What Astruc, when speaking of his seven transition-periods of the acute epidemic to our modern syphilis, says of his second period immediately succeeding the epidemic, namely: that this second period has been distinguished by the appearance of condylomata, these condylomata cannot be regarded as a new product, but have to be looked upon as the reappearance of an old symptom that had been known already for centuries; provided always that Astruc does not understand by such condylomata the fungoid growths occurring in the second stage of the Hunterian- chancre; these growths, of whose selfexisting contagium we shall speak in the next chapter, are likewise to be regarded as pathological products essentially distinct from idiopathic figwarts. The same remark applies to Astruc’s subsequent periods, in the third of which he locates the falling off of the hair, and the appearance of leucorrhoea, in the fourth gonorrhoea, in the fifth the supervention of buzzing in the ears, and in the two last the appearance of the much-discussed and the much-dentoid mother vesicle (chancre-matrix). Arranging together such pathological facts as had become manifest subsequent to yonder epidemic, and of which nothing had been known before we have: (1) callous, lardaceous ulcers, transmitting the infection by immediate contact with the mucous membrane, or with some other part denuded of its epidermis (chancre): (2) secondary phenomena (upon the skin, in the bones, mucous membranes, etc.); in one word, the whole of our modern chancre-plague (to which Frascatori first applied the name syphilis), whose products, if they had been known to the older writers, would certainly have been recognized by them as connected with the primary syphilitic ulcers, and would not have been confounded with lepra.
Whether syphilis and all truly venereal phenomena depend, as most authors believe, upon a specific virus, or whether these products, as some assert, can develop themselves spontaneously out of the simplest inflammations, is a subject that shall be examined more particularly in the next chapter.
SECOND CHAPTER
OF VENEREAL CONTAGIA
I. OF THE SYPHILITIC VIRUS GENERALLY.
Secale 167. Disputed Points.
THERE is probably no point in the domain of medicine, concerning which so much has been argued pro and con, as concerning the existence or non-existence of the syphilitic contagium. Whereas some, starting from the fact that syphilis and its demonstrable infections exist, regard the existence of the syphilitic contagium as an axiom that should be accepted without any further proof; others, on the contrary, who deny the existence of syphilis as a specific, idiopathic disease, endeavor to show the non-existence of a syphilitic contagium by the absolute impossibility to trace it in the syphilitic pus; and, since chemical physiologists have come to the same conclusion regarding the existence of a syphilitic contagium, that they have come to regarding our homoeopathic attenuations: “Where there is not any thing, nothing can result; where there is no syphilitic contagium, there cannot be any syphilis.” In spite of all this, syphilis has continued to rage without bothering about the chemists any more than do out attenuations, and like these, has continued to hide its secret from the microscopical eye of the most practised investigator. It is only by the process of inoculation that it manifested to those who had eyes to see, not only its contagious nature, but likewise its existence, without, however, shedding a single ray of light on the nature of its contagium, for the reason that the pus obtained from the products of inoculation showed nothing different from any other non- contagious pus. Those who reject the existence of syphilis as an idiopathic disease, and who account for its manifestations upon the ground that an individual morbid disposition is excited into activity by the acrid properties of an inflammatory purulent secretion, are no more convinced now than they were before the experiment of inoculation had been instituted; whereas the other party put the difficulty of an explanation further off, saving that the contagium was not the virus itself, but only its vehicle; for that which they were unable to prove remained, after all, for the present at least, the contagium itself. In this way the dispute has been continued to the present time, nor is it likely ever to be terminated, since one party seeks that which does not exist, and the other party is unwilling to admit that something may exist where there is apparently nothing to be found. Truth, in this case, does not lie in the middle, but on both sides, since the syphilitic contagium exists just as certainly as it does not exist, and, on account of its non- existence, can never be demonstrated. Who has ever been able to demonstrate either chemically or microscopically warmth, the force of attraction, electricity, the power of the magnet, the germinating force of a grain of seed, and other mechanical or organic motor-principles, as specially existing entities, and separable from the bodies whose properties they are? Yet all these things exist, not as particular substances, but no less really as the inherent properties of the things to which they belong; for we see or feel warming attracting electrical, magnetic, germinating and other bodies, although neither a separate caloric, nor a separate attractive, magnetic, electrical or germinating principle exists, and, in chemical respects, a magnetic iron, for instance, resembles a non-magnetic as perfectly as contagious pus resembles non-contagious. As in the case of the magnetic needle the magnetic iron constitutes the attracting substance, so do, in the case of contagia, the infectious secretions and exhaustions of the patient constitute the contagion-transmitting substances. This faculty of transmitting the contagion is just as immaterial a property as the attractive force of the load-stone, or as any other properties that are inherent in different bodies, and the existence of which can only be inferred from their manifestations, but should be accepted as a self-evident truth wherever these manifestations take place.
