M. Auzias reproaches me with making a partial statement of M. Spérino's facts. As to my approximation to the number of inoculations required to be made, I maintain that I am correct. As to the phagedænic chancres, the cure of which was not prevented by the new inoculations, there is nothing which ought to surprise us; nothing which does not occur every day. I have stated, and I still maintain, that "every one does not have the pox who wishes to have it."

Finally, I have been reproached with abandoning the flag of Hunter, on which, among other things, is inscribed the unity of the virus. I have already made my profession of faith, and made known the colors of my banner; I shall not return to this matter. I will only say that, if what I have taught in my lectures for many years is about to be verified-to wit, that syphilis, which is so analogous to the smallpox, a fact made especially apparent since I have demonstrated the unity of the diathesis, must also have its vaccine-and if the assertions of M. Auzias shall be demonstrated, it would seem probable that the virus furnished by the non-indurated chancre is different from, or is a modification of that produced by the infecting, indurated chancre, and that the first is to syphilis what the vaccinia is to variola, influencing the economy after a local effect is induced without general manifestations, and preventing the other from afterwards acting, either locally or generally.

This, you perceive, is a grave question, and merits the greatest attention. To encourage young men to multiply the accidents of primitive syphilis, is to encourage them to return to the source whence they have derived them. To say to those who have constitutional syphilis: "Go; have no fear; allow secondary and tertiary manifestations to appear; omit the employment of remedies reputed efficacious; for, whenever you may please to do so, you can be cured by contracting new chancres;" the use of language like this, I say, would be too serious a matter in the eyes of those who are placed at the outposts of society, and on whom a certain degree of responsibility rests, not to induce them to demand facts in place of theories which, up to the present time, rest on no legitimate foundation, but which, on the contrary, all experience seems to condemn.

1. Therefore, I require M. Auzias to show us his syphilized individuals. They are all ready, he says; so much the better; I will then be convinced that a person may be refractory to inoculation.

2. I require the limit of the immunity, to which M. Auzias seems to attach but little importance, but in which the syphilized must be much interested. With this limit, M. Auzias must be acquainted; for, in such a matter as this, cases of yesterday do not form a proper groundwork of opinion. I am therefore justified in demanding the oldest cases.

3. I require that M. Auzias shall produce at will indurated chancres upon the first comers; that he shall arrest some of these chancres at will by syphilization; that he shall allow others to proceed to secondary accidents, which he shall afterwards destroy by his inoculations.

4. Let him present us, before and after these inoculations, with patients affected with constitutional syphilis at different periods, and cured by the syphilizing inoculations; and I will accept the revolution.

Until these conditions are fulfilled, my dear friend, your journal, which is of so discreet and rigid a character, ought to accept such works as those of M. Auzias only with extreme reserve, and without guarantee-I was on the point of saying, without encouragement; for when we call to mind the misfortunes which happened to the physiological school, whose adepts were as firmly convinced and as honest as M. Auzias, we tremble in view of the terrible consequences which reason, clinical observation, and science, give us occasion to fear.

MY DEAR FRIEND: It is a very long time since I wrote you my first letter; it is also a very long time since you received my penultimate; and, however agreeable this correspondence may be to me, it cannot, like everything which is too prolonged,

afford you pleasure. But this is not my fault, but that of time and circumstances; for I recollect one of your aphorisms: Pleasure is only pleasure because it is rare and brief. If my letters have caused you some satisfaction, it is because they have possessed at least one of the conditions of your programme.

The hope entertained by syphilizers that the pox will one day disappear from the list of diseases, and that it is essential to remove from treatises on therapeutics the useless pages on which antisyphilitic remedies are indicated, for a moment arrested my attention. Why continue the history of a disease which is about no longer to exist, and why speak of treatment which will, in that case, have no farther application? Hence, I was about to bid you farewell, when a visit to the hospital convinced me that, whatever might be the future history of syphilization, its present character is still sufficiently serious to induce us to leave our classical works on this subject intact; and we remain persuaded that the pox, alas! is neither dead nor dying!

In fact, while waiting until the idea of syphilization, the product of my school, which has prophesied a vaccine, shall be demonstrated by syphilizers; while waiting until it shall be proved that the pox, up to the present time, has been calumniated by all syphilographists of past and modern times; while waiting until it shall be recognized that, instead of being one of the greatest scourges ever inflicted upon humanity, syphilis is, on the contrary, a blessing from heaven, let us still direct our attention to those features of the disease which, whether a scourge or a blessing, are still sufficiently prominent to deserve our notice.

In a prophylactic point of view, I told you, in my last letter but one, that it was impossible to believe in a preservative inoculation with the pus or blood of tertiary accidents; and that syphilization, by means of experiment, ought to be carefully studied before being seriously adopted.

