mere fuppolition, nei-
ther founded on fads nor anatomical obferva-
tions. The third feems to be the mofl reafon-
able; though it mull be obferved, that if the
extended inflammation was the only true caufe
of this fwelling, it would feem that every pa-
tient who has a difeafed proftate, or an inflam-
mation at the neck of the bladder, fhould alfo
be afFeded with a fwelling of the teflicles ;

which.

76 VENEREAL SWELLING

which, however, is generally not the cafe. It
appears, therefore, moil probable to me, that
this difeafe is owing to the venereal poifon be-
ing retropulfed from its original feat, in the la*
cuna Morgagni under the fraenum, lower down
the urethra, where, by its acrimony, it irritates
the excretory duds of the feminal veflels ; where-
by the fecretion of the femen is increafed, but
its excretion prevented, on account of the ex-
cretory duds being irritated, contracted, and
fwelled: hence an accumulation of feed, firfl in
the vas deferens, then in the epididymis, and at
lall in the tefticle itfelf. Hence, from this di-
Jiention of the fpermatic vefTels, not from any
real inflammation of thofe parts, a pain comes
on, which, for this very reafon, is always, we
obferve, obtufe, never acute ^ and hence we of-
ten fee the patient fuddenly relieved by a fpon-
taneous pollution. But if the fame caufe conti-
nues, the epididymis, and the tefticle itfelf, will
become thereby afFeded ^ and its inflammation,
if the poifon irritating the excretory duds of the
feminal vefTels be not removed, will end in a
fuppuration or obftinate hardnefs of the parts.

From the caufe afligned, we clearly conceive
how it happens, that, after the fwelling of one
tefticle is gone, the other is fometimes attacked;
and that, after a fupprefTion of urine from a re-
tropulfed clap is removed, fometimes a fwell-
ing of the teflicle comes on. It is owing to the
tranfpofition or change of place of the poifon.
It will further appear, from the nature of this
diforder, why a man who has been once afFeded

with

OF THE TESTICLES. 77

with a fwelled teftlcle, is Co ealily afFeded with
the fame diforder a fecond time.

Bat all theoretical reaforiings are of little
ufe, if they do not lead us to eflablifh a more
rational and effedual method of cure than has
been before praclifed.. When I therefore Jirjl
obferved, That this difeafe is not originally an
inflammation of the tefticle, as has been hither-
to generally fappofed, but a fwelling of the
epididymis, as I have found to be the cafe in
all my patients : Seco?idly, That the applications,
otherwife very ufeful in topical inflammations,
fuch as poultices, fomentations, &c. were* in
this cafe of no ufe at all ; nay, fometimes even
hurtful, as I have experienced in myfelf : "third-
ly, That this fwelling is brought on, by what-
ever caufe, which ftops the running of a clap;
and moft generally by catching cold, or cold
applications to the penis, by violent exercife, or
by aftringent injections : Fourthly, That a fwell-
ing of the fame kind is fometimes brought on
by the iimple application of a larger bougie,
and cured without any other remedy than by lea-
ving offthe ufe of the bougie — I was led, in confe-
quence of the above obfervations, to conclude,
that the difeafe was brought on, not only by the
venereal poifon,but by any other fl;imulus applied
to and irritating the mouths of the excretory
ducts of the feminal vefl^els in the urethra ; and
that therefore a new method of cure, altogether
different from the old one, might be attended
with better fuccefs : and I was fo happy as to find
the fame, after I had occafion to try it, firfl; on

myfelf.

78 VENEREAL SWELLING

myfelf, and afterwards on other patients, aniwef
my mofl fanguine expedations.

Method of Cure^

^ The phyfician's firll intention fliould be to pre-
vent the difeafe altogether^ and if this fhould
be found impoffible, to cure it in the moft
fafe and fpeedy manner. To prevent a fwell-
ed teflielej every thing that is apt to bring
on a flopping of the running, or a retropul-
fion of the clap, ought to be carefully avoid-
ed. Such are acrid aftringent injections, wafh-
ing ^the penis with cold water, or expofing it
to the cold air; as, for example^ making wa-
ter in a ftreet where a cold wind blows; violent
exercife of any kind; the prepofterous ufe of
balfamics, internally or externally; purging me-
dicines : Which points carefully attended to, to^
gether with the wearing of a bag-trufs, from the
beginning of any clap whatever, have effedually
fcreened my patients from this diforder; fo that
none of them who complied with the rules juft
mentioned was ever affedted with this difeafe.

But we generally find our patients not fb com^
pliant, or we are called in to fuch, who having
been treated without any attention to thofe rules^
are adually affected with the fwelling. Thofe
require our compaflion, and the immediate ap-
plication of every means pofllble to relieve them.

The caufe of the diforder, as faid above, be-
ing an irritation of the mouths of the excretory
dudts of the feminal vefTels, from the venereal
poifon having taken its feat at the caput galli-
naginis, the moft efFedual relief we can give

tt>

Ot THE TESTICLES. 79

to our patient will be, firfl to allay the irrita-*
tion, and then to recal the poifon to its former
original feat, that is, re-eftablifh the running ;
both which points to attain, I fouiid the fol-
lowing method mofl efficacious.

If the pulfe be accelerated, full, and ftrongj
the patient is to be bleeded immediately ; and a
good quantity of blood is to be taken from him;
regard, however, being had to his conilitutionj
and other circumftances. If there be no irrita-
tion in the fyflem, or only a moderate degree
of it, bleeding is unnecelfary (and this will be
nearly alvf ays the cafe, if we are called in foon
after the commencement of the diforder); being
convinced, from repeated obfervations, that the
fever in this complaint is never an original dif-
eafe, but brought on merely in confequence of
the irritation of thofe delicate parts.

To the fwelling a common poultice of bread
and milk, with fome oil, and, according to cir-
cumftances, a little fugar of lead, has been re-
commended by moft writers : but having feen
fo little effect from this application, I have
not for many years paft made ufe of it. In-
ftead of a poultice, I order firft a giyfter, to
evacuate the faeces, if the patient had not a na-
tural ftool; and then I advife him, if his litua-
tion will allow of it, to fit for half an hour
in a warm emollient bath. If he cannot have
that convenience, he is to be placed in a perfo-
rated chair, upon the fteam of hot water, for
the fame length of time; previoully fufpending
his tefticles. From thence he is to be carried
to bed, and a dry bag-trufs to be immediately ap-
plied,

8o VENEREAL SWELLING

plied, in order to keep the tefticles conflantly
fufpended, as their hanging down produces or
contributes to their irritation and fweliing. A
warm poultice may then be alfo applied to the
penis, in order to recal the running again ^ or,
in other words, to determine the retropulfed^
matter from its new feat to come back to the
old one. But what I found principally to be re^
lied on is, to admioifler a full dofe of opium,
or, according to circumftances, a glyfler, made
of equal quantities of linfeed-oil and barley-
water, with forty or fixty drops of laudanum,
to be injecPced, and occafionally repeated. He
is to keep in bed and obferve a low diet, drink
nothing but barley-water, a decodion of figs
and barley, or an emulfion of almonds.

To this method of treating fwelled tefticles
by opium, I was led, as I mentioned above,
many years ago by a fevere cafe of my own 5
and I have feen afterwards fo good and fpeedy
effeds from it, that I fince conflantly made ufe
of it. I have had many inflances, where, by
thefe means, the fweliing and pain of the tef-
ticle were removed, and the running brought
back, in the fpace of twenty-four or forty-
eight hours y and in thofe cafes where it had
not that efFedl fo foon, it always greatly relieved
the patient, and prevented a fever. In all more
obllinate cafes, I conftantly obferved, that the
fymptom.s of irritation and the fweliing did ne-
ver quit the patient till the running of the clap
came on again ^ but the moment this latter
took place, the patient found himfelf relieved
of the pain of the tefticle, and the fweliing gra-

I dually

OF THE. TESTICLES. 8i

dually difappeared^ Tb alliil Nature in its be-
neficial eiForts, the opium internally, or in an
emollient glyfler, is to be repeated every twen-
ty-four hours p the parts to be expofed twice or
three times a-day, for a quarter or half an hour,
to the fleam of hot water or milk; warm poul-
tices to be conflantly applied to the penis j and
the accumulation of f&eces in the redum to be
prevented by a common glyfter occafionaliy re-
peated. Ey proceeding thus, we ihall generally
have the fatisfadlion to cure, in a few days, a
difeafe, which, by a difierent m.ethod of treat-
ment, require fo many weekSj and after all
fometimes ends in a fuppuration of the teliicle,
which often leaves a troubiefome fcirrhofity
behind. Of late we have been told, that
fomentations with cold water or ice, renew-
ed every quarter or half an hour, anfwered
beyond expedation in difcufling a recent fwell-
ing of the teflicle 5 and in other cafes, the re-
peated cold application of a folution of fugar of
lead in water has produced the fame happy eiFeds.

If the fymptoms of the fwelling is dangerous
or obflinate, more efRcacious means to re-eila-
blifh the running the fooner might likewife be
tried, and applied as mentioned above. The re-
eflablifhed clap ought to be treated afterwards
in the common manner^ taking great care to
give no occafion to a new retropuliion^ which,
it is to be remarked, in fuch cafes eafily takes
place a fecond time.

If the fwelling has been treated improperly, it
frequently happens that the fymptoms of irrita-
tion difappear, but leave a har<I fw^elling of one

F or

82 VENEREAL SWELLING

or both tellicles behind ; and the difeafe is then
commonly called a Scm'hous Tejiicle, In all
thoie cafes I conflantly found the epididymis
very hard and much fwelled. In fome, how-
ever, the tefiicle itfelf was likewife evidently
affeded, accompanied fometimes with a fenfa-
tion of a painful prelfure, but more frequently
without any pain at all. Mercury rubbed in exter-
nally into the perinaeum andfcrotum twice a-day,
with the conftant application of a warm poultice
n:iade of the root of atropa mandragora L. is, in
that cafe, the molt ufeful remedy. An emetic
has been fometimes found effedual. The de-
codion of the bark of the root of daphne jneze-
reum internally, and a poultice of it exter-
nally, has lately been much recommended;
but in feveral patients to whom I have given
that deco6lion, I obferved it made them fo iick
that they ^found it impoflible to bear it on the
ftomach, and even its external ufe requires fome
caution on account of its acrid quality. Elec-
tricity has been found ufeful in feveral cafes by
Mr Bh-ch in London. Van Swieten once told
me, that he had given, for an indolent chronic
induration of the tellicles, lapides cancrorunij
an ounce in a pint of good Auftrian wine or
old hock, taking three or four table-fpoonfuls
every morning and evening, with good fuccefs.
I once tried this remedy, and it anfwereci ex-
tremely well. After Van Swieten*s death, I met
a patient who told me, that he had been cured
by him of an hard fwelled teflicle, though not
from a venereal caufe, by the fame remedy; and
that he had been perfectly well ever lince. An

ointment

OF THE TESTICLES« 83

bintment: made of one drachm of camplidr to an
ounce of limple ointment applied to the fcrotunij
and in other cafes the application of the vola-
tile liniment by irieans of a feather, have proved
fuccefsful in feverai inllances. Hemlock inter-
nally and externally has been likewife recom-
mended; but upon what ground, I am uncertain^
Mr Acrell, one of the firft furgeons in Denmark^
has found the root of the ononis fpinofa - Li
given internally, anfwer extremely well in feve-
rai cafes. He boils half an ounce of this root
with a pint and a half of water to one pint,
fweetens it with fyrup of camomile, and gives
a table-fpoonful of it every three hours. The
wearing of a trufs-bag is at the fame tinie al-
ways heceifary. It is, however, to be obferved,
that we fhall fometimes be difappointed by all
thefe remedies; and that the hard fwelling, of
feverai months or yeats ftanding, will not go
off, except we have recourfe to the inoculation
of a new clap.

A cancer of the tejlicle requires extirpation;
but whenever a tefticie is cancerous, or in its
Itrudure difeafed, we ought always carefully to
examine whether the lymphatics of the fperma-
tic cord are not at the fame time affected; in
this cafe, the kidney of the fame iide, to which
thofe lymphatic veilels go, being generally dif-
eafed, the excifion of the tefticie proves an ufe-
lefs operation, and will only expofe, by its fatal
confequences, the furgeon's reputation.

We are told by fome Writers on this fubjecSls
that a venereal inflammation of the tellicles fre-
quently terminates in a fuppuration. This may
fometimes be the cafe, but never happened to

F 2 anv

84 VENEREAL SWELLING

any of my patients. I am therefore incllnec^
to believe, that, if it happens, it more frequent-
ly proceeds from a bad treatment, than from
any other caufe. But perhaps that fpecies of
venereal teflicles which, we are told, arifes from
a tainted mafs (if it ever exifts), is probably,
having its feat in the tellicle itfelf, more apt to
end in fuppuration', than that arifing from a
fuppFelled clap, which, as we have feen above,
very fcldom alTecis the teflkle. One particular
cafe, w-hich I faw eight years ago, though not
venereal, deferves, perhaps, to be mentioned
here.

A young man of twenty years of age, afflic-
ted with fcrophuious fwellings about his neck,
was advifed by a phyiician to make ufe of the
decoclum lignorum. Following this advice for
fome weeks, he was affeded with a cough,
which, in a fortnight after, ended in an hsemop-
tyfis. Though he now left off the decodion,
and made ufe of feveral other medicines pre-
fcribed to him, the cough continued for many
months, accompanied with fpitting of blood, or
mucus ftreaked with blood occahonally. Being
confulted, I gave it as my opinion, that his
lungs were affeded with fcrophuious tubercles,
for which I knew no remedy 5 and defired him
to confult the firfl men of the profeflion in the
place. Though the remedies ordered by them
did not in the leail alter his cough, he was^ in
other refpeds tolerably well, eat with 'appetite,
and ilept with eafe. One day he came to me,
and complained of a painful fwelling on both
iides of the inguina, but more fo on the one than

on

OF THE TESTICLES» Ss

on the other. Upon examining, I found the
ipermatic cord very much enlarged. I afed
him, whether he had made free with the fex ?
He declared upon his honour, he had never lain
w^ith a woman in his life, for fear of being pox-
ed^ but faid, he had had the fame complaint
ieveral times before, and felt it always whene-
ver he was in company with young women
who flrongly excited deiire^ that it grew fome-
times extremely painful, infomuch that he a-
voided fuch occafions as much as poilible. Ha-
ving been in fuch a iituation the day before, the
fame pain came on ^ but had continued fo much
Iqnger than ufual, that it induced him to apply
to me for afiiftance. I advifed him to apply
cold water to the parts ; Avhich cured him of
his complaint in a few days. Thus much I
thought to premife to what follows..

Some months after, he complained to me that
one of his teflicles had become very hard with-
out any apparent caufe. Upon interrogating
him about the ufe of women, he repeated the
fame thing he had done before 3 but confefled
that he had frequently mafturpated himfelf,
without knowing that fuch a pradice could pro-
duce any diforder. I prefcribed hemlock, and
all the refolvents the Materia Medica affords^
both internally and externally, but without any
efFe(5l : the tefticle grew painful, and daily lar-
ger^ and at lall burfi, and a fmall quantity of
purulent matter was difcharged. On my return
to town, after an abfence of fome months, he
told me, that during that time a fmall difcharge
had continued^ and that feveral fibres like

F 3 white

86 VENEREAL SWELLING

white threads came a\vay from the ulcer every
day. Upon examination, I found the whole
tefiicle reduced to a very fmall Hze, and the
ulcer nearly clofed up, and in a few weeks it
was quite healed. His cough continued during
all this time ; but he appeared not to be more
emaciated than whfen he firfl applied to me. E-
very three or four months, when the tickling
of the cough feemed to increafe, and he wa§
afraid of a {pitting of blood, he was bled by his
own advice. The fpermatic cords were quite
natural. The fame month of the following
year, the other teilicle became affeded juil as
the former had been. A furgeon of eminence,
who had treated the patient with me the prece-
ding year, was now called in during my ab-
sence ; and though every thing was done for him
which in my opinion could have been done,
when I returned back to town, the complaint
Hill continued, and had now lafted for ten
weeks. At the expiration of the feventh week
the tefiicle burft> and whole pieces of the
fpermatic velTels of the tefiicle were every day
difcharged from the openings and in three
months the tefiicle was reduced, like the other,
to the^ fize of a fmall hazel-nut. There was
no fwelling in the fpermatic cords ; and
the patient told me, he had flridly follow-
ed my advice, and avoided, for thefe two years,
his bad cuflom above mentioned. The cough
continued ^ but by degrees reduced him fo low,
that he died two years after.

The phyfician who attended him laft, in-
formed me, that, on, opening the body, he

found

OF THE TESTICLES. 87

found a vomica in one of the lungs, and many
large hard tumours or tubercles on both ^ but
he had not examined the tefticles. From what
caufe the difeafe of the tefticles arofe, whether
from a fcrophulous complaint, or from maftur-
pation, I fdo not pretend to fay : but I relate
the cafe only as a very particular and re-
markable one; which ihows, that there may
fometimes happen a fuppuration of the tefticles
even with the greateft care and naoft judicious
treatment.

F 4 CHAP,

88 INFLAMED PROSTATE GLAND.

G H A P. V.

Of the Inflammation and Induration of the.
Prostate Gland.

Y Have nothing in particular to fay on the in-
^ flammation of the proftate gland, except when
it arifes from a iupprefied Blennorrhagia. In
that cafcj we lliould ufe every means poflible to
reitore the running, particularly thofe recom-
mended for fwelled tefticles arifing from the
fame caufe ; becaufe, if this inflammation ter-
minates in fuppuration, whether the abfcefs
breaks into the urethra, bladder, inteilinum
rectum, or perinseum, it is always attended
with very difagre^eable confequences. The
fymptoms of an inflammation or fwelling of
this gland are known from the pain and difE-
culty in making water; belides, if we fliould
be doubtful whence they proceed, the finger
will almoil always clearly tell us. If a fuppu-
ration has already taken place, we have only to
obferve, that mercury internally and externally
will be neceflary, and afterwards proper injec-
tions) the compolitions of which are not pecu-
liar, and are to be left to the judgment of the
praditioner.

In the induration or fcirrlioflty of this gland,
the remedies recommended for indurated tef-
ticles or buboes are to be rnade ufe of ; but efpe-
cially blifl:ers, repeatedly applied to the peri-
ncEtim^ and internally the hemlock in large dofes.

If

INFLAMED PROSTATE GLAND. 89

If a total fuppreflion of urine is to be dreaded
from the fcirrhous fweliing of the proftate, as
is always fooner or later the cafe, every means
poflible ought to be tried to bring on a fuppura-
tion of the gland, in order to prevent ftill more
difagreeable cojifequences. There is, however,
to my knowledge, hardly any diforder which
baffles more the fKill of the phylician than a
fungous excrefcence or fcirrhous fweliing of
this gland, whether from a venereal or any-
other caufe. The root of the atropa mandrago-
ra, or the daphne mezereum in a poultice, and;
repeated blifters, or a feton applied to the ipe-
rinaeum, j^re the only external medicines, be-
iides thofe juit before mentioned, from which
we may expect any relief. Internally, a courfe
of mercurials, the pulfatilla nigricans, and
the hemlock, have been recommended^ but I
have never feen any ^ood efFed from any of
them.

CHAP.

90 VENEREAL ISCHURY

CHAP. VI.

the Venereal I s c h u r y and
Strictures.

TOTAL fuppreilion of urine, occafioned ei-
ther by the remains of a former fyphilitic
complaint, or of a prefent venereal virus affec-
ting; the urethra, or neck of the bladder, we call
a Venereal IJchury ), and a partial fuppreilion, or
a difficulty of making water in a continued and
natural flream, attended^ with pain, and a fre-
quent deiire to make water, a riling from the
fame caufe, is commonly, though not always
properly, called a Stricture.

When I fay, that the name StriBure, which has
been given to the latter complaint, is often a
very improper appellation, it is becaufe a par-
tial fapprellion of urine, as well as a total one,
may anfe from different caufes ; among which
a ftridrueor conftridion of one particular part of
the urethra is only perhaps the moft common
one.

The different caufes by which either a par-
tial or total venereal fupprelFion of urine is pro-
duced, are, iji, An inflammation or fpafmodic
contradion of the neck of the bladder, from a
recent retropulfed clap. 2dly, A chronic con-
ftriclion or narrownefs of one particular part
of the urethra, from a thickened and hard-
ened portion of its fubilance, properly cal-
led a Stricture. z^Uy, A compreilion of the

neck

AND STRICTURES. 91

neck of the bladder or urethra, producing a
partial or total abolition of its cavity, by a pre-
ternatural fwelling of the proftate or of any
other gland of the urethra, \thly, A prominent
cicatrix of a preceding ulcer, or a fungous ex-
crefcence in forae part of the urethra, common-
ly known by the name of Caruncle.

As upon the perfed knowledge of thefe cau-
fes the radical cure of the difeafe entirely de-
pends, we fliall conlider them more minutely.

Whenever the running of a clap is flopped
by any caufe whatever, the virus feems to go
lower down the urethra, and to excite there a
iimilar irritation and inflammation, as it did in
its former place. If it fixes its place at the ca-
put gallinaginis, and there irritates the mouths of
the excretory duds of the feminal veficles, it
produces, as we have obferved in the foregoing
chapter, a fwelling of the epididymis, or what
is commonly called 2i /welled tejiicle. If it goes
ftill lower down the urethra, and fettles at the
neck of the bladder, it will, in this circum-
ftance, not produce a fwelled tefticle, but an
irritation, fpafmodic contradion, or inflamma-
tion of the neck of the bladder, with a total or
partial fuppreflion of urine. The poifon in that
cafe, if the complaint be properly treated, will
produce no other difeafe than a fuppreflion of
urine for a few days only : after which it will
leave that place y and, on going more forwards
into the urethra, bring on either a fwelled tef-
tide, or, if it returns to the fame place which
it originally occupied, reproduce the running,
with the common fymptoms of a clap, and fo

92 VENE"^EAL ISCHURY

by degrees go off at laft, without leaving any
bad fymptom behind.

But this fomuch wifhed-for circumftance
does not always happen. The poifon lodged in
the neck of the bladder will fometimes produce,
befides a variety of very diiagreeable fymptoms,
an ulceration in that place, or in fome other
part of the urethra. Though the difcharge ari-
ling from fuch an ulcer be, by degrees, partly
or entirely flopped, and the ulcer itfelf healed,
we often obferve either a^ coarctation of the
urethra remaining at the place where the ulcer
was, or the cicatrix of the ulcer forming a
kind of knot or protuberance into the paflage.
Sometimes alfo the ulcers, on healing, will form
large granulations, or preternatural excrefcen-
ces, which afterwards produce the fame eifed:
as a prominent cicatrix, under the name of Ca-
runcles (which complaint, however, never occur-
red to me in pradHce) ; or the proftate gland,
or any of the glands of the urethra itfelf, form
a fungous excrefcence, protruding into the ure-
thra, or neck of the bladder, and thereby pro-
duce an angulation, or a total abolition of the
cavity of the palTage. Anatomical dilTedions
have alfo difcovered to us lately, that two ul-
cers of the urethra in oppofite diredions, or a
fingle large one, will fometimes, in fome place,
grow together by bands croiling the cavity of
the urethra ; and whilll the lower part of the
ulceration remains open, and continues the dif-
charge mentioned in the chapter on Gleets, the
upper parts grown together diminifh or abolifh

the

" AND -STRICTURES. ■ t)^

die cavity of the urethra^ and thereby prevent
the free paffage of the urine.

In feme of thefe cafes the patl&nt, efpeciallj^
by living fober and quiet, is able to make water
pretty freely, though he wants a long time for
doing it. But, on committing the leafl excefs
in eating and drinking, or by taking too much
exercife, the difeafe grov/s evidently worfe, the
urine is difcharged in drops only, or in a fmall
and interrupted ilream, exciting great pain,
anxiety, and uneafinefs 5 or the paffage is flop-
ped entirely, and thus endangers the life of the
fufferer. The urine, in thefe cafes, fometimes,
as I have {GCUy forces its way into the rectum,
and Is evacuated by the anus ; or it produces in
the urethra, behind the coardation, a dilata-
tion, erofion, finufes, orafiflula, through which
it afterwards conflantly difcharges.

The further back in the urethra this difeafe
has its feat, the more troublefom.e, in general,
is the cure, and the more danger awaits the pa-
tient. The more inveterate or complicated all
thefe fpecies of the diforder are, the more dif-
ficult is their removal. — Thofe arifing from a
callous or contracted ulcer of the urethra, are
more eafily cured than thofe arifing from a pro-
tuberant cicatrix or from caruncles. That kind
of ifchury which owes its origin to a retropul-
lion of a recent clap, I have obferved to be re-
moved eafier and fooner than all others 3 that ari-
fing from a fcirrhous proftate is often, though
not always, incurable ; but for an ifchury ari-
fing from a fungous excrefcence of the proflate,
the art has no remedv.

94 VENEREAL ISCHURY

Method of Treatment,

The firil thing, if we are called to a patient
alFeded with a venereal fuppreilion of urine, is,
to inquire : whether it arifes from a retropuilion
of a recent clap, or froiTi old complaints within
the urethra. Our chief aim, in both cafes, being
to remove the ifchury, we ought to examine,
whether the difeafe is ftiil merely local, or
whether there is a general irritation of the fy-
item. If the pulfe be quick and hard, bleed-
ing is neceiTary. The quantity of blood
to be taken is regulated by the Hate of t;he
pulfe and conilitution of the patient. A man
of a ftrong habit, or of a plethoric conili-
tution, will bear the lofs of a pounds whereas
half that quantity taken, will operate fufficient-
ly, and have the fame effecl:, upon a delicate
and tender habit. It ought, however, to be ob-
ferved, that, in fuch cafes, the patient will reap
more benefit from one copious bleeding, than
from two or three fmall ones fuceeffively made
one after the other.

This being done ^ or when the fyftem is not
afFecled, the bladder, if much dillended, ought
to be evacuated, and the catheter applied for
that purpofe. Its application, however, in thofe
circumftances, is often very difficult, and fome-
times utterly impoflible. This is certainly fre-
quently owing to thecaufe of the diforder^ but
much depends upon the fkilful management of
the furgeon.

3 In

AND STRICTURES. 95

In order to facilitate the introdudion of the
catheter, (after the patient has been bled,
which, if neceffary, fhould always precede), I
have experienced the following management to
be ufefuL The catheter being anointed with
fweet oil, is to be introduced gently. As foon
as we meet with, any obflacle, care ought to be
taken not to force it, but to wait a little, and
then try to piifh it on again gently 3 becauie
this obllacle feems fometimes to arife only
from a momentaneous ipaim of the urethra, ex-
cited by the mechanical irritation of the cathe-
ter itfelf 5 whicii, if we diicontinue pulhing, fre-
quently will go off in a few minutes, and the ca-
theter is then eafily introduced further: where-
as if w^e go on pulhing, in that cafe the i|3afiTi
grows more violent, and renders the introduc-
tion often utterly impoilible. It is ov^ing, pro-
bably, to this fpafm that we fee fometimes that
one furgeon is able to introduce it,, while ano-
ther, though by no means of inferior fkill and
talents, had before tried it in vain. If the
obflacle be at the caput gallinaginis, or further
back, we may very often remove it by introdu-
cing a finger in the anus, and thus ailifting the
catheter. I have feen infcances where the in-
trodudion of the catheter proved impoilible as
long as the patient was lying in bed }, whereas
it went in very readily on the patient's fitting
on the edge of the bedftead, his feet hanging
down. I have alfo obferved where a large ca-
theter was eafily introduced, after a fmaller one
had been repeatedly tried without fuccefs.

g6 VENEREAL ISCHURY

I have been perhaps too full in enumerating
all thefe circumllances. But I am confident,
that, by a careful attention to one or the other
of thefe points, we may not only often fpare
our patients a great deal of pain, but, what is
perhaps more material, prevent a lues taking
place y which eafily happens when, by a rude
treatment, the urethra has been wounded. I
certainly have experienced in myfelf the moil
evident fymptoms of the lues in the mafs from
fuch a caufe. I had an ifchury from a limple
clap ; the difcharge of which was flopped by a
bad treatment. The furgeon, who, was otherwife
a very fkilful man, on introducing the catheter,
found a great refiftance at the neck of the blad-
der, at the fame time that I felt a great deal of
pain. After trying it two or three times to get
through, he at laft pufhed a little harder, where-
upon feme drops of blood were difcharged from
the urethra, and the moment after, (the cathe-
ter having paffed the obflacle), an abundant
flow of urine. I recovered in a few days from
the ifchury , and a few weeks after, the clap
which had returned was likewife cured : but to
my aftonifhment, a fliort time after, I felt a fwel-
ling and violent pain in the flernum^ which was
radically cured by a courfe of mercury.

If the coardation of the urethra be fo llraic
as to refufe, even under the juil-mentioned pre-
cautions, any catheter whatfbever, an applica-
tion of ^ifmallcatgut will fometimes fucceed, and
prove highly beneficial.

If the danger is not fo great, viz. the bladder
2 not

AND STRiaXURES. 97

not very much diftended, confequently the irn-
mediate difcharge of urine not fo prellin^, and
the introdudion of the catheter proves very
difficult, feme other means to procure a dif-
charge of urine ought to.be tried ^ of which
I have found the following the moll efficacious
and ufefuL A common glyfler, mixed with
fome honey or lenitive eleduary, Ihould be ad-
miniftered, in order to evacuate the faces, and
thereby to prevent the conllant llimulus which
their accumulation is apt to excite. As foon
as the faeces are evacuated, a glyller of equal
quantities of barley-water and linfeed oil, with
a fulLdofe of the tindura Thebaica, fhould be
adminiflered, and occalionally repeated. Every
kind of medicine or food apt to go through the
urinary paffages, ihould be carefully avoided 3
and, for the fame reafon, the patient ihould not
drink even more of barley-water, or of the folu-
tion of gum arabic, than is necelTary to quench
his thirll. He Ihould likewife, according to cir-
cumftances, be put into a warm bath, tempered
with milk or adecodion of bran, for half an hour
or an hour, and the fame be repeated four or five
hours after ^ or, what I have found often very
ferviceable, he fhould be fet upon a perforated
chair, and expofe his private parts to the ileam
of hot water mixed with vinegar. If he be reft-
lefs and feverifh, bleeding will fometimes be
proper, and a full dofe of laudanum fhould be
adminiflered to him in the evening. ' The ju-
dicious application of thefe remedies I have feen
fometimes anfwer in. the moil defperate circum-
ilances.

G I

98 VENEREx\LISCHURY

I faw once, in a fuppreffion of urine, where
there was no catheter at hand, that a roafted
onion, applied to the perinaeum, by the advice
of an old woman, had the effed:, fo that two
hours after the application the urine flowed
plentifully : and, in another cafe, the life of an
eminent phyfician in the army was faved by co-
vering the glans penis with the frefh pellicle of
an egg found between the fhell and albumen.
As foon as the pellicle, growing dry, began to
contrad, the urine began to flow plentifully 3
but on applying it the fecond time, two days
after, when the fuppreflion of urine unexpeded-
!y returned, it proved, as the perfon who re-
comrrfended it foretold us, inefficacious, and the
patient died. Perhaps the volatile liniment, or
a blifl:i?r, applied to the perinseum, would pro-
duce the fame eifed, with more certainty, and
quicker, than the remedies did in the two cafes
related.

If we have been fo happy as to evacuate the
bladder, either by the application of the cathe-
ter, or by fuch other means as have been now
mentioned, our next care will be, to prevent a
frefh accumulation of urine, and to remove as
foon as poffible the caufe of the fuppreflion.
The firft will be effected by continuing the fame
remedies^ and efpecially (as has been recom-
mended by fome writers) by leaving the cathe-
ter within the urethra. This, however, none of
the patients, whom I have hitherto treated, were
able to comply with. They fuffered fo much
from keeping the common catheters applied,

whether

AND STRICTURES. 99

whether made of lilver or fteel, flexible or m-
flexible, as made them conceive, that the paiii
which would arife from a repeated application
of the catheter, or from a frefli accmnulation of
urine in the bladder, could not pofllbly be
greater;- and therefore withdrew the catheter,
though they were very defirous to have retain-
ed it if they had found it poflible. To guard
againfl: this inconvenience, I could never find
out a remedy, till I tried the catheters invented
by Mr 'Thedeti, firfl; furgeon in the army of the
king of Pruflia. They are made of a golden
wire covered with a folution of caoutchouc
(elaftic refin). Their application is not only, in
many inflances, ealier than that of the common
catheters, or of hollow bougies of any kind ;
but alfo, in all infliances in which I tried them,
I found the patients could keep them applied,
after the urine was difcharged, with much lefs
inconvenience. They are therefore, in thofe
cafes, much preferable to any other. But if we
have none of thefe catheters at hand, which
muft be the cafe as long as they are fo diflicult
to be got, and fo high in price *, we mufl: lifl:en
to the patient's fufferings, withdraw the catheter
as foon as it becomes too troublefonae, and have
recourfe immediately to fuch remedies as will
tend to prevent the return of the fuppreflion.
To fuch as are in pofleflion of any of thpfe
G 2 elaflie

* Both thefe inconveniences are now remedied by the catheters
made of the fame fubftance by Mr Bernard at Paris.

100 VENEREAL ISCHURY

elaflic catheters, the following rules, to be ob-
ferved in their application, may perhaps be ac-
ceptable.

The elaftic catheter, after being anointed
with fweet oil, is introduced in the common
manner. The furgeon, as ufual, gently draws
with one hand the urethra towards him, and
holding the catheter with the fingers of the
other, always at the diftance of an inch or two
from the glans, gradually introduces it ) whilfl
this is performing, the catheter generally enters
the bladder, without any particular diredlion
from the hand of the operator. If any refifl-
ance be found, the rules mentioned above are
to be obferved, to facilitate the introduction 3
but if the reliftance be at the neck of the blad-
der, there is nothing more to be done, than
gently pufhing the inflrument forward, at the
fame time turning it from the right to the left ;
for by turning it in the oppolite diredion, the
fpiral windings of the gold-wire of Mr Theden's
catheter would be feparated. If the furgeon
finds the obflacle greater, he fhould, as I faid
above, flop the introdu6lion till the contraction
or fpafm of the fphinder veficse and the refifl-
ance cecT&s which happens for the mofi: part
in a very (liort time, when he is enabled to go
through the paffage eafily. — This catheter is in-
troduced, like a common one, according to cir-
cumflances with or without a probe. After re-
maining in the urethra for fome time, on being
extracted, it is generally very foft, and there-
fore unfit for being ufed again until it has been
cleanfed and dried, and put for a little time in a

cold

AND STRICTURES. loi

cold place; which operation reflores it to its
former firm texture. The method of cleanfing
it is, to wafh the outfide with water, and like-
wife the cavity with the fame applied by rinfing.
For cleanfing and drying its infide, a long needle
with a filk thread will be mofi: fit. When about
to be ufed, and found to be too ftiff, it may be
foftened by keeping it a little in the hand, dip-
ping it in warm water, or holding it near the
fire-fide.

But if all our endeavours to introduce any ca-
theter or catgut have proved unfuccefsful, and
the danger of a rupture of the bladder, from its
difl:ention, be imminent, the urine mufl: be at
all events difcharged. This ftiould, therefore,
not be deferred too long; and may be done, ac-
cording to the feat ^ the diforder, either by an
incifion into the urethra behind the firid;ure or
feat of the fioppage ; or if that feat be in the
neck of the bladder, and the incifion and intro-
dudion of the trocar in that place perhaps be
found too difficult for the furgeon, the bladder
may be fafeiy tapped through the anus, as firft
propofed by Mr Fleurant, ox an incifion may be
'made above the fymphifis pubis, and the bladder
be tapped in this place under the peritonseum ;
both which operations are neither difficult nor
painful, and either of them becomes neceffary
to fave the life of the patient.

Thefe are the means generally ufeful to give
relief to the patient, in all cafes of ifcJmria iire-
thralis.

But, to cure that diforder radically, its caufe, as
I have.faid above, ought to be removed; which is

G 3 efFeded.

102 VENEREAL ISCHURY

efFed:ed, according to the nature of the com-
plaint, by different methods.

If the ifchury proceeds from a recetit repul-
iion of a venereal Blennorrhagia, the running
or clap muft be recalled. For this purpofe, be-
iides the general remedies before mentioned,
the fleam of hot water, alone or mixed with vine-
gar, or the volatile liniment applied to the peri-
naeum, I have feen and experienced befides the
inoculation of the clap, to be the mofl efficacious
remedies to remove the venereal poifon from the
neck of the bladder, and bring on the running
afrefh. I recommend the fufpenfion of the tef-
ticles during the application of the fleam ; be-
caufe I have feen inftances where the poifon,
leaving the neck of the bladder, inflead of re-
turning to its original feat under the fr^enum,
fettled at the caput gallinaginis, and thereby
produced a fwelling of the tefticle; which I
have never obferved fince I took the above pre-
caution. In the mean time, the patient fhould
keep quietly in bed, and warm poultices fliould
be conflantly applied to the genital parts, as
the accumulation of faeces be carefully avoided
by means of glyflers. Emetics are, occafion-
ally, as ufeful in this cafe as they are in fwel-
led tefticles^ and the internal ufe of opiates
produces, in many inftances, a fpecdy effed.
As foon as the venereal poifon, on leaving the
neck of ; the bladder, occupies again its ori-
ginal place, the running is re-eftabliflied, and
then to be cured as claps in general are 3 only
the patient ought to take the greatefl care to,

avoid

AND STRICTURES. 103

avoid all the caufes which are apt to bring on a
limilar retropullion ; becaufe we fee daily, that
fuch a retropullion, after having once taken
place, is eafily brought on a fecond time, even
on the flighteft occaiions.

I mufl, moreover, obferve, that in fuch a cafe,
after the ifchury is removed, I always found the
internal ufe of mercury necellary for a radical
cure ; having feen feveral inffcances where the
abforption of the virus took place during the
fuppreflion, and excited afterwards evident
fymptoms of its prefence in the mafs, though
the local complaint of the genitals was perfect-
ly cured.

If the fuppreflion arlfes from d chronic com-
plaint of the urethra, fuch as from a flri6lure
accompanied with an ulcer, or an eroflon of the
excretory duds of the proftate gland or feminal
velicles, this caufe we mull endeavour to remove
according to the rules laid down under the arti-
cles Gleets ^nd P^enereal Ulcers,

If the ftridure arifes from a limple conflric-
tion of one particular place of the urethra, with-
out any ulceration, our care muft be to dilate
this coarctation, which owes its origin either to
an ulcer healed up, by which the v/hole cir-
cumference of the urethra in'that place is lefl^ened ;
or to a prominent cicatrix or calloiity, occaiioned
by a previous ulcer. This is mofl efFedually ob-
tained by a long-continued ufe of bougies, begin-
hing with fmaller ones, and going on gradually
until the patient be able to bear thofe of the
largefl flze. The bougie he is to keep applied
in the beginning for a quarter or half an hour,

G 4 and

104. VENEREAL ISGHURY

and afterwards, if he. can bear it, for feveral
hours, morning and evening. If a bongie of
elailic refin be at hand, this precaution is hard-
ly ever neceffary, as they, growing foft and
flefh-like in the urethra, produce little or no
uneaflnefs. But as this kind of coardation or
ftriclure is fometimes fo very fmall that it does
not even admit the fmallell bougie, the applica-
tion of a fmall catgut is an excellent invention*.
The catgut once introduced, and left for fome
time in the urethra, begins to fwell, by which
means the coardated paflage infenhbly enlarges;
fo that fometimes, on withdrawing it the firfl: time,
the patient is able to make water with unex-
peded eafe ; afM the next time a larger may be
eahly introduced, and have the fame good ef-
fed. If by thefe means we have by degrees di-
lated the urethra fo far as to admit the largefl
catgut, a bougie may be introduced ; the ufe of
which is to be continued for feveral weeks or
months, even after the patient is perfedly cured
and able to make water in one large continued
natural ftream.

If the coardation does not even admit of a
catgut, and the feat of the diforder is at a place
which we can come at, an incihon into the ure-
thra behind the coardation is, as I have faid
above, mofl advifable : by thefe means the

urine

* The ufefulnefs of this application has been much enforced
and confirmed in pradice by Mr J. Foot. See Critical Inquiry
into the Treatment of the Difeafes of the Urethra; where the
author has given us, befides, a number of ufeful remarks on thofe

complaints.

AND STRICTURES. 105

urine will be difcharged through the inciiion,
whenever neceflary, and the return of the fup-
prellion thereby effedually prevented. We may
afterwards eafily dilate the wound, paillng the
knife through the coarctation ^ and then intro-
duce a bougie 3 which the patient is to wear un-
til the itridure be removed, the whole wound
be healed up, and thus the complaint be radi-
cally cured. The fame method, will be alfo fome-
times neceflary, if the urine accumulated behind
the coardation has forced its v/ay either through
the inteilinum redlum (in which cafe the pa-
tient will void his urine with the feeces through
the anus), or by a fiftulous opening through the
perinseum. But, in thefe cafes, it will be in ge-
neral neceflary to let him go through a courfe
of mercurials before we proceed to the opera-
tion of the fifl;ula ; otherwife we fliall find our-
felves very often difappointed in curing this lat-
ter. If he fliould not have flrength enough to
undergo fuch a courfe, as is frequently the cafe,
he is to be prepared by proper diet and medi-
cines. On performing this latter operation, an
inciiion mufl likewife be made through the
ftridlure, the original caufe and feat of the dif-
order ; and the patient is to wear a bougie du-
ring the cure, and for fome time afterwards.

If the ifchury arifes from excrefcences or ca-
runcles, as they are commonly called, or from
invincible coardations, the incifion of the ure-
thra at the place where the feat of the diforder
lies, and the cutting out of thofe extraneous
bodies^ has been propofed; but I have never

yet

io6 VENEREAL ISCHURY.

yet heard of any cafe where this operation had
been performed.

In a fcirrhofity or hard fwelling of the pro-
Hate, or a fungous excrefcence of the fame
gland, all the remedies recommended above for
refolving fuch a fwelling ought to be tried; and
if they fail, we fhould rather endeavour to bring
the gland to a fuppuration by irritating applica-
tions, than to let a diforder increafe which fo
frequently proves fatal.

If a fwelling of any of the fmaller glands of
the urethra fhould be the caufe of the ifchu-
ry, and the moft powerful refolvents Ihould
prove ineffedual, it will be proper to advife the
patient rather to have the extirpation of the tu-
mour performed, than to live in the conflant
anxiety about the dreadful confequences of this
complaint?

G H A P.

