First Chapter PATHOLOGICAL NATURE AND ORIGIN OF SYPHILIS I. PATHOLOGICAL NATURE OF SYPHILIS
Secale 152.- Pathological Unity of the Syphilitic Phenomena.
ALTHOUGH, in treating of the secondary phenomena of syphilis, we have taken the existence of the disease for granted, and have deemed it unnecessary to adduce corroborated evidence in its favor a an idiopathic pathological condition, yet, on the other hand, we must not forget that more than one reputable author not only denies the venereal origin of the syphilitic phenomena, but rejects even their idiopathic nature, and their derivation from one and the same pathological unity, even as a great man of Hahnemann’s disciples deny even to this day his doctrine, that psora is the fountain head of most chronic diseases. In order not to omit anything in our argument concerning syphilis, we will therefore state what seems to us the irrefutable truth in this respect. Casting only a superficial glance at both the primary and secondary symptoms of syphilitic, we see at once that, owing to the peculiar pathognomonic character of each of the primary symptoms, it is just as impossible to bring these different primary symptoms, under one generalization, as it is not possible, but becomes absolutely necessary to establish such a generalization with regard to the secondary phenomena. Whereas the primary phenomena do not seem to have a single feature in common; among the secondary phenomena, on the contrary, there is not one that does not show the characteristic sings of the whole series, so that, even if we should be unable to prove venereal origin of each member of the class, yet we shall have no consider them as symptoms of one and the same unitary disease. In further examining the form which the different secondary phenomena have in common, we meet with the copper color of the cutaneous exanthems, with the circular shape of the single pustules, tetters and tubercles, as well as of whole groups of these eruptions, and with the cup-shaped depressed form of the ulcers, with their callous and everted edges, in a manner so striking, and even so uniform, even to the destructions of the cellular tissue, muscles and bones, together with all the characteristic signs of chancre, that we feel tempted to regard this disease, without any further evidence, as an universalized chancre-plague, if it were not best, for many palpable reasons, not to adopt such a conclusion too hastily. For, because one disease agrees with another in its external form, we have no right to jump at the conclusion that these two diseases are identical in essence, and the question might be asked, and has been asked by the opponents of Homoeopathy, whether the two diseases may not have originated in different causes.
It is indeed true that, if certain symptoms are observed exclusively of a certain malady, these symptoms server as diagnostic or pathognomonic signs of this disease, by means of which we recognize this latter as a disease sui generis, than can no longer be confounded with any other; but, in order that this fact may likewise be asserted of the above-described symptoms of secondary syphilis, we shall have, in the first place, to show that they neither can nor do occur in any other disease in the same manner, not even by accident. Yea, in order to meet all objections at the very outset, we shall have to show that these symptoms belong to the syphilitic disease per se, and are not superinduced, as some assert, by accidentally, aggravating causes, such as: inflammation, a vicious mode of the living, improper use of drugs, and the like. Let us examine all these points, and inquire how far syphilis is or is not an unitary idiopathic disease.
Secale 153.- The Idiopathic Character of Syphilitic Phenomena.
“There is no syphilis, and hence no syphilitic phenomena.!” so say all the adherents of the Physiological School founded by Broussais some fifty years ago, and adopted even by some German homoeopaths. Physiological physicians deny the existence of idiopathic diseases, and of pathology generally, in so far, at any rate, as they view all morbid phenomena as abnormal physiological processes occasioned by accidental inflammatory irritations. According to these physicians, all the so-called scrofulous, scorbutic, rachitic, cancerous and other affections of the skin, mucous membranes, glands, bones, etc., are nothing but the natural consequences of simple inflammations, which according as they affect individuals of a lymphatic, leucophlegmatic, acrimonious or other temperament, or invade one or the other particular organ, adopt this or that particular course, and a more or less modified form, according to the influences that act upon the patient. As a proof of the correctness of their theories, they quote certain facts by virtue of which an act of coition that is supposed to be contagious, but, in reality, only occasions an inflammatory irritation through the acrid nature of certain secretions, produces, according to the constitutional differences of individuals, gonorrhoea in one, chancre the another, or buboes and mucous tubercles in a third; the subsequent benign or malignant character of these products depending entirely upon the individual constitution of the patient, upon this mode of life, or the treatment that is being pursued is the case; and from these general views they draw the inference that, even if there are venereal or non-venereal products, characterized by a copper- brown redness, a rounded form, or more or less depressed and callous ulcers, these phenomena can be accounted for by the individuality of the patient, and by other accidental influences, and that, in order to explain them, it is not necessary that we should lung in the doctrine of an idiopathic disease, or even of a specific morbific principle. Against this theory, which, at first sight, seems quite plausible, there could not be any objection, if what are called idiopathic diseases were