A treatise on the venereal disease / by John Hunter ; with copious additions, by Philip Ricord ; translated and edited, with notes, by Freeman J. Bumstead.

  • John Hunter
Date:
1859
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Licence: Public Domain Mark

Credit: A treatise on the venereal disease / by John Hunter ; with copious additions, by Philip Ricord ; translated and edited, with notes, by Freeman J. Bumstead. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    this disease, depend on collateral causes, pertaining to the individual, and foreign to the gonorrhoea, which is not here a specific cause. A bubo accompanying gonorrhoea is never syphilitic, as Hunter supposes, unless there exist, at the same time, a chancre, of which the bubo is the consequence. Glandular engorgements occurring during the course of a gonor- rhoea, and terminating in suppuration, never furnish inoculable pus; nor, in this case, are constitutional symptoms ever observed. We shall see hereafter that buboes following the absorption of pus from a chancre, or virulent buboes so-called, furnish pus which can always be inoculated. The explanation of those cases in which a patient has a true viru- lent bubo, with symptoms of gonorrhoea as the antecedent, is, that there was a chancre somewhere.—Ricord.] § 12. Of the Diseases of the Lymphatics in a Gonorrhoea. Another symptom, which sometimes takes place in a gonorrhoea, is a hard cord leading from the prepuce along the back of the penis, and often directing its course to one of the groins, and affecting the glands. There is most commonly a swelling in the prepuce at the part where the cord takes its rise. This happens sometimes when there is an exco- riation and discharge from the prepuce or glans, which may be called a venereal gonorrhoea of these parts. Both the swelling in the groin and the hard cord, we have reason to suppose, arise from the absorp- tion of pus, and that, therefore, they are the first step towards a lues venerea; but as that form of the disease seldom happens from a gonor- rhoea, I shall not take any farther notice of it in this place. However, I may remark that, from this observation of the lues venerea being seldom produced from a gonorrhoea, it should appear that a whole sur- face, or one only inflamed, does not readily admit of the absorption of the venereal poison; and, therefore, although the venereal matter lies for many weeks in the passage, and over the whole glans, it seldom hap- pens that any absorption takes place.1 I have seen a case where blood 1 Added: As a farther proof that these cords often arise from an inflammatory excoriation and tumefaction of the prepuce, a gentleman had a chancre on the right side, at the root of the prepuce, close to the penis, besides which there was an excoria- tion of the penis everywhere, with a thickening of that part. Although the chancre was on the right side, and the excoriation principally on the left, yet there was a hard cord along the left side of the penis, leading to an enlarged gland in the groin.—Home. [Hunter's explanation of this case may be incorrect, since we frequently see chan- cres on one side give rise to buboes on the opposite side, which proves that the lym- phatics cross the median line. This fact has also been proved by anatomical researches, and especially by those of M. Huguier. (Mtmoires de V Acad£mie de Mtdecine, t. xiv. et xv.) Otherwise, I am entirely of Hunter's opinion with regard to the nature of the cords which form on the back of the penis. They are true cases of lymphitis or angeioleu- citis, and not always phlebitis of the dorsal veins, as has latterly been believed. They are more rarely met with in true gonorrhoea, and are then simple cases of inflamma- tory lymphitis. They more commonly succeed the different varieties of chancre, and they present the same differences as the buboes which follow them.—Ricoed.] [These inflammations of the dorsal vessels sometimes give rise to chordee, in which the concavity of the arc is directed upwards towards the pubis.—Ed.]