ON VENEREAL ULCERS. i©7

CHAP. VII.
On Venereal Ulcers.

A N ulcer arifing; in any part of the body
"^^ from a venereal caufe is called a venereal
ulcer ; but if on the genitals, it is more common-
ly called Vipanker, from the f>ench word chan-
cre-, a name adapted to exprefs its corroding
nacure.

Venereal ulcers owe their origin either to a
primary or to Sifecondary itifections viz. to the ve-
nereal virus either originally applied, or depo-
Iked from a tainted mafs to the furface of the
body. Both kinds may arife on any part of the
body; but they appear more frequently upon
parts which are covered with a very thin cuti-
cle ', fuch as the glans penis, the infide of the
prepuce, the urethra ; the labia pudendi, nym-
phse; the lips, mouth, nipples, &c. Of vene-
real ulcers ariling in any internal part of the
body, we have not yet, as far as I know, any
authentic obfervation.

Though venereal ulcers, as I have juft now
obferved, do generally and mofl frequently ap-
pear only on parts which are covered with a
very thin cuticle, efpecially on the glans, pre-
puce, fauces, &c. yet we not unfrequently meet
with cafes where they affed: parts covered with
thicker cuticle; as the penis, fcrotum, thighs,
&c. There are likewife feveral inftances where

furgeons,

io8 ON VENEREAL ULCERS.

furgeons, performing operations, or perfons af-
fifting in the delivery of women, had the misfor-
tune of being afFeded with venereal ulcers in their
hands or arms. In all cafes of this lafl: kind, the
poifon Teemed to me univerfally to operate more
powerfully than when originally applied to the
parts covered with a thin cuticle, or v/hen de-
pofited from a tainted mals. I know now a
midewife, who, having been infected in this
manner feveral years ago, Hill fuffers from the
difeafe; and we have another inflance of an
eminent male-praditioner in the fame art, who,
by delivering an infeded woman, was affe(5led
with ulcers in his hand; and to this prefent
time ftill labours under the confequenc^s, tho'
is is now three years iince he received the infec-
tion.— I know a gentleman who, wounding his
finger by accident with a penknife, and expoiing
the fame, without thinking or fufpeding any
bad confequence, the very fame night got the
infedion; whereby the wound was changed in
two days to a very bad venereal ulcer, accom-
panied with a painful and obftinate fwelling of
the whole arm, together with a bubo under the
arm-pit, and other fymptoms of a general in-
fedion.

Though I have attended with the greatefl
care to all cafes of this kind which fell under
my obfervation, I could never difcover, in the
conflitution of the patients, any particular caufe
of fuch violent fymptoms. In two inllances,
the patients before and afterwards had venereal
ulcers in places covered with a thin cuticle,
and the poifon there produced the common

fymptoms

ON VENEREAL ULCERS. 109

fymptoms only. It feems therefore probable to
me, that, in order to produce primary venereal
ulcers upon a place covered with a thick cuticle,
the virus mufl either be extremely acrid in its
nature, or produce more violent effeds on ac-
count of its being applied to a part which has
no mucus to dilute the fame, or to defend itfelf
from its acrimony. At lead, we very feldom
obferve fuch violent and obftinate efledts in pri-
mary venereal ulcers upon parts covered only
with a thin cuticle, or in fecondary ones arifing
upon any part of the furface of the body. This
is owing mofl probably, in the former cafe, to
the poifon meeting with a quantity of mucus to
dilute it, and in the latter to its having been
diluted, or having undergone fome change by
its previous mixture with the mafs.

Venereal ulcers, ariling from a primary in-
fedion, are either local or univerfal; viz. the ve-
nereal virus having been applied to the part,
and, by its ftimulus, produced an Irritation and
fubfequent erofion, is confined Hill to that part
only ^ or it has been at the fame time abforbed
into the mafs, and thereby infeded the whole
fyflem. This diflindion is ufeful and necei^
fary in pradice; becaufe ulcers of the latter
kind, like thofe ariling from a fecondary in-
fedion, can never be radically cured without a
courfe of mercury; whereas the former may be
cured by fimple local applications.

But here I mufl take notice of another mate-
rial circumflance and diftindion, which is of the
greatefl importance in pradice, and to which
writers on this fubjed feem to have hitherto

paid

110 ON VENEREAL ULCERS.

paid little or no attention. Ulcers arifing on
the genitals are now-a-days generally, fome-
times even after the illghtefl: examination, pro-
nounced to be venereal, and treated as fuch ;
whereas it is a matter of fa 61, confirmed by daily
experience, that ulcers, both of the fauces and
genitals, may in our days, as well as in thofe
of Celfus, arife, and do actually arife, from acri-
monies or miafmata, which have nothing in com-
mon with the venereal virus. This is a point of
the utmoll confequence in practice to the phy-
lician as well as to the patient. However, by
not paying proper attention to it, I have not
only feen many times the charader of innocent
perfons brought into quedion, but patients re-
duced, by a prepofterous treatment, to a rnoft
miferable fituation.

I have further not unfrequently obferved the
moft dreadful confequences, when ulcers of the
mouth and fauces, occafioned by the ufe of
mercury itfelf, efpecially under a falivation,
are miftaken for venereal ones, or when ulcers
of the genitals or other parts of the body are
confounded with venereal ones, which, though
at firfl really venereal, during a mercurial
courfe afllime a different appearance, and thus
feem to have entirely changed their venereal
nature. Inftead of healing, to which point they
feemed to approach, they now prove not only
obftinate, but yielding a thin ichorous difcharge,
grow worfe and worfe under the continuation
of the fame remedy, and fpread further and
further. — To fhow the importance of thefe di-
ftindions more evidently, I ihall fubjoin an ac-
count

ON VENEREAL ULCERS. iii

count of a few cafes relating to that fubjed ;
but elucidate this point more fully hereafter,
under the head On Venereal Complaints incurable
by Mercury,

A gentleman, twenty-one years of' age, of a
ftrong plethoric conftitution, confulted me fome
time ago about a flianker, as he called it, on
the glans penis, with which he had been afflid-
ed thefe eight or nine months paft» He had
confulted, at the time he got it lirll, an eminent
furgeon at Dublin ; who prefcribed a courfe of
mercurials, which produced a flight falivation.
But the ulcer not healing, mercurial fumiga-
tior^s were applied for fome time to the part af-
feded ; by which the ulcer feemed to grow lefs,
and had affumed a better appearance, but had
not healed. He was therefore advifed to a fe-
cond mercurial courfe, with a different prepara-
tion of mercury, internally as well as externally;
but, under this courfe, the ulcer, inflead of
healing, grew from day to day larger, deej)er,
and in every refpedl worfe. In that condition
he came to London, and confulted me. Upon
examining the part affeded, I found a large
deep ulcer on the glans, with hard and promi-
nent borders, extremely fenfible to the leaft
touch. Its bafis appeared reddifh and pretty
clean: but the difcharge feemed to be of an
acrid corrofive nature; by which, indeed, half
the glans was already confumed. I told him
that I had feen fevera'l ulcers of this kind be-
fore; that it was not of a venereal nature; and
that mercury, according to my obfervation, was,
in that kind of ulcers, the mofl unfit remedy ;

that

112 ON VENEREAL ULCERS.

that I would undertake to cure him, but that
the cure would require at leaft two or three
months time. Upon which he left me, promi-
iing he would call the next day and put himfelf
under my care. He did not , and I heard no
more of him till four months after, when he
fent for me. At the time I faw him firfl, his com-
plexion had been lively and frefh; but was now
of fuch a lickly and cachedic appearance, that
I hardly knew him. His account was fhortly
as follows : That, having been diffatisfied with
my firll opinion upon his cafe, and with the
advice I gave him, he, at the defire of a friend,
had thought proper to confult an eminent fur-
geon in town ; who, after a clofe examination^
had pronouced his ulcer to be venereal, and
had aflured him that nothing but mercury could
cure him ; adding, that he had not taken^ e-
nough of mercury, nor the preparation which
was deemed the heft in thofe cafes ; and that,
far from two or three months being required
for curing him, his prefcriptions would effed a
radical cure in three or four weeks time : That,
upon thefe aiTurances, he had immediately fub-
mitted to this new mercurial courfe, which
brought on a gentle falivation^ but with fo little
efFea, that though the ulcer feemed to grow
remarkably better during the firfl three or four
weeks, it after^vards, inftead of healing, had
corroded the refl of the glans with part of the
urethra. Whereupon another furgeon was call-
ed in confultation, who advifed the amputation
of the part affeded ^ but the former refufing,
and the latter not being willing, to perform it,

ON VENEREAL ULCERS. 115

he had refolved to drop their advice altogether^
and to hear mine once more. On examination,
I found the remaining portion of the penis
fwelled to a monftrous fize, the prepuce form-
ing a perfed phymolis over the extremity, and
the urine difcharging through three or four
different holes. I advifed him therefore to have
the prepuce flit up, m order to fee the ilate of
the ulceration, and to clean the ulcer, or to
apply fuch medicines as fhould be thought pro-
per. Internally I prefcribed him fome ftrength-
ening medicines. He ufed thefe latter for eight
or ten days ; but the operation he put off from
day to day ; when he was advifed by one of his
friends to confult another phyfician, who, by
means of a decoction of hemlock and ginfeng
root, promifed to do fomething more for him
than hitherto had been done. This decodlion
he took for a fliort time with very little effect,
the corrofion creeping on further and further.
At lail another phyfician, an acquaintance of
mine, was confulted; who infifted upon the fame
ilrengthening courfe of medicines which I had
formerly prefcribed, recommending at the fame
time a nourifliing diet, the enjoyment of coun-
try air, and bathing in the fea; by which means
this young man is now re-eftablifhed with the
iofs of more than half of his penis ; which, had
he followed the advice 1 gave him when he firfl
confulted me, would have been without doubt
wholly preferved.

The following obfervatlons occur to me upon
this cafe. I think it extremely improper to ad-
minifter a courfe of mercurials for a. local vene-

H ' real

114 ON VENEREAL ULCERS.

real ulcere which was the cafe with this gentle-
man when he firfl applied to the furgeon at
Dublin. A fecond courfe and falivation with
mercurial fumigations were ft ill more improper.
Adviling him a third courfe of mercurials, after
the two former were found ufelefs, was not only-
very injudicious, but extremely hurtful; becaufe
it rendered him for ever unable for propoga-
tion, to the great forrow of his family. The
prefcription of ftrengthening medicines, given
to him by the laft phylician whom he confulted,
with a nourilhing diet, country air, and fea-
bathing, was the moll judicious, and the only
one to fave his life^ which was at the time in
the moil imminent danger. And I am firmly
perfuaded, that the patient, who was forced to
follow this latter advice only by the fenfe of
his fufferings, would never have experienced
any of all his miferies, had he followed my ad-
vice in the beginning.

I was confulted in another cafe, where ulcers
of the throat ariling during a mercurial courfe,
being taken for venereal ones, and treated ac-
cordingly, by the continued internal ufe of
mercury, became fo bad, that both the tonfils,
together with the velum pendulum, w^ere almoft
entirely confumed, and the patient reduced to
a moll miferablc lituation 3 when only by lea-
ving off the mercury, and by the adminiftra-
tion of a quite different courfe of medicines, he
recovered. And Mr Brambilla gives us an ac-
count of a patient, who under a courfe of mer-
cury being afFeded with ulcers of the fauces,
which having been miflaken by the furgeon for

venereal

ON VENEREAL .ULCERS^ 115

^Venereal ones, not only lofl his velum by the
continued ufe of mercury, but had a caries
maxillae brought on, which proved fatal to him.
The fame author alfo obferves, that inflamma-
tory tumors, or ulcers growing gangrenous, are
conftantly rendered worfe by the internal or
external ufe of mercury, though they had evi-
dently been originally venereal. I myfelf have
feen many inftances, where patients afFedled
with. venereal ulcers, united with a'fcorbutic
habit of body, by the imprudent ufe of mercu-
ry, were not only reduced to a mofl wretched
condition, but even brought to death. Mr
Fabre, in the Supplement to his Obfervations on
the Venereal Difeafe, relates likewife feveral
cafes, where ulcers, though evidently arihng
from a venereal caufe, by a long-continued ufe
of internal and external mercurials, and repeat-
ed falivations, were not only not cured, but
brought to a ftate, which afterwards yielding to
no other medicines whatever, proved fatal to
the patient. Whence, I think^ it will appear
to be of the utmoil confequence in pradlcCj
that we fhould beftow the greateil; attention in
dillinguifhing,

ijl, Local venereal ulcers from univerfal ones;
viz. from thofe united with, or ariling from, a
tainted mafs.

2dly, Simple univerfal venereal ulcers from com-^
plicated ones.; viz. fuch as are combined with
fymptomsoffcorbutns, fcrophula, &c.

3^/^, Ulcers of the genitals^ mouth, fauces, &'c,
refembling venereal ones, but ariling originally
from other caufes : For example, brought on by

H 2 the

ii6 ON VENEREAL ULCERS.

the acrimony of the faliva during the internal
life of mercurials or mercurial fumigations,
from real venereal ones. And, principally,

^thly, Ulcers of the month, nofe, genitals, groins ,
l^c, which, though feemingly or evidently
brought on originally by a venereal caufe, have
now, as it were, changed their nature, at leafl
fo far, that mercury has no further any good
eifedl upon them, but rather the contrary.

The characters by which thofe different kinds
of ulcers tnay be diflinguifbed are not eafily
defcribed; a careful inquiry into the hiftory of
the difeafe, infpedion, and practical knowledge,
are to be our beft guides. An attention to the
following points, however, may allift us in form-
ing a proper judgment.

.Venereal ulcers are, in general, pretty eafily
diftinguiflied by their hard margin or borders,
by the lardaceous crufl which their balis is co-
vered with, and by the preternatural rednefs of
the fkin all round the ulceration^ which will be
rendered more probable, if the patient is con-
fcious that he has previoufly expofed himfelf to
the infection. As there may, however, arife
ulcers in the genitals, of a different, or fome*
times perhaps of a nearly fimilar appearance,
from other caufes, as has been long ago taken
notice of by feveral of the mofl ancient medi-
cal writers, and confirmed in many inflances
by my own obfervation, we Ihould be extremely
cautious, and never form a rafh judgment about
the nature of fuch ulcers, nor pronounce them to
be venereal, before we are perfedly fiire of it. By
following a contrary method, we may not only

hurt

ON VENEREAL ULCERS. 117

hurt the reputation of an honefl perfon, and di-
fturb friendlhip, and fometlmes matrimonial
happinefs, as I formerly mentioned with refped
to Blennorrhagias; but do material harm to the
patient, by adminiftering- improper medicines.
Ulcers which are not of a venereal nature, may
be diflinguilhed from venereal ones,

ly?, By their diiferent appearance.

idly, By their either ariling only, or growing
worfe, during the ufe of mercury.

"^dly. By their having been unfuccefs fully-
treated with mercury before.

^thly, By their exquilite fenfibility.

Sthly^ By the relaxed ftate of the whole body,
or by the flabby relaxed appearance, with an
ichorous difcharge from the affeded part.

dthlyy By fymptoms of other diforders, either
alone, or accompanied with venereal ones.

Method of Cure,

It has been the opinion of feveral eminent
medical writers, to treat all real venereal ul-
cers or ihankers in the fame manner, viz. by in-
ternal mercurials only; and never to make ufe
of any external application. Several fpecious
reafons have been alleged for fuch a treatment;
which, however, feem to me nowife fatisfac-
tory. It is faid, that ihankers are ligns of the
prefence of the venereal poifon in the body; and
if, therefore, they difappear by the fimple in-
ternal ufe of mercury, we are fure that the me-
dicine has penetrated into the mafs, and that

H 3 the

lis ON' VENEREAL ULCERS.

the poifon is thereby totally eradicated. To this
I anfwer, That recent venereal ulcers, brought
on by an original infedion, are by.no means
fuch fymptoms as has been afTerted. On the
contrary, they are in that cafe only a local dif-
eafe, which requires no internal, but merely
local, remedies i and if no topical application is
made ufe of in time, they very often fpread ^
amazingly, the poifon is abforbed, and produ-
ces either buboes or other venereal fymptoms in
the mafs. 1 undoubtedly allow, that if venereal
ulcers are of fome flanding, the mafs will then
be in confequence infeded; in which cafe, as
well as when they arife from a fecondary or
univerfal infection, they are certainly what has
been alTerted of them, unequivocal ligns of the
prefence of the poifon in the mafs. Then, in-
deed, I perfedly coincide with the opinion,
that they may be treated only by the internal
ufe of mercury, without any external applica-
tion ; becaufe, if they difappear by the internal
ufe of mercury alone, without having applied
any external remedy, we are fure that we have
eradicated the poifon from the mafs, and cut ofF
the evil by the root. But even in this cafe, if
they afFe<S the genitals or the extremities, the
poifon is often apt to excite a violent inflamma-
tion, phymofis, mortification, &c. or it is ab-
forbed and carried to the lymphatic glands,
where it occafions buboes, before the mercury
has had time to produce its eifeds, and to dellroy
the poifon on the part aifeded.

Thefe are the reafons why I always choofe to
apply immediately to all venereal ulcers the

pioft

ON VENEREAL ULCERS. 119

Hiofl effedual remedies for removing them; be-
caufe I think there is nobody acquainted with
the nature of this diforder, who would not pre-
fer being afFeded with a real pox to a mortifi->
cation of the penis, or to a bubo. As to what
has been faid and obferved by fome, that a bu-
bo very often appears after fhankers have b€en
Lealed up by external applications, and that
confequently thofe very remedies which are re-
commended to avoid buboes not unfrequently
bring them on, I readily admit the fadt ; but I
am very far from believing the confequence
drawn from it, viz, that external remedies ap-
plied to a venereal ulcer, ever promote the ab-
forption of the virus. It happens, in that cafe,
what we fee happen every day, without any ex-
ternal application whatever, or what we mufl
daily be afraid of, as long as there is the leafl
appearance of a venereal ulcer. What they a-
fcribe in that cafe to the medicines externally
applied, I would rather afcribe to their applica-
tion being too long delayed, or to their not be-
ing fufficiently efficacious. In all cafes, there-
fore, where I have reafon to apprehend any
bad efFeds, I think it not only proper but ne-
ceiTary to apply to all venereal ulcers, whether
of a primary or fccondary infedion, the molt
efficacious local remedies, in order to remove
them as fpeedily as poffible : with this difference
only, that 1 confider ulcers ariling from a recent
original infedion as merely local, and think
they may be fafely cured by topical applications
alone, without the internal ufe of mercury;;
wjiereas thofe ariling from a tainted mafs, re-

H 4 . quire

I20 ON VENEREAL ULCERS.

quire always, at the fame time, a courfe of mer-
cury. This laft method I likewife think necef-
fary in venereal ulcers of fome days Handing,
though arifing from an original infedion ; there
being always the greatefl probability that fome
of the poifon has been abforbed into the mafs
during that time. External applications alone
will never have any permanent effedi in thofe
cafes 3 becaufe, if we are even able to deflroy
the poifon in the affected part, and to ,confoli-
date the ulcer, it will foon break out again on
the fame or fome other part of the body as long
as there remains the leaft particle of it fubfift"
ing in the mafs.

The beft remedy, as well for preventing as for
curing recent fhankers, 1 find, after repeated
trials, to be fpirit of wine, rum, and. Hill better,
Hungary water, or lavender fpirit *.

The other external remedies recommended
for curing venereal ulcers are, Caitjlics, Mercuri-
als, and AJiringents.

The application of caullics has been of late
warmly recommended in recent venereal ulcers,
fo as to touch them once every twelve or twen-
ty-four hours with the lapis infernalis, till
jQoughs falling off fucceffively, the bafis of the
ulcer becomes red and pure. This practice is
undoubtedly fometimes proper; but there are
conilitutions which will not bear any acrid ap-
plication

* The ufe of this efficacious remedy was firft communicated
to me by Dr Nooth, phyfician in London ; the fame who is the
inventor of the ingenious apparatus now generally in vAt for im-
pregnating water v/ith aerial acid.

ON VENEREAL ULCERS. 121

plication whatfoever, efpecially that of cauftics.
I have leen inilances where, in fiich irritable or
in fcorbutic conftitutions, very bad fymptoms
followed ; and in one cafe, a mortification of the
part was the confequence of fiich an application.
In thefe fubjeds, the internal ule of Peruvian
bark with external aftringents, or occalionaily
a mercurial lotion, will be more ferviceable.

Among the mercurials, the red precipitate
fprinkled upon them every morning and even^
ing, anfwers very well, as long as the ulcer is
covered with the white lardaceous crufl. The
mercurial ointment in this cafe is of little or no
ufe; but whenever the bottom of the ulcer af-
fumes a cleaner appearance, then the fimple
mercurial ointment, or calomel in powder, or
fufpended in lime-water, or, according to ci^-
cumflances, the fublimate with lime-water, or a
diluted folution of mercury in nitrous acid, are
ferviceable. In cafes more obllinate, the fumi-
gations with cinnaber prove fometimes very ef-
ficacious.

If the mercurial applications produce noeifecSI:,
or are judged to be improper, the external ufe
of aftringents anfwers often extremely well;
fuch as a decodion of the t:ormentilla root, or
of the Peruvian bark, or an infufion of the lat-
ter in lime-water. — In other cafes, the aqua vi-
triolica camphorata, a folution of blue vitriol,
or the viride aeris dillblved in oil, will be more
uieful. The fame aftringents will alfo fome-
times anfwer our expedations in ulcers of an
atonic or relaxed appearance, yielding an acrid
ichorous difcharge.

Againft

122 ON VENEREAL ULCERS. ^

Againfl obflinate venereal ulcers opium has
been lately found very ufeful, given internally,
beginning with one grain, and thus daily in-
creafing with a grain till the patient takes at
laft fifteen grains. It deferves to be remarked,
that opium in thofe large dofes never produces
coftivenefs. This method was firft difcovered
and recommended by Dr Nooth, at the time
firft phyfician and inrpe6lor of all the military
hofpitals of the army in America, and has fince
been publiilied without mentioning his name.

If venereal ulcers refift the means juft now
recommended, the internal and external ufe of
ilrengthening medicines, a full diet, the ufe of
wi'ne, country air, and fea-bathing, as mention-
ed above, will often prove effectual when all
■other remedies have failed. — Of other medi-
cines recommended for inveterate venereal ul-
cers, I fhall fpeak hereafter under the article of
Venereal Complaints incurahle by Mercury.

I have faid nothing about the venereal ulcers
of the nofe, eyes, face, &c. becaufe they require
the fame treatment as thofe of the genitals, and
may be eafily avoided, by taking care that the
patient afFecied with a clap or flianker on the
g;enitals, after having touched the part afFeded,
always carefully cleanfes his fingers.

Ulcers of the uterus or vagina^ accompanied
with an acrid ichorous difcharge, are not al-
ways, as is generally imagined, cancerous, but
not unfrequently venereal ; and may then often
be cured by proper injedions and a courfe of
mercury. I have feen feveral women, who
thought themfelves, from the pain and ichorous-

dif.

ON VENEREAL ULCERS. 123

difcharge tinged with blood, ailfeded with a
cancer of the uterus (believing in that point the
judgment of their attendants), radically cured
by the internal ufe of powerful, ftrengthening,
andabforbent medicines, and by injections made
of a folution of fublimate or calomel in lime«
water, alone or mixed with the tindure of ma-
ftic, or, according to circumftances, with the
infulion of Peruvian bark in lime-water.

But we Ihall find ourfelves much miftaken if
we exped any good effed: in this cafe, as well
as in the fluor albus or menorrhagia, from
injections, as they are commonly ufed. If
we wifh to fee any effe6l from them, they
mufl be applied to the part affeded ; and
therefore not thrown in the common manner
hito the vagina, in expectation that they will
of themfelves, by thefe means, reach the feat
of the diforder, or the cavity of the uterus. A
proper fyringe of a particular form and iize,
calculated to prevent the matter injeded from
efcaping and running out at the fides, muft be
introduced, and, in fome cafes, as high as pof-
lible into the vagina, or, if poffible, into the
orifice of the uterus itfelf^ the patient lying a
little declined, and her knees bent : and in this
iituation the injedionis to be applied, either by
herfelf or by an afliftant, three or four times
fucceflively, keeping the fyringe always in for
fome minutes, and repeating the fame operation

fix or eight times a-day. A fyringe made of

a bottle of elafi:ic refin, with a thicker and long-
er pipe than common^ will anfwer for the above
pufpofe extremely well, and will effedually re-
move

124 ON VENEREAL ULCERS.

move the. prejudices hitherto fo juflly entertain-
ed of the inefHcacy of injedions in females.

For cancerous ulcers of the genitals as well as
of other parts of the body, the Materia Medica
has, to my knowledge, if we perhaps except
cauflics, nothing to afford; and all the medi-
cines hitherto recommended for curing cancers,
appear to be deceptions of the inventors them-
felves or of the public. Surgery alone can ra-
dically cure cancers, if applied in time ; and no
honeft phyfician will ever recommend uncer-
tain remedies, ieil, by temporizing, he iliould
for ever lofe the moment where he could have
applied a certain one; I mean the extirpation
not too late deferred where it can take place.

' On Venereal Fistulas.

In treating of venereal ulcers, we mufl fay a
word about venereal fiftulas, which are nothing
but venereal ulcers penetrating deep into the
cellular membrane and adjacent parts, with a
fmall callous orifice, and callous infide. Their
feat is moftly in the urethra, groins, perina3um,
anus, &c. but fometimes alfo in the lachrymal
fac of the eye.

If there be an abfcefs formed in the peri-
naeum, this, like other abfcefTes in thofe parts,
iliould be very foon opened, in order to avoid fi-
ftulas, &c. Pus is foon formed in thofe parts;
and the application of an emollient poultice for
a few hours, will often readily foften the prece-
ding hardnefs, and render it fit for opening.

Befides the internal adminiftratipn of mercur

^7'

ON VENEREAL ULCERS. 125

ry, the injections above recommended ought
to be tried ; if they do not fucceed, the chirurgical
operation ought to be performed. We fhould,
however, never attempt this latter before we have
carefully eradicated the venereal virus from the
tainted mafs. From the negled of this point,
we fee daily, that fuch patients undergo two or
three times the operation, without being the
better for it : the fiflula remains as obftinate
as it was before ; or, healing in one place, it
foon breaks out in another. If the fiilula heals
quick and perfectly after the operation, it is a
certain fign that the patient has been radically
cured of the lues.

T^he jljlula lachrymalis, arliing from the vene-
real virus lodged in the lachrymal fac, yields
very often a yellow-greenifh difcharge, refem-
bling that oozing out of the urethra in a clap.
"Whether it ever arifes from a fupprefled or
retropulfed clap, I cannot politively fay ; but
it owes its origin frequently to the venereal
poifon depofited from a tainted mafs, and re-
quires internal and external mercurials.

The virus oozing out from venereal ulcers
and fiflulas, is fometimes of a very corrofive
nature; they fhould therefore be drelled with a
piece of foft fponge every twelve or twenty-four
hours ; and the furrounding furface of the fkin
iliould be carefully defended, by anointing it
with the white cerate, or faturnine liniment.

CHAP.

126 OF THE PHYMGSIS,

C H A P. VIII.
Of the. Phymosis.

THis difeafe, in which the prepuce is fo fwel-
led and flraitened that it cannot be drawn
back over the glans, has been called Fhymofis^
from the Greek (pijaow, pracludo, obtiiro.; and
might perhaps in our language be more proper-
ly called a coar Elation ox Jiri5ture of the prepuce.

To this diforder are efpecially fubjed thofe
men who from nature have the glans covered
with a more ftrait prepuce, or have too fhort or
toollrait a fraenum; all thofe whofe religion or-
ders circumcifion are free from it.

The phymolis arifes, in our days, generally
from venereal ulcers in the irilide of the pre-
puce, or from the Blennorrhagia balani (a clap
of the glans), commonly called ^o/2orrZ><3?^^z/ri^,
producing a violent fwelling and inflammation
of the prepuce and difcharge from the glans.

It has been recommended, in a violent phy-
molis, to flit up the prepuce ; which is certainly
fometimes neceilary : But where chirurgical
operations can be avoided, we ought to avoid
them. This operation has been advifed princi-
pally either to prevent the fpreading of rfiian-
kers, which are frequently the caufe of the phy-
molis ; or to avoid buboes ; or, what is ftill more

material,

OF THE PHYMOSIS. 127

material, to prevent a concretion of the glans
with the prepuce. Thofe who, in curing fhan-
kers, trufl entirely to the internal ufe of mercu-
rials, will hardly iniiffc upon this operation. As
to the danger of their producing buboes by an
abforption of the poifon, I allow the apprehen-
fionto be perfedly jult 3 but I cannot admit
that an incilion would prove a preventative. A
frelh wound, by expofinga new and larger fur-
face to the abforption of the virus, muft, in my
opinion, rather increafe the danger. I think it,
therefore, more proper to obviate thofe bad
confequences by proper injedions, and by in-
troducing, if poflible, fome fine lint once or
twice a-day with a probe between the prepuce
and glans. However, if this fliould be imprac-
ticable, or livid fpots fhould appear through the
prepuce, immediate recourfe to the operation
ought to be had, left a more dreadful evil, a
mortification, fiiould enfue.

Venereal ulcers, with a phymofis, corrode
very often the glans, the urethra, and corpus
cavernofum of the penis ^ and thus produce now
and then a violent hsemorrhagy, which requires
proper injedions, or the application of the lapis
infernalis. If the hsemorrhagy arifes from an
erofion of the vefTels, or their want of power to
contrad themfelves, ftyptics or oil of turpen^
tine^ if from too great an irritability of the
vefiels, a folution of opium in water fhould be
injeded. — The formation of pus which is con-
fined, renders the incifion necefiliry.

In order to afcertain whether there is a vene-
real ulcer between the prepuce and glans, I in-
troduce

128 OF THE PHYMOSIS.

troduce a probe, with fome lint afExed to It.
Then, turning it round the whole glans, the pa-
tient generally feels pain, if there be any ulcer,
as foon as the probe with the lint touches it >
and upon withdrawing it, a part of it will be
flained withpurulent or puriformmatter; where-
as, If there is but a fimple difcharge from the
glans without any ulceration, the whole of the
lint will be ilained with the fame equally. In
either cafe, if the inflammation and fwelling be
violent, leeches, or, according to circumftan-
ces, a poultice made of bread and water, mixed
with fome vinegar of lead, ought to be ap-
plied to the part affeded, and three or four
times a-day a diluted folution of mercury ■
in nitrous acid, or the fubllmate or calomel
fufpended in lime-water; or, according to cir-
cumftances, Plenck's folution of mercury with
gum arable, between the prepuce and glans,
ihould be injeded in fuch a manner, that
the interflice between them Is filled and a little
diflended with the inje6lion. If there be any
ulcer, fome lint dipped in the fame liquids may
be applied to it, by means of a probe, once or
twice a-day. Mercurial fumigations are in
this cafe often ufeful. I think there Is never any
danger of a concretion of the parts as long as
the ulcers remain venereal ; and meanwhile
their nature is changed, the phymofis is alfo
generally removed. A courfe of mercury ought
in fuch cafes never to be omitted. But, as I
have obferved before, the inciiion of the pre-
puce ought to be immediately performed, if the
fymptoms of the inflammation be very high; if
there appear any danger of mortification; or

I if

OF TH£ PHYMOSlS. 129

if we have reafon to fufped:, beneath, an ulce-
ration of a bad or perhaps cancerous nature.

In phymolis, we fee the prepuce often in-
creafe to an enoirmous lize, forming rugged
condylomatous excrefcences. This, I have ob-
ferved, has milled praditioners to propofe, or
actually to perform^ the amputation of the
penis, in the idea of being cancerous. I have
cured feveral of thefe cafes, and therefore think
it highly imprudent hardly ever to propofe or
perform that operation 3 eifpecially as thofe
fwellings frequently difappear in a few weeks
time, under a riiercurial courfe and proper es^
ternal applications.

G H A P.

130 OF THE PARAPHYM6SIi

Chap. ix.

Of the Parafhymosis.

Araphymosis, a word derived from the
Greek n«^<z, de^ and f«/«of, prceclufio, ohturamen^
turn, fignifying the oppofite of phymofis, is a
difeafe where the prepuce, being drawn behind
the glans, is fo contracted there, that it can-
not be brought again forwards over the glans ;
and would for this reafon, in my opinion,
be more properly named a Jlrangidation of the
glans.

Men who from nature have a flrait^ prepuce
are moft fubje6l to this diforder \ which arifes
when the prepuce has been drawn back at a
time when the fize of the glans, either from
venereal ulcers, or in a violent clap, is preter-
naturatly enlarged.

I have little to add to what has been faid
on this fubjed: by Celfus, and fome modern
writers.

It is a dangerous complaint, and requires
the moft fpeedy relief. I have feen an inflance
where a gangrene of the glans was the confe-
quence of fuch a j!lrangulation, before the fur-
geon could come to give ailiftance. We ought
therefore, without delay^ apply thofe means

which

OF THE PAHAI^HYMOSm 131

■Which may bring the prepuce forwards as quick
as poilible..

The moil effedual remedy is, to apply to the
fwelled glans the aqua plumbata (commonly
called Goulard's water), carefully avoiding to
touch the prepuce with the fame > by which
means the glans is fo powerfully contraded,
that the prepuce may be generally pretty eafily
brought over it forwards, and thus the cora^
plaint is efFecT:ually removed. Or if this folu-
tion be not at hand, cold water may be fprink-
led repeatedly upon the part, in the mean time
gently preiling the fwelled glans with the fin-=
gers dipped repeatedly in cold water, fo as to
fqueeze out, if polFible, all the blood extrava-
fated in its cavernous fubllance. By thefe
means, the turgefcency of the \corpus caverno-
fum glandis will be mofl efficacioufly diminiih-
ed^ and by Ikilful management, gently preiling
the glans backwards, whilfl we endeavour with
the fingers of the other hand to bring the pre-
puce over it forwards, we fhall very often fuc-
ceed, and relieve the patient from imminent
danger. Ice, or water rendered by art as cold
as ice, may perhaps be ufeful to the operator in
accomplifbing this delirable efFedt. But if the
difeafe be accompanied with a clap, we ought
to be cautious with regard to the application of
cold, left we might bring on a worfe complaintj,
by retropulfion, than the difeafe for which cold
is applied. If we fhould not be able to reduce it^
and the fymptoms be violent, we Ihould not de-
fer the operation, but make an incifion in the
prepuce or fr^num^ an operation by no means

I 2 dangerous^

Ui OF THE MHAPliYMOSIS.

D

dangerous, but abfolutely necefHiry to prevent
the mofb difagreeable of all confequenees of ve-
nereal complaints, a mortification of the glans
penis. If there are Venereal ulcers in one fide,
I prefer always to make the incifion of the frae-
num or prepuce on the other lide ; in order to
fecure the wound, as well as poiEble, from the
poifon, and to prevent its abforption by the*
lymphatics of the frefh wound.

CHAP.

pN VENER.EAI. BUBOES. 153

CHAP. X,
On Venereal Buboes,

A Swelling of any of the lymphatic glands
of the body is called a Bubo; and if fuch
a fwelling he Qccalioned by the venereal poifon,
we then call it a Venereal Bubo. The latter only
monies within the plan of this treatife.

Though buboes may arife in any part of the
body where lymphatic glands are fituated, yet
we have no authentic obiervation of their ever
.exilling any where except in the lymphatic
glands of the groin, arm-pit, or extremities ;
and even of thefe, the latter are much lefs, fre-
quent than the former.

Venereal buboes arife from two caufes, eflen-
tially diiferent from one another. This differ-
ence has hithejto, in general, not been attend-
ed to with that accuracy which the importance
of the fubjed feems to require.

Buboes have hitherto been fuppofed to arife
always from the venereal virus abforbed by the
lymphatics, and carried to the gland 3 but this
is not always the cafe. Swellings of one or more
of the inguinal glands frequently owe their
<)rigin to the poifon lodged on the furface of
ih^e glans or urethra, irritating there the mouths

I 3 of

134 ON VENEREAL BUBOl^,

of the lymphatics, without being abforbed by
them. Thefe veflels being irritated, produce a
fwelling in the neareft lymphatic gland they go
to. In the one cafe, the caufe of the bubo lie?
in the gland itfelf, in the other without it ; fo
that we may properly diltinguifh them, by call-
ing the former an idiopathicy and the latter ^Lfyjn^
pathic, bubo.

This diftindion, founded on fads, is necef-
fary to regulate the method of cure. But the
diriindion of buboes into primary 2Ci\^ fecondary ^
viz. fuch as arife from an original infedion,
and thofe which are fuppofcd to owe their ori-
gin to the poifon depohted from the mafs into
the gland, feems to be of np pradical ufe what-
ever.

Idiopathic venereal buboes, as we have obfer-
yed, owe their origin to the venereal poifpn
abforbed and lodged in the gland. This ab-
ibrption frequently takes place after the virus
has^ by its acrimony produced fome flight exco-
riation or ulceration in the farface of the glans,
prepuce, uretiira, penis, fcrotum 5 or extremi-
ties. Whether a bubo ever arifes, as has been
hitherto generally alTerted, from the venereal
virus being depofited from the mafs into the
gland, as peftilential buboes feemto arife in the
plague, is not yet perfedly afcertained. But that
buboes may fometimes, though feldom, arife
from an immediate abforption of the venereal
virus, without any previous excoriation or ulcer
on the furface of the genitals or neighbouring
parts, feems to me highly probable fropi feveral
authentic obfervations 3 though this opinion has

been

. ON VENEREAL BUBOES. 135

been controverted by fome modern writers.—
About twelve years ago, three foldiers came
into a military hofpital in one week, all af-
feded with a bubo from the fame woman. They
had all been in perfed health a few days before j;
neither had any of them, on being carefully
examined, any appearance of a clap, or the leaft
excoriation in the genitals or thighs. Whether
this immediate abforption is owing to a torpid
and lefs irritable habit of body, or to the greater
fubtilty or lefs irritating nature of the venereal
virus in fome cafes, I cannot pretend to^ al-
certain. But to this immediate abforption it is
perhaps owing, that we are not always able to
avoid a bubo, or perhaps even the lues itfeif ;
though by ufing preventatives, we may moft
efFedually prevent claps and original ihankers.

That idiopathic buboes arife from an abforp-
tion of the venereal poifon from ulcers of the
genitals or urethra, daily experience fhows^
but that they likewife arife from venereal ul-
cers in any part of the upper or lower extremi-
ties, is not fo general. I Ihall therefore adduce
a few examples by way of illuftration.

Some years ago, I had the misfortune of be-
ing affeded with a flianker. Being then on a
journey, I took fome mercurial pills 3 by the
ufe of which the ulcer was cured in about ten
days. I then difcontinued the pills, and felt
no complaint till fix months after, when 1 was
ono night awaked by a violent itching at my
right elbow. Next night the itching returned;
and the third morning, upon examining the
fpot, I found it covered with a thick yellow
■ ' I 4 fcurf

136 ON VENEREAL BUBOES.

fcurf like a tetter. As I had no medicines with
me, I was obliged to defer applying fome me-
dicine 3 when, two days after, I perceived a
fwelling under my arm-pit ^ which, in three
days more, increafed to fuch a degree, that I
was obliged to keep the arm a coniiderable way
out from my. fide. By the application of the
mercurial ointment to the tetter twice every
four and twenty hours, the tumor was in a few
days dxfcufled, and the difeafe, by a courfe of
mercury, perfectly cured fome weeks after.

A fliort time after, I was confulted by a gen-
tleman who had undergone a mercurial courfe
about fifteen months before, for a venereal
complaint, of which he imagined himfelf per-
fedly cured. Some weeks before he applied to
me, he began to feel a pain in the middle of the
ilernum, v^^hicb he took to be rheumatic. On
this fuppofition, he rubbed the part affet^ed
Avith a piece of flannel, morning and evening.
Thus the pain in the fternum was removed;
but, the feeond morning after, the great toe of
the left foot, and that next to it, were in like
manner afFeded. This pain bemg removed by
fri6tion with flannel as before, returned to the
llernum; from which being driven by a fimilar
fridion, it again returned to the foot. He now
began to imagine, that his complaint was of a
gouty nature; but having occafion to go abroad
that day, he bathed his foot in warm water,
and pared a corn which he had upon one of the
affeded toes, in order to walk the more eafily.
In performing this operation, by cutting too
deep he wounded himfelf. The next day, qn

examining

ON VENEREAL BUBOES. 137

examining the part, he found a little fuppura-
tion had taken place ; he therefore covered the
fore with a piece of clean linen. The fecond
evening he felt a flight pain in the groin, which
he then difregarded; but in a few days after,
when one of the glands fwelled to the big-
nefs of a pigeon's egg, he afked my advice.
I informed him, that he had not been radical-
ly cured of his former diforder, and that the
prefent fymptoms were a confequence of it;
that the pain both of the llernum and of the toes
had been venereal 3 and that from the wound of
the toe, and fucceeding fuppuration, the poifon
had been abforbed by the lymphatics, and car-
ried to the firfl gland they met }> which in this
cafe was one of the lov/er lymphatic glands of
the groin. The ulcer of the toe ftill continued,
but was very hBall, and difcharged a little mat-
ter refembling pus. I applied a mercurial pla-
ller upon it, and difcuiled the bubo by a courfe
of mercurial frictions applied to the thigh.

Some years ago, an eminent accoucheur in
London, as I mentioned in the firlt chapter,
was called to deliver a woman, who, unknown
to him, was afFeded with {bankers. Ulcers on
his hand, and a fwelling of the lymphatic gland
of the fore-arm, v/hich proved very obftinate,
were the dreadful confequences.

Syrnpathic venereal buboes, as I have already
mentioned, owe their origin, not to the vene=
real poifon abfox'bed, but to an irritation of the
mouths of the neighbouring lymphatic veflels.
This fpecies of bubo we frequently meet with
in fimple venereal Blennorrhagi as; or^ where

one

138 ON VENEREAL BUBOES.

one of the glands is idiopathically afFeded, we
fometimes fee two or three contiguous thereto
fwelled by fympathy. In this cafe, however,
only that which is really infected continues to
increafe in bulk; while the others remain in
the fame ftate, and at lafl difappear without
any further confequences.