On this subject, I will say that a courageous student of medicine has presented himself at the clinique of the Hôpital du Midi. This student has submitted to experiments for the past three months. During this time, he has himself made more than sixty inoculations, the traces or cicatrices of which are visi

ble; one of these still presenting, on the twenty-first day, the characters of ecthymatous chancre. I would give you an account of the result of the experiments which were to be continued at my clinique, if, since the first publication of this letter in the Union, this pretended syphilized person had not ceased to submit himself to my examination.* This case would have

* But in lieu of this patient, we have had the unfortunate case of Dr. L- 9 which was presented to the Société de Chirurgie, and which imposes a terrible responsibility upon the heads of those who recommend measures to which they should be condemned themselves to submit to.

:

The following are the words in which the Union Médicale published the transactions of this learned society at its session of the 12th of November, 1851 :"We have the following communication from M. Musset. We transcribe it word for word:

"Dr. L- was presented to the Société de Chirurgie by M. Musset, interne of the service of M. Ricord, in order to submit to the observation of this learned society the results of experiments undertaken with the object of verifying the views which were presented relative to syphilization.

"While awaiting, from Dr. L- himself, a complete history of his own observations relative to the case, we shall present the principal results at which he has arrived:

"Doctor L

had never had either chancres or blennorrhagias.

"In the months of December, 1850, and January, 1851, he inoculated himself upon the penis, each time at an interval of one week, with ten chancres, for the purpose of studying a new medication. These chancres disappeared in a short time under the influence of a simple, hygienic treatment.

"On the 2d of July, he inoculated himself anew upon the left arm; and an indurated chancre was the consequence.

"Three months afterwards, that is, on the 1st of October, an exanthematic, and soon a papular, syphilide appeared, accompanied by engorgement of the posterior cervical ganglia.

"Some days afterwards, mucous papules appeared upon the tonsils.

"Dr. L—— underwent no treatment.

"On the 17th of October, an inoculation was made upon the left arm, by M. Auzias, in presence of M. Ricord, with pus taken from a chancre twenty days' old, existing upon a patient who had himself been inoculated with the pus taken from a pretended syphilized individual who had contracted nearly his sixtieth chancre.

"On the 24th of October, M. Ricord made two inoculations, one upon the left arm, the other upon the mucous membrane of the prepuce, with the pus of a non-serpiginous phagedænic chancre, existing on a patient in his wards.

"On the 25th of October, Dr. L- inoculated himself on the same arm, and on the penis, with the pus of the first chancre.

"On the 28th of October, two inoculations were made upon the left arm; one with the pus of the first chancre, the other with that of the fourth.

furnished us, at best, but a single observation, of which you may conjecture the value; and there seem to be others, at which

"On the 29th of October, two inoculations were made with the pus of the fourth chancre.

"On the 30th, two inoculations were made upon the arm with the pus of the first and second chancres.

"Thus the number of inoculations amounted to eleven.

"1. Although ten inoculations had been made, this did not prevent an eleventh from indurating, and from being regularly followed by constitutional syphilis. 2. The new successive inoculations, which were made in view of syphilization, were all successful.

"3. The chancres had not a less extent in proportion to the inoculations made. "Thus, the diameters of the successive chancres were indifferently greater or smaller than the diameters of chancres which preceded or followed them. "4. Most of the inoculated chancres assumed the phagedænic form, as may be frequently observed in individuals who, having a constitutional syphilis, contract new chancres

"5. It is to be remarked that the most intense chancres were produced by the pus of M. Auzias's syphilized individual, who had contracted his sixtieth chan

cre.

"6. The non-serpiginous phagedænism did not depend upon the source whence the pus was taken, for most of the chancres produced by the pus of the syphilized individual assumed indifferently the phagedænic form; whilst of the three chancres produced by the pus of the patient in the wards of M. Ricord, affected with a non-serpiginous phagedænic chancre, only one took on the phagedænic form.

"7. The phagedænism of the first chancres was not destroyed by those which followed them, and which in turn became phagedænic.

"8. Hence, the phagedænism appeared to depend upon the general state of the patients, influenced by conditions in which he was placed: for, while most of the chancres inoculated upon the arm assumed this form, those inoculated upon the penis, the same day, with the same pus, remained very small, and quickly went on to reparation.

9. Not only did the successive inoculations, made with the object of producing syphilization, and which took so grave a course, fail to influence favorably the accidents of constitutional syphilis; but, on the contrary, these accidents seemed to assume a new intensity in proportion to the phagedænism of the chancres of inoculation.

"10. It is to be remarked that, while all the inoculations made with the pus of primitive ulcers, were followed by positive results, those made with the pus of secondary accidents pertaining to the gravest forms of the disease, and in all its intensity, remained without effect.

"11. The case of the courageous and learned Dr. L- which he will hereafter publish, with all its developments, should serve as an important lesson to those who, crying up the doctrines which lead to such results as we have just contemplated, have not the courage to experiment upon themselves."