ulcers of this kind (consecutive venereal ulcers), but my wish is to confine myself to such cases as do not rest on my own authority." It is my intention, on the contrary, to derive conclusions from such cases only as have fallen under my own observation; not, however, with a view to found a doctrine, but for the purpose of relating what Nature seems to be in the habit of doing; and because the examples to be detailed in the following pages so nearly correspond with the simple and graphic delineations left by our predecessors.

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CHAPTER II.

ILLUSTRATIONS OF TRANSMITTED SYPHILIS.

As medical readers in general are apt to recoil, with feelings of aversion and disrelish, from the perusal of casesa task often regarded by them in the light of an infliction to be escaped from if possible-I can but regret that so much of the matter which I have to communicate is necessarily embodied in this form. It has been my endeavour, however, to divest each observation, as far as was practicable, of all irrelevant and extraneous details; and indeed this has been so much practised-the histories having been cut down to the more important points merely that on a perusal of them I have felt fearful lest, in several instances, sufficient was not left for conveying a proper knowledge of the phenomena as they are intended to be understood. This curtailment, however, it is hoped, will be compensated for in the remarks offered in the subsequent chapters, where some of the cases will be again referred to in support of doctrines formerly received, but more recently attempted to be subverted. It should be borne in mind, also, that these histories are not those of acute cases, commenced suddenly and finished in the course of a few days, and affecting one individual merely many of them comprehend a period of several years, and implicate a number of individuals, in whom the disease appears under many varieties of form, entailing results equally variable and dissimilar.

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CASE I.

INFANTILE SYPHILIS; VENEREAL AFFECTION IN THE MOTHER, CONTRACTED FROM HER HUSBAND, WHO HAD BUT ONE SMALL TRACE OF SECONDARY DISEASE ABOUT HIM.

In February, 1846, I was applied to by a gentleman, nine months married, respecting his wife, who was stated by him to be labouring under what appeared to be secondary syphilis. She was then in the seventh month of her first pregnancy. Three months after marriage she became aware of a vaginal discharge, which she had often had occasion to remark was disagreeable and offensive. In a short time after the first appearance of this, a warty growth was noticed near the entrance of the vagina, which was soon followed by several more; and from this time, the excrescences continued rapidly to increase in size and number, until the boundaries of the orifice had at length become studded with them both externally and within.

Respecting the husband, he stated, that about six months before marriage, he contracted a venereal sore, which, while yet in its incipient stage, was shown to an "experienced druggist," who covered it with caustic and gave him sarsaparilla to take. The ulcer disappeared, and the surface healed speedily; but shortly afterwards, upon the same spot, a small wart sprang up, which had ever since remained: it was situated on the corona glandis, and had gradually increased to the size of a pea, this being about double the dimensions it possessed at the time of marriage. He was considered perfectly cured several months prior to his marriage, and had not again incurred the risk of a fresh infection. No other external symp

tom existed about him at this time, nor did any appear until several months later-about a year after marriage -when, on account of a crop of roseolous blotches on his face, chest, and arms, he was obliged to submit to an active course of treatment, which was continued several months.

In the wife's case, not only the labia externa, but also the whole vaginal surface, even to its upper part, as well as the cervix uteri, were thickly studded with warty excrescences; the orifice of the uterus being surrounded by a suppurating surface, covered with exuberant granulations. From the inner cervix escaped a sanio-purulent discharge, emitting a peculiarly sickly and offensive

odour.

For several days previous to my attendance, she had complained of sore throat; the tonsils were swollen, and the whole fauces presented a deeply-inflamed aspect, interspersed, here and there, with patches of excoriation. Her general health had declined; the countenance was sallow, shrunk, and slightly jaundiced, the voice hoarse, and the act of deglutition attended with suffering.

The treatment adopted consisted in a course of mercurial alteratives continued to ptyalism, and followed by sarsaparilla with iodide of potassium in high doses. The local affection was treated with injections of solution of nitrate of silver and opium, under which the vegetations entirely disappeared before confinement. Delivery took place, with no more than ordinary difficulty, at the full term of utero-gestation. On the third day she suffered an attack of convulsions of considerable violence, succeeded by puerperal mania, which lasted about three weeks, the milk entirely disappearing shortly after its first influx.

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The child, plump and healthy-looking at birth, when eight days old exhibited some diffused patches of dark erythema on the nates and face; a few days later, blotches broke out of an irregularly circular shape, with defined. boundaries and scurfy surfaces, and others of similar aspect were thickly scattered over the chest and extremities. The mouth and throat also became sore, the nose obstructed, the anus angry and fissured. During the treatment, which consisted in the exhibition of hydr. cum cretâ, a smart attack of diarrhoea came on, which seemed materially to hasten the cure. The patient was cured at the age of six weeks.

CASE II.

COMMUNICATION OF SECONDARY SYPHILIS FIVE MONTHS AFTER THE DISAPPEARANCE OF THE PRIMARY AFFECTION; REPEATED OUTBREAK OF THE SYMPTOMS AT DISTANT INTERVALS; HEREDITARY TRANSMISSION.

On the 8th of February, 1843, I saw the wife of a baker, two months married, affected with an eruption on the skin, which I suspected, on the first examination, to be venereal. It consisted of a number of copper-coloured blotches, scattered over the face and forehead, more numerous still on the arms and chest; they were irregularly circular in shape, from two to six or eight lines in diameter, their copper-coloured hue contrasting remarkably with the unusual paleness of the surrounding skin. The mouth was excoriated, and the fauces swollen and erysipelatous. She complained of heat and smarting of the vagina, of which the labia were red, swollen, with patches of excoriation on their opposing surfaces, and there was a plentiful discharge of a purulent character.