Sympathic buboes go off fpontaneoufly, as
foon as the irritating caufe in the neighbour-
hood is removed ; and it is only this kind of
buboes which quacks, with their pretended
noflrums, feem to remove fometimes. in a few
days y while, on the other hand, we frequently
hear patients complaining of intelligent phyfi-
icians, for not having been fufficiently expedi-
tious in curing their bubo, or not having done
it without fcippuration, though they had for-
merly been radically cured by a quack, by the
fimple application of a mercurial ointment or
plailer to the part affeded. If fuch patients,
however, were acquainted with the difference
between the true nature of their prefent and
former complaint, they would eafily fee, that,
in the former cafe, the cure was not to be at-
tributed to the ointment or plafter applied, but
merely to the nature of the difeafe.; whereas, in
the prefent fituation, perhaps great fkill and at-
tention is requiiite, either to difcufs the bubo
or to cure it, after the attempt of difcuffrng it
has proved ineffeciual.

Having thus eftablllhed the efTential diftinc-
tion betwixt Idiopathic and Sympathic buboes,
I iliould now proceed to fpeak of the method of
treating them ^ but, previous to this, it, will be

ufeful

ON VENEREAL BUBOES. 139

» ufeful to take notice of fpme prejudices pre-
vailing among a number of patients, concern-
ing the nature and cure of this complaint.

Many people, efpecially the inhabitants of
the more foutherly parts of Europe, think it
dangerous to refolve or difcufs a venereal bubo.
This prejudice arifes from an opinion, that the
virus is by this means repelled and abforbed in-
to the mafs, where it afterwards occalions a ge-
neral infection : whereas, if the bubo were cu-
red by fuppuration, they imagine that no in-
fedion of the mafs was to be apprehended;
but that, on the contrary, even in cafe any
poifon fhould have been abforbed during the
fuppuration of the bubo, the virus lodged in the
gland would thus not only be carried off, but the
whole mafs would thereby be purified. Hence
they imagine, that the abfcefs formed by the
fuppuration of a bubo, is a kind of channel for
cleanfing the body entirely from all the vene-
real poifon. As this opinion, however, is not
only altogether erroneous, but may prove hurt-
ful to the patient, at leall by depriving him of
an advantage which he might otherwife have
enjoyed, I fhall make two obfervations on this
fubjec^. Firft, That, by the modern improved
pradice of applying mercurial frictions, the
difcuiiion of a bubo cannot poflibiy occafiotx
any fuch thing as a repulfion of the venereal
virus into the mafs 3 that, on the contrary, the
virus lodged in the gland itfelf is thereby effec-
tually deftroyed. And, fecoiidly. That though
the virus fhould have been aduaily repelled
from the gland into the mafs, fuch a repulfion

would

HO ON VENEREAL BUBOES.

would flill be preferable to the method of curing
the bubo by fuppuration.

But in order to fet this matter in the cleareft
light, I mufl have recourfe to the anatomical
difcoveries which have been made about the
lymphatic fyftem; and 1 fhall theh confider what
will be the confequence of mercurial frictions
,ipplied in the manner to be mentioned here-
afte?-.

We know, from the obfervations of Profeflbr
Monro, and thofe of the late Dr W. Hunter,
and particularly froni Mr Hewfon's plates *, that
the lymphatic or abforbent vefTels begin every
where on the furface of the body, with the
fmallefl ramifications ) that, in going upwards
from the lower exti^emities, they unite into
larger branches, which terminate in the ingui-
nal glands, pouring into them the liquid which
they have abforbed at their extremities. This
liquid, which in a natural ftate is nothing but
mild lymph more or lefs diluted with water,
which has been abforbed by their extremities,
after being poured into the inguinal glands, is
again abforbed by other lynqiphatic ve0els,
v/hich carry the fame to the abdomen, and
thence through the thoracic dud: into the
njafs. Let us now fuppofe that fome of the ve-
nereal poifon has been abforbed by the lympha-
tic veflels of the genital parts, or the lower ex-
tremities.

* This, as well as the anatomy of the whole lymphatic fyftem,^
and the difeafes depending thereon, are now more fully illuftra-
ted by the accurate and beautiful plates of Mr CruiKS«a«K,

Ma?cagnij andliAASE.

ON VENEREAL BUBOES'. ,141

tfemlties, and that confeque^tly it has been
carried along with the lymph into one or more
of the inguinal glands. The poifon thus brought
into the gland will either be abforbed again by
the oppofite abforbent velTels, in which cafe it
is carried into the mafs ; or, what more fre^
quently happens, it will, by its acrimony, ex-
cite an irritation in the gland, and thereby not
only prevent its own abforption, but produce
an inflammation and fwelling of the gland. In
thofe circumflances, the moft eligible thing,
both for the patient and phyiician, would be,
if poflible, to deftroy and eradicate the poifon
lodged in the gland. For this purpofe, we know
mercury is a fpecific^ but the queftion is, how
to bring it into the gland aifeded ? Formerly
praditioners, from a defefi; of anatomical know-
ledge, imagined they could introduce the mer-
cury into the gland, by rubbing the mercurial
ointment upon the gland itfelf. But fo far was
this from having the intended effed, that bu-
boes treated in fuch a manner generally grew
more inflamed, fuppurated, and even fometimes
mortified. By fuch an application, no mercury
is introduced into the affedcd gland ; or, if it
happens now and then, it is merely by chance ;
for we know, that the lymphatics ariflng from
the fkin immediately over the gland, do not
taketheir courfe into the fubfiance of the gland,
but proceed obliquely upwards to the abdomen.
Hence the bad or good efFeds produced in that
cafe are not to be afcribed to the mercury, but
rather to the mechanical irritation occafloned
by the fridion, and would probably have taken
2 place^

142 ON VENEREAL BUBOES.

place, if any other ointment had been employ-*
ed. But if, inffcead of rubbing the mercuriai
ointment upon the gland itfelf, the fame be
rubbed into the thigh or leg of the fide afFedied,
we are to expect, according to the difcoveries
of the courfe of the lymphatic veffels, that the
mercury will be abforbed by their extremities^
and from thence be conveyed to the affecled
gland; where, meeting with the venereal poifon,
it Vv'iil moft effeclually exert its fpecific power
againfl it. That this really happens, appears
from the fuccefsful pradice of this method. For
if the mercurial fridions have been applied up-
on the proper place, and in time, before the
inflammation has gone to too great a length, we
find, that, in a great number of buboes, the
poifon is thereby dellroyed, or at leafl fo chan-
ged in its^ nature, that it now is rendered inca-
pable of irritating the gland any further. Nor
do we obferve, that the virus thus changed, and
then abforbed along with the mercury, ever
afterwards produces any venereal fymptoms in
the mafs.

But let us even fuppofe that the mercury has
not deflroyed the poifon lodged in the gland^
but has driven it into the blood, as thofe
patients commonly believe. What will be
the confequence ? The fame, undoubtedly, as
when a victorious hero dillodges and chafes a
flying enemy before him. The very fame re-
medy which drove the poifon from the gland
into the mafs, will purfue it there alfo; and
either expel it altogether, or render it, one
2 "vray

ON VENEREAL BUBOES. 143

way or other, harmlefs and inofFenfive to the

body.

To elucidate this matter ilill further, I fhall
anfwer a queftiou which I have heard frequent-
ly propofed, viz. Why does the method of rub-
bing mercury into the extremity not always
fucceed in difcufling the bubo ? For the ^ folu-
tion of this queflion, we muft have again re-
courfe to anatomy. DilTedions and injedions
ihow, that there are two feries of lymphatic
glands in the groin, called the upper and lower
inguinal glands. Jn moft people there is a com-
munication between thefe two orders of glands:
in this cafe, the lymphatic veffels of the infe-
rior glands communicate with the fuperior ones;
whence again others arife, which take their
courfe through the abdomen into the thoracic
dud. But in other perfons there is no fuch com-
munication; the lymphatic veiTels of the infe-
rior inguinal glands proceed diredly to the ab-
domen, w^ithout inofculating with the {"uperior
ones. Now, the venereal virus being abforbed
by the lymphatics of the genitals, is generally
carried to the fuperior inguinal glands, where
it produces the bubo. Wherever therefore the
inferior inguinal glands have the above-men-
tioned comxmunication with the fuperior ones,
the mercury rubbed into the inlide of the thigh
or leg will be abforbed, carried to the inferior,
and from thence to the fuperior inguinal glands,
where it will produce the defired efFed. But,
on the other hand, where no communication of
this kind takes place, the mercury is carried
from the extremity to the inferior inguinal

glands^

144- ON VENEREAL BUBOES.

glands, and from thence to the abdomen, with-
out ever reaching the afFedted gland; on whlch>
of eonfequence, it can produce no efFed:.- — The
fame will likewife happen where the inflamma-
tion of the bubo is gone too far, or where a
fcirrhoiity is formed in the gland. Mercury in
thefe cafes can have little or no accefs to the
gland ; or though it could, would be little able
to change the nature which the difeafe has now
allumed.

But let us even go further, and fuppofe, that
the method of treatment jull recommended has
not been followed ; but that, inilead of it, the
irritating matter has been blunted, and the ab-
forption of the poifon from the gland has been
efFeded by other fedative or difcutient applica-
tions. What will be the eonfequence ? I anfwer,
inflead of a bubo, the patient will probably be
affeded with a difeafe of the whole fyllemj
which, if recent, may be eafily and radically
cured in a few weeks time, without any bad
eonfequence remaining ; whereas the complaint
with which he was affeded before, is fometimes
not only very dangerous, and at other times ex-
tremely obflinate, but always of a very tedious
nature. Belides, even when the fuppuration is
of the beft kind, which, however, is far from be-
ing always the cafe, the poifon, before or after
the abfcefs is formed, inftead of being entirely
evacuated, is, if not conftantly, at lead very fre-
quently, abforbed into the fyftem. Thus the
diforder which the patient fo much dreaded is
really produced > for the cure of which he will

at

ON VENEREAL BUBOES. 145

at laft be obliged to have recourfe to mercury,

the remedy he was formerly fo much afrlaid of.

Let us now proceed to the method of cure.

Method of Cure,

From the obfervations laid down, it appears,
that every unprejudiced praditioner, in any cafe
of an idiopathic bubo, fhould always attempt to
difcufs it as foon as poffible, by any method
whatever, provided the inflammation has not
rifen to too great an height, or iigns of fuppu-
ration have already made their appearance.

The mofl efFedual method of difcuffmg tu-
mprs of this kind, is, as I have already mention-
ed, by mercurial frictions applied to the infide
of the thigh or leg of the afFeded lide, if the
bubo happens to be inguinal j or to the arm, if
the bubo be under the arm-pit. Occafionally
alfo, in the former cafe, fridions may be ufed
to the perinaeum or fcrotum. But as the fuc-
cefs of thefe fridions is limited to a few days,
they ought to be made not only with due care
and attention, but, if circumftances permit, bq
repeated twice a-day. Venefedion or purges,
together with cold topical applications, will, oc-
cafionally, greatly contribute to the intended
efFed.

Mr Birch found, in repeated inflances, that
gentle eledrical fliocks, paifed through the thigh
and glaiid affeded, greatly affifl the mercury in
difcuffing the bubo; and, in fome cafes, produce
that effed, without any mercurial fridion, even
in buboes much advanced.

146 ON VENEREAL BUBOES.

To the gland itfelf I never apply any thing
but a mercurial plafler ; and from this I expedl
nothing towards the accomplifhment of the
cure, but make ufe of it only to keep the pa-
tient's mind eafy. In obftinate c^fes alfo, I
would advife the application of dry cupping
glafles to the fwelled gland, which has been
attended with fuccefs in t-he Edinburgh Infir-
mary. Repeated vomits, with applications of
cold water to the part affeded, have been like-
wife recommended as ufeful for the difcuihon of
a bubo ; but 1 have never had occafion to try
either of thefe remedies. The volatile liniment^
rubbed into, and round about, the bubo for
eight or ten minutes, once or twice a-day, has
been found very effeduai to this purpofe, in fe-
veral inflances, by Dr Nootb,

During the whole time that we attempt the
refolution of a bubo, the patient ought to abftaiil
from exercife, and confine himfelf to a very low
diet ; as a contrary regimen might greatly tend
to increafe the inflammation. With regard
to mercurial fridions on the gland itfelf, I have
already . given my reafons for diiapproving of
thera. Indeed moil of the idiopathic buboes
which I have feen treated, either in this
way or by other irritating remedies, have
inflamed and fappuvated, though the appli-
cation was made with a, view to prevent this
difagreeable circumfl;ance ; and there are now
but very few praditioners, let their knowledge
of the recent difcoyerics concerning the lym-
phatic fyfl:em be ever fo confined, who would
trufl; to this application for producing a difcuf-

Ho'n.

When

ON VENEREAL BUBOES. 147

When I fay that a local irritation of the gland
will rather be followed by an iaflan^mation
and fuppuration than a refolution, I purpofely
mention the idiopathic yenereal bubo ; for fyni-
pathic buboes do certainly, as I have obferved,
frequently difappear after the ufe of mercurial
fridions applied upon the gland itfelf. We
pught not, however, eyen in this cafe, to af-
cribe the refolution to the mercurial fridions,
poultices, &c. which have been applied, but
to the fimple operation of nature ; becaufe fym-
pathic buboes will always go off by tliemfelves
without any application whatever. For their
removal, as 1 have already obferved, nothing
more is requifite than to abate or remove the
flimulus from the mouths of the lymphatics or
neighbouring glands. This fad is fufficient, I
think, to convince us of the importai^ce of di-
ilinguifhing in pradice the idiopathic buboes,
or Rich as owe their origiii to the venereal vi-
rus abforbed from fhankers of the genitals or
extremities, from fympathic ones^ arifing from
the mere irritation of the lymphatic velTeis, and
generally accompanying iimple claps, fwelled
teflicles, &c. without the appearance of any
venereal ulcer.

Thus far with regard to the treatment of ve-
nereal buboes by refolution, I now come to
fpeak of thofe that are either too far gone to
admit of a refolution, or that reliil it on fome
other account.

That a bubo will not admit of a refolution,
we know by the tumour continuing to increafe
in fize, and becoming red and painful after the

T48 ON VENEREAL BUBOES.

proper application of the mercurial fridions or
other refolvents have been made ufe of for four
or five days. As foon as we fee thefe our atr
tempts to procure a refolution fruftrated, we
mufl endeavour to bring on a mild and fpeedy
fuppuration. Here, however, we fhall often meet
with great difficulty, buboes being fo effential-
ly different from one another, that the treat-
ment which will bring the one kind to a mild
fuppuration, if applied to the other, will not
only occafion very dangerous confequences, but
even prove fatal to the patient.

They may, as far as I can judge, be brought
mofl properly under the following three differ-
ent heads.

In the/r/?, all the fymptoms of a real inflam-
mation run very high, fometimes even to mor-
tification 3 in the fecond J the fame fymptoms
feem to arife from too great an irritability of
the body ^ whereas, in the third, the moil irri-
tating medicines are hardly able to raife the in-
flammation to fuch a pitch as is neceffary for
bringing on a fuppuration. In xhtjirft or true
inflammatory bubo, our intention mufl be to mo-
derate the inflammatory fymptoms ; in the fe-
cond, to allay the irritability 5 and in the tbirdy
to ftimulate and excite.

In xhefirji kind, therefore, when the patient
is otherwife of a healthy, flrong, and vigorous
conftitution, the inflammation high, the pain
fevere, and accompanied with an inflammatory
fever ; bleeding, fometimes even repeated as cir-
cumflances require, will be neceffary. Leech-
es,

ON VENEREAL BUBOES; 149

€s, however, or. In want of them^ fcarificatlon
of the part affeded, are often preferable to ge-
neral bleedings. In other refpeds, reft, a low
diet, cooling drink, an antiphlogiftic purge^
the warm bath, and an emollient poultice ap-
plied conftantly warm to the gland, arid chan-
ged when it grows cool, are the means to be in-
Sited upon in this fpecies of bubo.

In the fecond kind, the fym.ptoms of inflam-
mation feem to run likewife very high, but
merely from too great an irritability of the fy-
llem. This we may eafily diftinguifh from the
former, by the weaker, fmoother, and more
frequent pulfe ; as alfo by the conftitution of
the patient. In fuch circumftances, general
evacuations, inftead of being of fervice, I con-
ftantly obferved to be prejudicial. On the con-
trary, a fuller diet ^ opium every night or every
other night, and the Peruvian bark through the
day, ought to be given ; and to the external
emollient are here properly joined fome feda-
tive applications. It was, probably, in a cafe of
this kind, that Mr Brambilla faw a bubo prove *
gangrenous and fatal, after a courfe of calomel
along with a ftrong decodion of the woods was
adminiftered to the patient.^ ' I muft, upon this ' '
occalion, make the general remarkj that mer- '^
cury fhould never be adminiftered either inter- /^
nally or externally, during the inflammatory ^^
flate of a bubo, or any other venereal com- ' '
plaint, unlefs we have fome very urgent reafona, If
During that ftate, I have never feen any goody
but frequently very bad efFeds refulting from

K 3 its

i5a ON VENEREx\L BUBOES.

its life, and more efpecially when rubbed into
the part affeded.

The thij'd kind of buboes, efTentially different
from the two former, we frequently meet
in patients of a relaxed, debilitated, cachedic,
or fcorbutic habit of body. When this is the cafe,
the tumour of the gland, though red and infla-
med, rifes very little and very flowly 3 the
patient feels but little pain ; no fever attends ;
or, if any, it is rather of the low kind, and the
-pulfe is weak, accompanied with a depreilion
of fpirits. — In fuch cafes, we muil endeavour
either to difcufs the fwelling, or to bring the
bubo to fuppuration. The former we obtain
by repeated purgings or emetics 3 and lately, a
poultice made of the root of the Atropa Man-
dragora has been recommended for that pur-
pofe, and by others a poultice made of the
root of Daphne Mezereum. They both deferve to
be tried in obilinate hard fwellings of this kind;
but their acrid nature fliould keep us carefully
upon our guard. For the latter, the admini-
Itration of mercury, internally as well as upon
the part afFeded, will fometimes be ufeful and
even neceflary^ but evacuations of any kind are
always hurtful : a full diet with wine, an infu-
lion of Peruvian bark in wine, or fome other
Itrengthening and aromatic medicines, together
with local applications more or lefs ftimulant,
fach as the common plafler with gums, a poul-
tice made of onions roafted or boiled in oil,
will be moft proper.

If fymptoms of the fea-fcurvy prevail, mercu-
ry ou^ht never to be made ufe of 3 but the patient

fliould,

ON VENEREAL BUBOES. 151

lliould, befides the ufe of wine and Peruvian
bark, &c. eat oranges and other ripe fruit, or
make ufe of the juice of antifcorbutic herbs, or
a decodion of mak, and take moderate exercife
in free open air every day.

When by any of the above-mentioned means^
the bubo is at iafl brought to fuppuration, and
an abfcefs is formed, moil writers advife the arti-
ficial opening of the abfcefs with the lancet or
cauftic ^ but this^ I think fhould almoft always
be rather left to nature. 1 have found, that na-
ture, left to herfelf, fcarce ever fails to make
an opening in due time ; whereas artificial open-
ings are often made before the abfcefs is fully
formed and ripe. 1 have befides obferved ano-
ther advantage from this pradice, viz. that
the abfcefs opened by nature generally heals
much eafier^ whereas that opened by an inci-
iion, or the application of a cauflic, we fee not
unfrequently followed by difagreeable confe-
quences. The cure is thereby often rendered ex-
tremely tedious and troublefome, and always a
vifible cicatrix left behind ; which laft we ought
to make an elTential point carefully to avoid,
efpecially in women, for reafons fufficiently ob-
vious. If the operation be left to nature, the
abfcefs will generally not buril till there is a
complete fuppuration of the gland; and the ci-
catrix in a fhort time after, for the moil part,
entirely difappear, or remain fcarcely vifible.

There are, however, fome cafes in which it
may be proper to afFifl nature, and either make
a dilatation of the opening, or make an arti-
ficial opening altogether. If buboes, notwith-

K 4 Handing

152 ON VENEREAL BUBOES.

ftanding the means above-mentioned, remain
inflamed and hard, without either coming to a
refolution or iuppuration, a fmail bit of the lu-
nar cauftic, about the fize of a pea, may be ad-
vantageouily applied to the middle of the bubo,
for about two, or at moll three hours, the efchar
afterwards to be anointed with a little of the
llrong blue ointment, and the whole covered
with a warm emollient poultice. This method,
firft propofed by Mr Plenck, I have fince feveral
times followed with fuccefs.

Here 1 muft add, that, in federal inflances, I
have obferved the common method of applying
a large cauftic on the bubo for ten or twelve
hours, in ol'der to bring it to fuppuration, at-
tended with very bad confequences. The event,
ill two cafes, was a mortification, and in others
a large ichorous ulcer, which in one inftance
feemed to aflume a cancerous appearance,
and at lall proved fatal to the patient. This I
have never feen happen from the application of
a fmall piece of the cauftic as above mentioned.

When the abfcefs has been opened either by
nature or art, it is called an exulcerated Bubo; in
which the fame diftindions ought to be careful-
ly obferved as laid down above, when I fpoke of
inflamed buboes.

Many writers advife in this cafe, to admini-
fter mercury internally and externally, and
thus treat the ulcer as a venereal one. This
pradice may be undoubtedly very good in fome
cafes ; but in others, a mercurial courfe will
prove hurtful, and often give rife to very dan-
gerous confequences.

No general method, I think, can be laid down

for

ON VENEREAL BUBOES. t$^

for the treatment of an exulcerated bubo ; but
the pradkioner ought to be entirely direded by
the nature of the difeafe, and the conflitution
of the patient, as mentioned above. If the pa-
tient be vigorous, without fever, the pus mild
and of a good coniiftence, no ejiternal applica-
tion to the fore feems necelTary ; and if any
thing is to be applied, a continuation of the
iame poultice which was applied before the ab-
fcefs burft, will certainly forward the cure more
than any thing elfe. If the abfcefs affumes the
nature of a venereal ulcer, a courfe of mercury
may be proper j but with regard to topical ap-
plications of mercury, in thofe cafes, we ihould
be highly cautious left we bring on a complaint,
of which I have feen feveral melancholy in-
itances.

But if, under the adminiftration of our medi-
cines, whatever they be, the abfcefs, inltead of
healing, either remains in the fame flate, or af-
fumes a relaxed and flabby appearance, and the
difcharge grows copious, thin, and ichorous,
and, at the fame time, the health of the patient,
inflead of growing better, gradually grows worfe
and worfe ; a different treatment will be ne-
celTary. If mercury had been adminiflered
and has produced fome fenfible effects in the
mafs, we fhould not obftinately infift to afcribe
the prefent fymptoms to the inefHcacy of the
mercurial preparation we have made ufe of, and
confequently have recourfe to another : we ra-
ther ought to take the hint given by nature, and
not perfift any longer in the ufe of a reme-
dy from which no good efFed had follow-
ed.

154 ON VENEREAL BUBOES. '

ed.^-Mercury is a poifon for thofe patients^
and fo is likewife the hofpital air. A decoc-
tion of the Peruvian bark in milk, a decoc-
tion of farfaparilla with antimony, the pow-
der of farfaparilla with milk (if the patient bears
milk), a full diet, wine, an infufion of the bark
in wine, with the free ufe of country air, and
gentle exercife, are the medicines required.
To the ulcer, an- injedion with the aqua vitri-*
olica camphorata, or, according to circumftau j
ces, a fomentation with the Peruvian bark re-
peated twice or three times a-day, is the necef-
fary application ; and the fore ihould be cover-
ed with fine lint or a piece of foft iponge, that
the matter may freely difchargCi The dreilings
may be kept on by a piece of adhehve plafler
fpread on linen. To prevent excoriations on
the thigh from the acrid difcharge of inch ul-
cers, the application of a little white cerate to
the furrounding parts will be neceffary *.

The following cafe may ferve as an illuftra-
tion of what I have juft now afferted. Sn ul-
cerated bubo was, according to the common
courfe of practice, treated as a venereal ulcer,
)y the internal and external ufe of mercury.
The patient by this method, after eight weeks
time, was fo much reduced, and the ulcer had
alTumed fo bad an appearance, that it was

thought

* Mr Foot has ingenioufly applied to this kind of exukerated
bubo, commonly called phagedenic bubo, the fame method, which
efFeaually anfwers in ulcers of the legs of the fame kind, with
the fame fuccefs i viz. a vitriolic folution with, the ftrait ban-
dage.

ON VENEREAL BUBOES. iss

thought proper to have the advice of another
phyiician. Being confulted, I found upon exa-
mination the flabby relaxed atonic appearance
of the ulcer which I mentioned above. I told
the phyiician and furgeon, who hitherto had
treated the patient, that I thought the continu-
ation of mercury improper ; and that the inter-
nal and external ufe of ftrengthening medi-
cines, and a full diet with wine, were now the
only proper remedies. They both thought my
advice unfeafonable; and that it was more pro-
per to continue the ufe of mercury, only with a
different preparation. However, after a good
deal of converfation, I prevailed on them to try
only for eight or ten days what I had propofed ;
and the patient finding himfelf the better for
the courfe he began, continued the fame for a-
bout fix weeks, when he was perfectly recover-
ed.

A fimilar cafe occurred fome time ago to a
friend of mine in London, who gave the fame
advice to a patient that had been treated for
a long time with mercurials, and the patient
found the fame benefit from the change. A
remarkable circumftance which^happened v/ith ^\
this latter patient, I mufl take notice of, Un-
'der the courfe of mercurials he fuffered violent
fweats every night ; for which he put on every
morning a clean fhirt made of new linen 3 all
thefe fhirts, about a dozen in number, after ha-
ving been once or twice wafhed with other li-
nen in the common manner, grew fo tender,
that they feemed to be perfed:ly rotten.

If, after a fuppuration has taken place and
q the

l?6 ON VENEREAL BUBOES.

'0

the abfcefs been opened, part of the gland
fhould Hill remain fwelied and hard, repeated
purges, with the continued ufe of the medicines
recommended above for indurated buboes, will
effeclually remove this diforder.

The JJnii/es ov Ji/iu las, which are fometimes apt
to arife after fuch ulcers, are for the mofl part
eafily prevented, as well by proper injedions
as by a fuitabie pollure of the patient when in
bed, and by a gentle, but careful, preffure, fquee-
zing out the matter all round, every morning
and evening. — -If fiftulas or iinufes have been
formed from an ulcerated bubo, and refufe to
yield to the injedions mentioned, the knife mull
be employed. Thefe complaints, however, fel-
dom or never occur, if the furgeon, in order to
give a free difcharge to the matter, be attentive
to the pofture of the patient, dilate the opening
in time if neceilliry, and the patient comply ex-
actly with his diredions.

Buboes grow now and then gangrenous from a
high degree of inflammation ; but more fre-
quently after they have been improperly open-
ed, efpecially in irritable habits or in fcorbutic
patients. The foul air of hofpitals proves often
fatal to fuch patients, and retards likewife very
much the cure of all exulcerated buboes. Mer-
cury increafes the mortification. The Peruvian
bark, or in fome circumftances large dofes of
opium internally y and the fame bark, or the ar-
nica root in powder, or camphor diflblved in vine-
gar, are the mofl effedual remedies externally.

Hemlock,' both internally and externally ap-
Dlied, has been ilrongly recommended ioxcance-

2 rous

ON VENEREAL BUBOES. 157

rous as well as fcirrhous buboes : but I never
faw it eiFed a radical cure where there was a
real cancer ; though there is nothing to hinder
its being tried : but in fuch cafes, the only me-
thod that I know for avoiding death, or at leaft
a moft miferable life, is the total exciiion of the
cancerous gland, if pradicable ; and this, if we
wifh to fave our patient, ihould not be too long
deferred.

Having thus finished the treatment t)f topical
venereal complaints, I now proceed to thofe ari-
fing from anuniverfal infedion, or^ as it is com^
monly called, a confirmed pox.

C H A P.

158 ON THE SYPHILIS,

C H 4 P. XI

On the Syphilis or Venereal Dljeafe in
particular.

'AVING premifed fome neceflary obferva-
tions concerning the venereal infedion,
the nature of the virus, and the dilFerent ap-
pearances of fyphilitic complaints in general, in
the beginning of this treatife, I now enter, in
particular, into the confideration of the nature,
fymptonjs, and cure of the fyphilis or venereal
difeafe, commonly called a confirmed lues ox pox.
The efFeds or fymptoms which the venereal
virus is apt to produce when abforbed into the
"mafs, are, now a-days, fhortly as follow.

1. In the eyes : The mofl: violent inflamma-
tion, with a difcharge of puriform matter
(froni a retropulfed clap), ending generally in
perfect blindnefs \ or an ophthaimy of a more
chronic kind (from the venereal virus depofited
from the mafs), affeding the eye itfelf, or the
eye-lids 5 and fometimes alfo producing the fi-
Itula lachrymalis.

2. In the ears .\ Tingling in the ears ; deaf-
nefs, with or without a puriform difcharge, ei-
ther from a retropulfed clap, or from the ve-
nereal virus affeding the ear, or the orifice of
the Euftachian tube in the fauces.

ON THE SYPHIDIS. 159

3. In the nofe : Ulcers in the noftrils ; an ul-
ceration of the mucous membrane of the nofe,
with a caries of the bones, efpecially of the fep-
tum^ whence the disfiguration of the nofe,
which we fee now and then in people walking
in the llreets ; or a difcharge of fetid ichor,
known by the name of ozcena fypbilitka, ^
" 4. Jn the mouth and throat : Ulcers, caries of
the oiTa palatinaor antrum maxlllare, eroiion of
^ the yelum^ &c. fore throat, coryza, paraphonia.

5, In or about the genital parts^ it produces,
or proves a perpetual fomes of, excoriations, ul-
cers, fiftulas, gleets, warts, condylomata. Whe-
ther claps, fwelled tefticles, or buboes, ever
arife from the poifon being depofited to thofe
parts from the mafs, is with me, for want of
authenticated fads, flill a matter of doubt. , ^

6, In the Jkin.: Copper-coloured fpots, fcurf,
tetters, fcabs, efpecially on the margin of the
fcalp, or in the beard ; a fcald head^ , or tinea ;
and when the difeafe is very inveterate, and
fomewhat degenerated, it fometimes, though fel-
dom, produces a kind of leprofy over the whole
furface of the body j a corruption of the nails,
and ulcers of the moil ol^flinate kind jn dii^t
rent parts of the body. ~ '

7, /// the hones : Either the mofl excruciating
pains and fwellings, commonly called tophi ^ ex--
oftofes, &c. efpecially troublefome at night when
the patient grows warm in bed 3 an ulceration
in their external, or a corruption of their inter-
nal fiibflance, difeafes known by the name of
caries a.nd Jpina ventofa. The bones moil liable
to be affeded by this difeafe, are thofe which

- are

i6o ON THE syphilis:

are not covered with mufcles, as the tibia, the
radius, the elbow, the procefliis coracoideus,
fternum, the os frontis, and other bones of the
head, &c.

8. Sometimes the venereal poifon will pro-
duce efFedls, the nature of which is fo concealed,
that they feem rather arifing from fome other
caufe. Such are pains in feveral parts of the
body, refembling thofe of the rheumatic kind^
pains in the articulations, refembling the gout;
afthma; nervous or hectic fevers; confumptions
of the lungs, or limple emaciation without any
apparent vice in any vifcus of the body. — Thefe
fymptoms have, among phylicians, obtained the
name of morbi venerei larvati. It is, however,
to be obferved, that many of thefe fymptoms
are not unfrequently owing to the improper ad-
miniflration, and confequent bad effects, of
mercury.

9. Sometimes the lues is really combined with
other diforders ; fuch as the fea-fcurvy, inter-
mittent fevers, confumptions, &c. Thefe are
called morhi verier ei compile ati^ and deferve the
utmoft attention of the practitioner; becaufe
the fuccefs of the cure will often in a great
meafure depend on the accurate knowledge and
diftindion of thefe complaints.

The fpecific remedy now generally applied
for all kinds of venereal diforders, is Mercury
in its different preparations. Though there are
perhaps remedies of the vegetable kingdom
as powerful as mercury, to cure the venereal
difeafe in all its ftages, yet being either unknown
or difficult to be got, they are now generally

negleded.

ON THE SYPHILIS. 161

liegleded. Mercury Is made ufe of, not only
on account of its fpecific power againft this dii-
order, but becaufe it is a remedy which is cheap^
eafiiy to be got, and quick and certain in its
efFeds; in the fame manner, though we are able
to cure agues by other rernedies, we employ
now-a-days feldom any thing elfe but the Peru-
vian bark.

Se-s^eral hypothefes have been advanced to ex-
plain the manner in which mercury produces
thofe powerful effeds. None of them feems to
be founded on real fads; all of them are there^
fore little fatisfadory^ Some fay mercury ads
by its metallic weight; others, by its altringent
quality ; and others, again, by its power of pro-
moting all kinds of excretions, &c. If thofe wri--
ters had only conlidered, that fometimes two ot
three grains of mercury brought into the mafs,
make the mod violent venereal fymptoms dif-
appear, I think they would have never had re-
courfe to fuch explications. Perhaps, if there
v/as an opinion to be advanced about this mat-
ter, chemiftry could afford us a more reafonable
and fatisfadory theory ; by fuppoiing, that
mercury has a peculiar attradive power, or
what is commonly called a chemical affinity^ to
the venereal poifon; by means of which, where^
ever it meets with that poifon, it readily unites,
and forms a kind of compound with it, which
then has no longer any of the qualities which
either of the fubftances had before the union \
and therefore the effed produced by the poifon
mull, in the moment that union takes place,
unavoidably, ccafe, and the patient find himfelt

L either

i62 ON THE SYPHILIS.

cither relieved, or, if the poifon has been fa-
turated with a fufficient quantity of mercury,
radically cured. By this theory we would per-
haps be more able, not only to account for a
few grains of mercury relieving fometimes the
moil excruciating venereal pains of the bones,
but alfo why mercury taken internally removes
venereal ulcers, without any external applica-
tion, &c. It would further feem probable from
thefe effeds, that mercury has a greater chemi-
cal attradion to the venereal poifon than it has
to any acid ^ and that, given in any of its faline
preparations, wherever it meets with that poi-
fon, it leaves immediately the acid with which
it was combined, and unites with the poifon *.
I could fupport this opinion, perhaps, if I added,
that mercury cures the venereal difeafe the ea-
iier and fooner the more minutely it is divided^
that, in order to produce the deiired efFed, it-
is always neceflliry that it be abforbed into the
mafs ; but that it never cures the venereal com-
plaints though abforbed into the mafs, if not
carried in fufficient quantity to the place or
part affeded. In this manner we could perhaps
•eafier explain why it often cures the venereal
diforder without any fenfible increafe of any
of the different fecretions or excretions of the
body; and why, if it produces purging, im-
moderate

* It is a very remarkable circumftance, which one day or
other may ferve to clear up this theory, that inercury has the
greateft affinity to, or, as I fliould fay with more propriety, that
of all known acids, that of the animal fat {acidwn febi) has the

greateft attradlion to mercury.

ON THE SYPHILIS. 163

moderate fweating, or falivation, it very often
leaves the venereal difeafe uncured behind. But
though we could thus refolve all thefe different
queftions in a more fatisfadory manner, I mufl
confefs, that this theory is as little as the former
founded on any real fad, but on mere conjec-
ture p and therefore, as long as it remains in
this Hate, it is equally ufelefs as all other hy-
pothefes in the pradice of phyiic, where it may
be fufficient for us to know the fpecific remedy
to cure the diforder, without being acquainted
how it produces its effeds^ though fuch a know-
ledge, could it be attained, would lead undoubt-
edly to great improvements in the pradice of
phyiic.

Method of Cure*

If the patient be flrong enough to bear the
immediate ufe of mercury, I begin generally by
giving him a purgative ; and the' next day I let
him bathe in a warm bath, made of a decodion
of bran, or of fimple foft water. In this bath,
the warmth of which fhould be determined by
the agreeable feeling of the patient, he ought
to lit for half an hour or an hour's time ; during
the latter end of which time, he iliould be rub-
bed gently all over with a flelh-brufh or a piece
of flannel. Coming out of the bath, he may
take a glafs of good wine, if his circumftances
will admit of it, and then go to bed. By thefe
means the fkin will be well cleanfed, and be
better fitted for tranfmitting the perfpiration.

L 2 If

i54 ON THE SYPHILIS

If he be plethoric, or accuilomed to bleedings
venefedion may be proper and ufeful, previous
to his beginning the ufe of mercury.

With regard to the feveral mercurial prepara-
tions made ufe of for the cure of venereal com-
plaints, I fhall fpeak hereafter. What-we fhould
firft obferve mofl carefully and attentively, is,
whether the mercurial courfe we began agrees
with the patient; and if it does not agree, with-
out hefitation change it. Thofe patients who
will not bear fridtions, bear fometimes very
readily the internal ufe of mild or more acrid
preparations of mercury, and vice verja; others,
who will not bear mercury internally, will bear
the fridions, or fometimes not bear one mercu-
rial preparation, while they bear another very
readily. Some will take it more ealily in pills,
others in powder, or dilTolved in fome liquid.
To thofe whole conftitution, circumftances, or
choice, are againfl mercurial fridions, we may
give Plenck's folution of mercury in gum arable,
made into pills \ or mercury triturated, and form-
ed into pills with the extrad of liquorice. Thefe
preparations agree with moll ilomachs, even
fuch as fometimes can bear no other mercurial
preparation. In other cafes, calomel prepared
by precipitation according to Mr Scheele's inven-
tion, or the hydragyrum nitratum cinereum
(pi/lvis mercurii cinereus) of the new Edinburgh
Pharmacopoeia, are the mildefl: and perhaps
mofl fuitable preparations for thofe flomachs
which are not able to bear any of the more
acrid filine mercurial preparations. Mercury
rubbed down with fjgar-candy, or calcined

mercury

ON THE SYPHILIS. 165

mercury mixed with opium, may fometimes,
according to circumftances, be more advanta-
geous ; but, as I have mentioned before, great
judgment and attention are required in admini^
ftering thofe medicines, as well as with regard
to diet,, bathing, Sec. about which it is impof-
fible to enter into a minute detail of every par-
ticular circumftance. The following rules,
however, befides thofe to be mentioned below
under the head of Mercurial F reparations^ may
ferve as general ones.

The patient whom we undertake to cure of
the lues, mull have fufficient Itrength to bear
the ufe of mercury 3 and neither be affeded
with any nervous, hedic, or inflammatory fe-
ver, nor with fea-fcurvy, cancerous complaints,
or gangrenous ulcers. In all thefe cafes,
I have conftantly obferved mercury not only
prove hurtful, but in fbme inflances, where
its ufe was infilled upon, even fatal to the pa-
tient. Thefe diforders, if poifible, ftiould there-
fore be previoufly removed \ or if the venereal
fymptoms prevail fo much, that they render the
immediate ufe of mercury indifpenfably necef-
fary, proper medicines ought to be conjoined
with mercury.

For reftoring a proper degree of ilrength and
vigour, an healthful country air is one of the
iirll requiiites \ then aifes or cows milk, as it
comes from the animal ^ or, what in fome in-
flances I have found far better for patients in
eafy circumftances, a llrong healthy country
wet-nurfe, whom the patient may fuck himtelf ^
or if he finds this difagreeable (or perhaps dan-

L 3 gerous),

i66 ON THE SYPHILIS.

gerous), the bread of the woman may be drawia
\¥ith a proper inilrument, and the patient Ihould
drink the milk immediately after : this milk is
the greateft flrengthener 1 know of for debili-
tated patients. His diet may otherwife confift
of light puddings 3 tender meat of middle-aged
animals of all kinds, efpecially roafted, not too
fat; and at dinner, if he likes good ftrong beer
(or porter), he may drink it ; otherwife a few
glailes of good and genuine Spaniih or Hunga-
rian wine will be ufeful. Moderate exercife of
any kind, and occafionally fridions of the whole
body, will greatly affifl the ^bove regimen. As
for medicines, if their ufe fhould be abfolutely
necelTary, or if the patient defire any, fmall
dofes of 'the bell Peruvian bark, finely powdered
in fubfiance, or mixed with cinnamon water or
genuine old hock, I have found excellent. If
the patient be very low, iron diffolved in vitriolic
gether, I have found fuperior to any other me-
dicine. The cold bath will be fometimes ufe-
ful, but at other times I have feen it prove ra-
ther hurtful. This, .with cheerful company,
and avoiding venery or nodurnal pollutions,
will greatly contribute to recover the ftrength
necellary for enabling the patient to bear the
ufe of mercury. I fhall, however, make one
remark more here, which, as tar as I know, has
not been taken notice of by any former writer
on this fubjed, viz. that weaknefs, low~fpirited-
nefs, and anaphrodyfia, are fometimes the im-
mediate effeds of the venereal virus lurking in
the body; and, in that cafe, 1 have obferved mer-
cury to be the bed ftrengthener. I have {een

people

ON THE SYPHILIS. 167

people in that flate gain fo much ftrength in
eight or ten days, from the internal ufe of mer-
cury, that they found themfelves moft agreeably
furprifed.

During the ufe of mercury, a mixed diet of
vegetables and animals, as the mofl natural to
mankind in general, is proper; avoiding fat, hard,
indegellible food. Acids will fometimes caufe a
griping or purging under a courfe of mercury :
where that happens, they ihould be avoided.
At table, the moderate ufe of wine cannot be
hurtful. As to porter, or any other kind of
beer, it does not agree with all flomachs under
a mercurial courfe > where it does, I fee no
reafon why it may not be moderately indulged,
and I never faw in thofe circumftances any harm
from it. But what I principally infill upon is,
that the patient lliould go early to bed every
day; as indulging fleep feems rather ferviceable
during a micrcurial courfe. Moderate exercife
on foot, in a chaife, or on horfeback, in a
warm and dry day, I found always more iifeful
than confinement to a room ; but if the weather
be moift or very cold, it will be fafer to ft ay at
home. Night air is particularly dangerous; for
it is in general cold and damp, and ihould be
therefore, by every patient under a mercurial
courfe, mod carefully avoided. I have known
feveral inftances, where venereal patients, du-
ring the ufe of mercury, through inattention to
this fingle point, have ruined their health and
conflitution for years, or even for life. Where
the patient's bufinefs or circumftances of life
abfolutely oblige him to go out in very cold or

L 4 damp

i68 ON THE SYPHILIS.

damp weather, he fhould never do it without
having on warm cloaths, a flannel or callicoe
waiflcoat under his fhirt, and a pair of good
warm woollen ftockings.

