In a late census of Norway, above two thousand lepers were found in that small kingdom; but the Scandinavian physicians do not confound together syphilis and Greek elephantiasis, and have no difficulty in distinguishing them. Nor have our own colonial professional men in the East and in the West Indies, where both diseases exist, any dubiety, at the present day, in recognising them as two totally different and specific maladies.
3d Corollary.—As regards the mode or modes in which syphilis was supposed to be so speedily propagated at its first appearance in Europe, the Aberdeen and Edinburgh records are both interesting, though in some respects they offer very opposite testimony on this point.
For some time after syphilis broke out, it was believed, both by medical men and by the non-medical public, that the disease was communicable, and constantly communicated from the infected to the healthy by the employment of the clothes, vessels, baths, etc., used by those already suffering from it, and by the slightest corporeal contact, or even by inhaling the same air with them. I might appeal on this head, if it were necessary, to the individual and general testimony of Schilling, Torella, Brandt, Massa, and almost every other early continental author, historical or medical, who mentions the first outbreak of syphilis. Some even thought that neither the presence of infected persons, nor of fomites, was always absolutely requisite. In his work, De Morbo Gallico, published in 1551 (above half-a-century after the disease commenced), Benedict Victorius, of Fienga, like most of his contemporaries, still maintained that “the state of the air” (to use his own words), “together with that of the putrid humours, are sufficient to beget the affection;” and in strong confirmation, he adds, “I myself happened once to know some honest and religious nuns, who were confined in the strictest manner, and yet contracted the venereal disease from the peculiar state of the air, together with that of the putrid humours, and the weakness of their habit of body.”
The same belief in the easy contagion of syphilis without contact or intercourse extended to our own country. It was, in particular, strongly believed that the malady could be propagated from the sick to the healthy by the medium of the breath. One of the gravest articles of guilt brought against the celebrated Cardinal Wolsey, when he was arraigned before the English House of Lords in 1529, was the allegation that (to quote the ipsissima verba of the indictment, as laid before Henry VIII.), “whereas your Grace is our Sovereign Lord and Head, in whom standeth all the surety and wealth of this realm, the same Lord Cardinal, knowing himself to have the foul and contagious disease of the great pox, broken out upon him in divers places of his body, came daily to your Grace, rowning in your ear, and blowing upon your most noble Grace with his perilous and infective breath, to the marvellous danger of your Highness, if God of his infinite goodness had not better provided for your Highness. And when he was once healed of them, he made your Grace believe that his disease was an impostume in his head, and of none other thing.”[619]
The notion that the breath of persons having the venereal disease was infectious seems to have prevailed as late as the reign of William and Mary. Dr. Oates, in his Picture of the late King James (1696), says,—“Tom Jones, your quondam chaplain, was afraid to go to old Sheldon, for fear he should give him the pox by breathing on him.” (Part II. p. 106.)
The Edinburgh regulations of September 1497 are evidently framed upon the idea that “the contagious plage callit the grandgore,” as they term it, was propagated by simple contact, and personal intercourse, or probably even by the air. Hence their strict injunctions for the removal and detention of the “infectit, or that hes bene infectit and incurit,” to their secluded position upon the island of Inchkeith, for “the eschewing” (to cite again the words of the edict) “of the greit apperand danger of the infectioune of the lieges.” Indeed, it seems to have been believed that the disease might be communicated through medical attendants, or intermediate individuals who were themselves unaffected. This is at least the natural, or, indeed, the only interpretation of that part of the edict which enjoined that all persons who take upon them “to hale the said contagious infirmitie,” go with their infected patients to Inchkeith; and if they attended and treated such cases within the city, they did so at the peril of being themselves cauterised on the cheek with the “marking iron,” and banished without favour (banisht but favouris) out of the town.
The anxiety of the authors of the Edinburgh regulations to prevent this supposed medium of communication through a third person is further displayed in the severity of the punishment—(the application, namely, of the actual cautery to the face)—denounced against the medical attendants who should infringe the above edict by not passing to, and remaining on, Inchkeith. “Lykwayis the saidis personis that takis the said cure of sanitie vpoun thame, sal be byrnt on the cheike with the marking irne that thai may be kennit in tyme to cum.”
For some time after the first outburst of the disease, sexual intercourse with the infected does not seem to have been suspected as the source and means by which the syphilitic contagion was propagated. Nor was the local primary affection of the sexual organs generally noticed by the authors of these times as either a constant or marked symptom. They were acquainted with, and described, only the secondary symptoms of the malady—the hideous eruptions on the skin—the ulcers of the throat—the nocturnal pains in, and lesions of, the bones—while they mostly all pass over the genital organs, as if they remained unaffected. So much so was this the case, that we find Montagnana, in 1498, advising not as a means of infection, but rather as a means of cure, moderate coition; for, in laying down various rules of treatment to a sick bishop under his care for syphilis, he inculcates, among other items “coitus vero sit temperatus.”[620]
When treating of this subject, and when speaking of both the usual mode of the infection of syphilis and its primary local symptoms generally escaping notice at the era of the first appearance of the disease, Swediaur observes,—“It is worthy of remark, that although many authors, since the year 1500, make mention of the genital organs, and say that syphilis may more generally (ut plurimum) be communicated by coition; not one before that time (1500) points out the (primary) affection as essential or characteristic of the disease. All (Swediaur adds) look upon it as a disease pestilential and contagious without coition, and even without any direct contact” (vol. i. p. 36). The observations of Astruc and Girtanner, and other authors on this point, are nearly to the same effect.
In relation to this question, that of the actual mode and means of propagation of syphilis, the edict of Aberdeen, in 1497, is particularly remarkable and interesting, and most fully maintains the character of the capital of the north for that native shrewdness and sagacity which the poet Dunbar long ago solemnly assigned to it. We have just now referred to Swediaur, etc., stating that up to 1500 all European writers looked upon syphilis as spreading, pestilentially and contagiously, without coition. Three years earlier, the aldermen and town-council of Aberdeen seem to have arrived at more just ideas of its laws of propagation, and to have distinctly suspected impure sexual intercourse as the mode of communication of the malady. This seems to be fully borne out by their ordering, “for the eschewing of the infirmitey,” that (to use the words of the edict) “all licht weman be chargit and ordanit to desist fra thar syne of venerie;” and we have the usual glowing and earnest threat of the application of the actual cautery, or “ane key of het yrne (hot iron) to thair chekis,” in case of disobedience. The later Aberdeen edicts of 1507, which we have already quoted at length, show, however, that the rulers of the burgh had been subsequently led to adopt the erroneous idea of the leading authorities of the day, that the disease might be transmitted also in the way of common contagions, and even, perhaps, by the medium of a third person.