The venereal diseases : including stricture of the male urethra / by E.L. Keyes.

  • Edward Lawrence Keyes
Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: The venereal diseases : including stricture of the male urethra / by E.L. Keyes. Source: Wellcome Collection.

    85/372 (page 65)
    Clinically, cases are encountered where blood seems to be the vehicle of contag-ion—where, for instance, a man acquires chancre, and confronta- tion fails to detect any physical lesion in the female, although perhaps here Morgan's theory of the contagiousness of vaginal mucus in syphilitic women may explain the infection. The secretions from pathological lesions, not themselves syphilitic, although occurring upon the bodies of syphilitic persons, do not contain the virus of syphilis, unless admixed with blood. Gonorrhciea upon a syphilitic patient reproduces gonorrhoea by inoculation, and not syphilis; and the same is true of chancroid. Vidal believes that urethritis upon a syphilitic person may produce syphilis by inoculation. Hill, Marsten, and Hammond incline to the same opinion. Tarnowsky,' in endeavoring to decide this point, made eighteen inoculations with blennorrhagic secretions from syphilitic upon healthy })atients, and got one positive result. This result goes to prove that such discharges do not contain the syphilitic poison, for in one case in eighteen there surely might have been an admixture of blood with the inoculated secretion. In further explanation of the exceptional case may be advanced the well-known fact that urethritis may come on in a syphilitic person, due solely to the development of suppurating mucous tubercles within his urethra, and these tubercles may yield a discharge which resembles that of ordinary mild urethritis (blennorrhagia) in all respects. Such discharges will get well under anti-syphilitic treatment, as I have had personal occa- sion to observe, and such discharges certainly must contain the syphilitic virus as well as do the discharges of mucous patches situated elsewhere. ]f the discharges of urethritis are hetero-inoculable, producing syphilis, many wives would get the disease who now escape, and certainly more than one out of the eighteen cases of Tarnowsky ought to have yielded a positive result. Without concluding, then, that such discharges cannot be contagious, it is best to consider that more proof is required before accepting the fact as demonstrated. Duplay's negative inoculation with pus from a pustule of acne pro- duced upon a syphilitic patient, by iodide of potassium, is in point here. Vaccinal syphilis perhaps yields the most convincing evidence that heterologous diseases upon a syphilitic person do not contain the poison in their secretions. It is well known in all epidemics of vaccinal syphilis, and there have been many, that all the children vaccinated from the vesicle upon the arm of a syphilitic child do not become poisoned, and, as a rule, that those first vaccinated escape (receiving the serum only), while the last comers get also some of the blood, and they develop both vaccinia and chancre at the inoculated spot. It has been demonstrated beyond question that pure, clean vaccine lymph, taken from a syphilitic person, is safe, and not poisoned with syphilitic virus, so long as admixture with blood has been avoided. The vaccine scab from a syphilitic person doubt- less could not be used without great danger of inoculating syphilis, since the scab always contains a portion of the true skin of the patient from whom it comes. The epidemics of vaccinal syphilis should teach the phy- sician never to use lymph taken from a child knov/n or presumed to be syphilitic, for no amount of care can absolutely guarantee the absence of a trace of blood from the vaccine virus he has gathered, k Even at the present day epidemics of vaccinal sj^philis are reported, and they are likely to continue. So late as Feb. 2, 18T8, there appeared ' Vortriig-e iiber venerische Krankheiten. Berlin, 1872.