Thus we proceed with the ufe of mercury, if no
peculiar fymptoms prevent it; and at the fame
time, order the patient to bathe once or twice
a- week in a warm bath, if' his conftitution be
ilrong enough: weak and relaxed habits will
not admit of thib. But whenever he perceives
a naufeous taile like copper in the mouth, flink-
ihg breath, fwelling of the gums, the teeth
feeling as if they were fet on edge, a larger fe-
cretion of faliva or fpitting than common, mer-
cury fhould be immediately left off for fome
days; a warm bath and fridions with the flelh-
brufh to be ufed in fome cafes ; a gentle phyfic
to be taken and occalionally repeated; and cold
moift air in thofe circumftances to be mod care-
fully avoided. If under the ufe of mercury
fymptoms of a general irritation appear, it
ought to be left off for fome days, and a dofe
of opium to be given in its ftead : but if fymp-
toms of an inflammatory diathefis prevail, bleeds
ing will be neceffary. Thus we continue with
the ufe of mercury, as I fald, till the virus is
wholly eradicated, which will generally be in
twenty-five or thirty days, if the difeafe has
not been of long {landing, and the fymptoms
have not been very ievcre ; but if the difeafe
be inveterate, and the flcin or bones feverely
affeded, ten or twelve weeks will be fome-
times neceffary to produce a complete and radl-

i^al cure.

Another

ON THE SYPHILIS. 169

Another circumflance to be attended to du-
ring a mercurial courfe is, that fuch patients
ilioald be previoufly told of the efFeds of mer-
cury on gdld, fuch as rings, watches, &c. By
not attending to this particular, difagreeable
difcoveries may fometimes be made, which fe-
male patients efpecially have great reafon care-
fully to avoid.

To know whether the lues is radically exter-
minated, is a nice point of pradical judgment;
and if I fay, that, from a carelefsnefs on the
part of the patient, or from want of knowledge
on the part of the practitioner with regard to
this point, a great many patients are unhappy,
and fufferers, I advance nothing but what we
fee daily confirmed. If we were in plofTeilion
of a remedy, which, having the power of ren-
dering the leafl particle of the venereal virus,
concealed in the body, adtive, and thus enable
us to difcover its prefence, in like manner, as the
loadflone difcovers the prefence of iron, there
would be nothing neceflary, but to adminifter
that remedy the moment we think the patient
had taken mercury enough. I have made fome
experiments on this fubjed ; but the number of
fads are not yet fufficient to enable me to form
a conclufion.

As foon as the mercury affeds the mouth of
the patient, we are fure of the moft ellential
point, viz. of its having entered the mafs,
which, as was obferved above, is a point ab-
folutely neceilary for eradicating the poifon.
The difappearing of internal venereal fymptoms,
and more fo that of the external ones, is ano-
ther,

170 ON THE SYPHILIS.

ther, not unequivocal fign, that the mercury has
exerted its acSlion upon the venereal virus. If
venereal ulcers which arofe from an infeded
mafs begin to mend or heal, if pains or tophufes
of the bones begin to difappear, &c. under the
ufe of mercury, we are fure of its having enter-
ed the mafs, and removed the elFe^ls of the ve-
nereal poifon ; but we are not yet fure of its
having eradicated entirely all the poifon prefent
in the body. For this reafon, we ought to con-
tinue the fame ufe of mercury for a fortnight
or three weeks, after all the venereal fymptoms
have entirely difappeared^ and then we may ge-
nerally be pretty confident that our patient is
radically cured of the diforder. — I have obfer-
ved in feveral patients who bore the internal
ufe of mercury extremely well, as long as the
difeafe took place; whereas, on the moment the
poifon was eradicated, they began to naufeate
it; which proved to be the flandard of their be-
ing radically cured.

But v^e are to obferve, that though the vene-
real poifon has been perfedly eradicated, and
the venereal difeafe confequently radically cu-
red, there are many inftances where exoftofes,
knots, or fwellings of the bones, owing their
origin to the venereal poifon, continue, how-
ever, all the life through, without any bad con-
fequences. A caries of the bones will often
remain, till nature herfelf, or affifled by art,
has made the exfoliation. Venereal excrefcen-
ces remaining after a mercurial courfe, are to
be looked upon as local complaints, and to be
removed by local remedies. It has been a ge-

I neral/

ON THE SYPHILIS. 171

neral obiervation, and I have feen it confirmed
in feveral inftances, that the venereal difeafe
yields eafier to a proper treatment in warm and
dry climates or feafons, than in cold and damp
ones. This is the reafon that has rendered
Montpelier fo famous for curing the moil ob-
ftinate and confirmed lues. This is like wife
the reafon that people, who are not cured of
venereal complaints at Peterfhurgh or Stock-
holm, &c. are fometimes cured when they go
to Italy or Portugal 3 and for the fame reafon
they fometimes will bear mercury there with-
out the leafl inconvenience, till they are per-
feaiy cured, when they could fcarcely bear a
few grains of it in cold or wet countries with-
out falling into an immediate falivation. I
have feen feveral ftriking inflances of this kind:
and it does not arife from fome peculiar balfa-
mic particles of the air in the fouth of France,
Italy, or Portugal 3 nor from any particular or
fuperior fkill of the phyficians at Montpelier,
above thofe of London, Stockholm, &c. as the
patients often wrongly imagine ', but merely
becaufe the atmofphere in thofe climates is dry
and warm, and nt)t unfrequently becaufe the
formerly negledful patient becomes now more
careful, and pays a more exad attention to the
advice of his phyfician or furgeon. — K ll^ilful
phyiician, however, will be able to put his pa-
tient, in any country whatfoever, in a fituation
which he finds neceffary for curing this com-
plaint, by producing for fome weeks or months
an artificial climate, by means of flannel, as
adequate and effedual for him as the natural
warm climate of Montpelier, Naples, or Lilbon.

CHAR

172 NEW VENEREAL DISEASE

CHAP. XIL

On the New Venereal Disease which of
late made its Appearance in Canada.

A New difeafe broke out fome time ago in Ca-
-^-^ nada, efpecially in St Paul's Bay 3 whence it
has been called he Mai de la Baye de St Paul (the
difeafe of St Paul's Bay). This difeafe has made
a rapid progrefs within thefe few years among
the inhabitants of Canada. The parents tranf-
mit it to their children. It is communicated
by eating, drinking, &c. If it once enters into
a family, rarely any one efcapes catching it.
Some habits feem to abforb the poifon^ and
then fometimes it remains concealed or quiet
for years, and breaks out at lafl with all the
fymptoms of the third ftage. The patients often
dragging out a miferable exiftence to old age,
lofe by degrees eyes, nofe, cheeks, velum pen-
dulum, and the whole balls of the fkuU, &c.
They call it Mai Anglois (the Englifh difeafe),
becaufe they think the Engllfli brought it firfl
amongft them. In feveral places, however,
they give it different names. At St Paul's Bay
the people call it la Maladie dcs Eboukments ; in
the neighbourhood of Boucherville, it is called
Lujlu Cruej and at Berthier and Sorel, la Maladie
I de

IN CANADA. 173

de Chicot, The name of Vilai?i 7nal, mau-
vais mal, and gros mal, are common in many
parifhes. Where it is of more modern date,
they call it lamaladie AUemande (the German dif-
eafe), as if it had been brought to them by the
German troops 3 but the name mal Anglois is the
moll frequently ufed. There were, in the year
1785, five thoufand eight hundred and one per-
fons difcovered to be infeded with it, belides
many"who concealed it ; but it was at that time
Hill unknown among all the neighbouring In-
dian tribes.

It firft manifefts itfelf generally by little ul-
cers on the lips, tongue, and infide of the
mouth; rarely in the genitals, Thefe little ulcers
are of a very corrofive nature, and were obfer-
ved in many children to have nearly deilroyed
the tongue. They firft appear in the form of
little puftules, filled with a whitifh purulent
matter; the poifon of which is fo infedive, that
it communicates by eating with the fame fpoon,
by drinking out of the fame mug, by fmoking
tobacco with the fame pipe; nay, it is even
obferved, that it is communicated by linen,
cloth, &c.

This poifon being abforbed from the ulcers,
or, as it often happens, originally abforbed
without any external fymptoms whatever, breaks
out afterwards either in large ulcers, or mani-
fefts itfelf by violent nodurnal pains of the
bones. The ulcers breaking out in the ikin or
mouth, diminilh the pain of the bones. Thefe
fymptoms are often accompanied with buboes
under the arm-pit, in the throat or groin;

which

174 NEW VENEREAL DISEASE

which fomethnes inflame and fuppurate, at o-
ther times remain hard and indolent. Some
patients feel pains in diiFerent parts of the body,
which increafe during the night-time, or when
they take fome violent exercife. This is the
fecond ftage of the diforder.

In the third ftage, tetters, itching crufts, or
ulcers, appear coming and going in different
parts of the body. The bones of the nofe, pa-
latum, cranium, clavicula, tibia, arm, and hand,
grow carious, or tophi appear in feveral of th^fe
bones. At laft, pains of the breaft, cough, lofs
of appetite, fight, hearing, fmell, and falling
off of the hair, clofe the fcene before death. —
Sometimes all thefe fymptoms appear at the
very beginning of the difeafe.

The patients drag the difeafe now and then
along for eighteen or nineteen years. One pa-
tient, who had this diforder twelve months upon
him, befides being affeded with many ulcers
and tophufes, loft at laft by the fame the calf
of one of his legs.

There are fome habits which feem not to be
fufceptible of this difeafe, at leaft they are ca-
pable of reftfting the infedion many years ^ but
in general both fexes, and all ages, are fubjecl
to it.

In the fecond, and efpecially in the third,
ftage, the difeafe is highly infedious.

There are many inftances where it has been
for years in the conftitution without giving any
ftgns of its prefence.

A vulgar opinion prevails amongft many,
that it affeds, like the fmall-pox, but once the

fame

IN CANADA. 175

fame perfon ; but this has been found to be ill-
grounded by feveral accurate obfervations.

There are fome perfons with whom the dif-
eafe proved fatal, by bringing on"a mortification
of the toes. Mr Bowman obferved two cafes ;
one where a little boy loft by the difeafe both
feet, the flumps remaining; and another where
the leg fell off by the knee. Both patients re-
covered.

After fome days ufe of medicines, the fymp-
toms often grow worfe, but afterwards difap-
pear.

The bed-clothes, as well as other clothes and
linen, are to be well wafhed in foap-ley, before
they are again made ufe of.

Coitus is very infeding, and ought to be
avoided during the cure.

Children form a large proportion of the in-
feded. There are examples where Mr Boivman
faw theconflitution of fome children get the bet-
ter ot the difeafe without any medicine 5 as is evi-
dent from the inflance of J. Simar, now nineteen
years of age, who had the difeafe when one year
old, and never took any medicines for it, nor was
fuckled by his mother when flie took medicines.
Some children teemed to be cured of the difeafe
by the medicines which the mother infeded
had taken formerly, though fhe herfelf was not
perfectly cured by them.

There is hardly any application that igno-
rance or fuperftition, influenced by necelfity,
could fuggeft, which had not been made ufe of
by the Canadians for the cure of this difeafe.
. The dock and burdock roots, farfaparilla, and

fpruce

176 NEW VENEREAL DISEASE

fpruce, have been generally made ufe of, and
with fome appearance of fuccefs. Moft fuccefs,
however, has been obferved from a decoction
of the bark of the branches of the hemlock-
fpruce (a tree fo called on account of the re-
femblance of its fraell with hemlock). And Mr
Bowman obferved afterwards, that it greatly
forwarded the cure, though none was found to
be cured radically without mercury. The fame
bark he found anfw^r very well, inftead of the
Peruvian bark for ilrengthening the conllitu-
tioti. Children were cured by fucking the mo-
ther to whom mercury was adminiftered.

Purified mercury, fimply divided and joined
with anodynes, feemed to anfwer bell.

Sublimate and farfaparilla were greatly prai-
fed, but have npt anfwered in the advanced
ftages of the difeafe. — In adults, however, the
folution of corrofive fublimate with the decoc-
tion of the bark of hemlock-fpruce, had very
good effects.

Mr Bowman, to whom we owe the beij ac-
count of this difeafe, found it neceffary to con-
tinue the mercury three weeks after all fymp-
toms difappeared. He obferved, that thofe pa-
tients who made ufe of the milk diet during the
cure, were fooneft re-eflablifhed. He cured
many of the worfl cafes.

Government, by the humane reprefentation
from Governor Hamilton^ thought proper to
appoint and fend out in 1786, fix furgeons, to
cure and adminifter medicines gratis to every
perfon afflicted with this new diforder^ in order

to

IN CANADA. 177

t'6 eradicate, or at leafl mitigate, this evil, with
which whole families were infe(5ted.

The mofl remarkable in this new difeafe isj
I. That itfeldom afFeds the genitals; and, 2dl}'^
That it is contagious, or at leafl communicated
without immediate contadl or coition, ^ ^

Thefe two curious circumftances appear t6
me highly interefling, becaufe they feem to elu-
cidate feveral paflages qf the earliell writers
oa the lues ; who all agree, that the difeafe,
when it firfl; appeared, and a good while after,
has been propagated withouf: immediate contact
or coition; and in none of the authors who
wrote the firfl twenty years after the venereal
difeafe appeared, I find any mention made of
the genitals being affedled* ^

The difeafe called the Sibbens, which feveral
years ago was very general, efpecially in Gal-
loway and Airfhire, but has now become rr^ucll
lefs common, is, on account of its mode of pro-
pagation, as well as on account of its fymptoms
and cure, fo very fimilar to this new difeafe of
Canada, that I think It is to be referred to this
head.

M ' CHAP.

Z78 ON MERCURIAL PREPARATIONS

CHAP. XIII.

On Mercurial Preparations Iri

generaL

BEFORE I enter into the confideration of the
different mercurial preparations, the reader
will perhaps be pleafed to fee a fynopticarl view
of all the preparations of mercury hitherto
known. I therefore fubjoin the following Table :

TABLE of all the different Mercurial
Preparations hitherto knownf ,

I. Preparations where the Mercury is limply

purified.

* Hydrargyrum puriflcatum.

Syn. Mercurlus crudus purificatus officinarum.

Argentum vivum purificatum. Pharm. London*
^ng/is, Quickfilver, rude purified n^ercury; Germanisy
Reines queckfilber j Gallisy Mercure pure.

II. Preparations in which the Mercury is only

divided.

I. By

I Thofe marked *, are mod in ufe.

IN GENERAL. 179

X. By gums or mucilages) fuch as gum arable^
tragacanth, &c.

* Hydrargyrum gummofum.

Mercurius guiDmofus of P/enck (the inventor).

. s. By refins or balfams ^ fuch as turpentine^
balfamum copaiva, &c.

* Hydrargyrum terebinthinatum, ^c,

3. By fuet or vegetable oils; fuch as hog^a^

lard, goofe-fat, or butter of cocoa nuts*

* Hydrargyrum unguinofum.
* Unguentum hydrargyri.

4. By calcareous earth; fuch as chalk, chelae

cancrorum, &c.

.Mercurius alkalifatus.

III. Preparations where the Mercury is cal-

cined by heat and air.

* fiydrargyrum calcinatum.
Syn, Mercurius ealclnatus.

Mercurius prsecipitatus per fe.

IV. Preparations where the Mercury is partly

divided and partly diflblved.

1. By fugar-candy, or faccharine compoiitlons;

fuch as conferva rofarum, cynofbati, &c.

* Saccharum hydrargyratum.

2. By honey.

* Mel hydrargyratum.

M a 3- Mer-

x8o ON MERCURIAL PREPARATIONS

3. Mercury combined with fulphur, (flowers

of brimilone).

* Hydrargyrum fulphuratum.

a. By fimplc trituration or fufion.

* Hydrargyrum fulphuratum nigrum.
Syn. ^thiops mineralis.

b. By fublimation.

* Hydrargyrum fulphuratum rubrum.
Syri' Cinnabaris fa£titia, feu artificialis.

4. Mercury combined with fulphur of anti-

mony.

a. By fimple trituration.

* Sulphur antimonii hydrargyratum nigrum.
Syti. JEthiops antimonialis.

b. By fublimation.

» Sulphur antimonii hydrargyratum rubrum.
Syn. Cinnabaris antimonii.

5. Mercury combined -with fulphur by preci-

pitation.

See below the Preparations with the Vitriolic acid.

V. Preparations where the mercury is redu-
ced to the form of a metallic fait or calx,

by acids : Such as,
I. Acid of fuet. 2. Acid of common fait. 3. Acid of
fugar, 4. Acid of amber. 5. Acid of arfenic. 6. Acid
of wood-forrel. 7. Acid of phofphorus. 8. Acid of
vitriol. 9. Acid of fugar of milk. 10. Acid of tartar.
1 1. Acid of citron or lemon. 12. Acid of nitre. 13. A-
cid of fluor mineral. 14. Acid of vinegar. 15. Acid
of borax. 16. Acid of Berlin blue. 17. Acid of mo-
lybdasna. 18. Acid of tungftone. 19. Aerial acid.

I. Mercury combined with acid of fuet (aci-
dum febi.)

Hydrargyrum fcbinum,

2. Mer^

IN GENERAL. i8i

2. Mercury combined wkh the muriatic acid^
or acid of common fait.

' * a. Hydrargyrum muriatum.

* Hydrargyrum' muriatum fortius'

■ By fublimationj
' or

By precipitation.

Syn^ Mercurius fublimatus corrofivus.
Mercurius fublimatus albus.
Mercurius corrofivus albus.

C By Sublimation,
* Hydrargyrum muriatum mitius. ^ or

^By precipitation.
Syn. Mercurius dulcis.

Mercurius dulcis fublimatus.
Calomel feu calomelas.
Aquila alba.
Panacea mercurialis.
Mercurius dulcis lunarls of Schroeder.
Mecurius dulcis precipitatus of Scheele (the inventor), or
calx hydrargyri muriata.
Preparations of muriated quick- filver by means of different
precipitations.

a. From its folution in muriatic acid by vegetable alkalio
1 Mercurius praecipitatus albus.

b. From its folution in muriatic acid by mineral alkali.

Mercurius praecipitatus albus.

c. From its folution in muriatic acid by volatile alkali.

Mercurius precipitatus albus.

d. From its folution in muriatic acid by copper.
Mercurius pracipitatus viridis.

e. Dr Ward's luhite Srop^ or mercury precipitated from
its folution in nitrious acid, and rediflblved by fal am-
moniac.

3. With the acid of fugar.

Hydrargyrum faccharatum. Bergman.

4. With the fuccinous acid; or acid of amber.

Hydrargyrum fuccinatum. Bergman-

5. With the acid of arfenic.

Hydrargyrum arfenicatum.

M q 6; With

ia2 ON MERCURIAL PREPARATIONS.

6. With the acid of wood-forrel, (oxalis acq-

tofella Linnaei).

Hydrargyrum oxalinum. Bergman.

7. With the phofphoric acid.

Hydrargyrum phofphoratum. Bergman.
By precipitation from its folution in the nitroiis acid by
recent urine.
Rofa mineralia,

8. With the vitriolic acid.

* a Hydrargyrum vitrioiatum.
Syn. Vitriolura mercurii.

Oleum mercurii.

* b. Hydrargyrmn vitriohtum fiavum.
Syn, Turpethum minerale.

Mercurius emeticus fiavus.
Mercurius fiavus.
Mercurius prascipitatus luteus.
Turpethum nigrum.

* c. Mercury precipitated from its folution in nitTous acid

by hepar fulphuris or hepar caki?.
Mercurius prsecipitatus niger.

9. With the acid of fugar of milk.

10. W^ith the acid of tartar.

a. Hydrargyrum tartarifatum. Bergman.

b. With piirified tartar, commonly called cream of tartar ^

viz, veg. alkali fuperfaiurated 'vjith the acid^of tartar.

* Tartarus flydrargyratus.

Terre feuilletee mercurielle of T^t PreJl[avlnj (the
inventor.)

c. Mercury precipitated from its folution in nitrous acid

by the acid of tartar.

* Calx Hydrargyri tartarjfata flava ; vulgo, Pulvis Con-

(lantinus.

d. Mercury precipitated from its folution in muriatic and

tartarous acid by fixed vegetable alkali*

* Calx hydrargyri tartaritatr; alba ; vulgo, Pulvig argen-

tcus.

II, With

I N G E N £ R A L. iSj

21. With the acid of citron 3 or lemon.

Hydrargyrum citratum. Bergman^

12. With the acid of nitre.

* Hydrargyrum nrtratum.

A. Simply diflblved.

* Acidum nitri hydrargyratu^i,
Syn. Solutio mercurii.

B. Evaporated and calcined by fire.

* Calx hydrargyri nitrati rubra.
^ji« Mercurius corrofivus ruber.

Mercurius praccipitatus ruber.
Pulvis principis.
Mercurius Gorallinus.
Mercurius tricolor.
Panacea mercurii.
Arcanum corallinum.
Panacea mercurii rubra.

C. Precipitated from its folution in nitrous acid,
a. By volatile alkali.

* Hydrargyrum nitratum cinereum.
Syn. Pulvis mercurii cinereus. Phartn. Edin^
Turpethum album.
Mercurius praecipitatus dulcis.
\i. By vinous volatile alkali, (fpiritus falis ammoniacf vi-
nofus).
Turpethum nigrum.
Mercurius praecipijtatus niger.

c. By fist vegetable alkali.

Mercurius prsecipitatus fufcus, Wurtz,^

d. By copper.

Mercurius pr?ecipitatu8 viridis.

13. With the acid of fluor or fpar, (fiuor mi-

neraljs.)

Hydrargyrum fluoratum. Bergman.

14. With the acid of vinegar.

Hydrargarum acetatum. Bergman^

15. With the acid of borax.

Hydrargyrum boraxatum. Bergmari'-

M 4 16. With

lU ON MERCURIAL PREPARATIONS

i6. With the acid of Berlin blue,

17. With the acid of Molybdaena,

r8, With the acid of Tungflone.

19. With the aerial acid, or fixt air.
Hydrargyrum aeratum. Bergman.

A Number of the different mercurial prepa-
rations mentioned in the foregoing table, have
been recommended at different times, by differ-
ent chemifts and praditioners, for curing the
venereal difeafe. We fhall confine ourfelves to
the coniideration of thofe marked with an aite-
riik, and principally employed now, having ei-
ther maintained their reputation from their firll
introdudion into pradjce, or having been dif-
covered in our times, and poffefling fuch qualities
as will intitle them to the fanie predicament.

They are fliortly as follow :

Mercury in its crude ilate rubbed down, or^
as it is commonly called, extingiiijljed or killed^
with fat or oils, with gum arabic, turpentine,
extract of liquorice or cpnferve of rofes, &c. — -
In a more diffolved itate triturated with fugar-
candy, a prepar^ation which I c^WqA faccharum
hydrargyratum.' — United with ililphur under the
name of cinnabar^ for fumigations. — The metal
calcined by itfelf, and thence called hydrargyrum
calcinatuvi.

Mercury diffolved by different acids, and uni-
ted with them into a metallic fait, or precipi-
tated from them in the form of a more or lefs
acrid calx. Such as,

Witl^

IN G E N E'R'^'A i:.' '^ ^85

With the muriatic acid : The corrofive filb-
limate, which I gave in the table the more ade-
quate name of hydrargyrum vinriatinn fortius, in
order to diftinguifh it as well from calomel or
mercurius dulcis, which 1 called hydrargyrum
inuriattivi mitiiis ; as from the mercurius dulcis
prepared by precipitation, according to the in-
vention of Mr Scheele, which may be called with
propriety calx hydrargyri muriata Schediiy or hy^
drargyrinn muriatum mitius pracipitatuvu

With the acid of vitriol : The turpeth mineral,
mercurius emeticus, or praecipitatus flavus, cal-
led more properly hydrargyrum vitriolatum.

With the acid of tartar : The hydrargyrum tar-
tarifatum, which ought to be diftinguifhed from
what I call the Tartarus hydrargyratus^ or terre
feiiilletee mercurielle of Dr Preflavin of Paris ;
which latter is a combination of mercury with
purified tartJ^r (commonly called creafn oj tar*
tar) ; whereas the former is a compound metal-
lic fait made of mercury and the pure acid of
tartar.

With the acid of nitre : The hydrargyrum ni-
tratum, either in a liquid limple folution, which
I called acidimi n'ltri hydrargyratum, or in a more
folid or compound form, as in the hydrargyrum
nitratum ruhriim, commonly, though very impro-
perly, called red precipitate ; or in the Jyrup of
Belief . The pulvis Tuercurii cinereus of the new
Edinburgh Pharmacopoeia 5 where the mercury
diflblved in nitrous acid is precipitated by vola-
tile alkali 3 however not quite deprived of the
acid, and therefore more properly called hydrar-
gyrum Jiitratum cinereum, Dr Ward's white drop,

where

i86 ON MERCURIAL PREPARATIONS.

where the mercury difTolved in the fame acid is
precipitated and redifTolved by means of fal am-
moniac, belongs rather to the preparations of
jnercury made by means of the muriatic acid.
And laftly,

With the acid of vinegar • Hydrargyrum ace-
tatum, known und^r the name of Keyfefs pills,
or troches j where the mercury, after having un-
dergone a long-continued trituration, is thereby
united with this acid.

All thefe different preparations are applied in
various forms; fuch as po\yders, pills, bolufes,
folutions, lotions, injcdions, ointments, &c.
feme of them for external, others for interna!
u/e ; for which, I mufl refer the reader to the
Pbarmacopceia Syphilitica annexed at the end of
this Treatife. In general, it is to be obferved,
that all dry mercurial preparations are the fafer
and better the finer they are levigated.

C HAP,

ON MERCURIAL PREPARATIONS 1^7

CHAP. XIV.

On Mercuriaj, Preparatioi^s /// parth

cidar*

I. On Crude Mercury, the Mercurial Ointment,
and on Mercurial Frictions.

O

F all the different metliods hitherto difcp-
vered for curing the venereal difeafe, that
%y mercurial fridions is perhaps the moil effi-
cacious, as well as the fafefl and niildeil. The
application of rnercury in this way, however, as
indeed the ufe of mercurials in general, re-
quires often considerable ikill and attention on
the part of the praditioner, as well as a very
ilrid compliance and obfervation of regimen on
that of the patient, in order to produce the de^
|ired effed in the fpeedieft manner.

Such is the difference of conflitutions, that
feme perfons will be more affeded by a fev^
fridions than others, feemingly in the very
fame circumftances, by twenty or thirty : and
if more mercury is rubbed in, with a view to in-
creafe its effed, inllead of benefiting the pa-
tient, we often run the rifk of bringing on very
difagreeable fymptoms^ fuch^as vertigo, feverifli
heat, falivation, trembling of the extremities, of
chronic violent pains in the articulations.

When fridions have their proper effed, the

i88 ON MEPvCURIAL PREPARATIONS

ufe of them is not attended with any bad fymp-
torn ^ the patient is eafily cured without fuffer-
ing niuch in the time, or without finding him-
lelf much weakened afterwards. Mofl people
have their fymptoms in fome meafure reheved
by four or lix fridions ; though fometimes four-
teen or fifteen are rec^uired to produce this ef-

The mercury employed for this purpofe ought
to be very pure ; and as practitioners cannot be
aiTured of the purity of that which is fold in the
ihops, they ought to purify it themfelves. Mofl
of our mercury comes from Idria, and paffes
through the hands of the Dutch, by whom it is,
not unfrequently, adalterated with heteroge-
neous fubftances, without any diminution of its
fluidity or metallic fplendor. But no phylician
who has the fafety of his patients at heart, ought
ever to employ quickfilver, either externally or
internally, without being certain of its being
perfedly pure ; for, by making ufe of the me-
tal in an impure flate, he may not only be dif-
appointed in the effects he expeded, but may-
do a real harm to the patient. This being the
eafe, the reader, I hope, will excufe the followr-
ino- reniarks upon the Adulteration and Purifi-
cation of Mercury.

Quickfilver is found In mines, either native,
in v/hich fcate it is called merciirius virgmeus ; or
mineral ifed, when it obtains the name of ore,
from which it is afterwards feparated by diftil-
iatlon.

The ores of mercury are of different kinds
and forms. The native cinnabar, however, is

the

IN PARTICULAR. l^

the kind which generally contains the greateft
quantity of quickfilver. But though many re-
commend the native cinnabar as a remedy to be
employed in practice, it is a matter of fad, that
it is often mixed with arfenic or other hetero-
geneous particles. It is, therefore, running a
riik to em-ploy native cinnabar, efpecially for
internal ufe }, and though it is fometimes more
beautiful in its colour than the artificial, we
may always depend with more fafety upon the
latter, if properly prepared.

The mercury being in the cinnabar, or other
ores of mercury, generally mineralifed by ful-
phur, or at leaft concealed under it, the procefs
to feparate it from the fulphur confifls herein,
that a fubflance be united with mercurial ores
which has a ^greater affinity with the fulphur
than with the mercury: Such fubflances, for
example, are alkaline falts, calcareous earth,
iron, fcoria ferri, &c. If, therefore, one or
other of the juft mentioned fubflances (of which,
however, the cheapefl is generally chofen) be
mixed with the ore of mercury, and expofed to
diflillation, this fubflance will unite with the
fulphur, and the quickfilver, being thereby fet
at liberty will go over into the receiver in its
liquid metallic fiate, in the form of vapours,

A bad cuftom has, alas ! arifen from interefl-
ed motives, viz. to adulterate mercury with lead,
with which it readily unites. This adulteration
is accomplifhed the more eafily by the medium
of fome bifmuth) becaufe the amalgam thus
produced is much more fluid, and retains much
better the metallic filvery fplendor of mercury.
I It

190 ON MERCURIAL PREPARATIONS

It IS thence evident, that the colour and fplen*
dor of quicklilver are not always certain cha-
radteriftics of its purity; and the purification
of mercury, by prefling it through a leather bag,
is by no means to be depended upon ; becaufe
the amalgam made of quicklilver, lead, and bif-
muth, is often fo perfed, that though even the
fourth part of the wholt mafs confifts of lead
and bifmuth, very little, however, of thefe he-
terogeneous fubftances will remain behind in
Uie leather bag.

The only fure means, therefore, to purify
quicklilver is diitillation. For which purpofe,
fome think iron velTels are beil fitted, iron being
the only metal with which the mercury refufes
to unite, and there being no fear that iron vef-
fels are defbroyed by the procefs as there is
with regard to thofe made of glafs. To make
life of iron velTels is the more advifable, becaufe
the mercury expands very much during the
operation, by which means glafs-veiTels are eafi-
ly broken. The higher the mercury is driven
before it defeends again, the better it is, becaufe
by thefe means the particles of lead cannot fo
eafily be carried with it. The veflH for this
operation may be an iron pot, with a long irou
neck like the barrel of a mufket. But in order
to condenfe the better and eaiier the mercury
riling in the form of vapours, the end of that
tube, bended downwards, ihouid be one or two
inches deep immerfed in vinegar. All the mer-
cury is, by this method, not only obtained
without lofs, and the operator is expofed to no
danger, but- the mercury will alfo be perfedly

i> freed

IN PARTICULAR* tpl

freed and purified from all particles of lead and
bifmuth which might poflibly have gone over
with it, they being foluble, and the quicklilver
infoluble, in vinegar.

The characters of pure quickfilver are, i.
That, when poured upon wood, it forms glo-
bules, which always retain a fpherical form, and
never are drawn into length, forming a line like
a thread. 2. That its furface is not covered
with a cuticle, but ihining. 3. That when rub-^
bed with water, the water grows thereby not
blackifli or foul. 4. That vinegar rubbed or
digeiled with it, does not acquire from it a
fweet tafte. 5. That put in an iron fpoon over
the fire, it evaporates entirely, without leaving
any thing behind.

I'he mercurial ointment is generally prepared
by rubbing, or, as it is commonly called, hilling^
or extinguifhing the mercury with hog's-lard
and turpentine. The preparation of the oint-
ment in this manner is very exceptionable. It
generally foon produces in many perfons, w^hofe
fkin is tender, puftules of an inflammatory kind,
very painful, which prevent the continuation of
the frictions. — A more proper method therefore
of preparing the mercurial ointment for this pur-
pose, is by triturating the purified metal with
frefh hog's-lard, repeatedly wafiied and cleaned
previouily for feveral days w^ith pure water^
without the addition of any tui'pentine. The
trituration ought to be continued for two hours,
even after all the globules of mercury have dif-
appeared, in order to be certain of the moll per-
fe<£t divifion. It iliould then be j)ut by in a cold

place^

192 ON MERCURIAL PREPARATIONS

place, not only to avoid its growing rancid, but
alfo to prevent its melting, which would pro-
duce a reparation and fubfequent precipitation
of the metal from the hog's-lard to the bottom
of the veiTel.

But, notwithftanding this precaution, we often
meet with patients, whofe fkin feems to be fo ex-
tremely irritable, that they cannot bear the ap-
plication of the ointment, even when prepared
according to the method jufl: mentioned. The
great propenfity of the hog's-lard to grow ran-
cid, efpecially in hot feafons or warm climates,
contributes greatly to occafion this troublefome
effed. In fuch circumftances, it will be proper
either to mix with the above ointment a fmall
quantity of the ointment of liquorice recently
prepared, or to prepare it entirely of mercury
and the butyraceous oil obtained from cocoa-
nuts by boiling them in water ; or to make ufe,
inftead of the ointment, of quickiilver rubbed
down with the mucilage of gum arable* Thus,
indeed, the procefs is rendered perhaps a little
more troublefome and expenlive; but the prac-
titioner who wifhes to render the cure eafy and
agreeable to his patient, will readily fubmit to
inconveniences of this kind.

By this method we may effedually prevent
the pruritus or puftules proceeding from the ap-
plication of the common mercurial ointment,
efpecially if, at the fame time, the place where
the ointment is to be rubbed in, be previoufly
ihaved, and too harfh rubbing with the hand be
avoided. For fuch puftules fometimes feem to
originate from the hair being violently moved

in

IN PARTICULAR. 193

in oppbfite diredions, which, by thefe means,
will be eafily avoided,

The principal objects, after the application
of mercurial fridions has been fixed upon, ought
to be, ifi, To difpofe the place, which the oint-
ment is to be rubbed in, to the ready abforption
of the mercury; and, 2dfy, At the fame time, to
difpofe the furface of the body to tranfmit the
metal as fpeedily as polTible through its pores,
after it has produced the defired effeds in the
fyflem; and thus to prevent falivating, purging,
or its fettling in the bones or any of the cavities
of the body. For this purpofe, it will be al-
ways advifabie to prefcribe, before we begin
the fridions, a purgative, and to order the pa-
tient to fit in a warm bath made with foft water,
and of about 86 degrees of Fahrenheit's ther-
mometer, for the fpace of half an hour or an
hour. After he has been in it for a quarter of
an hour;, he mufl be rubbed all over with a flefh-
brufh, or a piece of flannel and foap, to clean
the fkin, and adapt it the better to the purpofes
above mentioned. This is to be done, if no par- .
ticular circumflance forbids, the dav before, or
the very day when w^e begin the fridions; and
to be repeated once or twice a-week afterwards
during the whole courfe of the fridions.

The fame evening, or the day after, having
made ufe of the warm bath, the patient ihould
begin the fridion, rubbing into the outfide or
infide of his thigh or leg, before he goes to bed,
a drachm of the mercurial ointment prepared as
above direded. The fridion is to be performed
by the fire-lide in winter, and the rubbing ought

N to

194- ON MERCURIAL PREPARATIONS

to be made gently, and continued for half an
hour or an hour, till the whole be rubbed in.
The part is then to be covered with a piece of
linen faftened with a bandage^ or the patient ig
to put on a pair of drawers, or a pair of flock-
ings if the fridion has been made on the leg*
The fame bandage, &c. may ferve for the whole
time, or at leaft for feveral days, being applied
only to keep the fhirts and bed-linen from being
lullied and growing black from the ointment.-—
Before each new operation, the greafe and black-
nefs ought to be well cleanfed or wafhed off
with foap and warm water.
• The fridion itfelf is beft made by the patient
with his own hand ; but to fat people, or to the
female fex, this operation may prove tirefome :
in which cafe a fervant Ihouid be inflruded ho-W
to, do it, putting on a glove made of a foft hog's
bladder or oil-fkin. I would not advife any
perfon to perform this operation for another
without putting on fuch a glove, becaufe I have
feen inflances of a falivation being brought on
in the affiftant, from rubbing in the mercurial
ointment with his n^ked hand. Befides, we
cannot be certain how much ointment is rub-
bed into the patient, whenpart of it is abforbed
into the fervant's hand.

After the firfl; fridion, we are to obferve at-
tentively whether the mercury occafions any
irregular motion in the body : if it does fo, it
ought to be omitted for two days, , and the pa-
tient to obferve the fame regimen, to be well
clpathed, and to keep within doors, efpecially
in a cold feafon.

If

IN PARTICULAR, igs

If after two days, the patient fhouid perceive
no difagreeable iymptoms, the fecond fridion
is to-be made in the fame manner as the firfl.
The ne^ct day he mull leave it off again; and if
he then finds no ill effeds, the fridions ought to
be continued hereafter every day, either morn-
ing or evening, without intermillion, unlefs fome
accident intervene. The place of rubbing, how-
ever, mult be changed every day, or every other
day, in order to avoid irritating the Ikin, and
pullules riling upon it. If, after five or fix
frictions, we find that the patient has no fever,
diarrhoea, falivation, or immoderate fweating,
and that he will thus bear the mercury, we may
rub in two drachms of the ointment at every
fridion, efpecially if the fymptoms be oblli-
( nate.

In this fituation, if the weather be warm, or
indeed unlefs it be feverely cold and damp, the
patient may go out every day during the fric-
tions, provided he be warmly cloathed, and a-
void the cold wind, and efpecially the night air.
But he ought carefully to guard againfl: check-
ing perfpiration; and therefore, if the weather
be cold, windy, or moift, he fhouid rather keep
at home in a moderate warm room, and Ihun as
much as pofiible every inconvenience from cold.
In a fevere feafon he Ihould conllantly wear
flannel ftockings and a flannel waiftcoat, ac-
cording to circumfiances, either over or under
the Ihirt.

During all this time, however, he lliould if
poflible ufe the warm bath, as 'already direded,
once or twice a-week; proceeding in this man-

N 2 ner

i()6 ON MERCURIAL PREPARATIONS

iier until his health h^ perfe6!Iy re-eftabli{hed r
which win be after thirty or thirty-five fridions,
if the foft parts only have been affeded^ but if
the difeafe has been eonfirmed, or of a long
landing, fo that the bones are affeded, fifty,"
fixty, or feventy fridions wiU be abfolutely ne-
cefiary to procure a perfe(51: and radical cure;
though this, no doubt, will vary according to
the conftitution of the patient.

It m-uft'bere be remarked, as an obfervation
of great confeqiience both to the phyfician and
patient, that the ceflation of the fymptoms is
never to be looked upon as a fign of a radical
cure. This vv^e ought to tell our patients in the
beginnings efpecialiy to thofe of the female fex,
that to alleviate the pain or abate the fymptoms
of the diforder, and to defi:roy and eradicate
the venereal poifon from the body, are two
things widely different. The former may often
be aceompliflied in three or four days by a very
few frictions ; whereas the latter will fometimes
require as many months. The fame thing will
undoubtedly happen in this refpecS when we
leave off the frictions as foon as the fymptoms
difappear^ as when we leave off the Peruvian
bark in agues as foon as the fever is gone : the
fever foon returns again, although perhaps with
a different type ; but by continuing the bark a
little longer, w^e are fure of rendering the cure
pcrfed, and need not to be in the leafl: afraid
of a relapfe..

We muft, therefore, for the fafety of our pa-
tients, continue the ufe of mercury for two or

three

IN PARTI C U L A R. 197

tliree weeks, or at leaft ten days, after the fy-
philitlc fymptoms have perfediy dllappeared ;
but it is here where the praditioner muft give
proof of his judgment and experience.

When the patient, during the frictions, or
any other courfe .of mercury, feels his gums be-
gin to fweii, his breath fo fmeii difagreeably,
his throat to become -pa-inful in tke infide, or
when he is obliged to fpit oftener than ufaal,
the ufe of mercury is imniediateiy to be left off
till thefe fymptoms difappear, and then he may
.go on with it again, ^ut, in general, I think it
eligible to go on with the fridions, if the pa-
tient can otherv/ife bear them, pretty brifi^ly,
until the mouth be a little affeded; becaufe
thus we are certaiii that the fridions have had
their proper effed:, and that the mercury has
been abforbed into the fyftem.

The generality of patient?, as ha^ been al-
ready mentioned, find fome relief after a few
fridions ; but there are fome, efpecially thofe
who have the bones affed,ed with tophus, caries*,
&c. who feel no remiHion of the fymptoms till
after fifteen or twenty fridions^ and fom*etimes,
in this flate of the difeafe, feventeen ounces of
mercurial ointment will be requifite to produce
a perfed cure.

In all fuch cafes, we mufl; endeavour to make
the mercury go off by perfpiration; but profufe
fweating ought, on the other iide, not to be en-
couraged, left it fhould weaken the patient, or
bring on a coniumption, efpecially in fjch as
are cache die, or of a thin habit of bod/. Wh.ei'e

N 3 IWQ

198 ON MERCURIAL PREPARATIONS

we find the body naturally difpofed to falivation,
we ought to be very cautious how we proceed. In
this cafe the patient fhould, efpecially in bad
weather, keep carefully within doors, inarooiij
moderately warm, without being too much co-
vered, particularly on his head or neck. The
proper temperature of the room in winter is
to be betwixt 70 and 75 degrees of Fahrenheit'^s
thermometer. But in fine dry weather, I would
rather advife him to go abroad ; for I have
found, in many inflanccs, that the enjoying of
pure free air contributes rather to prevent a fa^
livation". In warm feafons or climates fuch pre-
cautions are unneceflary. If the patient- be
weak, the Peruvian bark may be given, at the
fame time, with advantage, from a fcruple to a
drachm, in milk or wine, according to circum-
flances, every morning and evening.

By this method I have generally jfucceeded in
preventing the above mentioned bad efFeds of
the mercury, as profufe fweats, falivation, and
its running off by ftool : in all thefe cafes, the
mercury, though abforbed in the two former cafes
into the fyilem, feems to run off by the falivary
glands as fail as it is taken, without perform-
ing thofe falutary effecls in the body, which are
abfoluteiy neceffary to deilroy the venereal poi-
fon, and to produce a radical cure. In the latter
cafe, when a diarrhcea is occafioned by the mer-
cury given internally, its abforption from the
inteftines into the mafs is thereby prevented,
and it can have little or no cfFecl: againft the
difeafe. I have feen feveral venereal patients

treated

IN PARTICULAR. 199

treated in this manner, who, after taking mer-
cury for fix or eight weeks, which kept them
all that time in a continual diarrhoea, were,
with regard to their original difeafe, nearly in
the fame ftate at the end of this courfe as they
had been at the beginning. of it.

