OF SYPHILIS.
Syphilis is another and a more violent form of the venereal disease than gonorrhœa. All its effects and symptoms are divided into two conditions, primary and secondary; the former being those which arise either from the direct application of the virus or poison to the part where the ulceration first shows itself, or from the irritative and specific effects of the poison on the absorbent vessels and glands, as it is passing through them on its way to the circulation.
Hence, among the first—the primary—may be classed the ulcer, or chancre, which in almost every instance is situated on the parts of generation, and may or may not be followed by a swelling in the glands of the groin, constituting that form of the complaint called bubo.
The secondary symptoms may be defined to be all those effects of the disease which take place subsequently to, and in consequence of, the absorption of the poison into the system: comprising sore throat, cutaneous affections—both eruptions and ulcers, pains in the bones and joints, and swellings thereon, called nodes.
I will first consider the symptoms of primary syphilis—chancre and bubo.
The coverings and linings of the body differ according to their situation. The former, the integuments become hardened by exposure and exercise, and preserve their velvety softness where protected by clothing, and where they are subject to less use—instance the hands, feet, face, and abdomen. Certain functions are assigned to each. The covering of the feet takes on a horny hardness, and in like manner the hands of a laborer assume a glove-like protection. The abdomen, by being constantly clothed, preserves its soft texture. The lining membranes of the body have also separate offices to perform—the serous and mucous, as they are called. The serous is a name given to those lining the cavities; the mucous, to those having outlets. From the glans penis being generally covered by the prepuce, the parts in contact are called mucous. It differs, however, in sensitiveness, from the urethra. The entire covering also of the penis is of a very delicate and tender structure; and hence also, from sexual intercourse, these parts become the chief seat of syphilis. Gonorrhœa confines its attacks to mucous membranes, or, in other words, secreting surfaces. In fact, the matter deposited on the common and exposed skin is harmless; so also, but to a less degree, is that of syphilis. Gonorrhœa is frequently seated on and around the glans, and the inner surface of the prepuce; but more frequently, by a hundred fold, within the urethra. The delicate surface, then, of the glans and prepuce, losing some of its sensitiveness by frequent exposure, and losing also the defence of the secretion which mucous membranes pour out, becomes accessible to an occurrence of syphilis—a disease that is readily communicable, by inoculation, to almost any part of the body. To quote Hunter, he says: “It is an invariable effect, that when any part of an animal is irritated to a certain degree, it inflames and forms matter, the intention of which is to remove the irritating cause. This has been before stated; but it is common only to secreting surfaces; and when the same cause is applied to non-secreting surfaces, ulceration is set up. This is not only the case in common irritation, but also in specific cases, as in syphilis, burns,” &c.
It is somewhat difficult to explain how a chancrous sore is produced. Surmises are at our service, and those which are founded upon certain facts are the more likely to be true. For instance, a person receiving syphilis must contract it from another individual having it. The mere solitary act of coition will not spontaneously produce it, provided the party be clean, for that surely is not an excess; but having connexion with an infected one, and thereby exposing a healthy surface to a diseased one, becomes an infraction of one of nature’s laws. Well, the patient contaminating the other must have a chancre, which giving off, by contact, its morbid secretion, produces a specific result, namely, a small pimple.
In men, the disease is generally contracted upon the frænum, glans penis, or prepuce, or upon the common skin of the body of the penis, but most frequently upon the interior. From the peculiar and alterable structure of the penis and its prepuce, the poison, unless well washed off, is apt to lodge in the folds thereof, and sooner or later it manifests its influence, which may occur in twenty-four hours, or may be withheld for months. Generally, however, seven or eight or nine days puts the patient out of suspense. The first symptoms consist in an itching, succeeded by a redness of the part, out of which is soon observed to spring up a small elevation or pimple. In connexions where haste, disproportion of size, or much excitement or excess prevails, an absolute abrasion of the skin often takes place, and the parts where such occur are generally the everted portion of the prepuce, or the frænum of the same.