The unity or duality of syphilis historically considered / by J.L. Milton.

  • Milton, J. L. (John Laws), 1820-1898.
Date:
1886
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Licence: Public Domain Mark

Credit: The unity or duality of syphilis historically considered / by J.L. Milton. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    with his conteraporariea or with later writers, to gain currency for liis views. He seems to have scarcely ever been mentioned by either chiss of authors, and his practical knowledge of the disease to have been in rather a crude state, for he was evidently not acciuainted with the Hunterian sore, common, according to what (If Vigo says, after the invasion of Italy, seeing that he could not ' ry well have mistaken it in a developed state for one of the old t chancres. It is not true, too, that those skilled in medicine .treated both kinds of primary sore—that is to say, the lesion seen before, and that first noticed after, 1494—in the same way; not a passage can be produced from any standard writer on syphilis to such effect. The purely local method pursued by the practitioners of the fourteenth and fifteenth centuries is as distinct as can well be from the constitutional means employed almost at the first appearance of syphilis, especially as regards the use of mercury, recommended as early as 1495; and for my part I cannot under- stand any person maintaining the identity of the two systems. Vella's evidence, therefore, in support of the unity of syphilis, which he is trying to enforce, must, I contend, be rejected, and, as well as I can make out, was rejected for long after. It was not even a novelty on his part to trace a likeness between the old sores and the primary lesions of syphilis. Six years previously Almenar had described the new disease as beginning with a corrosion on the penis like the caroli. But I must totally dissent from the sweeping statement of a modern writer, that when syphilis first broke out the authors of that day, Marcellus of Como, Leonicenus, Beniveni, Cataneus, de Vigo, Vella, and even Fracastoro, found no difference between the old caroli pudendorum and the pus sores on the genitals, which they described as an accidental symptom preceding syphilis ! Fracastoro is not entitled to a hearing, as he could only have learned about the matter from others. With Vella I have already dealt, and de Vigo must be eliminated, for his classical description of hard sore is the earliest thing of its kind; no such portrait of Hunter's chancre exists before his time. As regards three of the first four names I can say no- thing ; the author in question does not quote his references, and I have searched in vain for a single passage to which such an interpretation could be given. The evidence of Cumanus I must read the other way, for though he saw the two diseases side by side, he does not seem to have thought of confounding them ; and his description of sores the size of a millet seed, whether it refer to Itch or to follicular chancre, would be as difficult to find in any author before his era as would that by de Vigo. But, indeed, the question is one, not of resemblance, for that with some reservation niay be admitted, but of identity. On the latter point the evidence of the earlier writers after 1494 is decisive; they saw no identity And as I understand Vella, some of his contemporaries were anyilung but convinced that the two affections were one and the