II. X)n Mercurial Fumigations,

I HAVE little to fay on this fubje6l. Mercurial
fumigations ^ though now a-days no more in
nfe for curing the lues, prove often a mofl ef-
fedual remedy for curing local venereal com-
plaints. The artificial cinnabar is for this pur-
pofe to be put upon live coals, and the rifing
fmoak to be conveyed by rneans of i^ proper
funnel to the part affected.

III. Of Salin:^ and other Mercurial Prepa-
rations.

The hydrargyrum gummofum, (or mercurius
gummofiis), is a mild mercurial preparation,
in which the crude metal is divided by means
of gum arable. Mr Plcnck, the inventor of
this preparation, firit prefcribed it diluted with
water, in the form of a mixture; but this
form being found inconvenient on account of
the mercury not remaining properly fufpended,
he propofed, fome time ago, to form it into
N 4 pills

266 ON MERCURIAL PREPARATIONS

pills. He, for this purpofe, orders two drachms
of well purified quickfilver to be triturated
with three drachms of powdered gum arabicj,
and a fufHcient quantity of conferve of hips, in
a marble mortar, till the mercury has difap-
peared ; then continuing the trituration for ai^
hour longer, the mafs to be mixed with half an
ounce of crumb of white bread, and fo to be
formed into pills of three grains each, of which
the patient is to take fix every morning and
evenine. This form is undoubtedly lefs excep-
tionable, but ftill liable to another inconveni-
ence; which is, that thefe pills, like ail thofe
made with crumb of bread, when kept for a
length of tim-e, grow fo hard, that they fre-
quently pafs the flomach undilToived, and are
evacuated by ftool in the fame globular form
they \yere taken. This objedion, indeed, can-
not be made, if they are prepared frefh every
fecond or third day; and, in that cafe, they will
be found a very valuable acquiiition for our
Pharmacopoea Syphilitica.— A bolus made from
live to ten grains of quickfilver, with a fuf-
ficlent quantity of the conferve of rofes, or
confedio cardiaca, or, what is more prefe-
rable, with the extrad of liquorice, will, ac-
cording to circumftances, ferve for the fame
purpofe.

Mercury divided by means of fome balfam,
would be. a very acceptable and- ufeful medicine
in different cafes. An attempt of the kind has
been made in the pilulae ex hydrargyro terebin-
thinato, where one ounce of quickfilver is uni-
ted with a drachm and a half of turpeiitine; but

befides

IN PARTICULAR. 2qx

be*iides that the divlfion is extremely tedious,
which indeed may be obviated by adding fome
drops of the oil of turpentine, this compofition
is, like all the faline mercurial preparations,
very apt to excite griping and purging. This
efFed may be partly owing to the quality of tur-
pentine^ the bell fort fhould therefore be chofen
for this piirpofe, and,' according to circuniitap-
ces, inllead of the turpentine, the balfam q£
Gilead, or balfamum Canadenfe, formed into a
proper confiiience by means of the fpecies aro-
maticae, or fome other vegetable powder, might
be tried 3 and thus a pill or bolus of five or fe-
ven grains be given every evening.

The facchanivi hytlmrgy?'atum, or quickfilver
triturated with twice or three times its, weight
of fugar-candy, is, in many inilances, a moft
excellent medicine, as well for internal as ex-
ternal ufe. Its dofe internally is from four to
eight grains a-day, in tlieform of powders, pills,
or troches.

The hydrargyrum calcmatiim, or calcined mer-
cury, 1 have conftantly found to be apt to ex-
cite gripings- This may, in fome refpedt, be
avoided, by mixing half a grain of it with a
grain of opium, to be taken every night or every
fecond night in the form of a pill.

The hydrargyrum acetatum, known by the name
of Keyfer's pills or troches, has of late made a
great noife in France. It has been recommended
as the fafefl: and beft medicine for curing vene-
real complaints, even of the moil obftinate and
inveterate kind, without ever occaiioning a fa-
livation, or producing any of thofe bad -iymp-

toms

202 ON MERCURIAL PREPARATIONS

toms which fometimes attend the ufe of other
mercurials. Time and experience, however, have
fhown that this remedy fometimes proves inef-
fectual in removing the complaints, and in many
inflances produces the bad fyniptoms attending
other mercurials* Mercury, indeed, as long as
it retains its nature, certainly will falivate or
purge, if given imprudently, or if the patients
do not take proper care of themfelves. Befides,
among a variety of patients, fome will certainly
be met with where this medicine proves not fo
efficacious as has been pretended. For every
phyfician who has had fome pradice in venereal
complaints, muit have met with cafes where one
mercurial preparation has produced little or no
efFedj whilft another, tried afterwards, fucceed-
ed beyond expedation. Tliefe cafes we are not
able to account for }, nor do we as yet know the
nature of the human body fulhciently to forefee
them a priori. Keyfer*s pills are a faline mercu-
rial preparation, where the mercury is firft di-
vided by a long continued trituration, and then
diifolved in vinegar. Hence, like all other mer-
curial preparations, it may fometimes produce
very good effeds, and perfedly cure the difeafe ;
whilfl, in other inflances, it may prove lefs ufe-
ful or even hurtful. And this is probably the
reafon why this preparation is now moftly ne-
gleded, though there have been fmce two me-
thods difcovered to prepare it eafier, cheaper,
and better, by precipitation.

The hydrargyrum tartarifatum, we call a com-
bination of mercury with fimple acid of tartar,
in order to diftinguifli it from the "Tartarus hy^

drargyratuSj,

INPARTICULAR. 203

irar^yratus, an invention of Dr PreiTavin at Pa-
ris, who gave it the name oi terre feuilktes mer-
curidle. This latter preparation being a, combi-
nation of mercury with purified tartar, or cream
of tartar, which is a middle fait compound of
vegetable alkali, fuperfatured with the acid of
tartar. Both thefe preparations are nearly of
a iimilar nature with the former, though per-
haps, in fome refpet^ts, preferable to it.

The hydrargyrum nitratiwi, or mercury united
with nitrous acid, has been employed in diiFe-
Bent forms and preparations internally and ex-
ternally. For external ufe the fohition diluted
with water has been made ufe of as a waih, and
Js a very good medicine for lliankers, &'c. The
fame folution made with one ounce of quickiilver
to three ounces of nitrous acid, and while yet
warm united with a pound of hog*s-lard by a
careful trituration, yields, under the name of
ungiientum citrinum^ one of the moft efHcacious
remedies I know of for obllinate fyphilitic com-
plaints of the fkin. The red precipitate, or hy-
idrargyriwi nitratum rubrum, prepared from the
fame folution, expofed to tire till it acquires the
Colour mentioned, is of a corrolive nature, and
therefore employed only in powder fprinkled
upon venereal ulcers as a efcharotic: For internal
ufe the hydrargyrum nitratum has been com-
inonly given from half a grain to a grain, in a
quart of any of the decodions.— -But tht hydrar-
gyrum nitratum cinereian, in the new Edinburgh
Pharmacopoea, called by its inventor (Dr Black)
pulvis mercurii c'mereus, is one of the mildeit
of the faline mercurial preparations, and may

be

204 ON MERCURIAL PREPARATIONS

be given to the dofe of a grain every evening,
and occafionally alfo every morning.— ^The
following is the method of preparing it : Qiiick-
iilver, diluted acid of nitre, of each equal quan-
tities in weight. After the mercury is diiTolved,
the folution is to he diluted with pure water,
and as much liquid volatile alkali (fpiritus falis
ammoniaci) to be dropped into it as is fufficient
for depriving the mercury of the acid: after-
wards the grey powder is to be wafhed with

pure water and dried. -The fyrup of Bellet

(commonly called vegetable fyrup), a celebrated
compolition, the ingredients of which are kept
fecret, is, as I w^as informed by a perfon of au-
thority in France, mercury precipitated from
its folution in the acid of nitre by fixed vegetable
alkali, and the precipitate afterwards dilTolved
in vitriolic ether roixed \yit]x fome agreeablq
fyrup,

I fhali now take notice of a preparation of
mercury, firlt recommended by the celebrated
Baron Van Swieten. This preparation is the
corrolive fublimate (mercurius fubliviatus corrofi-
vus); or, as I would rather call it in the more
accurate language of chemiftry, the hydrargyrum
muriatum fortius. Some years ago this medecine
engaged the attention of all Europe. By fome
it was recommended as a mod excellent and
efficacious remedy for the mod inveterate com-
plaints, and word ftages of the venereal difeafe.
It was particularly praifed agahift eruptions of
the fkin, and venereal affedtions of the bones'^
while others exclaimed againil it as being fre-
quently

IN PARTICULAR. 205

quently productive of the worfl efFeds in the
fyflem, without hardly ever radically curing the
diltemper. Both parties feem to have gone too
far in praifing as well as blaming. I have feen
cafes where this medicine perfedly cured the
moil inveterate and obftinate complaints 3 while
in others, I found it produced effeds of the
worll confequence ; fuch as a total derange-
ment and pains in the ftomach, griping, purging,
headach, fever, anxiety, oppreiEoncf thebreaft,
and even fpitting of blood, without curing, or
even appearing to have the ieall effe^: on the
difeafe. But, in general, I have obferved that
this medicine very foon mitigates the mofl trou-
blefome fytnptoms of the venereal difeafe, with-
out effecting a radical cure, even after having
been given for a very confiderable time 5 and I
am apt to think now, that its great reputation
arofe at firft from this property of frequently
alleviating fo fpeedily and remarkably the moft
troublefome venereal fymptoms.

Upon the whole, though it is certain that
there are fome conftitutions which will never
bear this violent medicine without danger, yet,
from fuch obfervations as I have been able to
make,' it feems probable, that the bad effedls
attributed to the corroiive fublimate have fome-
times arifen either from its improper prepara-
tion, from an immoderate dole,- from a delicate
eonilitution of the patient, or otherwife from a
defect of practical judgment in the phyiician or
furgeon. Therefore, although I never like to
employ violent medicines where I am able to
effed a cure with mild ones > yet it mult be al-
lowed^

2o6 ON MERCURIAL PREPARATIONS

lowed, that, in pradice, cafes will fometimes
occur fittended with fuch fymptoms as require
the ufe of the mod powerful medicines, if for
no other purpofe but for a fpeedy temporary re*
lief. In thefe cafes, it will fometimes be highly
advifable to have recourfe to the fublimate;
though it is probable to me, that fuch cafes are
much lefs frequent than it is commonly thought.
But at any rate, the conftitution of the patient
ought to be well confidered before -We have
recourfe to this medicine. If he be of a flrong
habit of body, and his lungs healthy, we may
fafely try the fublimate, uling the neceifary pre-
cautions with regard to its dofe and manner of
exhibition; but I would never recommend it
where the patient is of a weak, delicate, and
irritable habit of body, or if he has a fmall chefl,
has had formerly an hsmoptyfis, or any pul-
monary complaint; for thefe perfons I have
always obferved to fuffer from the ufe of the
fublimate. Some indeed, who were apparently
of a ftrong conftitution, I have feen equally
affeded by this remedy; for which reafon I
think it always neceflary to be cautious in the
ufe of it. We ought never to begin with more
than a quarter or at moft half a grain a-day,
dilfolved in milk, barley-water, or a decodion
of farfaparilla. When given in this manner, if
the patient is a proper fubjed for this medicine,
it will not readily produce any bad or at leaft
any dangerous confequences ; the lefs fo when
adminiftered in a warm feafon, or in a hot cli-
mate. In ufing the fublimate, it ought befides
always to be remembered, that we can never be

too

IN PARtlCULAR. 207

too careful with regard to its choice; and that
with the utmofl care and attention to the pre-
paration of the fublimate, it is hardly ever pof-
fible to obtain it always of the fame degree of
llrength, even by following the very fame pro-
cefs *. In all cafes therefore the patient (hould
be ordered to leave it off immediately when-
ever he felt any of the above mentioned bad
fymptoms. Sometimes it alfo occurs in the
ihops adulterated with arfenic, which may be
difcovered when mixed with lime-water: in
which cafe it will produce a black colour ;
whereas, if genuine, it yields with the fame an
orange-coloured precipitate, to which we gave
the name lotiofyphiliticaflava^ if one drachm of
fublimate is added to one pound of lime-water.
Its texture belides, if genuine, ought to be of a
radiated appearance \ whereas the fame, if adul-
terated, has rather a granulated one.

The hydrargyrum miiriatum mitius, or perhaps
flill more properly the calx hydrargyri miiriata^
commonly called calomel, mercurius dulcis, mercu-
rius fuhlimatus dulcis, panacea mercurialis^ aquila
alba, &c. is a milder preparation than corrolive
fublimate, but flill an acrid one, and thus very
apt to produce gripings, and to run off by ftooL
3 Beiides,

* All thefe inconveniences are now remedied by a recent dif-
covery of myfriend the ingenious Dr Bertholet at Paris; who
by a new and eafy way obtains it always of the fame ftrength and
quality, by adding dephlogifticated muriatic acid to a folution
of mercury in nitrous acid, and inftantiy cryftals precipitate,
which are compofed of mercury and muriatic acid, and which I
therefore gave in the table the name of Hydrargyrum muriatunij
inftead of the pracititatum of Dr Bertholet,

2q8 on Mercurial preparations

Belides, as its manner of ading depends very
much on the accuracy of its preparation, and
other circumftances which we are not mafters
of, its efficacy in curing the lues is not much
to be depended upon. Indeed calomel is in
different countries, in different fhops in the
fame country, nay even in the fame illops at
different times, a very different medicinci On
this account^ though it cannot be denied that
many have been cured df the. venereal difeafe
by this medicine, I never made ufe of it inter-
nally but for a mercurial purge, till of late, when
Mr Scheele, by a nevv^ method of preparing it via
hiiinida, has greatly removed all the objedions
this medicine was formerly liable to. As it will
perhaps be agreeable to fome of my readers to
be more exadly acquainted with this procefs,
I {hall fubjoin it here.

" Half a pound of quicklilverj and the fame
quantity of pure aquafortis, are to be put into a
fmall vefTel with a long neck, the mouth of
which is to be covered with paper. . The vefTel
is then to be placed in a warm fand-bath^ and
after a few hours, when the acid affords no iigns
of its ading any longer on the quickfilver, the
fire is to be increafed to fuch a degree that the
folution may nearly boil. This heat is to be
continued for three or four hours, taking care
to move the vefTel from time to time; and at lafl
the folution is to be fuffered to boil gently for
about a quarter of an hour. In themean v/hile
we are to difTolve four ounces and a half of fine
common fait in fix or eight pints of water. This
folution is to be poured boiling iuto a glafs-vef-
3 fel.

In particular. 209

fel, in which the above mentioned folution of
quickfilver is to be mixed with it gradually,
and in a boiling flate alfo, taking care to keep
the mixture in conllant motion. When the pre-
cipitate is fettled, the clear liquor is to be drain-
ed from it; after which it is to be repeatedly
wafhed with hot water till it ceafes to impart
any taile to the water. The precipitate obtain-
ed by this method is to be filtered, and after-
wards dried by a gentle heat.

" It might be fuppofed, that w^hen the nitrous
acid ceafes to efFervefce with the mercury, it is
faturated with it 5 but this is far from being the
cafe; the acid, when the heat is increafed, being
Hill able to diffolve a conliderable quantity of
it; with this difference, however, that the quick-
filver at the beginning of the procefs is calcined
by the acid, but afterwards is diffolved by it in
a metallic form. In proof of this we may ob-
ferve, that not only more elaflic vapour arifes,
but alfo that by adding either fixed or volatile
cauflic alkali we obtain a black precipitate;
whereas, w^hen the folution contains only cal-^
cined quickfilver, the precipitate becomes yel-
low by fuch an addition. If this black preci-
pitate is gently diftilled, it rifes in the form of
quickfilver, leaving a yellbw powder, which is
in fad that part of the mercury that in the be-
ginning of the operation was calcined by the
nitrous acid.

" The boiling of the folution for about a
quarter of an hour is neceffary, in order to keep
the hydrargyrum nitratum in a diflblved flate, it
being much difpofed to cryflallize; in general,

O fome

210 ON MERCURIAL PREPARATIONS

fome of the mercury remains undiflblved ; but
it is always better to take too much than too
little of it, becaufe the more metallic fubftance
the folution containg, the more mercurius dul-
cis will be obtained.

" It is necelTary to pour the mercurial folu-
tion into the folution of fait by a little at a time,
and cautioufly, fo that no part of the undiffol-
ved quickfilver may pafs along with it. Two
ounces of common fait are fufficient to precipi-
tate all the mercury^ but then it may ealily
happen that fome fuperfluous mercurius corro-
livus attaches itfelf to this precipitate, which
the water alone is incapable of feparating com-
pletely. This is undoubtedly the reafon why
mercurius prsecipitatus albus is always corro-
five. I have found that common fait poflelles
the fame quality as fal ammoniac, viz. that of
making the folution of corrofive fublimate in
w^ater eafy. I therefore employ four ounces
and a half of common fait in order to get the
mercurius corrofivus entirely feparated.

" If we coniider the manner in which mercu-
rius dulcis is obtained in the dry way, by fubli-
mation, we fhall not find it difficult to give the
rationale of this new procefs.

" Mercurius corrofivus albus is a middle falt^
confining, as is well known, of marine acid com^
bined with calx of mercury. This fait is capa-
ble of difix)lving a good deal of quickfilver in a
metallic form^ but for this purpofe the mofl
minute particles of each muft be reciprocally
mixed. This happens, when by means of heat
they are both converted into vapour. The fame

thing

IN PARTICULAR. 2ii

tiling occurs in the above mentioned procefs»
The folution firfi: fpoken of contains the calx
mercurii and quickiilver divided into the moft
minute particles* If to this folution we add
marine acid, or (to fave expenee) common fak^
the marine acid will unite with the calx of mer-
cury, and the refult of this union will be a true
mercurius corrolivus albus }, and as the folution
contains quickiilver in its metallic ftatCj this
will immediately attract as much of the mercu-
rius corrolivus as is neceffary to faturate it, and
by this means a real mercurius dulcis will be
produced, which, from its being infoluble, will
be immediately precipitated.

" The following fads are proofs that this pre-
cipitatc is a good mercurius dulcis. i/?. It is
entirely taftelefs. 2dly, I have fublimed it, and
examined what afeended in the beginningj and
which ought to have been corrofive, if the pre=
cipitate had contained any thing of that nature,
it being well known that mercurius corrofivus
afcends fooner than mercurius dulcis^ whereas,
through the whole of the fublimation, what a-
rofe was a pure mercurius dulcis, exadly like
that which is obtained in the common manner^
^dly, I have mixed this precipitate with one fourth
part of quickiilver and fublimed it, upon a fup-
polition that if it contained too much mercurius
corrolivus it would be able to unite with more
quickiilver 3 but fo far was this from being the
cafe, that the quickiilver was not diminilhed in
weight by the experiment. 4.thfy, It is known
that caullic alkalis and lime-water, give mercu-
rius dukis a black colour. The fame thing

212 ON MERCURIAL PREPARATIONS

happened with mine. The black colour is no
other than quickiilver divided into very fine par-
ticles.

" That the procefs I have been defcribing is
more advantageous than that which is ufually
adopted, I cannot doubt 3 becaufe, in the firft
place, this mercurius dulcis can be prepared
with lefs difficulty, with lefs expence, and with-
out employing corrolive fublimate. 2dly, As
there can be no danger of its being in any de-
gree corrofive, provided it be fufficiently edul-
corated, it may alv/ays be given with fafety.
3^/1^, The operator is not expofed to that noxious
dull which in the old method arifes during the
trituration of the corrolive fublimate and quick-
filver. ^tbly, This is much finer than the com-
, mon mercurius dulcis, it being impoffible to
make the latter equal to it in this refped, how-
ever long it may be triturated."

Calomel thus prepared will prove fafe and
excellent, not only for internal, but efpecially
for external ufe, either in powder, or fufpended
in limple water or fome mucilaginous folution ;
occafionally alfo a drachm of it may be mixed
with four ounces of lime-water, under the name
of lotio Jyphilitica nigra, to diflinguilh it from the
lotio fyphU'itica fldva made with corrofive fubli-
mate and lime-water. Calomel, when well prepa-
red, mufi: give the lime-water a black colour, as
corrofive fublimate does a yellow. Calomel, thus
prepared, may likewife, occafionally, be ufefully
applied in the manner recommended by the late
Mr Clare, who recommended to rub it into the
gums or infide of the cheek, from two to three

grains

IN PARTICULAR. 213

grains every morning and evening. It would-
be by far the eafiefl method of adminiftering
mercury to thofe patients who cannot bear mer-
curial preparations upon their ftomach, and dif-
like to make ufe of the mercurial fridions. ^ It
labours, however, under a material objedion,
that it foon produces a ptyalifm.

Dr Ward's white drop, being a folution of mer-
cury in nitrous acid, precipitated and redifToi-
ved by fal ammoniac, comes like wife under
this head, and proves, in fome cafes, a valuable
medicine.

The hydrargyrum vitriolaturn, or calx hydrargy- .
ri vitrioiata, commonly called turpeth mineral, or
mercurius emetic u s flavus, is a medicine now very
little ufed, except by thofe who think a mercu-
rial vomit preferable to one of emetic tartar or
ipecacuanha, for curing a fwelled teflicle ariiing
from a venereal caufe. Some inllances, how-
ever, I have feen, where this medicine, given
daily in very fmall dofes, effedually removed
molt obflinate venereal complaints of the fkin.

I come laftiy to fpeak of a medicine, which,
fome time ago, and even yet, is made ufe of by
many for the cure of the lues \ 1 mean Flum-
mer's powder or pills ; which, properly fpeaking^
are not a mercurial preparation, but a mecha-
nical mixture of mercurius dulcis and fulphur
of antimony. I have already obferved, that
mercurius dulcis, when prepared by fublimation,
is a very different medicine in different comitries
and places ; that it is therefore a medicine not
to be depended upon : for this reafon, I never
. would advife any praclitioner, as well for his

O q owa

214 ON MERCURI AL PREPARATIONS.

own fatisfadlon as that of his patient, to truft
to Plummer's pills for curing the venereal dif-
eafe. Plnmmer has compounded the calomel
with fulphur of antimony, probably for the pur-
pofe which ftill feems to be expelled by thofe
who make ufe of this compolition, viz. by means
of the fulphur to prevent falivation, and to di-
rect the mercury to the fkin, This feems efpe-
cially to be the delign in cutaneous eruptions of
the venereal kind. But though this medicine
may fometimes be efFedlual in removing cutane-
ous diforders, I muil, from my own experience,
as well as from that of feveral other unpreju-
diced pradiitioners, pronounce it to be a very
improper one for curing a confirmed lues. Re-
peated inilan(pes indeed have come under my ob-
fervation, where thefe pills having been taken
for a conhderable time, have removed the
fymptoms for a time, without effeding a radi-
cal cure y which is to me a fufficient reafon for
thinking it an unfafe medicine, and confequent-
ly that no praditioner ought to put confidence
in it for the cure of the lues, when he has fafer
medicines for this purpofe at his command-.

Whether crude mercury boiled with fimple
water communicates to it ibmething of its qua-
lities, and with what fuccefs fuch a decodion
might be adminiilered for curing venereal com-
plaints, I am not able to fay. 1 have feen this
deco6lion given to children aiTeded with worms
in different parts of the continent: and I know
of a dog in London who was radically cured of
a mofl obflinate mange, for which a variety of
medicines had been tried in vain, from the ufe
of this deco6lion for his common drink.

CHAP.

PTYALISM. 215

I

CHAP XV,
On PtyalisMj or Salivation.

T has been a matter of controverfy, whether

a confirmed lues may be radically cured with^
out falivation ; and though there is now hardly
any medical man who doubts of the poffibility
of a perfed cure without it, there are Hill many
who employ falivation, not only for the cure of
the lues, but, in fome countries, for that of the
clap alfo. This mode of treatment, in the for-
mer cafe, is ftill very much in vogue, in private
pradice as well as in hofpitals, eipecially in
France : in other countries, it is almoft entirely
confined to hofpitals.

How far this pradice of falivating venereal
patients is jullifiable, fhall be the fubjed of my
prefent inquiry.

It has been the opinion of Dr Fricfid, and
many ancient as well as feveral modern wri-
ters, that a falivation is not only neceflary to
effed a radical cure of the lues, but even that
the greater the falivation, the more certain a;ud
effedual will be the cure of the lues, efpecially
when the bones are afFedted,

I inuft confefs, I have always experienced the
O A direct

2i6 ON PTY'ALISM,

dired contrary of this alTertion. Amongft a
great many patients of different ages and con-
ftitutions, in different climates, who have been
under my care, I have not only not found olie
who required falivation, but I have, on the con-
trary, conftantly obierved, that the greater the
falivation, the lefs certain and effediual was the
cure of the lues. This is fo true, that even the
modern advocates for falivation unanimoufly
confefs, that a ilrong falivation is hurtful, and
that only a gentle one ihould be raifed. Could
I allow this to be right, I would obferve, that
to flop, or even to moderate, a falivation once
begun, is in many cafes more ealily faidthanac-
complifhed. This is often entirely out of our
power; and it; is yet one of the great deliderata in
medicine, to know a fpecific remedy that will
produce fuch an effecl. This is fo little in our
power, that I have feen more than once patients
carried off by falivation (their flrength being
totally exhaufted), before it could be lelTened or
ilopt by any remedy whatfoever. Others who
did not fink entirely under it, remained languid
from the evacuation, for months and even
years; and feveral I have feen die, on a confump^
tion brought on by fuch a courie. Befides, a
falivation is not only very troublefome to the
patient, by fpitting day and night, and by fil-
ling the room with a very difagreeable fmeil ;
but frequently alio produces painful ulcers in
the mouth, fauces, &c. which, if not taken care^
of in time, or being miflaken for venereal ones,
by continuing the ufe of mercury, become more
dangerous than the venereal difeafe itfelf,

■ It

OR SALIVATION. 217

It may feem furprifing, therefore, how fuch
a dangerous method of attempting the cure. of
the venereal difeafe as that hy falivatioii fhould
Hill be retained and pratStifed in fome hofpitals.
The three following reafons, indeed, I have
heard alleged, i. To confine the patients with
a clap or lues to the room, and to prevent them
from getting a frefh infedion before they are
cured of the firll. 2. To get rid of fuch poor pa-
tients in a month or five weeks, in order to take
others in their place into the hpfpital, who are
treated and fent away in the fame manner.
3. Becaufe many of the lov/er clafs of people
have an unhappy prejudice in favour of this me-
thod, and imagine they cannot be radically cu-
red without what they call a good and conti-
nued falivation. Thefe reafons, however, ap-
pear to me wholly infufficient. To prevent the
patients from getting a frefh infedion, better
me'ans might be eafily followed. With regard
to the fecond point, I think it more reafonable
and more humane to cure a fmaller number of
patients radically without falivation, eveil
though a longer time fhould be taken up for the
cure, than to relieve the complaints of a great
number in a Ihorter time by fuch an uncertain,
troublefome, and fometimes dangerous method.
We may add to this, that experience daily fhows,
that a number of thofe patients who feem to be
cured by the celTation of the fymptoms during
a falivation, very frequently return in a fhort
time after to the hofpital with the fame fymp-
toms they were affeded with before, or find
themfelves obliged to feek affiftance fomewhere

/ elfe.

2i8 O N P T Y A L I S M,

elfe, at the fame time that they folemnly pro°
teft againft their having expofed themfelves to
a new infeclion. The third reafon alleged in
favour of falivation is the worll of all. I am of
opinion, that no perfon of integrity, who prac-
tifes medicine, fhould ever comply with the
prejudices of his patients when they may be
hurtful to them, or when he knows that by a
contrary method he is able to cure them with
greater certainty and fafety. Belides, it will
be an eafy matter for a phyiician or fiirgeon,
'who knows how to gain the confidence of his
patient, to convince him of the folly qf fuch
prejudices. Salivation, therefore, being, in my
opinion, an exceptionable method of cuire in any
circumftances whatever, I think it, in all cafes,
moil prudent to avoid it ; or, if it fhould have
taken place, to moderate and remove it as fpeedi-"
iy as poflible.

The method of preventing a falivation I have
laid down above, when fpeaking on mercurial
frictions. The means to be ufed for this pur-
pofe are fhortiy the following, i. A careful ad-
minillration of mercury both as to its prepara-
tion and dofe. 2. The avoiding cold or damp
air, efpecially at night. 3. The ufe of warm
cloaths y or, in a cold damp feafon or climate,
the conilant wearing of flannel next the fkin,
4. The repeated ufe of warm baths, and the in-
ternal ufe of diaphoretic or diuretic decodions
along with the mercury. 5. The avoiding too
hot rooms and confined air. 6. Covering the
neck and head but very ilightly day or night,
7. Taking a dofe of gentle cooling phyiic, and
2 in^

OR SALIVATION. 219

intermitting the ufe of the mercury as foon as^
the breath and teeth begin to be affeded. 8. If
the patient be not of a phlogiilic habit of body,
a free diet, with the moderate ufe of wine, is
to be ordered, rather than a low one, Smoak-
ing tobacco fliould alfo be avoided, during a
courfe of mercurials, by thofe who are accu-
fiomed to it.

It is likewife to be obferved, that, in general,
a falivation will take place more readily under
the ufe of acrid mercurial preparations, and in
a cold and damp feafon or climate }, that fome
conftitutions are more difpofed to it than others;
and that particularly thofe who have previoufly
taken mercury, are often ready to fall into a
falivation by uiing the fmallefl dofe, though
perhaps in the former difeafe they felt no fuch
effed from the ufe of it.

A variety of medicines given feparately, or
combined with mercury, have been recommend-
ed for preventing it from affeding the mouth,
as well as for checking a falivation after it has
taken place. The principal of thefe are ful-
phur, fulphur of antimony, camphor, the Peruvi-
an bark, and iron. By a careful attention, how-
ever, to the foregoing rules, I think it is in
general not very difhcult to avoid a falivation,
without having recourfe to any of thefe medi-
cines^ efpecially as I have feen fome of them
repeatedly applied without fuccefs. With re-
gard to the latter point, viz. the abating and
removing a falivation when once begun, 1 found
it moil always a very difficult matter : the follow-
ing method, however, with an exad obfervance
' of

220 ON PT YALISM,

of the rules above mentioned, will frequently
be attended with fuccefs.

As foon as the patient feels his mouth affec-
ted, he ought to leave off the ufe of mercury,
and keep within doors, in a moderately warm
room, if the feafon be cold. If his ftrength
and conilitution will allow, we may adminifler
him a gentle laxative ; but we ought to be care-
ful about prefcribing purgatives, becaufe they
will often bring on a diarrhoea, which we fliall
find fometimes great difBculty to flop, and which
may prove dangerous in its confequences. If
his ftrength will bear it, he fhould likewlfe, for
four or five days, be placed every evening in a
warm bath, rubbing his body during that time
with a flefh-brufh or piece of flannel 3 and when
he comes out of the bath, he is to drefs bimfelf
aeain immediately inflannel-cloatlis. Ifphlogif-
tic fyinptoms occur, bleeding may be neceffary;
the pa o be confined to a low diet, and drink

barley- vv ': : "^y other mucilaginous decoc-
tion; but if hiL ; . v^th he very much reduced, a
good nourifhing diet, together with the ufe of
wine, an infufion of Peruvian bark, orguafliawood
in wine or cinnamon-water, with fome prepara-
tion of iron, and the free country air, are certainly
more proper. If the air be dry, he fliouid not
confine himfelf to his room, but go abroad a
little, unlefs it be very cold. When the fali-
vary ducts are very much relaxed, the mouth
not very painful, and the fpitting continues un-
diminished, an aflringent gargle may, with pro-
per precautions, be prefcribed. It may be made
of the decoclion of Peruvian bark, of tormentilla

OR SALIVATION. 221

ereBa, or of the cortex falicis alboe^ in red wine
or in watery to which, according to circum-
flances, may be added fome tindure of gum-lac
or of myrrh and honey of rofes. Common ful-
phur has now and then a very good efFe6t for
relieving a Iklivation. The fulphur of antimo-
ny has been recommended in fuch cafes as a
diaphoretic. An eminent phyiician has recom-
mended for this purpofe the aurum fulminans^
given every day from three to five grains, as a
very efficacious medicine; but having never had
occafion to try this remedy myfelf, I am unable
to fay. whether this advice is founded on expe-
rience, or only on a theory derived from the
chemical affinity or attradion between mercury
and gold. In an obftinate ptyalifm, a blifter,
feton, or ilHie, in the neck, together with the
internal ufe of purified fulphur and camphor, and
the volatile liniment applied to the throat, fome-
times proves ferviceable; and in defperate cafes^
we might alfo try the effed of repeatedly pour-
ing cold water over the head and face, letting
the patient -fit in the mean time with the reft of
the body immerfed in a w^arm bath.

HAP*

223 ON VENEREAL OPHTHALMIA.

CHAP. XVL

On particular Venereal ComplaintSj
which require d peculiar Method of Cure.

L On the Vener/Eal Ophthalmia.

THERE are two diftind fpecies of venereal
ophthalmia. The one feems to be more of
a chronic kind, comes on gradually, and arifes
from a tainted mafs. The other is the mofl
acutCj violent, and dangerous of any ophthalmia
I know of: it comes on fuddenly^ and owes its
origin, as far as I have been able to obferve, to
a fudden retropulfion of a recent venereal clap.
■ — I have feen three inftances of this dreadful
diforder, every one of which proved fatal to the
fight of the fufFereri In two cafes, both eyes
were affeded with blindnefs ; in the third, one
■was affeded immediately, and feveral years af-
ter the fight of the other was likewife loll, with-
out any other apparent caufe. All old pradi-
tioners with whom I have converfed about this
dreadful complaint, and who have obferved it
feveral times in their pradlice, were of opinion
that it always originated from a retropiilfed recent
clap, by way of metallafis. In the three cafes
which I juft mentioned, the difeafe was certain-
ly

ON VENEREAL OPHTHALMIA. -^^^

3

ly accompanied with a fuppreffion of the clap :
but whether that fuppreffion was the caufe of
the ophthalmia, I was not able to determine
with certainty ; and am much lefs capable to ac-
count for fuch a metaftafis : though great connec-^
tion fubfiils between the eyes and the parts of
generation.

But whatever may be the caufe of thefe oph-
thalmias, the fa (ft is this. In the three inftances
which came under my obfervation, the difeafe
arofe in a cold climate in winter, after the pa-=
tient, afFedled with a recent clap, had been ex-
pofed to violent cold in the open air. None of
them had ever had any complaint in the eyes
before. The difcharge from the urethra was
evidently diminifhed or abolilhed. In the naeaa
while, a difcharge of a puriform matter of a
yellowifh green colour, refembling that of a
clap, took place from the eyes, with the moH:
excruciating pain, which was rendered infup-
portable on the leall application of Irght. The
fame matter which ran out of the eyes, feemed^
as far as I was able to fee by forcing up the
eye-lid, to be extravafated in the whole ante-
rior chamber of the eye, and, as it were, infil-
trated between the lamellas of the cornea tranf-
parens. All remedies which were applied pro-
ved inefFedual, and perpetual blindnefs was the
coiifequence.

As cafes of this kind may be initrudive, I
fhall tranfcribe one of them from my Medical
Journal. The patient, a young man of a flrong
dark complexion, of twenty-nine years of
age, a captain in the army, was ordered on

guard

224 ON VENEREAL OPHTHALMIA.

guard in the month of January, whilfl he was
afflicted with a recent, violent clap. Unfortu^
nately the day was exceflively cold, and he was
by duty much expofed to the open air all day
and the evening : in the night he found himfelf
at once afflided in both eyes with the moil ex-
cruciating pain, and intolerance of the fm.alleft
degree of light ; to which next day followed a
difcharge of puriform matter from both eyes.
Upon infpedion, the albuginea was everywhere
highly inflamed, and very much fwelled. The phy-
lician who was called, applied, beiides the com-
mon remedies, fuch as bleedings, purgatives,
&c. a fomentation of hemlock. On the third
day, upon a clofer examination, the cornea was
found entirely opaque, and an hypopyon for-
med 5 no ulceration appeared. The ufe of
hemlock was ordered to be continued. Some
days after, the inflammation and running aba-
ted ; but the cornea remained opaque, feemed
to be very much thickened, and the. patient re-
mained perfedly blind. In this patient, I clear-
ly faw the arteries of the cornea tranfparens,
coming from the albuginea, inflamed, and fo fil-
led with red blood, as if injeded like an ana-
tomical preparation, even till the fifth week of
the diforder.

In none of the three cafes which 1 had accefs
to obferve, any remedy was applied by the prac-
titioners to refl:ore the running of the clap ; nor
was there an incifion made into the cornea to
difcharge the extravafated matter : The only
two remedies from which I would exped any
^cacious relief in fuch an ophthalmy, befides

I the

ON VENEREAL OPHTHALMIA. :^2S

the general and topical evacuations by purga-
tives, leeches, bllflers, &c. with the internal and
external ufe of mercury.

1 was once inclined to believe, that this kind
of ophthalmia does perhaps arife from unclean-
linefs, when the patient affeded w^th a clap, of
Ihankers in the genitals, touching thofe parts,
and afterwards, without walhing the hands,
touches his eyes. I have certainly feen oph-
thalmies, and venereal ulcers of the eye-lids,
noftrils, lips, more than once ariling from fuch
carelefTnefs : but in thefe cafeS I have never ob-=
ferved an inflammation but in one eye, and it
was always far from being fo violent as the kind
juft mentioned ; andj like ophthalmies ariling
from a tainted mafs, gave way to the topical ap-
plication of the blue ointment; which, together
with the internal ufe of mercury, is indeed the
fovereign remedy for feveral ophthalmies.

The chronic venereal ophthalmies ariling from
a tainted mafs^ prove in many cafes extremely
obftinate for many weeks and months. They
require befides a very low diet, a regular mercu-^
rialcourfe, efpecially with fublimate if the patient
can bear it; repeated purgings; and in fome
cafes, efpecially if the eye-lid be the part af-
feded, the external ufe of the mercurial oint^
ment, or what is, according to the obfervations
of Dr Cullen, more preferable, the citrine oint-
ment rubbed down with double the quantity of
hog's lard, in order to render it lefs acrid. Lau-
danum dropped into the affeded eye gives fome-
times the moft evident relief. Bathing the eye
"with a weak folution of fublimate^ or with the

P lac

225 ON VENEREAL DEAFNESS.

lac hydrargyratum four or nx times a-day is j
likewife ferviceable. *

II. On Venereal Deafness.

I HAVE feen feveral inftances where deafnefs,
with a violent pain of the ear, was brought on
by venereal ulcers affeding the orifice of the
Euftachian tube in the fauces 3 and I have met
with one inftance, where a perfedl deafnefs was
the confequence of a flopped difcharge of a clap
by the internal ufe of turpentine. The patient
had had no fhankers, nor any other venereal
complaint ever before.

III. On Venereal Sore Throat.

Venereal fore throats, as well as venereal
ulcers of the mouth and fauces, ihould, as I
mentioned above, be carefully diflinguifhed
iTom fcorbutic ones, or from thofe originating
from the faliva rendered acrid by mercury; and
more efpecially from thofe which, though real-
ly venereal in their origin, have now changed
their nature, and acquired a charader entirely
different from the original difeafe, as by con-
tinuing the ufe of mercury, the patient rnay
be materially, and perhaps irrecoverably, hurt.
Pradical judgment muft be our only fure guide
in that cafe. Deep ulcers covered with a white
lardaceous cruft, and confined by a hard ele-
vated border, with a flrong rednefs round about

them.

ON VENEREAL SORE THROAT. 22?

them, will, I think, feldom millead if they are
treated as venereal. Venereal ulcers in the
throat are fometimes feated fo low down, and
lidewards, that we cannot ealily difcover theiti
at firft fight, and thence we are fometimes
led to miftake the nature of the diforder. An
account of the following cafes may perhaps b#
ufeful to young praditioners.

A gentleman of a ftrong plethoric conflitu-*
tion, fifty-five years of age, was affeded with a
fore throat and fever. The phyfician, after ex*
amining his throat and pulfe, ordered bleeding,
with an antiphlogiflic gargle and purges wheii
the difeafe not abating eight days after, another*
pradlitioner was called, who repeated bleeding,
purging, and ordered a different gargle, from
the ufe of which the patient found himfelf Ipet-
ten At the expiration of feven weeks, whent
he felt, as he exprelTed himfelf, the difeafe wa^
not quite gone, I was confulted. After the for-
mer prefcriptions were fhown to me, I examined
his throat j and though I could not difcover any
ulcer, told him I fufpedied a venereal caafe;
which he hardly would agree to, telling me that
he had had no venereal complaint thefe many
years pali, and that fince that time he had en-
jayed the" moil perfect fiate of health. I de-
fired to examine his throat once more: which
he readily complied with, though he v/as one
of thofe perfons who with the greateft difhculty
can let their throat be examined: Vfith a wa:S:
taper in one hand, and deprelling the root of
the tongue by means of a large fpatala as much
as poiiibie with the other, I difcoygred very low

Pa dowt^

228 ON VENEREAL SORE THROAT.

down on the right {ide, a deep but imall vene-
real ulcer, which had efcaped my light at firft,
and would now have done fo, had I not exa«
mined the throat with fuch peculiar care. Upon
mentioning to him the evident caufe of his difor-
der, my advice was complied with; and after
the internal ufe of mercury for eight days, his
fore throat was perfectly gone, and by continuing
it a month longer, a radical cure w^as obtained.

The other patient was a lady of rank. She
had but firft felt a flight difficulty in fwallow-
ing within a few days, which being frofty flie
afcribed it to a cold. I immediately, upon in-
'fpedion, difcovered the caufe of the diforder;
and as women have always a right to the great-
•eft delicacy and fecrecy of a phyfician, without
aiking her any queftions, I ordered her to keep
*her throat warm, and promifed to fend her fome
medicine which would relieve her in a few
days ; and the fame was afterwards, under a-
nother form and pretence, ordered to be con-
tinued for a few weeks longer, till I thought her
perfedly fafe.

