Secale 172. Chemical Equality of the Different Secretions.
Putting all things together which the advocates of the absolute unity of the different venereal contagia have asserted in favor of their theory, we may sum up their doctrines in the following three proportions: (1) The absolute chemical equality of the various different contagious secretions: (2) the undeniable fact, that products of different kinds have emanated from the same contagium; and, (3) sameness of the secondary and constitutional consequences resulting from the most diversified forms. The first of these three propositions has been advocated with most zeal by Berzelius and the partisans of chemical medicine, and has been transferred to every pathological manual as an irrefutable theorem, without any one taking the least trouble to inquire more particularly into the tenability of such a proposition. After what we have stated, in No. 167, that the infectious principle is, properly speaking nothing but a property inherent in certain secretions and exhalations, of an immaterial nature, and beyond the boundaries of experimental demonstration, it is evident that chemists who are not even capable, without physical experimentation, of distinguishing a Leyden battery charged with electricity from one that is not charged, have no claim to authoritative dictation, when the question is to investigate the presence and nature of properties than can only be determined by pathogenetic provings. It would be impossible to conceive that Berzelius, Liebig, or Dumas, should have undertaken to determine the medicinal powers of drugs by chemical analysis, if we did not know that chemistry and logic are not always inseparable companions, and if, in our own school, physicians who pride themselves in a knowledge of chemistry and the microscope, had not undertaken to issue their mandate, that those who believe in any thing higher than the twelfth attenuation are ridiculous fools. This is not the place to inquire how certain properties, medicinal properties, for instances, can be grafted upon other non-medicinal agents, such as alcohol; what is certain is that, physics, with its movement theories, by which the properties of all substances may, perhaps, be made to appear movement- principles, in future will do much more for physiology, pathogenesis, and pharmaco-dynamics, than chemistry has done, which itself has to borrow of physics more than one proposition, whenever it endeavors to account for many of its processes. If the different contagious secretions were examined with the microscope, certain movements or currents might perhaps be discovered, which, if they did not remain hidden in pus as much as unexcited electricity does in certain substances, might, perhaps, by their different directions, shed light upon the different natures of the contagia. Until now, nothing has been determined in this direction; except, perhaps, that Doctor Donne, of Paris, has discovered certain infusoria in the secretions of some chancres, which animalcules, however, have not been shown to constitute a necessary requisite for the production of contagion, since the pus, after the animalcules are killed by vinegar, remains as efficient for the purpose of inoculation as before. Even if the presence of these animalcules should constitute the rule, and their absence the exception; or even if we should be able to show that these animalcules, though not containing the infectious principles in themselves, should yet result from the living movement-principles of the latter; and even if we should be able to demonstrate further, that each special specific form of this infectious principles produces a special kind of these animalcules a long time would certainly elapse before such a discovery would decide the question of the unity or plurality of venereal contagia. Those who desire to have light on this question, will have to depend upon other facts beside those furnished by an analytical examination of the pus.
Secale 173. Equality of the results of Contagion.