Secale 168. Objections of the Opponents.
The main point in discussing the question of the real existence of a venereal contagium, is therefore not to demonstrate its material existence, but to first prove the existence of syphilis itself, as well as its inherent faculty to transmit the infection by a product of its own kind; for we may regard this faculty as the conditio sine quanon of its own existence, and as a means of inferring this very existence from that faculty. These two points are the very facts that are denied by the opponents of the idiopathicity of venereal diseases. They base their denial not only upon the frequent non-occurrence of the syphilitic products after inoculation; but, in order to show that the individual disposition is the sole cause of all so-called venereal phenomena, they refer to the circumstance that, according to a number of facts, all these phenomena can be demonstrably occasioned by a non-contagious sexual connection. According to their assertions, it suffices that even the healthiest woman, who had not the least sign of a venereal infection, may have her catamenia, or an acrid leucorrhoea, or may be unclean, or that the husband may have practised the act of coition with too much fire, in order that a simple inflammation may be occasioned, which, through a somewhat heating and irregular mode of life, may give rise: (1) to gonorrhoea, which, when neglected, may cause, (2) a chancre: in scrofulous individuals, (3) a bubo, and finally, in scorbutic or otherwise diseased individuals, (4) all the symptoms that are generally designated as secondary syphilis. This view seems to have been entertained by the ancients, who, previous to the well-known great epidemic, were acquainted with sordes foetidates, immundities, as causes of venereal phenomena, but were unacquainted with a virus in the modern acceptation of this term. According to Cazenave, this expression has never been used with reference to sexual phenomena by any author, except Vulgarius, who lived in the 13th century, who, however, applies this expression to the consequence of a licentious life generally, rather than to any particular disease, in the following satirical verse concerning Pope Bonifacius VIII.:
“Hic vir decanus est, qui viri specie, Non vir, sed virus est, virosa facie.”
However, whatever opinions the ancients may have entertained concerning the phenomena on the sexual organs, the truth is that, at the present time be it in consequence of a more thorough knowledge of these diseases, or of the appearance of an entirely new morbific cause, a whole series of phenomena is known which modern pathologists describe as a distinct and accurately defined class, to which, in contra-distinction to other diseases of the sexual organs, they apply exclusively the term venereal, and which are distinguished from other phenomena of these organs by the property of being able to transmit an infection of a like nature to other individuals by a specific contagium inherent in the products of this same infection. Let, therefore, the inexperienced in medicine continue to believe that even the soundest woman may communicate a chancre, or a gonorrhoea, running a definite course, as the result of too much fire during the act of coition, and let the woman try ever so hard to make the simple believe that the discharge was caused by an acrid menstrual blood, or by leucorrhoea: a scientific physician, if he means to make similar assertions, has to prove, if not that the most harmless embrace is succeeded by phenomena on the sexual organs, at least that a non-infectious act of coition is capable of developing in the sexual sphere all the phenomena of which pathologists assert that they can only be produced by means of an infectious contact. In order to conduct this argument, it will be necessary to show that these phenomena can develop themselves spontaneously, and that, where this spontaneous development has taken place, the resulting phenomena are entitled to the exclusive appellation of venereal. Let us therefore inquire how far these two points will stand the test of critical inquiry and analysis.