Laft fummer, I was confulted at Paris by a
young gentleman of about twenty-eight years
of age, about a fore throat for which he had
taken advice and medicines already, for the
fpace of three weeks, without any relief. I
•told him, that, from the very appearance of his
face and eyes, I fufpeded quite a different
caufe of his diforder than he had hitherto
imagined ; which indeed was moil evident-
ly confirmed by a large venereal ulcer; which,
upon infpedion. I found feated very low

down

ON VENEREAL SORE THROAT. 229

down behind the velum. He then gave me the
following account. That he had been afFed:ed
with a violent clap two years ago when he was
at Venice, which for a particular reafon he had
wifhed to be removed or flopped as foon as poi-
(ible; that, for this purpofe, he was recommend-
ed by a friend of his to a furgeon in that place,
who was in pofleffion of an injedion which had
that infallible ' effed:. That this furgeon com-
plied with his dciire, though with reludance;
and foretold him, that fome time after being
cured thus hailily by his injedion, the venereal
difeafe would break out in forae other part of
the body ; alTuring -him that he had feen the
fame effed, from the fame remedy, happen in
feveral other patients who applied to him in the
fame manner he did. That he negleded this
caution^ that the running was perfedly flopped
in 48 hours ^ and that he had never thought more
about it, having been perfedly free from vene-
real as well as any other complaints ever fince.
This cafe was to me a very initrudive one.
Firfl, it iliows how long the venereal poifon lies
fom.etimes concealed in the mafs, without pro-
ducing any fenfible effeds: And, fecondly, it
evidently confirms what I have aiferted above,
that the poifon which produces a clap, may be,
and is mofl; frequently, the very fame with that
of the fyphilis; and that, if abforbed into the
mafs, it therefore produces the fame effeds.
But, laftly, it alfo fhows, which 1 could not have
expeded a priori , that a recent clap may fome-
times be flopped or repelled, without producing

,P 3 fwelied

i}30 • , CUTANEOUS COMPLAINTS,

fwelled tefticles, irchury, llridlures, or any other
immediate effeds In the mafs.

Venereal ulcers of the throat require fome-
times, belides a courfe of mercury, topical ap-
plications; fuch as iujedions or gargles made
of a foiution of fublimate mixed, according to
circumftances, with the tindure of maftich,
&c. But if the ulcers are owing to the acrimony
of the fallva, t'ley ought to be kept conftantly
dean, and mercury fhouid be difcontinued. If
they arife neither from the one or the other of
the caufes juit mentioned, but are of that pecu-
liar nature defcribed above under the head of
VenerealXJ leers ^ they require, inflead of mercury,
the internal and external ufe of opium. Power-
ful tonics, internally as well as externally, in a
gargle, have been found very ufeful in fuch cafes*

IV. On Venereal Complaints of the Skin.

Cutaneous diforders of a venereal nature,
fuch as venereal tetters, venereal fcald-head, ve-
nereal leprofy, &c. are often very obllinate. It
is in thefe complaints properly, where the foiu-
tion of fublimate, given iuternally, proves now
and then excellent; and 1 think I have obferved,
that it often effedually removes the difeafe of the
fkin Vv'ithout removing radically the lues : This at
ieafl I aflert with regard to colder climates; as
to warmer climates, 1 know certainly many pa-
tients who have been radically cured of the fy-
phliis by the fublimate alone.

Befldes the internal ufe of the fubljmate, warm

baths

CUTANEOUS COMPLAINTS. 231

baths made with a decoAion of bran, in every
gallon of which half a drachm of fablimate is
to be difTolved, gently rubbing at the fame time
the affeded part, have fometimes proved to me
very ufefuL For more confirmed venereal cpm-
plaints of the fkin, the topical application of
the folution of the fublimate, the citrine oint-
ment fometimes alone and fometimes with .the
addition of the faturnine, have faeceeded in tet-
ters, tinea, &c. where all other remedies proved
ineffedual. The decodum Lulitanicum, the
decodion of the ftipites dulcamaras, of the me-
zereum root, and efpecially that of the lobelia
fyphilitica, deferve, for thefe as well as other
obflinate and i«iveterate venereal complaints, in
my opinion, a much greater attention than is
ufually paid to them. I have feen a moft ob-
flinate and inveterate difeafe of the ikin of a
venereal nature cured by a folution of turpeth
mineral in fmall dofes, where all other remedies
failed. Some phyhcians pretend to have feen
great fuccefs alfo from arfenic^ but I never tried
this latter,- — The decodum fyphiliticum robo-
rans is in many cafes a fovereign m.edicineo
The infufum ledi paluftris has proved very ef^
fedual in many cafes of ieprofy in Sweden:
but it ought to be 'obferved as a general rule,,
that without the ufe of warm emollient baths,
or vapour-baths, all thefe medicines will often
fail in producing the defired eifed.

P4

232 ON VENEREAL EXCRESCENCES,

V. On Venereal Excrescences.

Venereal excrefcences on the furfaceofthe
ikin, known by the different names, warts, tii-
befcles, condylomata, ficus^marifca, &c. arife either
from an original infedion, in which cafe we
confider them as a local difeafe, and prefcribe
local remedies, or they originate from a taint-^
ed mafs, which indeed is more frequently the
cafe, and then a full mercurial courfe will make
them difappear fometimes without any external
application. But frequently external remedies
are likewife requifite. Caullic.'^ have been re^
commended for that purpofe: they are now and
then employed with fuccefs ; but in fome cafes
I have feen thern productive of bad effeds, Ex-
cifion has been likewife recommended, and is
fometimes necelfary^ but I have feen feveral
inftances where, after thefe excrefcences had
been cut out repeatedly (even after a full courfe
of mercurials), they grew again and again,
fometimes to a larger fize than they had former-
ly. To prevent this regeneration, feveral re-
medies have been propofed; of which, in all ob-
itinate cafes that have come under my obferva-
tion, 1 have obferved only two or three which
were fuccefsfully employed after the mafs had
been previonlly perfedly purified. The one
confifls in mercurial fumigations, the other
in the application of the juniperus fahina L.
either by itfelf in the form of a powder, or mix-
ed v/ith red precipitate in the form of an

oint-

VENEREAL WEAKN"ESS. 233

ointment; and the third is the liquor ad
condylomata ^lately propofed by Mr Ple?icL I
have applied, it once or twice a-day with a hair
pencil in feveral cafes with very good efFed:.
Jn cafes where a great number of fmall warts
bad fprung up about the genitals, the folution
of fublimate in fimple water or lime-water I
have obferved fometimes to fucceed perfedly
well. If warts have a fmall balls, and are but
few in number, the belt rem.edy is a ligature
made tighter every day. 1 have feen a man with
feveral hundred little warts upon the part of the
chin vfhere the beard grows, and underftood his
difeafe to be owing to an ill-treated lues.

VI. On Venereal Weakness, or Impotency.

This complaint, though not dangerous, is
very alarming, and renders the mind of the pa-
tient extremely uneafy. I have repeatedly ob-
ferved it 3 but in a particular manner in one
patient, who feveral months before had been
affeded with a violent clap ; of which at lafl he
was cured, after having undergone a tedious
and very improper treatment. The only re-
maining fymptom was now a total inability and
w^ant of defire of venery, which rendered him
extremely low-fpirited. On confulting me, I
judged the complaint to proceed from the ve^
nereal poifon lurking in the body, and prefcribed
him a mercurial courfe, and afterwards fome
tonic medicines, with two tea-fpoonfuls of Hoff-
nian's anodyne liquor morning and evening.

He

234 VENEREAL PAINS,

He was likewife ordered to wafh the fcrotum
and fpermatic cord twice a-day, with a table-
(poonful of the fame liquor mixed with fome
water: in three weeks time he had fufficient
reafon to be as high-fpirited as ever.

VII. On Venereal Pains, Spasms, &c.

Fixed or wandering pains arifing in different
parts of the body, are generally afcribed, by all
patients who were formerly affeded with the
lues, to the remains of the venereal poifon in
the mafs. This is indeed fometimes the cafe ;
but it ought to be obferved, that tbofe pains, fo
generally afcribed to the venereal poifon, are
often owing to very different caufes^ which, if
not properly diftinguifhed, we fhall find ourfelves
frequently difappointed in the effeds of the re-
jnedies prefcribed.

Pains limilar to venereal ones are often the
efFeds of the improper ufe of mercury. Thefe
cafes ought to be carefully diftinguifhed in prac-
tice> becaufe, if the venereal difeafe has not
been radically cured, and the pains arife from a
half-cured lues, the ufe of mercury will be ne-
ceffary to complete the cure (though the patient
will often be of a contrary opinion, conlidering
the length of time and quantity of mercury he
has already taken); whereas, if the venereal
virus has been radically cured, the ufe of mer-
cury will prove evidently hurtful. I know pa-
tients who, having made ufe of mercury repeat-
edly in their younger days for feveral venereal

com-

S PA S M, &c.

complaints, find themfelves now, whenever they
take the leail quantity of mercury, conilantly
afFeded with the mofl violent rheumatic pains
in different parts of the body. Authors who
have mentioned this latter difeafe generally a-
fcribe it to the mercury lodged in the bones ;
pay, there are even examples recorded in medi-
cal hillory, where mercury had been found, af-
ter the death of fuch patients, colleded in glo-
"bules in different parts of the body, efpecialiy
in the bones and their cavities. Whatever cre-
dit may be given to thofe alFertions, it is certain
that we may generally, and fometimes pretty
ealily, cure thofe patients by a proper regi-
men, warm baths, and by adminiilering at
the fame time internally proper tonic me-
dicines, either alone or united with anti-
monials. But if thofe pains, inftead of being of
the chronic kind, arife from a fudden check of
perfpiration during a mercurial courfe, the ufe
of tonic medicines would be improper. In fe-
veral defperate cafes of this kind, where the
body feemed as if it was affeded with a general
fpafm or tetanus, 1 have found, beiides the warm
bath, efpecialiy the vapour-bath, the fulphur of
antimony, united with the extract of hemlock,
a moil efhcacious remedy, given to the quantity
of fifteen grains of each a-day.- — Dover's pow-
der, with a proper regimen, proves fometimes
in this cafe, as well as in rheumatifm, a very
ferviceable medicine.

VIII.

236 VENEREAL COMPLAINTS

VIIL On Venereal Complaints of the Bones.

The bones are feldom afFeded by the vene-
real poifon, but in a confirmed or neglected lues.
1 have feen, however, one inflance where the
patient, being aiFedled with a flianker on the
glans, was attacked the fifth day after with a
confiderable fwelling in the lower part of the
ulna. — In thefe cafes, the longer the difeafe is
negledied, the more difRcult and tedious is the
cure y and of all others the caries, or ulceration
of the external furface, and the corruption of
the internal cavity of the bones, are the mofl
difagreeable and tedious.

In all cafes of ulcerated bones we ought to
remember, that they cannot be cured until the
poifon be totally eradicated from the mafs. To-
pical applications feem to have very little effed;
though the effential oil of fafTafras has been re-
commended by fome. Mr Plencl recommends a
lotion compofed of elTentia mailichina, corro-
iive fublimate, and honey of rofes. Belides
this, he direds the internal ufe of the Peruvian
bark, and mercury mixed with afafoetida, toge-
ther with a decodion of farfaparilla, united with
mezereum and cicuta: by thefe, he fays, that 'he
cured feveral perfons of the diforders juft men-
tioned.

Venereal exoflofes and tophi, efpecially thofe
in the middle of the tibia, fternum, and bones
of the head, will fometimes, efpecially at night,
give the mofl excruciating pain. In thefe cafes,

OF THE BONES. 237

I have obferved no good efFed: from any topical
application whatever. Mercury, blifters, or an
incifion, have been recommended for this pur-
pofe ; but the faline mercurial preparations
are the medicines moft to be depended upon,
together with the decodions of the woods,
efpecially the decodum mezerei, the sethi-
ops antimonialis of Huxham; according to
circumftances, opium in large dofes, may be
likewife tried in obftinate caies»

Of the extraordinary fragility of the bones
mentioned by fome writers as proceeding from
a venereal caufe, I have never feen an inllance 5
though it may not be improper to Aiention one
cafe which, I think, may be referred to this head :
A man broke his tibia by a fall; but after the
bell treatment of the fradure, and twelve weeks
confinement, upon examination it was found,
that no callus was formed, and the broken bone
remained nearly as loofe as at iirft. After a
clofe inquiry and confultation, the venereal poi-
fon was fufpeded, and a courfe of mercury pre-
fcribed; which fucceeded fo well, that in a few
months after the patient was perfedly cujred.

CHAP.

338 O N C O M P L I G A T E D

CHAP. XVIL

On Complicated Venereal Complaints.

andfiich as have been fuJpeSied to be of the

Syphilitic Kind,,

nn O this clafs belong fyphllitlc complaints,
■*■ joined with fea-fcurvy, pfora, leprofy, rheu-
matifm, gout, and fcrophula.

The difeafe called the Sihhms in Scotland, was
fuppofed by fome to be a complication of the ve-
nereal difeafe with the itch \ but I have referred
it under the fyphilis, efpecially as its fymp-
toms are fo nearly related to the new vene-
real difeafe of Canada. See Chap. XII.

Syphilis ^'ixh fea-fcurvy requires the ufe of
antifcorbutic and ftrengthening diet or medi-
cines, previous to the ufe of mercury.

Syphilis with leprofy requires warm baths, the
decodum fyphiliticum roborans, or the decoc-
tum corticis ulmi with antimonials.

Syphilis with rheiimatfm is beil relieved by
warm baths, the vapour-bath, together with the
ufe of the flefh-brufh, and the internal ufe of the
decodura lignorum, efpecially the decodion of
guaiac and sethiops antimonialis of Huxham,

Syphilis with fcrophula is relieved by fea-ba-
3 thing

VENEREAL COMPLAINTS. 239

thing and fea-water taken internally. Hemlock
united with the Peruvian bark have been found
fuccefsful in fome cafes. In places where the
patient has no accefs to the fea, we may pre-
pare artificial fea-water compounded of the fame
conftituent parts as fea-water, by mixing to
five pints of v^^ater two ounces and 433 grains
of pure common fait, 380 grains of magnefia,
muriata, and 45 grains of terra calcarea vitriola-
ta or ,gypfum.

The Taws 1^ only a local excrefcence or ex-
ternal cutaneous difeafe, entirely different from
the lues ', the cure of which is often performed
by nature, without any internal or external me-
dicine, but may be, according to the obferva-
tions of Dr Nooth, accelerated by lint dipped
into a folution of blue vitriol in water, fre-
quently applied to the parts.

Whether the Mai de Siam, the Variola Amhoi-
nenjisy and a difeafe nearly fimilar to this lat-
ter defcribed lately by Dr Schotte, to which the
negroes at Senagambia are fubje6t, belong to
the head of fyphilitic complaints, I ana uncer-
tain.

CHAP.

240 ON VENEREAL

CHAP XVIIL

On Venereal Complaints di/guijed, fuch
as Confumption, Rheumattfm, Fevers, &c.

SOME perfons formerly afFeded with vene-
real complaints, of which they have been
apparently cured feveral months, nay fome-
times feveral years, grow emaciated, begin
to cough, and are affeded with hedic fever,
and other fymptoms which accompany a con-
fumption, or a phthylis pulmonalis. Thefe
complaints are often miftaken and afcribed
to fome other caufe, and medicines ordered
for the moft part without any fuccefs, Som.e-
times, likewife, the diforder arifes from the pre-
pollerous ufe or too large quantities of mercury.
I have feen feveral inftances where a hedic fe-
ver with cough, and fometimes even with a pu-
riform expedoration, far from owing its ori-
gin to an ulceration of the lungs, arole from a
latent venereal polfon, without any other vene-
real fymptom in the body. The fame has been
obferved by others y and Mr Brambilla relates a
cafe, which ihows fuch a ftriking inftance of the
I kind

CON SUMPTION, &c. 241 '

kind, that I fhall tranfcribe it here. An elec-
tuary, he fays, was prefcribed for a coufump-
tive man, who was in a defperate iituation. By
a miflake of the apothecary, the eled:uary was
given to a venereal patient to rub himielf with,
and the mercurial ointment, inftead of the elec-
tuary, was fent to the confumptive patient to
take it internally. The confumptive man, know-
ing nothing of the miftake, took a quantity of
the oiritment, about the bignefs of a nutmeg,
two or three times a-day, and was effedually
cured of his diforder, to the no fmall furprife of
his phylician, who learned by chance from the
apothecary the miftake that had happened. ThiS'
miflake was certainly a very happy one for the
patient ; and though it might be doubted whe-
ther the confumption proceeded from a vene-
real caufe, it proves however evidently that it
yielded to mercury. I had feveral patients of
this kind who was, radically cured of confump- >c^^<^/v^^
tionbyadminifteringtothemnothingbutacourfe
of mercury. — The farfaparilla in powder, from
half an ounce to an ounce in a day, has been
found ufeful in feveral cafes of this kind.

Agues J or intermittent fevers, have alfo been
obferved by Dr Wherlhof and others, either to
be produced by the venereal virus, or conco-
mitant with the venereal difeafe ; and mercury,
combined with the bark, has been given with
fuccefs in thofe cafes. Perhaps fome of the fe-
vers cured by Dr Lyfon, with calomel, have
been of the fame kind.

Flying rheumatic fains, violent headachsy and
- Q^ pain

242 O N V E N E R E A L

pain in the hipy fometlmes originate from this
fource. The warm bath, with fome faline pre-
parations of mercury, with the decoftion of the
flipites dulcamara, I have feen cure diforders of
this kind, which refifled every other medicine.
Mercury, with the decodion of daphne meze-
reum, or of daphne laureola, L. has alfo been
recommended as a, very efficacious medicine for
' thofe complaints*

G H A P.

COMPLAINTS, 243

CHAP. XIX.

hi Venereal Complaints incurable by
Mercury.

Y Have already fpoken fo fully concerning the
■*• nature and cure of thefe complaints under
the different heads of Venereal ulcers^ Exulcerated
Buboes y Venereal Sore Throat, Difeafes oj the Skin,
Venereal Pains, and efpecially in the chapter
where I conlidered the reafons why fo me vene-
real complaints do not yield to mercury, tjjat
very little remains to be added here.

I mufl only obferve, that I have found mofl,
if not all, of thele complaints admit of great re-
lief, or even of a radical cure ; and. that the
great point for accomiDlifliing thjs delirable endj,
lies lefs in thefe complaints themfelves, than in
an exad knowledge of their nature. This cer-
tainly requires fometimes' more practical faga-
city than is generally imagined. The great ob-
jed: is, to diilinguifh exa6lly 5 fit'Jly whether
thofe runnings, ulcers, cutaneous eruptions,
pains, &c. are really of a venereal nature; I
mean, whether they owe their origin really to
the venereal poifon, or rather to fome other
caufe widely diiTerent; ovfecondly, whether they
are the eff^ds of mercury ; or, what is perhaps

Q 2 of

^44 VENEREAT COMPLAINTS

of the greateit confequence, thirdly, whether,
from having been originally owing to the ve-
nereal virus, they now, by time or other cir-
cumftances with which we are not yet fafficient-
ly acquainted, have changed their nature. In
which cafe, inilead of yielding to the power of
mercury, they feem to be not only in every de-
gree exacerbated by that remedy; but likewife,
if its ufe be imprudently infifted on, will at
iaft prove fatal to the patient. In proof of
this, I have adduced", under the above men-
tioned heads, feveral flriking, and, as I think,
convincing inftances. And thofe of my readers
who are particularly interefted in this fubjed
may find a good many more in Mr Fabre^s Sup-
plement to his Treatife on the Venereal Difeafe, I
now proceed to the confideration of thofe medi-
cines which I have hitherto found mofl effica-
cious in removing thefe dreadful and pbftinate'
. complaints.

To dillinguifli complaints arifing from mer-
cury from real venereal ones,' great judgment is
often required. I havefeen patients who com-
plained of rheumatic pains, pains of the bones,
headachs, fpafms in different parts, and trem-
bling of the extremities^ &c. owing, as they
thought, to the enormous quantity of mercury
they had taken 3 whom, however, after a care-
ful inquiry, I have effedually cured by giving
them more mercury ; becaufe I found that the
obftinacy of their prefent complaints, though
really venereal, was owing to an improper pre--
paration of mercury made ufe of, or to a pro-
per-preparation improperly adminiflered; which
being evacuated b,y flool^ falivation, or immo-
derate

INCURAiBLE BY MIlRCURY. 245

derate fweats as fail as it was given, thereby,
though taken for a great length of time and in
conliderable quantities, could never exert its
proper effedl upon the poifon lodged in the bo-i
dy.

Difeafes are often incurable by mercury, on
account of their miftaken nature. I have ob-
ferved above, that claps, ulcers, and buboes^
may, and do often, arife from a caufe very dif-
ferent from the venereal; and that, in this cafe^
they are not unfrequently miftaken by fupexfi-
cial practitioners for venereal complaints, where
there never was as much as a fhadow of any fy-
philitic poifon in the cafe. It is, therefore, no
wonder, that they find, in fuch inftances, all the
mercurial preparations, tried often one after the
other, prove, if not hurtful or fatal> at leafl
perfectly ufelefs to the patient* I have men-
tioned under the different heads, how thofe com-
plaints are to be diflinguiihed and treated 3 and
therefore find it fuperfluous to repeat any thing-
further about them.

There are difeafes which arife from ill-treated
claps or gleets, and prove obilinate and incurable
till we bring on a running. In thofe cafes, where
the difeafe is not of a venereal nature^ but owingj
as is not unfrequent, to the effects of mercu-
ry, infl;ead of following the general routine of
practice, to give new mercurial preparations,
after two or more of them have been already
tried in vain, we muft endeavour to countera(!l
and deflroy thofe effeds. This is moft efFeduaily
done by the internal ufe of purified fulphur^
commonly called flowers of fulphur, and by

246 VENEREAL COMPLAINTS

repeated warm baths, and flannel drefs, taking at
the fame time proper care to keep up the vi-
gour and ftrength of the body by a good nou-
rifliing diet, wine, and ftrengthening medicines,
if required. The fulphur of antimony with the
refill of guaicum along with the warm bath, will,
in thefe inftances, be efpecially ufeful, where the
fymptoms have been brought on by Gat<:hing
cold.

Thofe complaints which are neither owing to
the venereal virus nor to the effects of mercury,
but which, though originally venereal in the be-
ginning, having by time, by the ufe of mercury,
and other circumftances, changed their nature,
relift now the one as well as the other of the
inethods jull before recommended. In thefe
cafes, it is often befl: to leave off for a time all
medicines whatever : change the low diet for an
invigorating and ftrengthening one, and the con-
fined air of a town-room for the healthy country
air, efpecially at the fea-fide. If medicines are
to be given, the tonics or ftrengthening ones are
thofe from which we have mofl to exped. Un-
der this clafs I principally reckon autimo-
nials, and more efpecially, in the cafes alluded
to, chalybeates. But, when fpeaking of the ufe
of thofe medicines, I would not be undcrilood
to prefcribe them in the quantity of a few grains
as ufually given, but in much larger dofes. The
preparations I generally make ufe of are, the
crude antimony, the ^ethiops martialis, and
more efpecially a tindure made of iron and vi~
triolic ether. Of thefe I adminifter fuch dofes
as the conflitution of the patient will bear, ei-
ther

INCURABLE BY MERCURY. 247

ther alone or united, according to circumftan-
ces, with the decodions of farfaparilla, the Pe-
ruvian bark, or walnuts. The fulphur of anti-
mony, united with the extrad of hemlock, will
be fometimes very ferviceable, alone or with
a decoclion of farfaparilla with the mezereuni
root, and the ufe of warm baths. Sometimes the
cold bath, and efpecially bathing in the fea,
will greatly contribute to the effed; of the above
medicines.

From the deco6lum Lulitanicum I have feen,
in feveral inftances, evident good effeds. But
of all the remedied hitherto recommended for
venereal complaints incurable by mercury, I
have feen none e;qual to a decodion made ufe of
by HvPaullini, phyfician at Lay bach in Carniolia*
With this decodion, the moft. malignant and
obflinate ulcers, cutaneous diforders, tophus,
caries, pains of the boiies and other parts of the>
body, arifing from a venereal caufe, which re-
filled the power of all other medicines prefer!-
bed by different phyficians in dilFerent climates,
have been effedually cured ; and, what is flill
more remarkable, for the moft part^ in a very
iliort fpace of time. It is, however, much to
be regretted that this remedy cannot become of
more general ufe, nobody hating been hitherto
able to prevail upon him to make it public*

<^4 CHAP.

24B Why some Venereal Complaints

C tt A P XX.

Of the Reafons why certain Venereal
CoMPLAiNis^^ not yield to Mercury. '

•T^HE reafons pradlical obfervations have fug-
•*■ gefled to me why mercury fometitnes fails
in curing venereal complaints, depend on the
following caufes; viz. i. On mercury and its
preparations. 2. On the method of exhibiting
the fame, internally as well as externally. 3. On
the greater or lefs irritability or conftitutional
ftrength of the patient, or fome faults commit-
ted by the fame. 4. On the nature of the dif-

eafe itfelf.- 1 fhall treat of them in order.

Concerning x\i^ firjl ^nd fecond point: Since
the ufe of mercurial ointment in fridions, the
firft and only method made ufe of in the lix-
teenth century, feveral other preparations, both
for internal and external ufe, have been difco-
vered and tried, with a view to cure venereal
complaints which would not yield to fridions,
or to remove the difeafe more fpeedily or in a
more convenient manner. I fhall avoid making
here any reflections on the preference which
either of thofe methods may claim over the reft;
and fhall here confine myfelf entirely to the
reafons why mercurial fridions, as well as other

pre-

Resist MERtURY. 249

preparations of mercury, fometimes prove inef-
fe(5tual for removing fome venereal complaints,
having offered the neceffary bbfervations on
thefe preparations before.

I have feen a variety of perfons affeded with
gleets, {hankers, pains and caries of the bones,
cutaneous eruptions, herpes, ulcerations of the
nofe, throat, &c. condylomatous or verrucous
excrefcences in diiFerent parts of the body, but
efpecially about the anus and pudenda, which
feemed obilinately to refifh the effeds of mercu-
ry ; and which, fo far from being removed by a
copious and difagreeable falivation, were rather
increafed by it, and, when removed, often re-
turned again fhortly afterwards.

After a careful inquiry, I found that the cau-
fes of this difficulty are frequently to be fought
for in the medicine itfelf; being owing, either,
\Jl, To its being badly prepared, or ill fitted for
curing the difcafe. 2dly, To its not havmg been
given in a fufficient quantity, or continued for
a fufficient length of time. And, 3^/y, To its be-
ing adminiflered in too great a quantity, and by
that means exciting a falivation, fweats, and
purging, without deflroying the venereal virus
m the body.

The great point in curing the venereal difeafe
by means of mercury, being to introduce fuch a
quantity of it into the habit as fhall be fufficient
totally to eradicate the venereal poilbn, it is
evident that medicines unikilfully or negligent-
ly prepared, may have the worfl effeds, or no
efFed at all. Thus, for example, if fublimate be
mixed with arfenic in order to render it whiter,

and

25© Why some Venereal Complaints

and give it a better appearance, or if mercury
be combined with fubflances incapable of hold-
ing it fufpended, or if;^ when made into pills, it
be not fufficiently triturated fo as to be equally
divided, its effects cannot be but precarious. In
the latter cafe^ one pill may contain three oi'
more grains of mercury, and another only one
grain, or perhaps none at all ; and when this
is the cafe, the latter will have no effed, while
from the former^ the patient may experience a
violent griping, purging, &c.
. Here we may obferve, that a m-ercurial pre-
paration is always ill fitted for the purpofe,
w^henever it is incapable of entering into the
habit, or if, when it has entered the circulation,
it excites a falivation before it has deitroyed the
virus 3 for it is erroneous to believe, as I men-
tioned above, that by a falivation all the poifon
is carried off, and the difeafe by that means ra-
dically cured, jult the contrary to this being
often the cafe. It is true, that if a falivation is
brought on, the patient will often find all his
fymptoms difappear, and of Courfe be induced
to think himfelf cured ^ but fome months, nay
fometimes only a few weeks afterwards, the
complaints in many cafes will return again with
increafed violence. I do not deny, however,
but that the difeafe, efpecially if flight, may by
this means be radically cured: but I maintain,
from repeated obfervations in private as well as
hofpital pradice, that the praditioner can never
be certain of a real cure , and of courfe, that the
cures effeded by falivation are not only doubt*
ful, but oftentimes altogether ineffedual. But
2 upon

R E s I s T M E R e tj R Y. V 251

upon this fubjed I have ah-eady fpokeri more
fully in the foregoing chapter.

The principal remark to be made here is, that
to cure the lues well and radically, no prad:!-
tioner who has the welfare of his patients at
heart, and who does not choofe to adminifter
his medicines at random, will ever make ufe of
any mercurial preparation or compofitlon which
he has not prepared himfelf, or at leaffc taken
care to fee the fame prepared by fome perfon on
whofe integrity and care he can rely. The re--
peated difappointments I have experienced my-
felf, and which 1 have feen happen to others,
have rendered me fcrupuloufly exadi: on this
head. ,

We lliould likewife be careful not to make
ufe of mercurials combined with medicines,
which may render the former lefs efficacious ;
becaufe they not only difappoint us, but often
render the cure more tedious and precarious*
I have feen repeated inftances of this with Plum-
mer's pills ^ and have heard the fame remark
made by other attentive and eminent pradition^
ers.

We ought never to give acrid preparations of
mercury when we can efFed a cure with mild
ones. The dreadful effeds I have repeatedly
been an eye-witnefs to, from remedies of this
fort, efpecially from the corrolive fublimate,
oblige me to inculcate this caution with the
8:reater warmth. The conftant effeds of fuch
acrid compohtions, efpecially in delicate habits,
are pains in the ftomach and bowels, lofs of ap-
petite, .violent grjpings, diarrhoeas, and fome-

times

252 Why some Venereal Complaints

times dangerous colics; or, if they enter into the
niafs, they excite fpitting of blood, convullions,
nervous fevers, and other complaints, more bane-
ful even than the difeafe they were intended for
to eradicate ; or elfe they will perhaps excite a
falivation, and of courfe prevent from being
continued to complete the cure. If we fome-
times adminifter them, as may now and then
be requiiite in cutaneous or deep>feated vene-
real complaints, we fliould carefully conlider
the habit of the patient; and if that appears to
admit of them, begin with very fmall dofes, in
order to avoid the above mentioned fy'mptoms,
particularly the diarrhoea; for when that takes
place, the mercury, inftead of entering into the
mafs, will be carried off by ftool, and of courfe
occalion trouble and pain to the patient, with-
out affording him any relief. In general, there-
forcj we fhould be careful in the choice and ad-
miniftration of mercurial preparations : we fhould
find out, in every cafe, that preparation which
feems befi: to agree with the confLitution, and
never infifl obflinately on the ufe of a prepara-
tion ordofe which excites bad fymptoms in the
body: We fhould not imitate the example of
thoie quacks whofe knowledge coniifts entirely
in a noilrum, which they give indifcriminately
to all their patients, for every kind of venereal
complaint, and pronounce their patients cured
as foon as the fymptoms of the diforder have
difappeared; to which affertion, credit is the
more readily given^ as mofl young men diflikc
to be conflrained or confined to a courfe of me-
dicines for a length of time. Thus they will

now

Resist Mercury. 253

now and then cure a patient j but in the mean
time ruin the conftitution of many, and com-
monly render the difeafe more obftinate and in-
veterate for the future. The poifon indeed re-
mains latent for weeks, months, or fometimes
even for years 5 but then it breaks out with re-
doubled rage and violence, and not unfrequent-
ly produces fymptoms and difeafes ; the nature
of which, efpecially in women, we mull only
guefs, and which, in that ftate, fometimes baffie
the fkill of the mod able phylician 5 for, vene-
real complaints, the older they are, the more
obflinate they prove againfl the power of mer-
cury.

I come now to the third point, why mercury
proves unfuccefsful in curing the lues, viz. on
account of the conftitution of the patient, &c.
We fometimes meet with patients, efpecially
among the female fex, or fuch as have taken
mercury for former venereal complaints, whofe
conftitution is now fo irritable, that after the
adminiftration of a few grains or a few fridions,
they are either affeded with a nervous fever,
fpafms, headach, or they very readily fall into
a falivation on the fecond or third day. In
thefe conftitutions we ought to be peculiarly
careful to find out the preparation and dofe beft
adapted to them. The Peruvian bark, or feme
other vegetable tonic, is here fometimes admi-
niftered with mercury to great advantage. By
the neglect of thefe precautions many patients
of this kind will be fufTerers for life, without
ever being cured radically.' There is one remark
to be made here, to \yhich in general little at-
tention

254 Why SOME Venereal Complaints . J

tention has been hitherto paid. Moft writprs
and praditioners confine their venereal patients |
under a mercurial courfe, without any dillinc- "
tion to a low diet, as well with regard to eating
as drinking. This rule is however a very im-
proper one when generally applied. Such a
diet will be very proper for flrong, vigorous
conilitutionsj but for weak, delicate, or irrita-
table ones, it is fometimes highly improper. A
full diet, with the moderate ufe of wine, ought
to be allowed to them ^ otherwife mercury will
produce no efFeds upon the poifon, though very
difagreeable ones upon the conftitution. The
warm bath will fometimes much affift in thefe
cafes. Nature readily co-operates with niereu-
ry in fome conftitutions j whereas in othets it
does but little, or ads flowly, and with difHeul-
ty. But befides this peculiarity in the- confti-
tution, we often obferve, that patients I'ender
their complaints complicated and obllinate, by
attempting to cure themfelves, or by applying
to quacks, or unikilful perfons in the art of
healing. They frequently alfo hurt themfelves
by negled of diet, or by not making ufe of the
medicines in the manner prefcribed, or by not
continuing the fame long enough, but leaving
off as foon as the fymptoms difappear, by e^^po*?
iing themfelves imprudently to the damp an(^
cold atmofphere, efpecially at night ; or when
they grow impatient and inconftant, going from
one phylician to another, or making ufe for fome
days or weeks of one medicine and then of an
HQXhQVr By all theft different circumllances,

yene-T

Resist Mercury. 255

venereal complaints are ofteii rendered extreme-
ly obftinate,

Mercury llkewife fometimes fails, when the
patient, by a previous large or imprudent ufe of
mercury, can hardly bear a few grains or a few
fridions without falivation: in this cafe, if v/e
leave off the ufe of mercury, our patient will
not get rid of his diforder; and if we continue
it, we are fure to bring on a troublefome ptya-
lifm, which will laft fometimes for weeks or
months, expofing the patient to dangerous con-
fequences, and often leaving the principal dif-
order uncured. What ought to be done in thefe
circumftances, I have hinted in feveral places
of the foregoing chapters.

But we are, fourthly, by far more frequently
difappointed in our expectations from mercury,
by miftakin-g the nature of the diforder; by
judging thofe complaints venereal which never
were venereal, or which often are owing either
to the eifedf of mercury, or to a ftate of the
diforder j which, though originally ariling frora
the venereal virus, has degenerated, either by
time or other caufes, Into a difeafe of a quite
■ different nature, for which mercury is not only
no antidote, but a real poifon. Of thefe com-
plaints we have fpoken already, and ftiall have
Qccalion to fpeak further hereafter.

C H A p.

255 OTHER REMEDIES

CHAP. XXL

On different other Remedies, befides Mer*
CURY, recommended for curing the Lues*

BESIDES the mercurial frldlons, the fumiga-
tions, and the internal ufe of the different
mercurial preparations, a variety of other me-
dicines has been recommended, either to cure
the different venereal complaints without mer-
cury, or to aflill mercury in its operation; and
as there are inftances where the mercury fails,
or where patients by its ufe are expbfed to dif-
agreeable confequences, a remedy has long been
fought for, which, without having any of the
noxious qualities of mercury, might have all its
powerful and good ones. — Mofl of the quack
medicines, fold and praifedas preparations from
the vegetable kingdom for this purpofe, I have
been at pains to analyze, and have found them
generally to be nothing but one or other mer-
curial preparation difguifed.

Several remedies have been recommended as
fuccedaneums for mercury for the cure of the
venereal difeafc, which have been made ufe of
for this purpofe, we are told, with fuccefs, be-
fore or lince mercury was introduced. Some, we
are credibly informed, are even at this time
2 ' adually

FOR CURtNG THE LUES. 2sf

adlually employed with the bell efFect, in Sduth
as well as in North-America, for curing the ve=
nereal difeafe radically without mercury. Such
of them as I have feen made ufe of for the fame
purpofe in Europe, have generally failed; and I
have never feen yet one inftance of a confirmed
pox radically cured without mercury. Some of
them, however, are worthy of our attention,
and certainly deferve a fairer trial than has
hitherto been bellowed on them, in order to
afcertain their power, efpecially fuch as are re-=
commended by men of knowledge and obferva«
tion. The root of the Lobelia fyphilitic a, w^ith
which, as we are inllruded by Dr Kalm, and
afterwards more exadly by Mr Bartram*, the
inhabitants of North America cure the venereal
difeafe as effedually and radically as we do with
mercury. They take a handful of the frelh, or
(which he fays is better) dried plant; they walh
it, and boil it in a gallon and a half of water >
of which decodion the patient drinks every day,
if his conllitution will fulFer it, a quart in the
beginning, gradually augmenting the dofe, till
he can no longer bear the purging excited by it;
then he leaves it off for a day or two, and, if

R necef-

* The latter author advifes the patient to take two gills of this
dcco£lion three times a-day on an empty ftomach, and augment
the dofe according to the ftrength of the patient, making ufe of
warm baths, and a proper diet at the fame time. Care fhould be
taken not to make ufe of the lobelia longiflora inftead of the
lobelia fyphilitica, the former being of a much more acrid nature
than the latter. — In fome parts of Italy it is even now a law of
government, not to make ufe of mercury in hofpitals for curing
the venereal difeafe. /

258 OTHER REMEDIES

neceflary, continues it again till he finds himfelf
perfedlly well, which is for the moft part in a
fortnight. If there are any external diforders,
they waih the affeded parts with the fame de-
codion. — If the difeafe is very obflinate, they
mix with the lobelia, the root of the Ranunculus
aborthnu, but in a fmall quantity on account of
its acrimony. In order to heal up the venereal
ulcers, they dry the root of Geum nivak^ and
fprinkle its powder upon them. They alfo cure.
deep and putrid ulcers, by the external ufe of
the powder of the interior bark of the Ceanothus
Americanus^ A decodion of the flipites of the
Sclamim dulcamara, or of the root of the Daphne
7}ieze?'eu7n, or Daphne laureolay and more efpecially
the powder of Sarfaparilla in large dofes, have
been |of late much recommended in obftinate
venereal complaints ; but how far their opera-
tion fucceeds without the previous ufe of mercu-
ry, is not yet afcertained.

In South America, and in the Weil Indies,
the decodion of the woods of guaiac, faflafras,
&c. is praifed as a remedy, with which alone
the mofi: confirmed lues may be eafily cured.
It may be that venereal complaints are thereby
removed between the tropics, and in the warmer
climates of our globe ; but in Europe I have ne-
ver feen one cafe where they efFeded a radical
cure ; but fometimes rather prove hurtful, pro-
ducing profufe fweats, hcemoptyfis, confump-
tions, &c. efpecially in delicate and thin habits.
—Several complicated prefcriptions are made
Tife of, and greatly praifed, though generally
3 kept;

FOR CURING THE LUES. 259

kept fecret, fome of -whicli I have inferted at the
end of this Treatife in the formulas.

fiAy friend Dr IVinterl, ProfelTor of Botany at
Buda in Hungary, difcovered lately^ that the in-
habitants in the confines of Turkey cured them-
felves of the iues in all its ilages by a decodion
of the AJiragalus exfcapus.- — The infpifTated juice
of the Papaver fomnijerum, known under the
name of Opium, by fucceilive increafed dofes
from one to twelve or lixteen grains in a-day,
firfl propofed for a trial by Dr kooth, as I men-
tioned above, has proved very fuccefsful in the
Great Military Hofpital at New York. But how
far all thefe medicines, as I laid juft before, do
or may fucceed without mercury, I am not able
to decide. So much it feems to be certain, that
the lues is in general much ealier cured in warm
climates, when properly treated, than in cold
ones. A decodion of the bark of Primus Padus
has been lately found very efBcacious, efpecially
when joined with the ufe of mercury, in many
violent and inveterate venereal complaints, by
Dr Biornlund Phyfician in Sweden \ and an ac-
count of them has been inferted in the Swedifh
Philofophical Tranfadions for 1784.

White arfenic mixed with the powder of the
root and berries of the Solanum lethate, one
grain of the former to thirty-nine grains of the
latter, have been of late found very ufefui in
obflinate phagedenic ulcers, attended with fun-
gous fiefh and callous edges, by Dr Bjip^ Pro-
felTor of Chemiltry at Philadelphia ; he alfo re-
commends a weak folution of white arfenic in
boiling water for the fame purpofe. And Mr

R 2 B lizard

26o OTHER REMEDIES, &c.

Blizard has publiflied lately in London fomfe
Pradical Obfervations, where he employed eme-
tic tartar in powder, fprinkled upon phagedenic
ulcers, with great fuccefs; the acrid ichorous
difcharge being thereby changed into mild pus,
the ulcers foon put on a good appearance^ and
healed up.

G H A P.

l^REJUDIGES CONCERNING 261

CHAP. XXIL

Observations on Jbme dangerous or un-
happy Prejudices generally prevailing a-
bout the Venereal Disease.

YT is an opinion imbibed by fome patients, that
•*• the venereal poifon, when once alDforbed into
the fyflem, can by no means be totally eradica-
ted 3 confequently they believe, that a perfon
who is once thoroughly infeded, can never look
upon himfelf as radically cured. This opinion,
beiides its abfurdity, renders thofe who enter-
tain it very unhappy. 1 have feen frequent in-
ftances, in the female fex efpecially, where fuch
patients led a mofl miferable and melancholy
life, notwithftanding every thing the phylician
could fay to the contrary. The leafl; fliadow of
a headach, a rheumatic pain, or the fmalleil
pimple upon the fkin, were by fuch patients ac-
counted certain proofs of the poifon lurking in
the mafs, and about to produce the moft dire-
ful effedts. Thefe patients are real objects of
compaflion^ Vv^e ought to beflow fome time for
inquiry, and pay the moil careful attention to-
wards them ; for indeed we can hardly think of
a greater degree of mifery than to be perpetual-
ly hapnted with fuch an imagination. If, there-

R .3 , fore,

262 PREJUDICES CONCERNING"

fore, after our moft careful inquiry, we find no
fymptoms of a venereal kind remaining, we
riiould endeavour to correct their prejudice, by
fetting before them the examples of others of
their acquaintance, or, if circumftances admit,
of thofe of our own, who have been affected as
much as themfelves, or perhaps much more, and
who now, perhaps, after a great nurnber of
years, enjoy the mod perfed Hate of health,
are married, and have healthy and fine chil-
dren.