If the advocates of the unity of the venereal contagium rest their theory upon the fact that women who were affected with chancre have communicated gonorrhoea instead of chancre, and vice versa; if women who had a suspicious-looking gonorrhoea have communicated chancre instead of gonorrhoea, we have to accept their conclusions, for the additional reason that every physician, whose opportunities for observation are sufficiently numerous, has seen statements like the above substantiated by facts from his own practice. In reply to these observations, Ricord, Hernandez, Bell, Baumes, etc., answer, that they must necessarily be erroneous; that whenever they had inoculated a chancre, a chancre was the result, and that the inoculation of the simple and uncomplicated gonorrhoeal virus never resulted in any thing whatsoever; and that, whenever the inoculation of the gonorrhoeal virus resulted in a chancre, a careful examination of the female organs always revealed the existence of some hidden chancre. The correctness of these facts has not been denied; nevertheless, the opposing party argue, in reply, that the advocates of the plurality of contagia admit the existence of cases where inoculation does not readily succeed, and that, where the inoculation of the gonorrhoeal virus does not cause a chancre, this is no argument against the syphilitic nature even of the most simple gonorrhoea, and that such cases most likely belong to the number of those where inoculation had no effect. Castelnau, of Paris, even mentions a case where, in spite of the total absence of all chancrous symptoms, the inoculation of the gonorrhoeal pus resulted in a chancre. Cazenave even remarks, that chancres in the male urethra are very rare, and that, if women become affected with chancre through contact with gonorrhoeal matter, this is not always owing to masked chancre, but in all cases to the chancrous nature of the gonorrhoeal contagium. Cazenave, however, overlooks the fact, that the number of hidden chancres or mucous tubercles in the urethra, is much less than the number of chancres communicated by simple gonorrhoeal matter. In my own practice, I have met with three cases of gonorrhoea, which I treated for four weeks unsuccessfully with all sorts of remedies, and which finally disappeared all at once, in consequence of a metastatic transfer of the inflammation, in one case to the testes, in another, to the right knee, and in a third, to the inguinal glands; immediately after which, a simple, soft chancre showed itself in the urethra of each of these three patients, which, until then, had remained hidden from observation, in consequences of the swelling of the meatus urinarius, and which, in one of these cases, soon became converted into a phagedaenic ulcer. Considering, however, that women are not near as often infected with chancre by the gonorrhoeal matter of males as authors would have us believe, at any rate, no more frequently than we meet with chancres in the male urethra; considering; furthermore, than men are much more frequently infected with chancre by women who were supposed to have a simple gonorrhoeal discharge, but in whose case the chancres, if any exist, remain much more easily hidden from view; we shall have to admit that the facts with which the advocates of the unity of the venereal contagium seek to combat the arguments of their opponents are not sufficient to invalidate the objections which Ricord and his adherents have raised against the conclusions of the former.
Secale 174. Further Proofs of the Unity of the Venereal Contagium.
Beside the facts just mentioned, there are other so-called proofs of the unity of the venereal contagium, which, however silly they may seem, have to be mentioned in this place, were it for no other reason than that they are found in pathological manuals, and are even promulgated by medical authorities, as demonstrated matters of fact. A Dutch physician asserts that if a patient who has a chancre on the penis keeps this organ too warm, he becomes attacked with gonorrhoea. It is strange that not one of the manuals, which enumerate this absurdity among their reasons in favor of the unity of the venereal contagium, makes the least effort to inquire into the correctness of the statement. Another equally discreditable assertion is the following in a well known German publication: “Physicians who have been employed in brothels have observed that syphilitic women, who had connection with several men in rapid succession, communicated a chancre to the first, a simple gonorrhoea to the second and third, a still lighter form of gonorrhoea to the fourth and fifth, and left the sixth and seventh untainted.”If all these statements and observations were correct, the whole matter would be at once decided, the identity of the venereal contagium would be proven, and we might admit, with Schoenlein, that there only exists a quantitative difference between the gonorrhoeal and the syphilitic matter, in so far as the gonorrhoeal matter contains the minimum, and syphilitic matter the maximum of the venereal contagium. Upon tracing the above statement to its origin, we find that its correctness is not by any means backed up by the experience of a number of physicians, but that the author or this statement is the surgeon Vigarous, who relates the following: “six young men who were intimate with each other, partook of a rather liberal supper, after which they had connection with a prostitute one after the other; she infected the whole of them, the first and fourth, who applied to me first, with chancre and buboes; the second and third with gonorrhoea, and the other two, one with a chancre and the other with a bubo.” Does this story, which has been thoughtlessly copied from one writer by another, contain one word about the gradual weakening of the infectious matter, until it has lost all its poisonous properties? Who does not see that before accepting this statement as thoughtlessly as pathological authors have done, and building upon it pathological theories, the nature of these two discharges ought to have been critically examined, in order to find out whether there was not something hidden underneath them? And who knows whether each of these young people had not had connection with some other women, one, two, or three weeks previous? History does not furnish a single ray of light upon these points; of what avail, then, can such a case be toward a correct and scientific diagnosis?
