stant state of moisture, namely, the mucous membrane, is exposed to the poison; moreover, a membrane presenting folds and nooks innumerable, in which a morbid secretion may lodge, and from which it would be difficult to remove it. Hence, the transmission of the poison to the system, through the medium of the mucous membrane, is more facile and certain than through the skin.

When there is abrasion of the cuticle, or of the mucous membrane, the process of inoculation is obvious, and unobscured by the apparent impediment presented. by the epiderma or epithelium. The agent of absorption, however, in every case, whether the cuticle be broken or whole, is the same, namely, that property of all animal tissues which is termed imbibition, and by the aid of which the functions of nutrition, growth, and secretion are accomplished.

The imbibition of the poison by the animal tissues is performed insensibly and slowly, and there is no appearance on the inoculated spot to show that any vital process is in action. This is the period which is denominated latent; but although hidden from view, we know that the poison is passing into the blood, and that, at the end of a few days (from three to seven), certain local appearances will be seen, which will demonstrate its presence. The local action so excited is the primary syphilitic disease, or syphilis.

I have said that the common mode of transmission of the syphilitic poison is through the agency of a morbid secretion poured out upon the surface of a syphilitic sore, and brought into contact with the tissues of a sound person; but there is another mode of transmission, which we may now take into consideration. It is that in which a man or a woman having been contaminated by the poison, and having been to all appearance cured of

the consequent disease, has, nevertheless, become so saturated with the virus, as to possess the property of communicating syphilis to a sound person, by means of his secretions. This mode of transmission is so important that I will proceed to illustrate it by means of cases which have fallen under my observation.

CASE 1.-A gentleman had a small venereal sore on the prepuce in the month of November; it got well speedily. In the succeeding month of February he suf fered from sore-throat and rheumatic pains, but of so slight a nature that he took them to be merely symptoms of a common cold. In March he married.

In the month of June following, I was called to see his wife, in consultation with her medical man. She was suffering from a furuncular abscess, situated at the upper and inner part of the thigh, and my opinion was sought more on account of the obstinate nature of the sore which the abscess had left behind it, than from any suspicion of its being of a venereal nature. I was struck by the unhealthy-looking, red, and fungous surface which the sore exhibited; and making further inquiries, found that on the day before she had perceived a rash upon her skin which had now become an unmistakable roseola. She had a feeling of soreness in the throat, but without congestion, and her skin was muddy and discolored.

She had no disorder of the genital organs, and her husband was free from any symptoms of disease.1

This is not an isolated case; but I select it from others on account of its freedom from complication, either

'Three weeks after my visit I again saw her medical man, who informed me that the furuncular sore had soon got well, but that a few pimples had broken out upon her body, and that her husband had had an attack of iritis.

by time or medical treatment. The primary disease in the husband was slight, but well established; the syphilitic fever or secondary fever was so trivial as to be taken for a common cold; and although the patient consulted his medical man, a relative, on the propriety of marrying under the circumstances, the medical man saw no reason to object.

I apprehend that, in this case, no one can doubt the natural secretions of the mucous membrane of the husband being the medium of transmission of the poison; and as there was no local disease in the wife, the poison must have been imbibed into her system at once, and thus have contaminated her blood. Then came the period of latency, during which the poison was accumulating and gaining strength, and then followed the outburst of exanthematic eruption. The furuncular abscess I consider to have been of the common kind (at the time there existed a kind of furuncular epidemic) in the first instance; its angry appearance and its indisposition to heal having been occasioned subsequently by the approach of the syphilitic crisis.

In the above case there can be no question as to the poisonous condition of the blood of the husband at the time of marriage; that was proved by the attack of secondary symptoms which he had experienced three weeks before; but instances sometimes occur in which the constitutional action would seem to be absent, and yet manifest proof is afforded, when too late, that the person was a fomes of contagion. The following case is an illustration of this fact:

CASE 2.-A gentleman had had repeated attacks of venereal sores, the last being unusually tedious, and continuing for three months. Two months after the cure of the latter, he married, believing himself to be tho

roughly well. He was not aware of having experienced a secondary symptom of any kind.

The wife, at the time of her marriage, 'was a fine, healthy young woman, who had never had a day's illness. She was married in March, 1845, and remained well until the month of July, when she gradually fell into bad health, was languid and depressed, lost her appetite, and, in the following month of August, miscarried. She was not, during this illness, aware of the presence of any sore on the genitals, or of any abnormal discharge. After her miscarriage she went to the seaside, and recovered.

On her return home, towards the end of September, she again became dispirited and ill, and in the beginning of October was attacked with sore-throat and eruption on the skin The eruption continued slightly to increase until the month of January, when she first consulted me. At this time her entire skin was sallow, dry, and muddy; she was dejected, weak, and thoroughly out of health. Her tongue was white and coated, pulse languid and small, and bowels confined; the fauces were of a dull red color, and congested; there were several tender, aphthous spots on the mucous membrane of the cheeks, and the sub-occipital and post-cervical glands were swollen and tender; she also complained of rheumatic pains in her shoulders and elbows, and stiffness of the neck.

The eruption was principally distributed over her head, neck, and face; there were a few spots also on her arms, and a very few on the trunk of the body; there were, besides, three on the mucous membrane of the vulva, the epithelium of which had been rubbed off, and they were moistened by a muco-purulent secretion.

That the husband in the above case was a fomes of contagion is quite evident, but the question suggests itself Whether a man can be constitutionally affected

with syphilis, without evincing, or having evinced at some period or other, symptoms demonstrating the exist ence of the poison in his system? I doubt if such could be the case, but the question serves to raise a nice point of diagnosis-as to whether the last-named venereal sore, under which this gentleman suffered, might not have been a secondary sore. Its long duration unhealed would lead to this supposition, since it is not usual for primary sores to remain so long open. I will illustrate my meaning by the following case :—

CASE 3.-A gentleman had three small sores on the glans, for which he took mercury until his mouth became tender. They healed in a fortnight. At the end of six weeks, without any suspicious connection, he had what he considered to be a "return of the old sores:" he again took mercury, and the sores disappeared. This was repeated a second and a third time, at intervals of six or eight weeks; each time the sores, which were of very small size, reappeared in the old place, and during the whole period he remained unexposed to contagion. He was not aware of the presence of any other symptoms; he might have had a little cold at the time of the attacks, but he did not observe it.

Nine months after his first attack of disease, he again had a small sore on the glans, and as shortly before he had been exposed to risk of contagion, he regarded this as a second appearance of primary disease. Having observed the successful result of his treatment in the first instance, he had recourse to blue-pill, and after taking twenty-four pills the sore had disappeared. Six weeks after the healing of the sore, two small tubercles appeared in the original place, and he again consulted me. He told me that he was at a loss to account for these appearances, as he had not been exposed to contagion