both parties. Several illustrative examples were given in detail.

The subject, however, was no more than passingly noticed. At page 301 it was stated that, besides women suffering from uterine disease, a great number of infants and children also were made the subjects of inquiry, with a view principally to ascertain the period of the first appearance, as well as the characterizing features and the mode of development of inherited specific maladies, in cases where such maladies were known to exist, or were suspected to have previously existed, in the parent. And, although forming a very important and interesting branch of pathological study, it was mentioned that their consideration was not intended to occupy any place in that treatise, except so far as their occasional mention might be made serviceable in elucidating the character of the affections from which they appeared to have derived their origin.

At page 369 it was stated that a venereal affection in the wife might exist "as a consequence of secondary inoculation; the affection having lost its primary character in the first individual before being transplanted by contact upon the second." It was further said, at page 370, "The female system appears, upon superficial observation, to suffer less severely from the effects of syphilis than does that of the male. This seeming difference in their relative susceptibilities may be owing to the circumstance that the phenomena are differently manifested in the two sexes respectively; but it is not improbable that, when the subject shall have been submitted to a more rigid investigation, the state of the

case will be found to be precisely reversed-the dis in some instances, continuing in active operation years where its existence was not suspected, the sigus announcing its presence, although sufficiently intelligible, having been altogether misinterpreted." This observation, it is needless to say, refers to uterine syphilis. Indeed, it is recorded in another paragraph that "evidences of syphilitic disease may be found in the lower part of the uterus long after the disorder was believed to have been driven altogether out of the system."

At page 372 the general evidences of constitutional syphilis in the female are stated to be "pallor of the countenance, languor, precarious appetite, loss of rest, hectic feverishness, lumbar and hypogastric pains, disordered secretions, and the appearance of the disease in the offspring." Certain signs, thought to be pathognomonic, were also given, such as endo-metritis, a mottled or patchy aspect of the cervix uteri, aphthæ of the cervix, and warty excrescences. Several additional years of

observation have served to confirm these statements, and have enabled me to furnish other particulars, which I doubt not will be found to be accordant with what may have fallen under the notice of those of my professional brethren who have paid attention to the subject.

But, besides confirming the statements relative to the transmission of the syphilitic taint from parents to their children, even from those parents in whom all external evidence of the disease had ceased to exist, the inquiry may also contribute towards the further elucidation of another fact of equal importance; that, namely, of the derivation of certain forms of disease, commonly consi

dered as of simple nature, from imperfectly cured syphilis ; a doctrine much more generally believed in by physicians of past ages than by those of the present day. Children who had exhibited evidences of constitutional syphilis of a genuineness which could not be doubted, both on account of its form and of the antecedent circumstances, were seen, some time after the first accession of symptoms had been subdued, to have relapses at intervals varying from one to several years, the character of the disease undergoing certain changes, in some of its phases, at each recurrence, but still retaining one or more of its essential attributes. In course of time, however, it gradually altered, assuming at a later date more the type of disease not commonly deemed to be of specific nature. For example, an infant of syphilitic parents has an attack of syphilitic erythematous disease in the second week after birth; this is speedily subdued by treatment, and the child thrives for a time. During the period of teething, or after that of weaning, an eruption of vesicular or squamous character breaks out, attributed usually to error in diet or to atmospheric influences. This also may be modified, or even made to disappear, by remedies in common use. At the second teething period, often much earlier, impetiginous eruptions come out on the scalp and elsewhere, with enlarged lymphatic glands about the neck; these symptoms partaking less of the venereal character than those of earlier date. At a still later epoch the hypertrophied glands become more prominent, some undergoing the process of suppurative inflammation, and the patient is considered to be decidedly scrofulous, the secreted matter possessing

the sanio-flocculent character of scrofulous suppuration. In this way the purulent, the scrofulous, or other morbid habit of body, is developed, liable to manifest itself, each in its particular way, at certain critical periods of life, especially at puberty; or it may be brought into active existence by external agencies at any period, in form of chronic abscesses, arthritic affections or white swellings, or laryngitis terminating in fatal disease of the lungs; or the latter malady may be produced more directly by tuberculous deposit, or abscess of these organs, having in like manner a disastrous result.

In other instances disease of the mucous tissues developes itself, the direct effect of perverted nutrition, with impairment of the assimilative function of the solid fabric. Thus the rachitic diathesis is determined. These and other immediate sequelae of syphilis may be modified to a certain extent by treatment; but, should the cause be not fairly understood, the proper remedies are not applied, and the taint remains to a certain extent as a constitutional evil, destined to stamp its character upon generations to come.

On comparing the morbid phenomena thus brought about, the history of which has been carefully traced from the beginning, with others of similar aspect whose history is not known, one is led to inquire more minutely into the etiology of those affections usually regarded as of simple or rather of unknown origin. In several instances of this kind submitted to rigid investigation, it has appeared highly probable that such agencies were in operation immediately previous to the first appearance of such symptoms.

I do not by any means attribute the origin of all cases bearing but a remote resemblance to those directly resulting from syphilis, to causes of specific nature. My wish is, having satisfied myself respecting the specific sources of some, to direct more particular attention to the subject. I have known a family of children whose father suffered from both acute and secondary syphilis in early life, of which he was considered perfectly cured before marriage, but who had, notwithstanding, a most violent attack of secondary disease of long duration, in form of cutaneous eruptions and burrowing inguinal abscesses, commencing twelve months after marriage, and without any additional infection-his wife suffering at the same time under a train of symptoms of like nature. Two of the daughters of this pair died before the age of twenty years of phthisis, complicated with white swelling of the knee in both-diseases which had previously been unknown in the family of either parent. The two sons suffered from syphilis in the usual form during infancy and childhood, the traces of which existed. in adult life. The offspring of one of these bear evidence of the same taint in characteristic form. I was personally acquainted with these individuals, and had the early history from the father himself—a man of education and probity.

The perpetuation of sycosis is a fact sufficiently known. A case will be found in the following pages of its continuance to the fourth generation, on what I deem satisfactory evidence. In another instance where this form of disease existed with great severity in the second remove, in the person of a husband, the wife and off