I.– To Sections 35 and 36.
NOT only these two paragraphs, but upwards of two-third of this work, had already been printed, and the whole of my manuscript had already been sent off, when in the course of last month, I had an opportunity of making tow interesting observations, that, on the one hand, seemed to confirm my views concerning the essential oneness and purely accidental, external, or phenomenal differences of the various kinds of chancre, and, on the other hand, seem to favour the views of those who hole, with Virchow and Yvaren, that syphilis is at the bottom of every thing, and that even tubercular phthisis, cardiac polypi, disorganizations of the liver, several kinds of jaundice, even scrofula, white swellings, and sarcocele, originate in syphilis. However, firmly I have been resolved not to discuss points of doctrine that, owing to the absence of reliable facts,. are still exceeding problematical, yet I deem it incumbent upon me to publish these two cases.
The first is the case of a man of seventy, who consulted me in the month of August on account of a profusely-secreting soft ulcer on the prepuce, for which I prescribed Mercurius sol., first trituration, half a grain twice a day. However, dreading Mercury a good deal, he took, without my knowledge, two pellets of Mercurius 12, and several other remedies. On the 7th of november he came again, his forehead manifestly covered with isolated, scattered syphilitic tubercles. The chancre had become cicatrized, without having shown the least hardness in its course; at the place where the chancre had been located, a tolerably large, cock’s- comb-shaped fig-warts was seen. Last September he had had two buboes, which he had cured himself with Nitri acidum, on which account I gave him Lycopodium 30. Since then (now December 7th), then fig-warts and the dry, scattered tubercles on the forehead have disappeared; in their places, a cough, with purulent expectoration, had set in, which night lead others to suspect pulmonary phthisis. Unfortunately for this diagnosis, this patient has had such a cough twice before, during the twenty-five years that I have been acquainted with him. The other case is that of a young married woman, who consulted me in the month of May on account of a soft chancre at the lower commissure, that had been there for about a fortnight. She continued her visits for eight days, when I did not see her again until the 15th of November following. Not having perceived any improvement the first four days of my treatment, and fearing the return of her husband, who happened to be absent on a journey, she had had the chancre removed by cauterization, and had, at the same time, continued my prescription for another week. She thought herself free from all trouble, when, all at once, in the month of November, an unmistakable papulous exanthem broke out, which covered chiefly the abdomen and lower extremities, particularly the thighs. Individuals, with old soft chancres, and simultaneously existing roseola syphilitica have frequently applied to me for treatment, so that notwithstanding the observations recently published by the hospital-physicians of Lyons concerning the supposed essential difference between the contagia giving rise respectively to the soft, hunterian, and phagedaenic chancres, I am unable to regard such a distinction as founded on fact;l for, if it is certain, as I know from personal observation, that a Hunterian chancre may, according to circumstances, produce any of the other forms, and that any of these forms may superinduce the same secondary consequences, although these results may not always follow, the fact that there inheres, in all these forms, a faculty of superinducing the secondary consequences, is sufficient to induce us to regard the identity of the contagium as an established fact, and to attribute the apparent differences of forms to the influence of, as yet unknown, but, at all events, non-essential circumstances. Who knows whether the ulcus molle is not derived from the Hunterian chancre, by the bare fact, that the profuse secretion of the former prevents the specific inflammation upon which the characteristic induration of the Hunterian chancre depends. It is true that, beside the Hunterian chancres, all other chancres, as we have shown in the third division, No. 156-166, seem to have existed since the remotest period; but, in the same place, we have likewise shown that the great epidemic of the fifteenth century produced a new unitary syphilitic disease, from which not only the ancient gonorrhoea and condylomata arose in their new forms of syphilitic gonorrhoea, and syphilitic mucous tubercles, but likewise the ancient soft and phagedaenic, even gangrenous chancres, modified by the new syphilitic virus.
II. To Sections 176-178
What I have said just now, leads me to utter a few other remarks which I should have kept suppressed, but for the fact that i met in the past week young men who had fallen a victim to a new pathological and therapeutic theory in Homoeopathy. I allude to the theory which accords an undue extension to the boundaries of Sycosis and accepts a large number of new remedies for this disease, that purely speculative grounds. There is no doubt, whatever, that there are chancrous-syphilitic as well as non- chancrous syphilitic fig-warts, although we may not as yet have it in our power to distinguish these two kinds from each other. If we adopt, after the example of Hahnemann, a special contagium, the so-called sycosic contagium, which is different from the contagium of chancre; and if we class, as some French homoeopaths are in the habit of doing, in the category of sycosis any thing that bears the remotest anatomical analogy to sycosis excrescences, such as: common warts, steatomata, sarcomata, polypi of the nose, ears, hearts, bladder, uterus, it seems to us, that this mode of generalizing is crying the application of a theory beyond the bounds of logic and even of the most superficial pretension to science. Either these theorizers admit, with Hahnemann, that some of these condylomata are of venereal origin, and can be communicated again by the act of coition; and that others cannot; or else they regard all these condylomata as elements of one and the same pathological series. If they regard only some of these condylomata as contagious, they can no more class the non-contagious excrescences in the same category with the former, than simple maculae, vesicles, papulae, pustules, etc., can be classed with their syphilitic analogues in the same series. If yonder theorizers regard all the above-mentioned excrescences, on the ground of their pathological resemblance, as elements of the same pathological series; they must, for consistency sake either regard all of them as contagious, or else as non-contagious, for the simple reason that what constitutes the pathological unity of a series, is the pathological identity of the generating cause or principle of the whole series, and consequently of each of its constituent elements. Now, if we mean to assert that steatomata and sarcomata, as well as common warts, are equally contagious as the fig-warts whose contagious character is established by abundant experience, we shall find purely anatomical demonstrations utterly insufficient, and we shall have to call in aid arguments based upon the etiological, physiological, and pathological origin and behaviour of those excrescences. A confusion of this kind, introduced in our anatomical and pathological definitions, is to be deplored all the more, since, when therapeutic measures are to be governed by such erroneous theories, the selection of remedial agents is no longer regulated by positive and decisive science, but by superficial sophisms. That the anatomical structure of certain pathology products is sometimes determined by an analogues pathological activity, and hence, may lead to the selection of the same remedial agent, cannot be denied; but hat which is decisive in the selection of a remedy, is not the inanimate pathological product, but, on the one hand, the specific generative cause, and on the other hand, the physiological and pathological activities, and vital manifestations of the disease; where these are alike, the most diversified anatomical malformations can be cured by the same remedy; but if the causes and vital manifestations of such malformations, are of a different kind, anatomical products that are ever so much alike, require the most varied remedies for their cure. Those are to be pitied who, misled by such erroneous theories, and falling to cure evidently venereal fig-warts, in hurry, with Nitri ac., Thuja., Staphys., Phosph. ac., Cinnabaris, and Lycopodium, now jump at Calcarea, Teucrium, Secale cornutum, Sepia, and Dulcamara, for no better reason than because these last mentions remedies have cured steatomata, polypi, or common warts, and, in accordance with the new theory, should be powerful anti-sycotica. Even if, by pursuing this course, physicians do not always allow the fig-warts to grow to the size of one or more inches, it is certain– we can probably this results most positively- that, by this means, they will most uselessly incur the loss of precious time that it may be beyond their power to repair.
