6. Exanthemata on the Genitals.
Long ago Hensler endeavoured in the Graduation Theme of his mentioned in the list of Historical Authorities to prove that certain eruptions occurring on the genitals were communicated and acquired as the result of coition. In particular did this apply above all to herpes (creeping eruption), under which name must be understood, as is distinctly implied in a passage of Galen,[415] a form of eruption accompanied by ulceration. It is true the passages of Hippocrates[416] cited by Hensler in regard to the herpes esthiomenos (eating herpes) would appear to be open to some doubt and obscurity, while the interpretations given by Pollux (Onomast. IV. 25. 191.) φλυκτίς, φλύκταινα ἐπιμήκες, μάλιστα περὶ βουβῶνας καὶ μασχάλας. φύγεθλον, φῦμα περὶ βουβῶνα μετὰ πυρετοῦ, (φλυκτίς, a long-shaped blister, particularly in the groin and armpits. φύγεθλον, a tumour in the groin accompanied by fever) refer probably only to bubonic swellings; still these objections hardly apply to the φύματα (swellings) described in § 32,—the less so as Celsus himself (VI. 18.) explains: “Tubercula etiam, quae φύματα Graeci vocant, circa glandem oriuntur, quae vel medicamentis vel ferro aduruntur; et cum crustae exciderunt, squama aeris inspergitur, ne quid ibi rursus increscat;” (Tuberculous swellings also, which the Greeks call φύματα, arise about the glans penis, and are burned away either by caustic drugs or by the actual cautery. Afterwards when the scabs have fallen off, the sore is dusted with slag of bronze, to prevent any second growth later on). Moreover it is possible the passage of Galen,[417] πρὸς δὲ τὰ ἐν αἰδοίοις φυόμενα ἀπίου σπέρμα ἐπίπασσε καὶ τραγείᾳ χολῇ περιχρῖε. (But for growths on the privates sprinkle pear-juice and rub in goat’s gall) may refer to these cases, though no doubt it may also be held to apply to the tubercles occurring in the female vagina (§ 41,—3. B.).
Again epinyctis (night-pustule),[418] which Hensler also mentions but declares to be equally open to suspicion as to interpretation, would seem hardly pertinent in this connection, for the violent pain experienced at once tells against the likelihood of its being an affection of this class. Its appearance in eminentibus partibus (on prominent parts, on the extremities) finds a clear explanation in the words added by Pollux (loco citato, 197.) περὶ κνήμας καὶ πόδας ἐν νυκτὶ γενομένη (appearing on legs and feet during the night); while it is proved that Celsus meant to indicate nothing else by it from his words in describing φλυζάκιον (little blister), which he says occurs raro in medio corpore, saepe in eminentibus partibus,—rarely on the trunk, frequently on prominent parts, extremities. Still we do not for a moment wish to dispute the fact that the male genitals were at any rate among the Ancients counted as belonging to the partes eminentes, and as chancrous blebs do usually appear suddenly and often during the night, it is quite possible these may have been all along intended by epinyctis,—especially as on Hippocrates’ authority[419] creeping eruptions (ἕρπητες) arise from night-pustules (ἐκ τῶν ἐπινυκτίδων.) However Pollux (loco citato, 206.) likewise again mentions the legs and feet (κνήμαις καὶ ποσίν), declaring these eruptions attack those of elderly people. From this we may conclude the epinyctis of the Ancient writers to have been very likely nothing else but that form of impetigo (scabby eruption) which is vulgarly known as the salt-flux.
Aetius[420] mentions pustulae spontaneae in pudendis (pustules spontaneously set up on the privates), provoking phimosis, and describes[421] scabies scroti (scab of the scrotum) with metathesis into ulceration and scaliness, after the disappearance of which very often acute pruritus scroti (itch of the scrotum) is left behind. Galen (XIX. p. 449.) defines psoriasis scroti (itching of the scrotum) as a form of induration of the scrotum accompanied by itching, as well as in some instances by ulcers.
Under exanthematic types come also the various condylomata. These when they appeared on the genitals and in other localities of the body, were called by the Greeks σῦκος, συκώσις, σύκωμα, συκώδης ὄγκος, (fig, figlike excrescence, figlike swelling, figlike lump), by the Romans ficus (fig), whereas the same disease when it showed itself on the fundament, received the name of condyloma[422] par excellence. At the same time this distinction was by no means strictly observed; in particular the larger forms of thymus (warty excrescence) were designated by the name σῦκος (fig), albeit it would seem that thymus was used as specific name for all protuberances on the fundament and genitals. Σῦκος or ficus is according to Galen[423] an ulcerative tubercle secreting moisture,—the varus (blotchy eruption) on the contrary being dry, according to Oribasius[424] of circular shape and reddish colour, hardish and rather painful. It is found above all on the hairy parts of the body, the head, chin, fundament and genitals,[425] as the passages quoted above in § 13 from Martial show. They occurred, as it would seem, most frequently on the female genitals, in which situation they are described so long ago as by Hippocrates[426] under the name of κιων (pillar, pillar-like excrescence) and said to be evil-smelling. Aspasia[427] says, “condyloma est rugosa eminentia. Rugae enim circa os uteri existentes dum inflammantur, attolluntur et indurantur, tumoremque ac crassitudinem quandam in locis efficiunt.” (a condyloma is a wrinkled protuberance. For when the wrinkles surrounding the orifice of the uterus grow inflamed, they become prominent and indurated, occasioning a swelling and thickening in the parts). Paulus Aegineta (III. 75., VI. 71.) describes them under the name of hemorrhoids as painful, reddish, excrescences suffused with blood, which break (διαλείμμασι), and give off a pale discharge in drops. Much more common was the appearance of condylomata on the fundament,[428][429] particularly in male subjects; in which case they were specially ascribed to pederastia, as we have already seen. This makes it impossible to decide definitely which condylomata were of primary and which of secondary character; but the fact in no way authorizes us to deny altogether the occurrence of the latter in Ancient times.