The fame attention we ought to pay to thofe
who imagine, that if mercury is once taken for
the cure of the lues, it will not fo efFe(5lually
cure it a fecond time. Thefe prejudices are
moil frequently found among the women,
though fometiiTies alfo men of a rnelancholic
conftitution will be influenced by them 3. but
there is another prejudice of which 1 am now to
fpeak, which is not only abfurd but crimi-
nal, and deferves a moilfevere punifhment from
the magiilrate wherever it can be proved. It
exifts only among fome young men of a loofe
character, and dilFolute and brutal manner of
thinking. With thefe v/retches it is an opinion,
that the befl method to get rid of a clap is coi-
tion v^ith one or more healthy women; and in
this manner I have feen venereal complaints pro-
pagated, in the courfe of a few days, to ten or
twelve healthy perfons, v/ho had the misfor-
tune to fall in with thofe wretches, or with the
objeds of their brutality and cruelty. The ab-
furdity of this notion is evident to every perfon
of common {er}k\ who has the ieaft kno\yiedge

of

THE VENEREAL DISEASE. 263

of the nature and feat of the difeafe -, and where
this pradice arifes merely from prejudice, the
flighted information will be fufficient to remove
it. But it is to be feared, that the caufe may
frequently lie deeper in the heart of thefe per-
fons; and that this abominable pradice pro-
ceeds from malignity, or from a mean and low
difpofition to revenge themfelves upon innocent
perfons, becaufe in their imprudence or drunk-
ennefs they themfelves had become the dupes
of others.

II 4 P H A R^

PHARMACOPOEIA

YPHILITICA,

So modern 'Pothecaries, taught the art
By Dodlors biils, to play the Do6i:or's part ;
Bold iij the praflice of miilaken rulee,
Prefcribe, apply, and call their mafters fools.

Garth's Difpenfary.

LECTORI,

EN fpecimen PharmacopcEiae Syphiliticae, complec-
tens medicamenta pleraque, fi non omnia, tarn lim-
plicia quam compofita, ad curandos morbos fyphiliticos
hodie adhibita. Nomina plantarum et praeparatorum
chemicorum antiqua, minus congrua, impropria, aut
falfam penitus rei ideam fuggerentia, confulipne fertilia,
genio faeculi indigna expunxi, mutavi. Cur enini
Gallimachiam nominum chemicorum veterem retineas,
dum exaclior corporum analylis, ac nomenclatura Berg-
mani rei veritati magis congrua fuppeditat ? Cur no-
mina plantarum pharmaceutica vaga adhibeas, dum no-
men fyftematicum Linnaei, ad quem pro jufta plantae.
defcriptione fempet recurras, in promptu habes ? Me-'
moriae tyronum hoc modo aeque ac tua3 parceres, et
pofteritati (iiquidem liber tuus ab ea legi meretur) pro-
defles, difficultatem removendo, qua tu quidem legen-
do veteres praecipue, et non raro etiam recentiores,
continuo premeris. Si Hippocrates, fi alii poll eum ia
medicina fcriptores id obfervaffent, id cbfervare potuif-
fent, fciremus hodie, quid ille fub fuo Helleboro, quid
alii fub plantis fuis aut preparatis chemicis faepe adeo,
nee forfan immerito, laudatis intellexerint.

I. S I M P L I C I A,

Ex regno Vegetahilu

AcoNiTUM Napellus (Herba, extraftum).

Offic. Aconitum; Anglis, lVolfsba?ie; Germanis, Blauer SturiTihuii
Gallis, Chaperon de Maine.

Anemone Pratensis (Harba, extraftum).

A. Windfloiuer; Ge. Windhlume; G. Papfieurs.

Arctium Lappa (Radix).

Off. BarduTia; A. Burdock-root; Ge. Kleften'wurzel ; G. Bar"
dane.

Astragalus Exscapus (Radix),

•-

^tropa Mandragora (Radix).

OS. Mandragota; A. Mandrake; Ge. Alraun; G. Mandragore.

Jalsamum Canadense, ex Pinu ^alsamea.
A. Canada B a If am.

BiLLSAMUM COPAIV^, eX CoPAIFERA OFFICINALI.

A. Balfam of Copaiva; Ge. Copaiva Balfani; G. Baume Copaive,

Balsamum Peruvianum, ex Myroxylo Balsamifera-

A. Balfam of Peru; Ge. Peruvianifchcr Balfam; G. BauJite di
Perou.

Cannabis Sativa (Semina).

A. Hemp feed; Ge. Hanfsaaj^sn; G. Semences du Chauvrc,

Ceanothus Americanus (Cortex interior ; Radix).
A. iVifw Jerfey Tea; Ge. Ceanothus.

Cinchona Officinalis (Cortex).

OfF. Cortex Peruvianus ; A. Peruvian Bark ; Ge. Fieherrinds ;
G. Kinkina.

Clematis Recta (Folia).

Off. Flamrnula Jovis ; A. Upright Lady-lo^jjer ; Ge. JValdrehs;
G. Clemaiite.

CONIUM

a68 PHARMACOPEIA SYPHILITICA.

CoNiUM Maculatum (Herba, Folia, extraftum).

Off. Cicuta; A. Hemlock; Ge. Schierling; G. Cigue,

Daphne Laureola

Laureola 7 n j- . o . J- •

Mezereum J Radix, et Cortex radicis.

Off. Mezereum; A. Mezereon; Ge. Seidell aft j G. Garou.

Geum Nivale (Radix).

Glycyrrhiza Glabra et Echinata (Radix; fuccus infplflatfus, z;«^<?
extraftum).

Off. Liquoritia; A. Liquorice; Ge. Susjholz; G. Reglijje,

Guajacum Officinale (Lignum, Cortex, Refina).

Off. Lignum Sanilum; A. Guajac; Ge. Franzofenholz.

GuMMi Mimosa Nilotic^, vel Mimosa Senegal.

Off. Gumyni Arabicu7n; A, G, Gum Arabic; Ge. Arahifcher Gummi.

IIyosciamus Niger (Extraftum).

A. Black Henbane; Ge. Bilfenkraut; G. jfiifquiaine.

JuGLANS Regia (Nux cu'm Cortice viridi, ejufque extraftum).
Off. Nux Jnglans; A. Walnut; Ge. Walnufs.

JuNiPERUs Sabina (FolIa).

Off. Sabina; A. Savin; Ge. Sevefibaum ; G. Sabine.

XiAURUs Sassafras (Lignum, Coftcx, Radix).
Off. A. Ge. G. Safaffas. '

Ledum Palustre (Folia cum Florlbus).

Off. Rofmarinus Sylvejlris ; A. Bohe?nian Rofemary ox HihofC'.
Ge. Wilder Rofmarin; G. Rofmarin Sauvage.

Lobelia Syphilitica (Radix).

Malva Rotundifolia (Herba, Folia).

Ononis Spinosa (Radix).

Papaver Somniferum (Succus infpiffatus).
Off. A. G. Opu7n; Ge. Mohnfaft.

Prunus Padus (Cortex).

Ranunculus Abortivus (Radix).

pAPONARiA Officinalis (Folia, Herba).

^. Soapiucri } Ge. Seifenkraut ; G. Saponfiire,

Smiia?

PHARMACOFCEIA SYPHILITICA. 269

Smilax Sarsaparilla (Radix).

Off. A. Ge. Sarfaparilla ; G. Salfepareile,

SotAy/uM Dulcamara (Stipites). ^

OS. Dulcamara ; A. Bitterfvoeet i Ge; Bitterfufs ; G. Morelle
Grhnpante.

Terebinthina Larigna, ex Pinu Larice.

Off. Terebinthina Veneta; A. Venetian Turpentine', Ge. Terpen^
tin'', G- Terelintine.

•^onMENTiLLA Erecta (Radix).

A. Septfoil; Ge. Birknuurzel; G. Tortnentille-

Ex Regno AnimalL

Hirudo Medicinalis.

A. Leeches; Ge. Bliitigd; G. Sangfu'e,

Lac Humanum^ aliorumque Animalium.

Meloe Vesicatorius (Emplaftrum, Tinftura).

Off. Cantharis: A. Cant bar ides; Ge. Spanifche Fliegen; G. Moucht
Cantharide.

Ex Regno Miner all .

Antimonium feu Stibivm.

AntiiAonium Sulphuratum. .

Off. Antimonium Crudum ; A. Antimony; Ge. Spiefsglafs ; G.
Antimoine.

Praparat. Sulphur Antimonii.

Antimonium Muriatum.

Off. Butyrum Antimonii; f. Caiijiicum Antimonials.

ARGENtUM.

Prcpparat. Argentum Nitratum.

Off. Lapis infernalis, Caujlicum lunare ; A. Lunar
Cauftic; Ge. Hoellenjlein ; G. Pierre Infernal.

Arsenicum Calcinatum.

Off. Arfenictim Alhwn; A. Whits Arfenic»

Cuprum,

ayo PHARMACOPCEIA SYPHILITICA.

Cuprum.

Praparat, Cuprum Acetatumi

Off. JErugo ; S. Firide Mr'rs ; A. Verdegr'u i
Ge. Grunfpan } G-- Verd de gris.

Cuprum Vitriolatum.
OfF. VitriQlum Gupri; {. Cyprinum; f. Cceruleum; A. Blue
Vitriol ; Ge. Kupfir-pltrial ; G. Vitriol de Cuivre.

Aurichalcum (Pulvis)*

Ferrum.

Praparat. Ferri LImatura.

Calx Ferri nigra. Off. JEthi<sps Martialis,

. rubra. Off. Ochra. .

Ferrum Muriatum.

Off. Flores Salis Ammoniact Martiales.

Ferram Saccharatum. Off. Mars Saccharatus,

Ferrum Tartarifatum.

Ferrum Vitriolatum. Off, Vitriolum ferric Sal Martit.

Plumbum.

Praparat, Calx Plumbi ; feu Plumbum Calcinatum.

Off. Lithargyrum; A. G. Litharge; Ge. Bleyglxtte,

Plumbum Acetatum.
Off. Saccharum Saturni; A. Sugar of Lead; Ge. Bley-

zucker.

Calx Plumbi Acetata.. Off. Ceruja.

Acetum Plumbatum.

Off. Acetum Saturni; f. Lithargyri ; f. Biatraiium
Saturni; f. Extra{iu7ti Goulardi.

ZiNCUM.

Praparat. Calx Zinci. »

Off. Tutia Praparata ; f. Lapis Calaminaris.^,

Calx Zinci Sublimataj f. Zincum Calcinatum
Off. Flores Zinci.

Zincum

PHARMACOPCEIA SYPHILITICA. 271

Zincum Vitriolatum.

OfF. Vitriolum Zinci; f. Album ; A. WhlU Vitriol ;
Gt.Zink'Vitriol; G. Vitriol de Zinc.

Hydrargyrum, eju%uc Praeparata varia, in Tabula fequenti exhi-
bentur.

TABULA exhibens diverfa, ex Hydrargyro Prje-
PARATA et CoMPOsiTA, hadlcnus cognitaf .

I. Hydrargyrum simpliciter purificatum,

* Hydrargyrum purificatum.

A. ^lickfilver, crude purified 7fiercury; Ge. Reines queckfil'

ber ; G. Mercure pure.
Syn. Mercurius crudus purificatus officinarum.
Argentum vivum purificatum.

II. Pr^parata in quibus Hydrargyrum solummodo

DIVISUM ESSE VIDETUR.

I. Decoftum Hydrargyri, i. e. Hydrargyrum fimpliciter in aqua
coftum.

3. Extrafto Glycyrrhizse fubaclum.

3. Gummiaut.mucilagine, e.g. Gummi Arabico, Tragacanthae, &c,

* Hydrargyrum gummofum.

Syn. Mercurius gummoiusj inventore Plenck.

COMPOSITA-

f L?tterK,'quibus prjeparata et compofita notantur, fignificant: O. Officinarum;
I.,. Fliarmacopcea Londinenlis ; S. Pharm. Suecica; D. Pharm. Danica; E. Pharm.
_Edinl-)urgenfis; B. Difpenf:itorium novum Brimfwicenfe; 'E. faup, Pharm. Edinbur-
geiilis pauperum ; T. Pliarm. Nofocomii Sti. Thuma.Londinenusj G, Pharm. No-
ibcomii Sti, Georgii I^-ondinenfis,

27^ PHARMACOPCEIA SYPHILITICA*

GOMPPSITA.

.*>» Pilulas ex hydrargyro gummofo.

' Syn. Pilule ex mercurio gummofo. Plenck. Pharm. Chin

/2 Solutio mercurialis gummofa. Ibid.
Syn. Mixtura ftierciirialis. G.

y Potio mercurialis. B»

^ Lac mercuriale. Plenck.

4. Refma aut Balfamo; e. g. Terebinthina, Balfamo Copaivaej &c>

* Hydrargyrum terebinthinatum, &Ci

COMPOSITA.

* Pilule ex hydrargyro terebinthinato*
Pilulae mercuriaies. L.

Pilulss mercuriaies laxantes. G.
Pilulse merctiriaieS fialagogse. D.
In]e<3:io mercurialis. E. Paup.

ST. Piaguedine animali aut oleis unguinofis; e. gj Axungia porciilEj,
anferlna ; butyro Cacao.

* Hydrargyrum Unguinofilm.

* Unguentum hydrargyri. Vid. infra Hydrargyrum Sehihum.

Syn. Unguentum ex hydrargyro coeruleum. E.

Unguentum mercuriale, itxi. unguentum Neapolitanum;

COMPOSITA.

« Unguentum coeruleum fortius. Li

Unguentum cosruleum mitius. L.

Unguentum mercuriale. D.
n Ceratum mercuriale. L. ,

y Emplaftrum mercuriale. 0.

Emplallrum ex hydrargyro. ii-

Emplaftrum ex gummi ammoniaco cum mercurio. X.

Emplailrum commune cum mercuiio. JL.

Emplaftrum de ranis cum mercurio.

6. TeiTaCaicarea; Ci g. Creta, Lapidibus aut Chelis Cancroruni, &c*
Mercurius alkalifatus. E.
Pulvis mercurialis. G. ^

III. PRiEPAR'ATA IN QJJIBUS HYDRARGYRUM, MEDIANTE
IGNE ET LIBERO AERIS ACCESSU, IN CALCEM VERTITUR,

* Hydrargyrum calclnatum.

Syn. Mercurius calcinatus. L. S.

Mercurius prsecipitatus per fe^ L.

2 ■ Com-

PHARMACOPEIA SYPHiLItrcA^ 2n

COMPOSITA.

* Pilulas ex hydrargyrd calclnato.

Pilulee fyphiiiticas. T.

PilulcC ex mercurio calcinate. G.

Pilulas ex mercurio calcinate anodyiise. G.

IV. Prjeparata in qjjibus Hydrargyrum partIm nu

VISUM, PARTlM SOLUTUW ESSE VIDETUR.

I. Saccharo, Manna, Conferva Rofarum, Gynofbati, &e,

* Saccharufti hydrargyratum.

COMPOSITA.

* Trochifci ex hydrargyro faccharata.

Bolus coaruleus. "T,
Bolus mercurialis. G.
Syrupus Hydrargyri. S.

* Mel hydrargyratum.

COMPOSITA.

Pilulas jEthiopicse. E.

Pilulse mercuriales purgaates. E.^aup.

Pilulse BeUofti.

3. Sulphure purificato*

* Hydrargyrum fulphtiratutti.

a Trituratione aut fufione.

* Hydrargyrum fulphuratum nigrunl.

JEthiop3 mineralis. 0.

COMPOSITA.

Pulvis jSlthiopIcus. G.

b Sublimatione.

* Hydrargyrum fulpliuratiim rubriim.

Cinnabaris faftitia, feu artifioialis. 0.

CoMPOSlTAi

Pulvis antilyflus Sinenfis. 0.

c Prsecipitatione. Vid. infra Hydrctrgyrtm •yltriolatum,

4. Sulphure Antimonii.

a Trituratione.

* Sulphur antimonii hydrargyratum, _

^thiops antimonialis. 0.

COMPOSITA.

Pikilas iEthlopicse. E. D.

h Sublimatione.

Stilphur antimonii hydrargyratum rutaruct'
Syn, Cinnabaris antimonii. Oo

2^4 PHARMACOPCEIA SYPHILITICA. .

COMPOSITA.

Bolus Cinnabarinus. G. ' ]

V.PrEPARATAIN QUIBUsHyDARGYRUM MEDIAfJTE ACIDO
IN FORMAM SALIS AUT CALCIS MUTATUM EST.

I, Acido Sebi. ^ 2. Acido Muriatico. 3. Acido Sacchari. 4, Acido
Succini. 5. Acido Arfenici. 6. Acido Acetofellse. 7. Acido
Phofpbori. 8. Acido Vitrioli. 9. Acido Sacchari Ladlis.
10. Acido Tartan, ii. Acido Citri. 12. Acido Nitri. 13.
Acido Fluoris imneralis. 14. Acido Aceti. 15. Acido Boracis.
16. Acido cserulei Berolinenfis. 17. Acido' Molybdsenae. 18. A-
cido Tungftenico. 19. Acido aereo.

I. Hydrargyrum cum acido fehi combinatum.

Hydrargyrum febinum.

* Prap. Unguentum Jiydrargyri.

II. Cum acido muriatico.

* Hydrargyrum muriatum.

* Hydrargyru77i tnuriatmn fortius. •

A. Sublimatione^

* Hydrargyrum muriatum fortius fubKmatum,

Syn. Mercurius fublimatus corrofivus.
Mercurius fublimatus albus. 0.
Mercurius cum fale ammoniaco fublimatus.

B. Prjecipitatione.

Ex acido nitri mediante acido muriatico dephlogifticato, in-

ventore Bertholet.
Hydrargyrum muriatum fortius praecipitatum.

COMPOSITA.

(t Solutio fublimati fpirituofa (FifTW ^W^/tfw).

Syn. Solutio mercurii fublimatl corrofivi. E.
Mixtura mefcufialis. S.
Mercurius fublimatus folutus. G.
fi * Solutio hydrargyri muriati fortioris aquofa.
Pilulae e mercurio corrofivo albo. S.
Dr Ward's nvhite drop.
Syrop du Cuifinier.-
y * Lotio fyphilitica flava, f. lotio ex hydrargyro'muriato fortiori.
Syn. Aqua phagcdaenica. O.
Liquor mercurialis. y^.
Lotio Mercurialif!. T.
^ Solutio fublimati balfamica. Pknck.
* * Liquor ad condylomata.

Syn. Aqua cauiHca pro condylomatibus. Pknck.
*■ Hydrargyrum rnuriatum viitiui ; i. e. acidum muriaticum by-
drargyro fuperfaturatura.

PHARMACOPCEIA SYPHILITICA. 275

A.. Sublimatione. ^

$y7U Mercurius dulcis (fublimatione paratus). 0.

Mercurius dulcis fublimatus. L^

Calomel feu calomelas. /..
Aquila alba.
Panacea mercurialis.
Mercurius dulcis lunaris. Schroeder,
B. Prsecipitatione.

Ex acido nitrpfo mediante fale communi, Inventore Scheek,
* Hydrargyrum muriatum mitius prscipitatum.

Mercurius praecipitatus dulcis.
Calx hydrargyri mitriata pra^c'ipitata.

a Ex acido muriatico mediante alkali vegetabili.

Mercurius prascipitatus albus. L.
b Ex acido muriatico mediante alkali minerali.

Mercurius prseclpitatus albus. A.
C Ex acido muriatico mediante alkali volatlUf

Mercurius praecipitatus albus. JE.
d Ex acido muriatico mediante cupro.

Mercurius prseclpitatus virldis. £•

COMPOSITA.

Bolus mercurialis. JS.

Bolus jalappas cum mercurlo. i£r.

Bolus rhei cum mercurlo. lb.
Pilulas calomelanos. G.

Pilulae Plummeri. E.

Pilulae alterantes Pliimmerl. 0.

Pilula depurans. T.

PiJvis Plummeri. 0.

Pilulae mercuriales purgantes. yf.

Pilulas catarrhales purgantes. D.

Pilulse laxantes cum mercurlo. Tk

Pulvis e fcammonio cum mercurlo. T.

* Lotio fyphilitica nigra, lotio ex hydrargyro ftiurlato mltiod,

Syn. Lotio mercurialis. G.
Unguentum e mercurlo prcecipitato. L^
Linimentum mercurlale. E. Paup,

III, Cmn acido facchari.

a Hydrargyrum faccbaratum. Bergman,.

* b Saccharum hydrai-gyratum, feu

Hydrargyrum faccharo cando fubadlum.

IV. Cu7n acido fuccini.

Hydrargyrum fuccinatum. Bergman.

S 2 ^> Cup;.

3576 PHARMACOPCEIA SYPHILITieA.

V. Cu7}i aclao arfenlct.

Hydp^rgyrum arfenicatum. Bergman.

VI. Cum acida oxalis acetofella.

Hydrargyrum oxalinum. Bergman,

VII. Cum acido phofphorico.

Hydrargyrum phofphoratum. Bergman.
^raecipitatione ex acido nitrofo mediante urina JCcentL
Rofa mineralis. 0.

Vni. Cum acido vitriolico.
* a Hydrargyrum vitriolatum.
Vitriolum mercurli. 0.
Oleum mercurii. 0.
b Hydrargyrum vitriolatum flavura,
Turpethum minerale. 0,
Mercu-nus emeticus flavus. L.
Mercurius flavus. E.
Mercurius prascipitatus luteus. U.
Turpethum nigrum, 0.
c Hydrargyrum praecipitatum ex acido nitrofo mediante hepatc
fulphuris aut calcis.
Mercurius prsecipltatus niger. (X>

IX. Cujn acido facchari lailiso

X. Cum acido tartari.

a Hydrargyrum tartarlfatum, Bergman,

* b Tartarus hydrargyratus ; i. e. hydrargyratiira cum tartaro

purificato unltum. Terre feuilletee mercurielk, Inventore
Prcjfavin.
c Prascipitatione ex acido nitrofo mediante acido tartari.

* Hydrargyrum tartarlfatum flavum; vulgo, Pubis Conjlantinus:
d Prsecipitatione ex acido murlatico et acido tartari jundtis me-
diante alkali vegetabili.

* Hydrargyrum tartarifatum album ; vvlgo^ Pulvjf argenteus,

XI. Cum acido citri.

Hydrargyrum citratum.^ Bergman.

XI I. Cum acids nitrofo.

* Hydrargyrum nitratum.

a Calcinatum mediante igne.

* Hydrargyrum nitratum rubrum.

Mercurius corrofjvus ruber. L. E.
Mercurius prajcipitatus ruber. 0.
Pulvis principis. 0.
Mercurius corallinus. L,
Mercurius tricolor. 0.
Panacea mercurii. 0,

Arcanum

PHARMACOPEIA SYi>HILITlCA, 2:77.

Arcanum corallinum.
Panacea mercui-ii rubra. 0.

COMPOSITA.

Balfamus mercunaKs. Plenck.
Unguentum ophthalmicum. St Ives.
Balfamum ophthalmicum rubrum. D.
Unguentum praecipitatum. G.
Unguentum ad lippitudinerfi. T.
Unguentum mercuriale rubrum. D.
Unguentum pomatum rubrum. D.

* b Acidum nitri hydrargyratuni ; i; e. hydrargyrum in acido

nitrofo folututti.
Solutio mercurii. E,
CompositA.

Unguentum citrinum. E. S,

* c PrjEcipitatione.

Ex acido nitri mediante alkali volatili.
« Hydrargyrum nitratum cinereum.

Pulvis mercurii cinereus. E.

Turpethum album. 0.
fi Ex acido nitrofo mediante alkali volatili vinofo (fpiritu falis
ammoniaci vinofo).

Turpethum nigrum.

Mercijrius praecipitatus niger.
y Ex acido nitrofo mediante alkali vegetabili.

Mercurius prsecipitatus fufcus, inventore Wiirtz.
^ Ex acido nitrofo mediante cupro.

Mercurius precipitatus viridis. JS.

XIII. Cu?n acido fluorts mineralls.

- Hydrargyrum fluoratum. Bergma?!.

XIV. Qum acido aceti.

* Hydfargyrum acetatum. Bergman.

.CoMPOSITA.

Troehifci, S. pilulae Keyferi.

XV. Cum acido boracis.

Hydrargyrum boraxatum. Bergman,

XVI. Cum acido cxrulei Berolinenfis.

XVII. Cum acido molyhdneme.

XVIII. Cum acido tungjtemc<^> ^^

XIX. Cum acido a'erea.

Hydrargyrum aeratum. Btrgmaiu

S 3 II. COJv£r

278 PHARMACOPCEIA SYPHILITICA^

IL C O M P O S I T A*,

Aqua Picea.

S> Picis liquidae, libras duas j
Aquse libras o6lo.

In vafe ligneo mixta agita baccillo ligheo : deinde per duodecinif
horas fubfidat, pix et aqua decantetur.

Aqua Plumbata (vulgo Aqua Saturnina Gouhrdi).

ft Aquse diftillatae;, libras duas ;
Spiritus vini, unciam unam ;
Aceti plumbati, unciam femis.

Aqua Galcis.

ft Calcis recenter uftse, libram unam.
Senfim affunde aqu^e libras o6lo.

EbuUitione, quas inde oritur, pera£la, vas agitetur : deinde
fublidat calx, et aqua per chartam colata in lagenis rite oc-
clufis fervetur.

Bolus ex Hydrargyro.

ft Hydrargyri puri, grana decem.

Extrafti glycyrrhiz'tc, fcrupulum unum.
Terantur fmiul, donee globuli hydrargyri perfe£le difparucrint-

Fiat Bolusa

"Bolus ex Hydrargyro calcinatq.

ft Hydrargyri calcinati,

Succi papaveris fqmniferi infpifTati, ana granum unum femie.

Extracti glybyrrliizas, quantum fatis.
MifcCj iiat bokiii.

Bolus

* In farmulisfcqnent.I])iisnoincn gencfkuni ct fpccificum piantanmi adhihitarum
T.innaeanuni ubique ictiniii; ira taiucti, ut durn KOinen plaiitas genericum et ipcci-
lU um ex duobus Iiibftantivis cofiiyoiitvin; eft, piimum ubique ir.decl!C'''-tuni, majon'i
■'■.ci-jplcuita;:j cauf;;, r.;!iou!.

PHARMACOPCEIA SYPHILITICA. 279 .

$OLUS EX HVDRARGVRO COMPOSITUS,

^ ' Hydrargyri muriati mitioris prascipitati granum unum — duo,

Sulphuris antimonii, grana duo — quatuor.

Succi papaveris fomniferi infpifTati, granum unum.

Confervse cynofbati, vel

Extradli glycyrrhizjE, quantum fatlsj
Ut fiat bolus.

Cataplasma Discutiens..

Bj Micse panis, quantum placet.

Aquse plumbatas, quantum fatis, ut fiat cataplafma ; frigide
applicandum.

Catheteres.

Ex argento, melius ex refina elaftica variEe magnltudinis.

Cerei.

Ex refina elaftica ; aut ex chordis muficis ex inteflinis ovium
confeftis, varias magnltudiniso

Cerei Medicati.

5t Cerse flavas liquefaftae, libram unam.

Sebi phyfeteris macrocephali (vulgofperma ceti), drachmas tres.

Aceti plumbati, drachmas duas — unciam unam.
Commixtis et ab igne remotis, imraerge telas tenues, ex quibus
fiant lege artis cerei,

Cerei Medicati (inventore Le Dran).

1^ Herbse conii maculati,

Foliorum nicotiana-tabaci,

Summitatum florentium hyperici perforati,

Radicis iridis Florentinse, ana manipulum unum.
Infunde in decofti nucum juglandis regise, libra una.'

Adde, herbse anchufe officinalis, libram unam, (N. unde color
ruber)

Axungias porcinas,

o villa curatas, arta libias tresT

Mifce fuper ignem; dein adde

Ceras fiavK, libras duas.

S 4 13s.

38p PHARMACOPCEIA 3YPHILITiGA,

Pecoctum Astragali.

R Radicis aftragali exfcapi, uneiam iemis.

Coque ia aquse fontis libra una femis ad colaturam librae unius,
Sumat tepide mane et vefpere.

DeCOCTUM DuLCAIvIARiE.

R Stipitum folanum-dulcamarae recentlum, drachmam femif.^
Coque in aquas fontanas libra una, ad colaturain li^rse fejiais,
• Sumat quotidie cum anatica portione laftis.

Pecoctum Guajaci.

Bt Ligni et corticis guajaci officinalis rail, libram unam.
Infunde in aqua; fervid^ libris o6to

P^r viginti quatuor horas; dein lento igne coque per fex horasj
addendo, fub finem coftionis,

Spiritus vini redlificati uncias quatuor,
Radicis glycyrrhiz^ uncias duas.
Cola. Sumat libram femi bis de die.
Maffa a colatura refidua denuo coquatur cum aquoe libris oi\a

per bihorium, cola.
Utatur hoc decofto fecundario loco potu« ordinarii,

Pecoctum Guajaci Compo5,itum,

13^ ILignl et corticis guajaci officinalis, uncias fex.

Radicis laurus-faflafras, uncias quatuor.

Coque in aquag fontanse libris viginti quatuor
Ad librae duodecim ; fub finem coftionis adde,

Radicis glycyrrhiza;, vel pafTularumj uncias duaSa
Cola. Sumat libras duas de die.

Decoctum Lapp^.

J^ Radicis arftium-Iappse, uncias tres.
Coque in aquse fontanae libris tribuSj
Ad colaturam libraruni duarum.
Sumat de die.

Decoctum Lobelia.

J^ Radicis lobeliae fyphiliticas ficcatae, manipulum unum,

Coque in aquas fontanae libris duodecim,

Ad colaturam li,brarum fex vel novem.
^umat libram femis bis de die in initio, deinde libram femis qua?

ter dt die, donee vim purganteija ampliiis ferre non poffit; tunc

defift^iV

PHARMACOPCEIA SYPHILITICA, 281

defiftat per tres aut quatuor dies, dein jterum continnet, donee
curatus fuerit.

Nota. Eodem modo paratur decodlum radlcis ceanothi Amc-
ricani.

Decoctvm Lusitanicum.

^ Radicis fmilax-farfaparillas,
Ligni laurus-faffafras,

pterocai-pi fantol'mi (vulgo fantoli rubri),

• guajaci officinalis, ana uncias tres.

Radicis daphne-mezerei, unciam unam.
Seminum coriandri fativi, drachmas fex — unciam unam.
Coque in aquae fontanse libris viginti, ad libras decern.
Sumat libram unam — tres de die,

Allter:

V^ Radicis fmilax-farfaparillae,

Ligni pteroearpi fantoiini,

fantoli albi, ana uncias tres.

Radicis glycyrrhizas,

daphne-mezerei, ana unciam femis,

Ligni geniilte Canarienfis (vulgo lignum Rhodium),

guajaci officinalis,

— — . laurus-faflafras, ana unciam unam.

Antimonii fulphurati, uncias duas.
Mifce, et infunde in aquas fervidss libris decem per viginti quatuor

horas, dein coque ad colaturam librarum quinque.
Sumat libram unam femis — libras quinque — quotidie.

Pecoctum Mezerei.

B: Corticis radicis, vei Radicis, daphne-mezerei,unciarafemis — unam.
Coque in aquae fontanas libris fex, ad libras quatuor.
Sub finem coftionis adde,

Radicis glycyrrhizse, unciam unam. Cola,
^umat quotidie libram unam — libras quatuor, prout ventriculus ferat.
Nota. Quidam corticem radicis radici preeferunt.

Ab aliis daphne^laureola daphne-mezereo pra;fertur,

Pecoctum Prunus-Padi.

I^ Corticis prunus-padi, uncias fts — oclo.

Coque in aquae marinae, vel, in ejus deteftu,

Aquae fontanae libris fex, ad colaturam iibiarum trium — qUatuor*
Sumat libram femis quater de die.

De-

282 PHARMACOPCEIA SYPHILITICA.

Decoctum Saponari^.

. R Herbae faponariEe oiEcinalis recentis contufse, libram iinam.
Aquae fontanss, libras fedecim,

Coqiie ad colaturam librarum o£to. Jb

Bibat aeger libras duas — quatuor — de die.

Decoctum SaRSAPARILLjE.

I> Radicia fmilaxrlarfaparill^, uncias tres.

Infunde in aquas fervidse libris tribus, per duodecim hor^s,

Dein coque ad colaturam librarum duarum.
Suinat quotidie, fi placet, cum lafte.

Decoctum Sarsaparillje cum Mezereo.

5^ Radicis fmilax-farfaparillae, uncias tres.

Corticis radicis daphne-mezerei, drachmas duas.
Coque in aquae fontanae libris tribus ad libras duag.
Sub finem coilionis, adde,

Radicis glycyrrhizas, unciam unam,
Sumat quater de die, libram femis.

Decoctum Syphiliticum Tvoms Gatikes.

B; Ligni guajaci oilicinalis rafi, uncias tres. ,■

. :. junipt^i communis, uncias duas.

Radicis fmilax-chinae, unciam unam.
Hydrargyri purificati, in facculo linteo humido ligati,
Antimonii fulphurati, in facculo feparatim ligati, ana unciam
unam.
Infunde in aquae fervidas libris duodecim, per duodecim horas j
dein coque ad libras fex.

Sub finem coftionis, adde,
Radicis glycyrrhizae, uncias duas. Cola. ^
5umat uncias triginta— quadraginta, calide, quotidie per 30 ad 50
dies. ■ ,

Decoctum SypHitiTicuM Roborans.

B; Antimonii fulphurati, pulverifati, et In petia ligati, uncias
quatuor.
Lapidls pumlcis, pulverilliti, et in petia feparatim ligati, un-
cias duas.
Radidis fmilax-farfaparillae,

.^ fmilax-chinae, ana uncias duas.

Nucum juglandis regiae immaturarurn, cum hills, putaminibus,
et cqrtice viridi ficcatarura, Num° quadraginta.

Concua»

PHARMACOPOEIA SYPHILITICA. 281

Goncifa, mifta, coque in aquas fontanse librls viginti ad libras

decern,
Remanentem liquorem, per linteum colatum, quatuor lagenis

inde, quse bene claufas, ilfui ferventur.
Suraat dimidium lagenas mane, et dimidium vefpere, tepide.
Magma decofti denuo coquatur cum aqua, ut ante ; quo decoflo
fecundario abluantur loca ulceribus, aliifve cutis morbis infefta.
iV. B. Hoc decoftuin a quibufdam fupponitur effe genui-
num ita di(3:um Decorum Litfitaiiicuvi.

Pecoctum Syphiliticum Rosetti.

B; Antimonii fulphurati, unciam unam.

Cortlcis Drymi Winterani recenter pulveriiati, drachmam femis.
Mixta, in mortareo marmpreo piftillo marmoreo optime inter fe
terantur ; dein adde
Cretae puras, unciam femis.
Triturentur denuo per horam integram in eodem mortario, pulvis
fubtilis fervetur prq fequenti decoclo :

Bi Radicis arftium-lappse, uncias tres.

fmilax-farfaparillEe, uncias duas.

. — fmilax-chinas [N. B. Genuinae orientalis, vel in ejus
defeftu occidentals feleftiffims), unciam unam.

convolvulus-mechoacannae, unciam femis (in lue me-

diocri).

drachmas fex (in lue vehem-

tiori).

glycyrrhizas, drachmas tres — fex.

Corticum viridum nuCum juglandis regise, grolTo modo pulve-

rifatse, unciam unam (in hie mediocri).
— — — " uncias duas — tres (in lue peffima, praccipue fl ijmul

Blennorrhoea adfit inveterata).
Seminum coriandri fativi, drachmas duas.
Incifa et mixta infundantur in aqus fontans libra una femis per

duodecim horas, dein coque ad libram unam; colatuise adde,
Pulveris fupra difti, drachmas tres (in lue mediocri),

m unciam femi^ (in lue vehementiori),

drachmas fex (in lue defperata cum tophis,

ulceribus, &c.)
Sumat libram femis omni mane, et libram femis vefpere, cum pulvere
fequente :

J3t Radicis fmilax-chin£e orientalis, fubtiliffime pulverifatl, drach-
mam unam..
Ligni laurus-falTafras fubtiliffime pulverifati, fcrupulcs^ duos (in
lue niedtocri}.

Lirni

^ PHARMACOPOEIA SYPHILITICA.

Lii-gni laurus-faflafras fubtilifiime pulverifati, drachmas duas fex

(in cafu graviori, et tunc femina coriandri ex dtcofto prjece-
denti omittenda funt).
Durante xifu hujus decofti, asg^r ab acidis abftineat; et ante ufum ejus,
per triduum quotidie fumat purgans fequens :

Bi Hydrargyri muriati mitioris, grana decern.

Refmas jaxappse pineis fubaftse, grana ofto.

Trochifcorum alhandal pineis fubadlorum, grana quatuor.

Terebinthinas Venetas, quantum fatis, ut fiant pilulac N° quln*
decim, pulvere glycyrrhizas infpergends..
Sumat pro dofi. (N. B. Hanc doii nmedicamenti hujus draftici

pauci sgri, precipue per triduum contmuando, ferre poterunt ;

hinc dofis aetati et temperamento, &c. adaptanda erit, vcl potius

aliud purgans fimplicius prsefcribt^l^ prellabit.)

Electuarium.

R Pulverls tragacanthae compofiti, drachmas duas.

gummi arabici, drachmas fex.

. — rhei, fcrupuhim unum.

Confervas florum malvae, uncias duas.

Syrupi altheas, quantum fatis, ut fiat eleiluarium.
Sumat cochleare parvulum ter aut quater de die,

Electuarium Laxans,

IJi Eleftuarii lenitivi,

Alkah' vegetabilis tartarifati, vulgo tartari folubilis, ana uncitm
unam.
Mifce, fiat eleftuarium.

Emulsio Amygdalina.

R Amygdalarum dulcium decorticatarum, uncias duas,
Terantur in mortario ; fucceffive addendo

Aquas fontanas Hbras duas,

cinnamomi tenuis, uncias duas,

Sacchari albi quantum fatis ad gratiam.

InJECTIO ad BlENNORRHAGIAM INCIPIENTEM.

1^ Cupri acetati, drachmam unam.

Liquoris alkali volatilis (vidgo fpiritus falis ammonlaci), quan-n
turn fatis ad folutionem.
Guttae quatuor hujus liquoris cum uiicia una aquse commixtas in^
jiciantur quater aut fexies de- die.

PHARMACOPOIIA SYPHILITICA, 3^3^

InJECTIO AD BtENNOR-RHAGIAM INCIPIENTEM ALIA..

5t Hydrargyri muriati fortioris, granum femis — ununti,
Pliimbi acetati, granu quindecim — drachmam femis.
Aquas fontanx, libras^ duas.

Mifce, injiciat portionem omni femihora.

Injectio ad Blennorrhagiam.

^ Olei olivarum dulcis, uncias tres.
Injiciat tef quaterve de die portionem.

Injectio ad Blennorrhagiam. Sxehiliticam.

■^t Succi papaveris fomniferi infpiflati, vel

Extrafti hyofciami ni'gri, drachmam unam.
Terendo adde fucceffive
Infuli feminum lini,

Olei olivarum dulcis, ana uncias qiiatuor.
Unguenti hydrargyri, drachmas duas — unciam femis.

(Quidam hujus loco prjeferunt hydrargyri muriati mitioris
cum pulveris e ceruffa compofiti drachma una, triti, grana
quinque- — o£to. )
Mifce, injiciat quater de die, reddito prius lotio.

Injectio ad Blennorrhoeam prima.

^. Cupri acetati Isevigati, unciam unam femis.

Spiritus volatilis aromatici, Ph. Lend, uncias duas.

Melis, drachmas duas.
Mifce ; guttae fex hujus liquoris cum aquse tepida: uncia una mifce-!

antur, ejufque portio quater aut fexiesde die injiciatur,

Injectio ad Blennorrhoeam secunda.

5t Hydrargyri muriati mitioris, unciam femis.

Aqu« fontanae, uncias o6to.
Mifce agitando.

r^ . . . . , ■

^ Hydrargyri muriati fortioris, grana quatuor.
Aquas fontanse, uncias fedecim. Mifce.

Injectio ad Blennorrhoeam tertia.
, . ^ Plumbi calcinati pulverifati, unciam unam.

Hydrargyri muriati fortioris, drachmanv femis.
Aceti concentrati, uncias quinque.

Dlgere

egg PHARMACOPCEiA SYPHILIITICA.

Discere in loco calido per duodecim horas, faepius agitata pliiala;
Dein efFunde liquorem per fubfidentiam depuratum, qui fervetur-

ufai.
Hujus liquoris drachmas duse — uncia femis, cum aquae deftillatsc

unciis quatuor mifceantur, ejufque portio ter aut quater de die

injiciatur.

Injectio ad Blennorrhoeam q^tArta, '

I^ Plumbi acetati,

Zinci vitriolati, ana grana o6to.
Camphcrse pineis fubaftae, grana quatuor.
Aquae fontanas, libram unam.
Mifce, injiciatur portio fsepius de die.

Nota. Quandoque aluminis drachma femis additur.

Injectio ad Blennorrhoeam quinta.

I^ Hydrargyri muriati mitioris, fcrupulum unum.
Olei amygdalarum, unciam unam.
Liquaminis myrrhse, unciam femis.

Radicis Tormentillse ereilas pulverifatre, drachmam unam,
Mifce ; portio hujus injiciatur ter quaterque de die.

Infusum Cannabis.

Bi Seminum cannabis fativse

Infunde in aquas fervida: libris quatuor. Per mediam horam,
Cola. Bibat pro potu ordinario cum facchari quantum fatia ad

gratiam.

Infusum Ledi Palustris.

, 5i Ledi paluftris, unciam femis.
Aquae fervidae, libram unam.
Stent per horam, cola*
Sumat libram femis ad libram unam de die-

Infusum Malvje.

15; Foliorum malvae! rotundifoliaej manipulos tres*

Infunde in aquse fervidae, libris quatuor.
Cola, pro potu ordinario cum faccharo.

Lac

PHARMACOPCEIA SYPHILITICA. 287

Lac Hydrargyratum.

5c Hydrargyri purificati, drachmam unam.

Gurami Arabici pulyerifati, unciam femis.

Mixta terantur in mortario non metallico ;
Senfim addendo

Syrupi papaveris albi, quantum fatis,
Donee hydrargyrum perfefte difparuerit ; dein fenfim affunde

Laftis vaccini bullientis, uncias ofto.

Liquor ad Condylomata.

5^ Spiritus vini reftificati, ^ ^

Aceti concentrati, ana unciam unam femis.
Hydrargyri muriati fortioris, drachmam unam.
Aluminis,
Camphorae,

Calcis plumbi acetatas, ana drachmam femis.
Mifce. Verrucse aut condylomata penicillo hoc liquore madi4«
femel vel bis de die tangantur.

