If we turn now from these discussions to the statements of the ancient Physicians themselves, there are two different ways in which we may regard them ourselves and present them to the reader’s eyes. Either we put down consecutively everything that has been said by one and the same Author and examine each single datum we owe to him by itself, or we bring together the data given by different writers on one and the same subject, and then compare these one with another. The first way, the one generally followed by historians of Venereal disease hitherto, gives us it is true the general results of the knowledge possessed by the several writers on the different forms of Venereal disease; but, seeing on the one hand we do not in most instances actually possess all the works of our Author, while on the other even when we do, we are not justified in looking upon his report as embodying a résumé of all the knowledge of his time, the advantages of such a way of dealing with the subject are on the whole but slight, while it has the disadvantage of rendering considerably more difficult the general survey of the information possessed by Antiquity as to Venereal disease, which nevertheless is really our immediate and capital concern, and cannot fail moreover to occasion a host of contradictions.
The second way not only relieves us from this disadvantage, but also ensures us that general Survey which is peculiarly necessary, and to the absence of which the circumstance is chiefly to be ascribed that it has been possible hitherto to convince the opponents of the antiquity of Venereal disease only in the most incomplete manner of its actual existence in those times at all, as the exposition of the contrary view, in itself incomplete, was bound in its fragmentary presentment to seem even more incomplete still. Of course, in following the second way of exposition, there is an unavoidable dislocation of the data communicated by each individual writer, but this is a thing of but little moment, more particularly as its inconvenience is minimised by our giving the passages, when quoted for the first time, in extenso, so as to have on subsequent occasions merely to refer back to them. Again the want of a clear marking of dates, a point undoubtedly of great importance in historical researches, is readily obviated by our laying down the available fixed points of our chronology in the general Survey that forms a necessary conclusion to our exposition.
No doubt Hensler and Alex. Simon had already struck out this second way of exposition; but the latter writer merely examined the data of the several Writers by themselves without making any effort to build them up into one whole. To do this was, it is true, a proceeding quite foreign to the method adopted by the Ancients, but for our own time, accustomed as we now are to demand a systematic exposition of a subject, it seems absolutely indispensible. Hensler on the other hand in his treatment of the question fixed his particular attention solely on the Middle Ages, and made it his immediate aim merely to prove that previously to the ninetieth year of the XVth Century local affections of the genital organs were already well known, and had been subjected to treatment.[297]
Now with regard to the actual exposition that follows, we shall refrain in it as much as possible from going into particulars, such as the text itself or the views of the Authors might seem to make obligatory, as the needful space fails us, at any rate for the present. Moreover the matter coming under review has been discussed already by many others, while as for critical elucidations, let them be as pressingly required as they may, we lack all the necessary apparatus criticus. In fact in the case of several Writers, the translation, let alone the original text, was with difficulty accessible, for which reason many a passage of those already known may perhaps have been passed by unregarded. A complete collection of all passages, including those still unknown,—for the harvest as was mentioned above has by no means been all reaped,—will certainly not be demanded by any reasonable reader from a Student of thirty, for hardly even a greybeard Enquirer surely could boast of having read all printed works of the ancient Physicians. For the rest, our present object is not at all to give an exhaustive exposition of all the ideas and observations of ancient Physicians as to affections of the genital organs; it only concerns us here to bring together what is true and directly available for our task. Under this head would certainly seem to come the following seven points:
1. Gonorrhœa (Clap).
Nimia profusio seminis,—excessive flow of seed (Celsus), γονόῤῥοια.
Gonorrhœa, the name of which is compounded of γονή (badly made semen) and ῥεῖν (to flow),[298] consists in an affection of the seminal vessels, not of the private parts themselves, which merely serve as the road for the excretion of the seed.[299] Two kinds of gonorrhœa must be distinguished, according as the malady is, or is not, combined with erection of the penis.[300]
Gonorrhœa with erection of the penis is called sometimes Satyriasis or Satyriasmus sometimes Priapism,[301] and is a species of cramp,[302] which however only attacks the penis, belongs to the category of the emphysemata, or inflations,[303] and is conditioned by an afflux of the humours, particularly of conspissated or badly compounded humours.[304] However this last phænomenon is only a symptom of that morbid lasciviousness which Paulus Aegineta entitles Priapism, while he designates the condition connected with it by the name of Satyriasis, this having its origin in an inflammatory affection of the seminal vessels.[305] No proof is needed that both these views are right so far as this, that gonorrhœa is both spasmodic and inflammatory, and in either case may be accompanied by priapism. Nothing, or only very little, is evacuated of a nature to make the patients experience relief; and if there is, they are again attacked by the evil, until the original cause of the erection is eliminated, on which the penis relaxes of itself and subsides.[306] According to Paulus Aegineta paresis of the spermatic vessels,—the second form of gonorrhœa,[307]—supervenes, if the disease is not relieved, or else general spasms. Patients attacked by such spasms succumb rapidly, suffering from cold sweats and tympanitic distension of the abdomen. Alexander of Tralles (IX. 10) saw the erection even continue after the death of the patient. This form is not a common one; it occurs pre-eminently among young people,[308] and according to Themison’s observations, who frequently saw the complaint in Crete, where however it was probably very often a result of pederastia, is subject to epidemic influence.
The treatment of this form of gonorrhœa demands according to Paulus Aegineta (loco citato) immediate general blood-letting,—this Galen[309] also recommends, and practised with advantage,—local cupping or leeching, simple clysters, cooling and composing embrocations and poultices of solanum (nightshade) or cicuta (hemlock) in the lumbar region, of litharge, Cimolian earth, psymithium (white-lead) with vinegar, water or sweet wine, on the perineum. Internal remedies are a decoction of mallows, mercury and birch-bark, sap of rue, decoction from the root of the iris, nymphaea (water-lily) and adianthum (maidenhair). Diuretics are injurious. Patients should at the same time be put upon a low, vegetable diet, and the supine posture avoided. Galen (loco citato) recommended in addition emetics, but not purgatives, also embrocations of ceratum rosaceum, friction and subsequently gymnastic exercises. Alexander of Tralles insists particularly on the patient avoiding[310] all wanton scenes and thoughts, and forbids the use of any cold, specially astringent things, whereby the resolution of the contraction is made more difficult (πάθος δυσδιαφόρητον γενέσθαι,—the affection is rendered hard to be resolved).
Gonorrhœa without erection of the penis, that is to say gonorrhœa proper, exhibits a persistent, involuntary discharge of the seed,[311] has some analogy with incontinentia urinae, and usually depends like the latter on weakness or failure in the retentive power of the spermatic vessels.[312] Very often an inflammatory stage supervenes, making the complaint approximate to the first form; patients secrete copious and hot semen, which provokes them to ejaculation,—an ejaculation however that is followed by great exhaustion. If they avoid copulation, headache is established, pains in the stomach and nausea, while nocturnal pollutions cause them similar inconveniences to those they incur from coition. The ejaculation is accompanied by heat and smarting pain,—and this not solely among men but with women as well; for one of these patients, Galen writes,[313] told me that not only himself, but also the women with whom he had accomplished coition, experienced during the discharge a biting, burning pain. On the contrary, according to Aretaeus,[314] it would seem the only symptoms found in conjunction with the complaint are itching of the privates, a voluptuous feeling and a violent inclination to sexual intercourse. This datum admits of ready explanation if we consider the fact that in southern countries the inflammatory stage that makes its appearance is very brief and as a rule hardly noticeable, provided,—though no doubt this condition was pretty often broken,—coition was not indulged in during its course.