Secale 201. – Transition of syphilis into other Diseases.
There are physicians who not only persist in asserting that syphilis can pass into scrofulosis even during the life-time of the organism, but likewise in believing that children, born of syphilitic parents, may born scrofulous instead of syphilitic; some even go so far as to assert that scrofulosis is nothing else than hereditary syphilis. A physician who starts such doctrines, neither knows the history of diseases, no is he acquainted with what is understood by a special disease depending upon same specific principles; otherwise he would know that scrofula has been just as frequent as it now is, even prior to all syphilitic manifestations, and that a specific disease cannot be transformed into another specific diathesis, any more than a cat can be changed into a dog. Altogether, even as Hunter correctly observes, syphilis is never transformed into, any more than it coalesces with, another disease. In herpetic, scorbutic, and scrofulous individuals, the various products of syphilis, and of the natural diathesis, can be seen associated side by side with each other, without a single one of them lossing its specific character. The only thing that may take place indeed, does take place, is, that syphilis may, like may other powerful invasion of the organism, rouse a latent, but already existing diathesis from its slumbering state, and that this diathesis, as soon as the syphilitic disease has become somewhat subdued, may seem to take the place of the latter, without any sort of transformation from the latter into the former having taken place to any extent whatsoever. In this sense syphilitic buboes may continue, in the form of scrofulous buboes, in scrofulous subjects; if in such cases the syphilitic disease had assumed the essential character of scrofula, the specific remedy for the syphilitic bubo would be required; the syphilitic disease, having been transformed into scrofula, would yield to an anti-scrofulous treatment. As a general rule, the morbid dispositions which syphilis excites into active manifestation, do not break forth until sometime after the syphilis is cured; very frequently, however, they become manifest towards the termination of the cure, or perhaps do not owe their awakening to syphilis, but to the insensate masses of Mercury, Iodine, Iodide of Potassium, and other powerful agents with which Old-School physicians sometimes drench their patients, as if they were chemical resorts; it is even possible that many of the so-called sequelae of syphilis, which likewise occur under improper homoeopathic treatment, are caused by excessive doses of Mercurial Iodides, Phosphorus, Nitric acid, etc.; such sequelae may constitute a sort of pseudo- syphilis, and, in reality, may be nothing else than medicinal diseases. However, in whatsoever manner certain original morbid dispositions become roused, be it by the syphilis itself, or by the tumultuous manner in which this disease is treated, the disease thus roused into action, such as tubercular suppurations of the lungs, scrofulous glandular, swellings, affections of bones, cancerous ulcerations, etc., continue to exist, by virtue of their own specific cause, long after the syphilis had been cured; but, in such a case, will only manifest their own special characteristic properties, and none of those of the syphilitic disease. Even if this disease should not have been entirely eradicated, but should continue to betray its existence by the occasional outbreak of constitutional symptoms, these latter will always appear perfectly distinct from the symptoms of scrofula, and will be clearly recognizable by their own specific forms.
IV. OF THE INFLUENCE WHICH OTHER CIRCUMSTANCES EXERT UPON THE DEVELOPMENT, COURSE AND TERMINATION OF SYPHILIS
Secale 202. – Age, Sex, and Conditions of Life
Regarding the different circumstances that may exert an influence upon the development and ultimate shape of syphilis, very little is said that can be considered positive. The teachings of pathological manuals, in reference to this matter, are so general and unmeaning, that it would seem as though their authors had preferred filing their columns with insignificant statements and hypothetical inferences rather than to devote their space to something more useful and tangible. Nevertheless, a few sensible remarks concerning these influences can be uttered, were they nothing else than simple criticisms suggested by the aforesaid manuals.
Influence of age. – There is no doubt that syphilis is much worse and more dangerous among children than among adults. The danger is equally great, no matter whether the disease is contracted at birth, or at the moment of conception, or had been transmitted as an hereditary condition. Exostoses, ophthalmic affections, and diseases of the throat, are indeed less frequent among children. syphilitic exanthems are of more frequent occurrence, more particularly pemphigus, which is the most dangerous disease of this class; but even without such an eruption, all such infants sink very readily under a general cachexia. Past the age of pubescence, the danger resulting from syphilitic infection decreases, but increases again in proportion as individuals grow older. If the danger among young people is less, it is not only because the syphilitic disease, among this class of patients, runs a less dangerous course, but likewise because the forms of syphilis to which young people are liable, are in themselves of a milder type than the forms of syphilis which are most exclusively confined to persons of a more advanced age. The more frequent occurrence of secondary syphilis among young people than among old, is not owing to age, but to the fact that young people than among old, is not owing to age, but to the fact that young people are more reckless and less mindful of the consequence of neglect or improper treatment than older persons.