Liquor Stypticus, feu Solutio Styptica»

Bi Aluminis, . '

Vitrioli cupri, ana uncias tres.
Aquae fontanse, libras duas.
Coquantur ad folutionem ; liquori filtrato adde
Acidi vitriolici concentrati drachmam unam femis»

LoTio Prophylactica.

"^ Hydrargyri muriati fortioris, drachmam unam.
Terendo in mortario vitreo feniim affunde

Aquse calcis recentis libras duas.
Liquor in vafe claufo per fubfidentiam depuratus a fedimento flavs,

et lirapidus in lagena probe obturata, ufui fervetur.

LoTio Prophylactica alia*

"^ Acidi nitri hydrargyrati, grana' oAo— duodecim.
Aq\ia£ deftiliatEC, libram unam.

Vel,
!^ Hydrargyri muriati fortioris, grana decern— duodecim.
Aquce deflillatsE, libram unam.

Vel, ^

% Aquae calcis recenter paratse, quantum placet*

Vei,

1

:g88 PHARMACOPCEIA SYPHILITICA.

Vch

5L Alcali cauftici, guttas fex.

Aquas deftillatas, quantum fatis,-
Ita ut mucum a lingua leniter toUat.

LoTio Syphilitica Flava.

Eadem eft ac Loth ProphylaSlka prima,

LoTio Syphilitica Nigra.

5: Hydrargyri muriati mitioris, drachmam unam. •
Aquae calcis recentis, uncias quatuor.

LoTio Syphilitica Tonica.

Vide fupra DecoBum Magmatis ex Decofio SyphHitko' Rohorante.

iiOf!0 AD Ulcera Syphilitica.

R Spintus Rofmarini, vel fpiritus alius cujufcunque, quantum
placet.
Linteum carptum eodem madidum faepius ulceri applicetur.
Nota. Idem quoque egregie fervit pro lotione prophy-
ladlica.

Vel,

Bt Acidi nitri hydrargyrati, grana qoindecim.
Aquae deftillatas, libram unam.

Vel,

B; Hydrargyri muriati fortioris, grana decern.
Plumbi acetati, drachmam femis.
Aquse fontanae, libram unam.
Mifce.

LoTio AD Ulcera Syphilitica Composita.

B; Aquae calcis recentis, uncias duas.

Tutiaj preparatae, grana undecim.

Vitrioli cupri, grana tria — quatuor.

Mellis rofacei, drachmam unam.
M/fce.

Mix-

PHARMACOPCEIA SYPIilLITICAe 289

MiXTURA LaXANS.

R Gumml Arabici, unciam unlm.

Olei amygdakrum dulcis, uncias duaSi

Decofti hordei, uncias decern.

Mannse, unciam unam.

Mellis, unciam femis.
Mifce, fumat eochlearea quatuor bis terve dc die.

PlLUL^E AD BlENNORRHOEAM.

I^ Cupri vitrioiati, grana fepteni, cum fcmifla.

Radicis rhei palmati, drachmam unam.

ExtraAi cinchonje officinalis, drachmas duasi
Mifce ; fiant pilul* N° triginta.

Sumat unam— quatuor de die.

IJ; Terebinthinae co6la£, drachmas duas.

Radicis rhei paimati pulverifati, drachmam unam.
Mifce, fiat mafia dividenda in pilulas triginta fex.
Sumat pilulas quatuor bis de die.

Notd. Quandoque adduhtur limatur£e, vel calcis ferri, g^ana
decern.

VeU

IJ: Gumrtii Arabici

Radicis rhei palmati, ana unciam unam.

Balfami copaiv£E, quantum fatis, ut fiant pilulse granoruBi

quatuor.
Sumat quatuor — fex — mane et vefperi.

FlLULiE EX HyDRARGYRO NITRAtO.

5^ Hydrargyri nitrati cinerei, Ph. Editi. grana viginti quatuor.
Tere cum extrafti glycyrrhlza; quantum fatis "ut fiant pilulse
N° triginti quatuor, confpergendse pulvere fpecierum aroraa-
ticarum.

PiLULiE EX HyDRARGYRO CALCINATO.-

I?i. Hydrargyri calclnati Isevigaiti, grana ofloi

Extrafti glycyrrhizae, quantum fatis ut fiat maffa dividenda in
pilulas duodeclm.

Not a. Quandoque adduntur maffse, extrafti thebaici Ph.
Loiid. grana ofto.
Sumat pilulam unam omni node, vel duabus noftibus con-
tinuisj intermifTa tertia.

T PltULj®

?9o PHARMACOPCEIA SYPHILITICA.

Pilul;e ey Hydr.ar.Gyro muriato mitiori.

5c Hydrargyri muriati mitioris, drachmam femis.

Succi papaveris fomniferi inlpiffatl, grana quindecim.

Tartari antimonialis, grana tria.
Confervas cynofbati, quantum fatis ut fiat maffa divldenda in pl-

lulas quindecim.
Sumat pilulam unam omni no(5te.

Pilule eX Hydrargyro Vitriolato,

I^ Hydrargyri vitriolati, grana quatuor.

Balfami Tolutani, grana quinque.

Succi papaveris fomniferi infpiffati, granum femis.
Mifce. Fiant pilulas duse, quarum ima vel ambas de die fu-

mantur. -

PlLUL>E EX HyDRARGYRO TeREBINTHINATO.

5i Hydrargyri purificati, unciam unam.

Terebinthinse optimae, drachmam unam femis.
Terantur fimul, donee hydrargyrum perfefte difparuerif; addendo,

fi opus fit, guttulas aHquot olei terebinthinas; dein cum pulye-

ris glycyrrhizas, quantum fatis, fiant pihilsc oftoginta.
Sumat unam vel duas pilulas omni mane et pro re nata, etiam

vefpere.

Pilule ex Hydrargyro Gummosov

5^. Hydrargyri purificati,

Pulveris gummi Arabici, ana draclimas tres.
Confervas cynofbati, quantum fatis.

Terantur in mortario vitreo ■ vel marmoreo, donee globuli hydrar-
gyri perfefte difparuerint ; continuetur tunc trituratio adhuc
per horam ; dein adde

Micas panis albi, unciam femis.

Subigantur bene in maffam, ex qua formentur pilulae granorum
trium, pulvere magnefiae vel glycyrrhizaS confpergendE.
Sumat pilulas fex omni mane et vefpere.

Veh

i^ Hydrargyri purificati, fcrupulum unum.

Amyli, drachmam unam.
Formentur cum mucilaginis gummi Arabi«i quantum fufficit ih

pilulas viginti.
Sumat dwas quotidica

P*.

PHAtlMACOPCEIA SYl^HILITICA, 2$i

I*ilul;e Laxantes. ' " -

I^L. Aloes foccotrins, grana duodecira.

Gummi gambogias, gi-ana fex*

Olei ftellati anifi, guttas tres.
Probe fimul tritis adde

Syrupl limplicis quantum fatis ut fiat maffa dividends in puu»
las fex.
Sumat pilulam unam vel duas vefperi*

Pilule PuRGANTEs.

J^ Maffse pilularum Rufi, drachmam femis.

Refinse jalappas,

Hydrargyri muriati mitioris, ana grana quatuon
Mifce, fiant piluls N" tres.

Sumat pro dofi.

PULVIS AD BLENtlORRHAGIAM.

R Nitri,

Sacchari, ana grana quindecimi

Camphorse pineis fubaftee, grana duo.
Mifce, fiat pulvis omni hora vel bihorio fumendusi

* Multum a quibufdam laudatur.

J^ Gummi Arabici, fcrupulum unum.

Nitri, grana decern.

Camphorae pineis fubaftas, granunl unum — tria; »
Mifce. Sumd,t pulverem hunc quater de die.

PuLViS SvPHILlf icus.

B; Hydrargyri muriati mitioris prxcipitati, grana duo,

Sacchari, gratia quindecim.
Mifce. Sumat omni nofte^

SoLUTio Gummosa.

R: Gummi Mimofa: niloticae pulverlfati, (gurami Arabici), drach-
mas duas.
Solve in aqux fervidx, libris duabus.

. T 2 So*

fit PHARMACOPCEIA SYPHILIT'ICA.

SOLUTID HyDRARGYRI MURIATI FORTIORIS.

5t Hydragyri muriaiti fortioris, grana fexaginta quatuor.^

Aqux deitillatas, uncias quatuor.
Solutis adde

. Sails ammoniaci, drachmam unam. Mifce.
Sumat guttas fedecLm in libra decofti farfaparillas, vel maiti, hor-

dei, &c. omni die'.
Pro re nata tinftura Thebalca additur, et dofis guttarum ad qua-
draginta o£lo gradatim augetur.

Nota. Sedecim guttde folutionis hujua continent granum fc*
mis hydrargyi'i.

Syrupus HyDrargyri.

^ KydrargyrI purificati, fcrupulum unUnt.
Gummi Arabici, fcrupulos tres.
Confervse cynofbati, quantum latis.
Tere in mortario non metallico, donee hydrargyrum pcnitus dif-
paruerit ; dein continuando triturationem adhuc per horam^
adde
Syrupi fimplicis, unciam unam femis.
Sumat mane et vefpere quantum capit^cocUeare parVultim ligncf>
um vel eburneunl.

TiNCTUKA FeRR*.

I^ Ferri vitriolati,

Tartari purificati-, ana uncias quatuor,
Aquse fontanas, libras fex.
Coquantur in vafe ferreo fub continua agitatlone, ' ad ficcitatcni
fere, tunc in
Aquse cinnamoni fimplicis, unciis quatuor foluta, atque cuin
Hquoris anodyni mineralis HofFmanni diluta, digerantur, et
filtrentur.

P^el tnelius., *,

Bt Limaturae ferri purse Isevigatae, unciam unam'.

Acidi muriatici concentrati, quantum fatis ut ferrum pcrfedc

folvatur.

Solutio per aliquot tempus quieti expofita, filtreter ; dein ex rc-

torta vitrea in balneo arense deftilletur ad iiecitatem. Maffa in

retorta reiidua in loco huiiiido feponatur, donee deliquefcat.

Mafia deliquefcens phialas epiftomio vitreo inflruftte immittatur,

cique ^theris vitriolici concentrati uncias duae addantur ; tunc

phiala exafte claufa probe agltetur, unde maxima pars ferri

atheri jungitur. Quamprimum sther ferro impraegnatus poll

. brevem quictem fupernatat, a ilquore inferiori effynditur, et

cum

PHARMACOPCEIA SYPHILITICA. 299

pum dupla quantitate fpiritus vini reftificatiffimi mifcetur, at-
que in vafe vitreo exaftifEme obturato ufui fervatur.

Nota. Hasc tinftura eft prasparatio correfta TipSiura Ncr-
shie, jure Celebris, quas diu fecreta liabita, nuper
Imperatricis Roifias munificentia publici juris fafta
eft,

Tr^ghisci Keyseri.

I^ Hydrargyri puri-ficati, quantum placet.

Piuturna trituratione vertatur in pulverem nigrum, qui ex retorta
fublipaatus, longa denuo trituratione in aceto concentrato dif-
folvatur ; addendo fub finem

Mannae, quantum fatis, ut fiant trochifci,

'Nota. Tsediofo huic procefTui fequens pr£eferri meretufo

~^ROCHisci EX Hydrargyro Acetat.o.

I^ Hydrargyri nitrati rubri, quantum placet.
Cum aceto deftillato coquatur ad ficcitatem, Mafla refidua cuga
manna, lege artis, in trochifcos formetur,

Trochisci EI Saccharo Hydrargyrato.

5ii Hydrargyri purificati, unciam unam.

Sacchari candi, uncias duas,
Triturentur, donee hydrargyrum perfefte difparuerit ; tunc e^

mafia, lege artis, fiant trochifci ponderis drachms dimidis.

ViNUM ROBORANS AI? BlENNORRHOEAM,

Bt Corticis cinchonas officinalis, uncias duas.
Gallarum, drachmas duas.
Caryophillorum aromaticorum, drachmam femis,

Pulverifata infunde in

Vini rubri libra una per biduum, fepius agitando ; liquorem per
fubfidentiam depuratum effunde, et maflam refiduam cum aquae
fontanae, libra infunde per horam. Cola, et mifce euro priori.

Sumat cochlearia quatuor majora ter quaterve de die..

Vis[UM

494 PHARMACOPCEIA SYPHILITICA.

VlNUM TONICUM.

I^ Corticis cinchonas officinalis fubtiliffime pulverifatl, unclani
unam fenlis.
Infunde in vini generofi unciis fcdecim ber biduum, faspius
agitando,
Dein efFiinde liquorem per fubfidentiam depuratum, eique adde
Olei cajeput (ex foliis melaleuca-leucadendri deftillatione ob»
tenti), cum facchari albi, uncia una triti, guttas quadragin-
ta ofi:o.
Liquoris anodyni mineralis, uncias duas.
Sumat uncias duas — tres, bis terve de die.

Unguentum-Hydrargyri.

1^ Adipis fuilli recentis curati, uncias duas.

Liquefiat leni calore, et dum ab igne remotus fpiflefcere incipit,

adde gradatim, triturando,
Hydrargyri purificati, uncias duas,

Continiiando triturationem, poilquam hydrargyrum omne dif-
parucrit, adhuc per bihorium.
Servetur in loco frigido.

Nota. AHquando prssftat parare hoc unguentum ex anatica
portiore butyri cacao, vel etiam mucilaginis gummi
Arabici.

Ungventum ex Plumbo Acetato=-

Be Olei olivarum dulcis, uncias o6lo.
Ceras albas, vmciam unam femis.
Plumbi acetati, laevigati, drachmas duas.
Plumbum acetaUim cum portione olei triturctur ; dein cer^ cum
oleo reliquo calefafta, addatur agitando maffam, donee frigel-
cat. , ' ~

Unguentum Syphiliticum Album.

5^ Hydrargyri ex acido muriatico mediante alkali vegetabili pras-^
cipitati, drachmas duas.
Axiingiae porcinas recentis curatas, unciam unam femis.
Mifce terendo.

y>iqu EN-

PHARMACOPCEIA SYPHILITICA, 295

Unguentum Syphiliticum Citrinum,

Hydrargyri purificati,

Acidi nitrofi concentrati, ana unciam unam.
Digere in balneo arenae, donee folvatur hydrargyrum ; dein adds
triturando
Olei olivarum dulcis, uncias quatuor.
Axungise porcinas, uncias oAo,

l^lota. Quandoque prgsftat dupla quantitas axungise.

Unguentum Syphiliticum Rubrum.

5c Hydrargyri nitrati rubri, drachmas duas.

Unguenti balilici, unciam unam femis.
Mifce triturando.

Unguentum Syphiliticum Resqlvens.

R Unguenti hydrargyri,

de arthanita, ana unciam unam.

Radlcis atropa-mandragoras pulverifatSf unciam unam femis.
Mellis quantum fatis,

Unguentum Syphiliticum Viride.

V)s. Cupri acetati Isevigati, grana duodecim.

Olei olivarum dulcis, uncias tres.
Mifce terendo.
Portio linteo carpto excepta uloeri fyphilitico applicctur.

T 4 ■ 'A

A

SHORT REVIEW

O F A L A T E

TREATISE

O N T H E

VENEREAL DISEASE
By JOHN HUNTER.

'R Foot, in his Ohfej'vations upon the ne\i:
opinions contained in this Treatife, has
taken them up already in fo maflerly a manner,
that there remains little to be added. However,
on perufing the great book, I found feveral paf-
fages which deferved fome further notice, in or-. ^
der to render young practitioners more cautious
iiot to be deceived by fpecious and fallacious
reafoning, fupported by profelTorial authority^
as well as to fhow my readers more particularly
the reafons how it happens that my ideas ou
the nature as well as on the cure of venereal
complaints (nearly of evfery one of them) are
either different or diredly oppofite to thofe ad-
vanced by Mr John Hunter.

Mr Hunter lets out with faying, ^* That he
" was induced by two motives to publiih hi$
" Treatife: Firft, In hopes that feveral new obr^
*' fervations contained in it will be deemed wor^
** thy of the public attention ^ and, in the next

•^ place

298 REVIEW OF A LATE TREATISE

^' place, becaufe he was defirous to have an op-
*' portunity of ailcrting his right to fome- opi-
^'' nions that hav.e made then- way into the world
*' under other names." Had he inverted the
thelis, and faid, that he fat down with the pen
in his hand, to prove how many whimlical ideas
and monflrous excrefcences of his brain an in-
genious man may think worthy of the pubhc
attention 3 and, fecondly, How much a vain
man, who is ignorant of the different writings
and difcoveries made by his cotemporaries of
the fame profeilion, can attribute to himfelf
what he fliould have attributed to others — he
would have come, I believe, pretty near the
truth. This, however, muii always be the cafe,
when a man lits down and writes with the ful-
left perfuafion, that, feeling himfelf poffefTed of
fome genius, all the reft of his profeilion have
4ione ', or becaufe fome new ideas on a particular
fubjed: occur to his mind, nobody elfe can have
difcovered, or is able to difcover, any thing new
upon the fame fubjecl:. He muft of confequence
be greatly miftaken, efpecially if fome of thefe
new ideas Qr difcoveries now claimed by him,
have been made a long while before by others,
and he having been informed of them in private
converfation, had either forgot this point, or
wiihes to make the world believe that thefe
difcoveries were made by himfelf. — The author
feems here to iniinuate, that fome difcoveries of
his on this fubjecl have been publifhed by others;
but as he, does not fpecify this kind of theft or
I'obbery, we muft defer this difcuflion till he has
made good his charge, and points out the par-
ticular

ON THE VENEREAL DISEASE. 299

ticularfads, experiments, and obfervations which
he claims as his property.

Page 2. he fays " The fuppofition of the hies
*^ being combined with other difeafes, appears
" to me to be founded in ignorance ; becaufe I
'^ have never feen any fiich cafes, and becaufe
■' they do not feem to me to be confident with
^' the principles of difeafed action in the animal
*' ceconomy." As Mr H. is fo liberal in charging
others with ignorance, he will excufe me, when
I fay, that this manner of reafoning appears to
me to be founded on ignorance and pride, and
confequently perfedly inadmiffible ', efpecially
as there is hardly a practitioner who has not
feen repeatedly the contrary in his pra6lice.
Patients of the lower clafs of people are often
affeded with the itch, and at the fame time
with cutaneous venereal eruptions. In failors
too, it is not fo rare to find blotches produced
by the fea-fcurvy united with venereal ones :
and who has not feen fcrophulou^ perfons af-
feded with all the fymptoms of the lues vene-
rea?

P. II. is iaid, " That a woman without any
*' fymptom may give the lues^" and, p. 12. " That
** to communicate the difeafe, it is neceiTary
'* that the venereal adion fhould firft take place,
** and that the matter fhould be formed in con-
*' fequence of that a6lion 3 and that therefore a
" perfon having the venereal irritation in any
" form not attended with a- difcharge,. cannot
^* communicate the difeafe to another." Mr
H. in confequence of this, " allows married
- men to cohabit with their wives as long as

'^ there

300 REVIEW OF A LATE TP.EATI^E

^^ there appear no fymptoms; nay, he even woul<i
'^ allow a man, who has a clap, to have connec-
^* tion with a found woman, if he took great
" care to clear all the parts of any matter, with-
" out any fear of infeding th^ woman." The
firft of thefe proportions feems to be an open
contradidion : And with regard to the latter, I
fear Mr H. would not truft to make the expe-
riment himfelf upon his own wife ; I certainly
would not try it upon mine.

P. 17. From the frequent appearance of {bank-
ers and gonorrhoea in the fame perfon at the
fame time, I fufped: indeed with Mr li. ** that
" the urethra nQY^x Jympathifes with the fhanker i
*^ and that confequently t\iQ difeafed aBion of the
" one does not def];roy thq difeafed a6lion of the
^' other."

P. 19. line 4. he maintains, " That the matter
^' of every fore or fecreting furface will not be^
*^ come venereal by applying venereal matter to
*^ it."r— From my obfervations I am convinced
of the contrary.

P. 20, 21, Nothing but loofe theoretical rea-.
foning, unfupported by any well authenticate4
fads.

P. 29,30,31. He attributes the difcovery "that
*' pus may be formed by inflammation without ulr
*' ceration, to his brother Dr W, Hunter and to Mr
" Sharp, made 1749 :" Probably, becaufe he wa?
ignorantof this difcovery having been made feve-
ral years before hj ^orgagni in Italy, and DeHaen
at Vienna. This alfo ealily accounts for other
writers not mentioning Dr Hunter or Mr Sharp,

P. 3 J, 32, 1 find the aflertion, " That after the

** con-.

' ON THE VENEREAL DISEASE. 30 1

^* contamination the gonorrhoea is earlier in its
" appearance than ihankers," falfe, or at leail
too general. I have feen many times fliankers ap-
pear within 12 or 24 hours after coition, andhard-
ly ever a gonorrhoea before the fecond or third
day. Gonorrhoeas arifing fo late as four or fix
weeks after a fuppofed infedion, with an unu-^
fual fenfation before its eruption, made me of
late rather believe, that thefe gonorrhoeas arife
from a formerly tainted habit, having often feen
fhankers arife with the fame fymptoms from
the fame caufe*

P. ^^, *' It has been afferted, but without proof,
" that in cafes of fwelled teilicles in confequence
*^ of a gonorrhaea, it is not the tefiicle itfelf that
*^ fwells, but the epididymis.'' The writer who
firfl: made this difcovery, faid in exprefs termSy
that this was the cafe in the beginning of the dif-
orders Which every unprejudiced perfon may
Convince himfelf of by daily experience.

P. 69. He fays, ^* I am inclined to believe,
" medicine is very feldom of any fervice in this
" form of the difeafe (gonorrhoea)." A favour-*
ite alfertion of fome of^thofe gentlemen who
wifh to make the world believe they are more
enlightened and more candid than the reft of
their brethren. However, in p. 75. I find "local
*^ applications may be either internal to the
" urdthra, external to the penis, or both; all of
" which will in many cafes be necefTary." — ^—
" Internal medicines feem the moil likely to
" cure this fpecies of difeafe." And a little
further on, " local applications are either- in a
" folid or fluid form .- the fluid is a temporary

" appli-

302 REVIEV\^ OF A LATE TREATISE

" application, and of lliort duration: the folid
** applications would appear to have an advan-
" tage over the fluid applications by their con-
" tinuance ^ but they in general irritate imme-
" diately, from their folidity alone, &c." This,
and the whole ftyle of reafoning till the end of
this fection, if it be reafoning, is a ftrange.kind
of reafoning indeed ! But let us fee the inference
of this reafoning, " That folid applications are
" preferable to fluid ones ^ but that this latter
" irritate in general immediately, and the lefs
" ufe we make of them the better s though he
" had never feen any bad efFed from them in
" any cafe/' And a moment after, he fays, *' fluid
" applications, it appears from pradice, will of-
" ten have almoft an immediate effed upon the
" fymptoms ^ and they muft be ufed often in cafes
*' where they are found to be of fervice." The
whole, I think, needs no comment !

P. 77. We find the fame flrange manner of
reafoning " about the flopping the difcharge
" and inflammation" continued. The following
will ferve as an example : " When the difcharge
*' is an effedl of prefent inflammation, it may be
'* flopped by injedions, though the inflamma-
" tion flill continue in fome degree, and may
" afterwards be removed without the difcharge
" ever reappearing : but I believe, that by this
" pradice little is gained > for the efFed of the
** inflammation is not the difeafe which we wifh
*^ to remove. However, we find, that the fame
" method which flops the difcharge, alio removes
*' the inflammation, although not always, and

" only

■ ON THE- VENEREAL DISEASE. 2>03

''only I believe when the inflammation is flight."
And,

P. 79. " Sedative injections will always be of
*' fervice \> not by lefTening the difeafe, but by
" lefTening the difeafed adtic^n, and are very
'^ ufeful in relieving the painful feelings." I
think, if they do this, Mr H. might have allow-
ed that they lefTen the difeafe.

P. 80. He fays " the balfams, turpentines, dif-
" folved in water."— This, I luppofe, is one of
Mr H's difcoveries in chemiftry, which certain-
ly nobody will difpute him ; for this is the
iirfl inftance, I know of, of thofe iubftances be-
ing foluble in water.—- In the fame page, I find
" femollients may be ufed likewife externally (in
" gonorrhoea), in form of fomentation ^ and p.
" 81, External applications, fuch as poultices
" and fomentations, can be of little fervice."

P. 82. He recommends the mercurial oint-
ment ; but obferves, " that the pra6lice rather
" arifes from a kind of practical analogy, than
" real knowledge of its ufe in fuch cafes." And
p. 83. " When the inflammation runs along the
" ducts of the glands, in particular the mer-
*^ curial omtment is to be freely applied to the
" -parts."

P. 91. He recommends bleeding and purging,,
fomentations and poultices, for fwelled tefticles,
without mentioning upon what ground or au-
thority.— I wiili the patient joy of a fpeedy re-
cover-y under the ufe of thefe medicines.

P. 92. He obferves, " Some have gone further,
" by recommending the introduction of vene-
" real matter into the urethra (for removing a

" fweliing

304 Review of a late treatise

** fwelling of the teflicle) ; but this appear^
" to be only conceit, and is founded upon a
** fuppofition that fuch difeafes arife only from
•" venereal irritations, &c/'— This method ha^
never been recommended but in fwellings of
this kind from a venereal caufe^ and by no
means upon conceit ^ as now and then, I am afraid,
is the cafe with our author^ but from authentic
obfervations, founded on numerous experiments
made and publifhed about twenty years ago, in
one of the greatell military hofpitals of Europe,
v/hich were afterwards confirmed by Mr Plenck
and Dr Lang* The author feems to give it like^
wife as a new obfervation of his own, that*
fwellings of the tefticles are produced by other
caufes. This, however, has been known and*
mentioned by nearly every writer on the difeafes
of the genitals, ancient and modern, from Gel-
fus down to the prefent age.

P. iili note, He fays: ^* Many other kinds of
" obflrudions (in the urethra) are defcribed by
" authors, none of which I have ever feen; and
*^ as probably I have opened more urethras
^^ after death, where there was an obftruc^
" tion of the paiTage, than all the authors who
" have written on this fubjed, I am inclined to
" believe, that they wrote from imagination
** only." — Allowing the principal alFertion to
be trae, it vv^ould appear that Mr J. H, has read
ail the authors that have written on this fub-
jed:, which I will not now difpute ; but we
fhould rather exped, that a man of fo great
learning and erudition would be a little more
inodeft in drawing fuch general conclufions.

P.

ON . THE VENEREAL DISEASE. 305

P. 237. In fpeaking of the treatment of phy-
mofis, he fays, " I believe the mereury Ihould
" be ^lYQnfparihglyy And the mo.ment after,
" I therefore do fuppofe, that fuch medicines
" as may be thought neceffary for the conftitu-
*'* tion, fhould be given liberally as well as the
" ^^a/<:."— -If under the ^ox^fpecific, mercury is-
to be underllood, and I cannot fuppofe any
thing elfe, the young praditioner, who wifhes
to follow Mr H's advice, will be a little puZzled,
I am afraid, about the dofe of the remedy.

P. 248, 249. He gives us another fpecimen of his
chemical knowledge. " In the following cafe",
he fays, " the lixivium Jap onarium produced a
** fpeedy cure ;" and then proceeds, ** After ha-
** ving tried feveral methods in vain, I ordered 40
** drops of the liximum tartari to be taken every
'* evening in a bafon of broth." Mr H. furely
does not mean, that thefe two fubflances are
the fame : for if he w^as of this opinion, I would
humbly fuggeft, that the former is caujiic al-
kali, and would undoubtedly kill the patient
if given in the dofe he prefcribes \ and the latter,
which is mild alkali, may be given without any
danger.

P. 255* Inthehillory of abforbents, no men-
tion is made of Dr Meckel^ who was the firfl
writer on this fubjed, and who firft taught
publicly the dodrine about the lymphatic fy-
ftem and abforbents at Berlin, a good many
years before Dr Will. Hunter or any other Pro-
fefTor in this country.

P. 293. " We never find a bubo from the
'^ abforption of matter ^ when tjiere are vene-

U " real

-^oS REVIEW OF A LATE TREATISE

j>

"real fores on the arms, &c. there are no fwel-
" Ihigs of the glands of the arm-pit" — If Mr H.
by the word zue underflands himfelf, I cannot
controvert that he has never feen any fuch
thing; but I have feen a bubo under the arm-
pit from a venereal tetter on the elbow, and a
bubo in the loins from a venereal ulcer in the
toe; and other praditioners have obferved fimi-
lar fwelltngs from the fame caufe. — The reafon-
ing throughout the whole of this page is vague,
and contradided by fads.

P. 294, 296. We find the fame reafoning con-
tinued ; and p. 297, he tells us modeftly, that
he has more knowledge and fagacity than the reft
of his brethren; and pronounces ulcers not vene-
real^ which the reft of the London furgeons decla-
red to be venereal. And when we come to inquire,
why he thought them to be not venereal, we
f^nd it is, becaufe it appeared to him fo.

P. 300, 301. Nothing but vague and falfe
conclulions from vague and falfe premifes.

P. 302. He fays, " that a gonorrhoea orihanker
" are as eafily cured when the conftitution is
" poxed either by them or previous to their ap~
'^ pearance, as when the perfon is in perfed
'* health ; but the conftitution cannot be cu-
*^ red without the fhanker being cured." — ^Both
thefe propofitrons are groundlefs and contradic-
ted by every day's experience.

P. 307. " The parts affeded in the early llage
*^ of the difeafe are the ikin, tonfils, nofe, &c.;
" when in its latter ftate, the periofleum, faf-
" cise, and bones come into adion."— -We find
in pradice, that nature does not always follow

fo

ON THE VENEREAL DISEASE, qof

.J

n

f(3 exactly the limits prefcribedtoher by Mr Hun-
ter. I have feen a patient, whofe ulna was fwel-
led to an enormous Hze, from a fhanker on the
glans penis the third week after its appearance,
without any other venereal fymptom in the
body.

P. 364. " From the above experiments It ap-
" pears to be immaterial what preparation of
" mercury is ufed in the cure of this difeafe,
** provided it is of eafy folution in our juices,
the preparation eafieft of folution being al-
ways the befb."— ^This conclufion, drawn from
a few experiments made upon himfelf, is very
defective and inadmillible in practice : for we
daily fee, that the preparation of mercury, which
agrees very wxll with one patient, difagrees with
the other; and that it is confequently very ma"
terial what preparation of mercury we ufe.

P. 368. The poultice made of gum gualac
and deco6lion of farfaparilla with oat-meal, ap-
pears to be a very unfair trial, deferves no com-
parlfon, and confequently no coneluiion can bd
drawn from it.

P* 374. The nature of the cafe related here:
iiot being afcertained, proves nothings

P* 307, Note. He fays, that becaufe the ulcer
of the tongue ga.ve way ro mercury, he fuppo-
fed it to be venereal ; whereas before, he flatly
denied this inference to be jufl.

P' 3C^> 3^9- ^s a continuation of vagiie hypo-
thetical reafoning.

P. 310. He obferves, "that when the lues ve-
" nerea has been cured fo far as only to removei
*^ the firfl anions, but not to eradicate the dif-

U 2 " politioK

^

08 REVIEW OF A LATE TREATISE

'^ pofition in the deeper feated parts; under
*' luch circumftances of the difeafe, it never
" attacks again the external, or the parts that
" were firll affeded, but only the deeper-feated
" parts, which are fecond in order of time." —
This propofition would make us believe, that Mr
H. had feen very few patients, or that he has
concealed a fa6l which occurs almoft daily in
pradice, viz. that fhankers, after difappearing
undertheufe of mercury, when this is left off, ap-
pear again repeatedly on the prepuce or glans.
The cafe mentioned in the fame page fhows
clearly, that the venereal poifon may lie con-
cealed in the conftitution for many months, con-
trary to his alfertion.

P. 312, ?2ote. This is to exculpate his firfl
wrong judgment of the cafe, and is as lame as
the reafoning upon the cafe itfelf.

P. 313. Contrary to Mr H's opinion, we
really often fee the parts, which he calls firfl
and fecond in order, affeded at the fame time ;
and I wonder he fhould not have obferved this'
himfelf. — Well authenticated obfervations prove,
though much againfl his theory, that the vene-
real poifon may be in the mafs, after its vifible
effeds are cured.

P. 314. " Mercury, prior to the adion, will
*' not remove the difpolition, and of courfe
" will not hinder the adion coming on after-
" v\^ards. Flov/ever, it is poffible, and mofl
" probable, that the medicine, while it is pre-
*' lent, will hinder the adion taking place; fo
" that no venereal complaints will take place
" while under the courfe of mercury, although

" the

ON THE VENEREAL DISEASE. 309

^' the parts may be contaminated."-— This pro-
pofition is abfurd, refuted by every day's obfer-
vation, and contradided by Mr H. himfelf 3 for^
if this was true, what reafon could he have to
give mercury internally during a clap, bubo, or
fhankers of the genitals ?— ^' The parts firil in
*' order are more eafy cured than thofe of the
" fecond order." This is not generally true ;
much depends of the time they are afFeded : if
recent, the latter , yield often as readily as the
former, or even "more fo, if the former are old
and inveterate.

P. 318. He fays, " we never find that a man
" had a flianker a twelvemonth ago, and that it
^' broke out after in venereal fcurfs upon the
" fkin or ulcers in the throat." — I have feen
numberlefs Inftances to the contrary.

P. 331. Mr H. feems as unlucky in his mathe-
matical calculations concerning the feat, extent
of venereal complaints, or number of days re-
quired for the cure, &c. as he is in his chemical
obfervations.

P* 333* " This pradice miiil be continued
fome time after all fymptoms have difppear-
ed," &c. " If the medicine (mercury) were
alfo a cure for the difpofition in the parts fe-
cond in order, and could prevent their co-
ming into adion, it would be necefTary to
" continue it fomewhat longer on their account:
" but this is not the cale 3 for the vifible efFedls,
*^ fymptoms, or appearances in the firil order
" of partSj give way to the treatment, while
" the parts that have only acquired the difpofi-
*^ tion, and are ftill inadive, afterwards aifume

U q " the

i6

i(

310 REVIEW OF A LATE TREATISE

*' the adion and continue the difeafe. This de-
*^ ceives the fiirgeon, and leaves the ground-
" work for a fecond fet of local effects in the
" parts fecond in order. But 1 have afTerted,
*' that what will cure an action will not cure a
" difpofition : if fo, we iliould puili our medl-
" cine no further than the cure of the vilible
" effects of the poifon, and allow whatever
" parts may be contaminated to come into ac-
" tion afterwards."— We leave this unintelli-
gible jargon wiLhout any comment; but we
think the quacks greatly indebted to Mr H. for
the lait precept : they may thus charge their pa-
tients with two_, three, or four different cures.
Mr H. appears, in this cafe, like an acute law-
yer, who makes out of one law-fuit five, and
we have nothing to fay but to pity the poor
client.

^' 335> 33^' " The effedts of mercury on a
" conftitution will always be as the quantity
^' of mercury; and when the fame quantity af-
*' feds one conftitution more than another, it
" is in the proportion of the irritability of that
"conftitution to the powers of mercury, enr
" tirely independent of any particular pr^para-
" tion, or any particular mode of giving it."
Mr H.'s Ikill in chemiftry, we have before ob-
ferved, is not very extenftve ', and we may there-
fore overlook, when he afferts, that crude mercury
and corroiive fublimate deferve- no diftindion
as to quality or manner of adminiftration in
pradice. However, at the end of the page, he
fays, *' that in fome cafes it is right to try all
■ • the different preparations of mercury ; for it

" will

ON THE VENEREAL DISEASE. 3 1 1

" will fometimes happen, that one preparation
** will fucceed when another will not." Does
he afcribe this likewife to the quantity of mer-
cury ?

P. 339. Mr H. warns us againfl a great im-
pofition, as he calls it; he means the art of
avoiding the bad or difagreeabie efFeds of mer-
cury ; becaufe, he fays, '* I believe that w^e are
" not pofTefTed of any means of avoiding thefe
*^ efFeds \ viz. of either driving the mercury to
** the mouth," &c. We are much oblired to
any man for warning us againfl impofitions :
but 1 muft beg leave to warn young pradition-
ers again the impofing language of the Profef-
for^ and not go on harilily in pouring in large
quantities of mercury into the conflitution,
without any precaution againfl falivation, fym-
tomatic fever, violent fweats, or gripings and
purgings. A man like Mr PI. may perhaps
perCuade his patients that thofe difagreeabie or
dangerous. eiFeds are, not owing to his inat-
tention or want of fkill ; but a young man
who fets out in pradicc, will often find the
contrary, and thereby lofe his reputation.

P. 346. " I do conceive that the recent ve-
** nereal fores are upon the whole more difii-
" cult to cure than the conflitutional ones ; at
"leaf!:, they commonly require longer time,
^* although not always," — 1 do believe that this
is really the cafe when treated in the manner
Mr H. prefcribes : but I do alfo humbly con-
ceive, that Mr H.'s method of treating recent
fliankers is a bad one 3 and that, on the con-
trary, recent fhankers, when properly treated,

U 4 are

it

313 REVIEW OF ALATE TREATISE.

are much more eafily cured than conflitutional
ones ; and I think, he might have afcribed here
to his manner of treatment, what he has afcri-
bed to the nature of the comxplaint.

P. 347. 1 mufl diiTent here, as well as in mofl
other cafes, from Mr Hunter ; for I have gene^
rally obferved, that mercury given to perfons
who had made ufe of it formerly, were con^
ftantly m.ore eafily afFeded by it in the mouth
and conftitution hereafter,

P. 348. He fpeaks of a tainted conftitution,
which he denied before, when fpeaking on the
lues in general.

P. 349. " Let me afk any one what effed:

eating a hearty dinner, and drinking a bottle
" of wine, can have over the a6i;ion of mercury
" upon a venereal fore? Or what effect can
^^ walking in froll and fnow have upon the ope-
*^ ration of mercury, either to make it affed:
^^ any part fenfibly, as falling upon the glands
** of the mouth, or prevent its efFed upon the
*' venereal irritation ? in ihort, I do not fee
*' why mxcrcury iliould not cure the venereal
*' difeafe under any mode whatever of regimen
*^ or diet."— I am afraid, that if Mr PI. does
not fee it, his patients will feel it ; and young
practitioners, following the advice of the Pro-
feffor, may expofe their patients either to vio-
lent inflammatory fevers, or to the mofl obfti-
nate excruciating pains, if not to an incurable
palfy for life.

P. 350, 351. If the rules laid down in thele
pages about the different preparations of mer-
cury be true, and the care recommended for

ren-

^ ON THE VENEREAL DISEASE. 313

rendering them more fufe and eiFed:ual founded
in practice, it clearly fhows, that the efFedts of
mercury are not only in proportion to its quan-
tity, as Mr H. afTerted above; but that fo much
depends on its quality, as he fays here. This,
however^ is one of the numerous inflances of Mr
H.'s pradice contradicting his theoretical af-
fertioTis.

P. 352. I find the following firange propoli-
tion : " If a more iimple preparation was to be
^' found out than crude mercury, it ihould be
" made ufe of." — What Mr H. properly means
by this I do not well underftand ; for I cannot
believe him fo ignorant, as not to know tLat
crude mercury is not a preparation, but ^fimple
produd of nature. But v/hy wifi ing to employ
a more fimple mercurial preparation than the
limplefl of all, viz. crude m.ercury 3 efpecially
if all the different preparations, as mentioned
above (p. 135, 136.), are the fame j and if their
effects are only in proportion to their quantity,
and entirely independent of their quality?

P^ 359. He fays, " That the increafed fecre-
^' tions in falivary glands, cutaneous vellels,
" interftices, arife from the conilitution being
" loaded with mercury." — If this be owing only
to the quantity of mercury, without any reipe(5l
to its quality, we would afk Mr H. How it
comes that two or three grains of calomel pro-
duce now and then fuch violent effeds upon the
inteflinal canal ? or why three oi'^four dofes of
fublimate, of half a grain each, not unfre-
quently produce fo violent fweatings or faliva-
tioa? This, we apprehend, he will not main«=
, - taii^

3 T 4 REVIEW OF A LATE TREATISE

tain from the conflitution being loaded with,
mercury. • ^

P. 360. Note. " Sulphur united with any <^f
*' the metals, probably deflroys their folubi-
" lity in the juices, or at leafl their efFeds in
'' the circulation. None of the cinnabars acS
" either as fulphur or mercury. Crude anti-
** mony, which is regulus of antimony and
" fulphur, has no effed. Arfenic, when join-
" ed with fulphur, has no efFed^ nor has iron."
The firft proportion of this note is a mere con-
jedure, unfupported by any argum-^nt or fad ;
the fecond is true; and the third, viz. that
crude antimony, yellow arfenic or orpiment,
^nd iron united which fulphur, have no effed,
is totally falfe without foundation.

I now come to what I referved for the lad
point of difcuflion, the chapter on Impotence ; in
which I fliall only take notice of the two fol-
lowing proportions. Here are Mr H.'s own
words : " I think I may afhrm, that the ad of
^' manuftupration in itfelf does lefs harm to the
" conflitution in general than the natural ad
^' of coition : That the natural ad of coition
*' Y/ith common women, or fuch as we are in-
*^ different about, does lefs harm to the coniti-
'^ tution than where it is not fo felfiih, and
*' where the affedions for the woman are alfo

" concerned." Was this reafoning juft, it

would apply to prove, that our hands were made
for *** . and'that it would be better and more
healthy to the human conilitution to commit
all kinds of Sodomies and beftialities. — The in-
tention of Nature, amongft all the more perfed

animals,

ON THE VENEREAL DISEASE. 315

animals, k to throw the femen into the vagina
of the female. No animal, when able to get a
female, deviates from this univerfal law> and
it is the moll confummate impudence even to
attempt to reafon men out of it.. But Mr H.
feems to delight in advancing paradoxes, and
in employing his mental as well as generative
faculties contrary to the laws of Nature, at leaft
he wifhcs to perfuade us fo. However, as he
is married, and not, as we might exped from
the principles laid down above, for the care of
his own health, to an ugly beafl, but to a very
fine and amiable woman, this dodrine feems to
me nothing more or lefs but a new kind oi puff
of highly refined quackery ; and as the pradice of
the ProfefTor in this point agrees fo little with
his theory, we hope, for the happinefs of his
venereal patients, the fame will be the cafe
with regard to the manner of treatment of their
refpedive complaints.

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