not made up of precisely such symptoms as do not depend upon individual peculiarities and accidental conditions, but, under all conditions, manifest themselves with the same signs, and in the same of manner; thus determining, among organic alternations, swellings, ulcers and inflammations of a like form, certain fixed, not individual nor accidental differences, founded in the specific nature of these alternations; in other words, essentially distinct kinds or species thereof. For the very reason that certain specific pathognomonic signs which always manifest themselves alike among different individuals, and among a multitude of the most varied influences, induce us to distinguish not only scrofulous, cancerous, scorbutic, but likewise rheumatic, catarrhal, arthritic and other ulcers, swellings, inflammations, eruptions, etc., as to many special kinds of these organic alternations-for that very reason we have to regard syphilitic alternations, on account of the signs that are specifically peculiar to them, and to no other form of disease, as a species or morbid phenomena, whose concordance, agreement or identity with certain chancres more particularly with the Hunterian variety, induce us to rank them in this category of syphilitic products. Inasmuch as every fixed special disease must necessarily have a fixed cause a that is, a cause that is permanently the same or specific, it seems fair to assert that, as long as no other disease can be pointed out to which those phenomena belong as specific characteristic signs, the specific cause of these phenomena must be the very cause that makes a Hunterian chancres to always appear under the most diversified circumstances, and upon individuals of the most varied constitutional peculiarities, with characteristic signs that are always the same, and peculiar to it alone.
Secale 154.- The Venereal Nature of Syphilis.
This unequivocal idiopathicity of its symptoms, which distinguishes it from every other disease, is admitted by many of those who reject its venereal nurture. They assert, however, that syphilis did not assume this venereal nature until, after the great epidemic of the fifteenth century all venereal diseases were treated with Mercury. After this period, all the phenomena that were attributed to the so-called secondary syphilis, so far form being venereal, were on the contrary purely mercurial products occasioned by the insane abuse of this metal. In this respect it is indeed true that, previous to that terrible epidemic, the history of the ancients never make the least mention of our modern syphilis, and that the indiscreet use of Mercury, first introduced in that epidemic, may cause phenomena which an unpractised eye might easily confounded with such as originate in venereal sources. Nevertheless, as has been in the two former paragraphs, there exist on the one hand essential diagnostic signs, and, on the other hand, even the most declared opponents admit that these phenomena likewise occur among patients who had never made the least use of this metal. Hence if secondary syphilis, whose unity as a disease sui generis, can after what has been said, no longer be doubted, is to be accepted a non-venereal disease, the advocates of this doctrine will have to show in the first place, that notwithstanding syphilis was first described in the middle ages as an idiopathic disease, it had existed from the immemorial without having been recognized as a specific malady; or, if they are notable to accomplish this, to show that beside Mercury another non-venereal morbific cause had become operative at that period, which likewise had power to produce a disease resembling secondary syphilis. In this respect some contend that the so-called primary syphilis, and venereal products, which, indeed, are not denied, were known to the ancients as well as to us, and that the absolute silence of ancient authors regarding secondary symptoms, shows that not one of these symptoms had ever been produced by the disease, and hence, that the modern existence of secondary symptoms, if at all proven, must be traced to any other, perhaps as yet unknown, rather than to a venereal cause. This assertion is met by the counter-assertion that the ancients did not known all the secondary phenomena of modern times; that the phenomenon which constitutes the main subject of discussion, namely, the true chancre, afterwards called Hunterian, had only first been observed towards the end of the fifteenth century, and that, if the non-existence of secondary venereal products was to be proved, the discussion would have to be conducted, not with reference to all the phenomena that are designated as secondary, but exclusively with reference to the above mentioned chancre. In order to ascertain which of these two assertions is correct, it might be sufficient to rely exclusively upon the facts by which the derivation of secondary phenomena from this chancre is as good as proven; but inasmuch as those who assert that this chancre was like wise known to the ancient, might, as a counter proof of our own assertions, resort to the statement that the existence of secondary phenomena as emanating from the Hunterian chancre was unknown to antiquity, we deem it incumbent upon us to ascertain the exact bearing of the arguments drawn from ancient authors. For this purpose, we shall avail ourselves of “Rosenbaum’s History of Syphilis among the Ancients” (Halle, 1830 where we find and a complete collection of the passages bearing upon this subject in ancient authors, and where we can see with our own eyes how far the ancients were acquainted with syphilis and how far they were not. Let us therefore critically examine the different passages in Rosenbaum’s work, that may shed slight on the history of syphilis, in order to determine whether they justify the assertion the secondary syphilis has a venereal origin, notwithstanding that the ancients were entirely ignorant of this fact.