Sex. – Among females, the primary as well as secondary forms of syphilis are much milder than among males. Among the former we find, in Paris at least, proportionally fewer chancres than mucous tubercles and fig-warts, together with symptomatic gonorrhoea. I have known young men affected with Hunterian chancre communicate the disease to female friends, in whom it resulted in the breaking out of superficial chancres or syphilitic erosions that soon began to change to fungoid excrescences, associated with a number of small mucous tubercles on the neighboring parts, and with symptomatic gonorrhoea, the whole of which symptoms were rapidly cured with Cinnabaris. Nobody can imagine how such excrescences prevail among the young prostitutes of Paris, who fancy themselves attacked only with gonorrhoea; this being a fact, we cannot wonder that french blennorrhagia; so often entails sad consequences upon the patient. This is the reason why the young men in Paris are much more frequently attacked with gonorrhoea and fig-warts, than with simple idiopathic gonorrhoea.
Social condition. – If we may judge of the statistical tables arranged by writers on syphilis, the various trades and professions do not exert any visible influence on the shape and course of syphilis; but the social circumstances of the patient, in other respects, do exert such an influence. It is quite natural that secondary syphilis among the poorer classes occurs much more frequently than among the more opulent classes. The latter have the means of taking better care of their health; whereas the privations, the cares, the bad food, the hard work, the unhealth dwellings, and the poor and scanty living of the working classes, constitute some of the main causes that aggravates the syphilitic disease among the latter.
Secale 203. – Climate, Season, Weather.
If pathological manuals teach the doctrine, that the syphilis of warm climates is less malignant, and generally embodies itself in the shape of some cutaneous affection; whereas in the cold climate, we have more diseases of the mucous membranes and affections of bones- this doctrine is indeed confirmed by a large number of undeniable facts. If Northeners move into a southern climate, their syphilitic ailments decrease perceptibly in a very short period, and soon disappear entirely for some time; on the other hand, if the inhabitants of southern climates move northward, they frequently witness a new outbreak of syphilis, even after it had become all but latent. French soldiers, for instance, who have contracted syphilis in Africa, Naples, Madrid, Algiers, and Mexico, after their return home, become subject to severe aggravations of their complaint, which obstinate resists all the means employed against it. But if our manuals teach that the syphilitic disease is cured in the above-mentioned countries without Mercury, by the mere use of sudorifics and purgatives, all we have to say is that this is no cure, but only a reduction of the disease to a latent condition; otherwise it could not break out again after the patient’s travel from a warm climate into a colder one. It is likewise wrong to assert, as some of our pathological manuals do, that, if the form of syphilis contagium; in proof of which, they assert the fact that one half of the inhabitants of Spain and Italy are affected with syphilis. It is true that syphilis is more frequent in the south than in the North; but this greater frequency is not owing to an increased susceptibility, but to an extraordinary looseness of morals, and to the recklessness with which the people in those countries expose themselves to syphilitic contagion; so that, if all these men and women, with a single syphilitic disease, would probably be the same as among the natives. Even here in Paris, the ardent and inconsiderate sojourners from warm climates are much more frequently attacked with the syphilitic disease than our cold and more discreetly-indulging natives. The assertion that gonorrhoea is more frequently in warm, and chancre more frequent in warm, and chancre more frequent in cold climates, likewise has to be manifested so far as this, that the gonorrhoea of warm climates is not our simple, idiopathic gonorrhoea, but a gonorrhoea depending upon mucous tubercles, of which we have already stated in the receding paragraph that is quite common in Paris. It is likewise incorrect to assert that syphilis occurs more frequently in warm than in cold seasons. A statistical table, now lying before us, shows that, of 112 cases of syphilis, 11 to 14 occurred in each of the months of December, January, March, April and June; 7 to 9 in each of the months of February, May, August, October, and November; and only 4 to 5 in July and September. These numbers show conclusively that, in respect to this point, our pathological manuals are entirely mistaken. Of greatest importance is undoubtedly the influence of the epidemic genius of certain seasons upon the prevalence of certain forms of syphilis; although, even in this respect, existing statistics do not furnish any definite results, and whatever has to be said on this subject, has to be viewed in the light of theoretic hypothesis, rather than in the light of carefully verified facts.
