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A Theoretical and Practical Treatise on Diseases of the Skin. 8vo. SYPHILIS IN THE INNOCENT (SYPHILIS INSONTIUM) CLINICALLY AND HISTORICALLY CONSIDERED WITH A PLAN FOR THE LEGAL CONTROL OF THE DISEASE BY L. DUNCAN BULKLEY, A.M., M.D. PHYSICIAN TO THE NEW YORK SKIN AND CANCER HOSPITAL; CONSULTING PHYSICIAN TO THE NEW YORK HOSPITAL; LATELY PROFESSOR OF DERMATOLOGY, NEW YORK POST-GRADUATE MEDICAL SCHOOL AND HOSPITAL; ETC. THE ESSAY TO WHICH THE COLLEGE OF PHYSICIANS OF PHILADELPHIA IN 189I, AWARDED THE ALVARENGA PRIZE, FOR THE BEST MEMOIR ON ANY MEDICAL SUBJECT Ardua molimur; sed nulla nisi ardua virtus." NEW YORK BAILEY & FAIRCHILD 29 Park Row Copyright, 1894, By L. DUNCAN BULKLEY Right of Translation Reserved. In Exchange K Mr 1901 STUYVESANT PRESS, 154 & 156 WEST 27TH STREET NEW YORK. TO ALFRED FOURNIER AND JONATHAN HUTCHINSON WHO HAVE DONE MORE TO DEVELOP AND ENCOURAGE THE STUDY OP SYPHILIS INSONTIUM THAN ANY OTHER LIVING MEN THIS VOLUME IS RESPECTFULLY AND AFFECTIONATELY DEDICATED BY their friend and admirer The Author. SYPHILIS IN THE INNOCENT INTRODUCTION The following essay, the result of ten years' work, is presented as a contribution to the study of syphilis. Syphilis is not essentially a venereal disease, It has been too frequently regarded as being only such, and consequently some of its important features have been overlooked. Many able writers describe well its clinical history, pathology, and treatment, as also its connection with prostitution; but the element of its non-venereal character, in many instances, has been relatively little considered, and no full presentation of the subject has ever been made. In the present essay the attempt is made to consider only this single aspect of the malady, namely its innocent occur- rence and the modes of infection whereby it is innocently acquired, by means wholly unconnected with the venereal act. Nor is the entire subject of innocent syphilis here com- passed, for that would lead us much farther than proposed, and its consideration might well occupy many volumes such as this. As will be seen later, this would include hereditary syphilis, and that acquired in the ordinary relations of married life; subjects Xll INTR OD UCTION which have been so fully treated by others that they are omitted from the present work. i But even this single branch of the subject is of such vast extent that I can hardly hope that the entire ground has been covered, or that all of the observations which have been made have been here utilized ; and yet it is not too much to claim that this is the most complete monograph on this subject which has yet appeared. In the preparation of the work, writings in a dozen languages have been consulted directly, in addition to certain quotations or translations which may have occurred in print from other sources. Clinical records, more or less complete, are given of one hun- dred and sixteen original personal cases of extra-genital chan- cres, a greater number than has ever before been reported by any observer in the United States. For the first time there is here offered a classification of the modes or methods of infection in syphilis insontium, describing over one hundred categories of transmission. These are grouped under three main heads, according as syphilis occurs, ist, In connection with household and industrial life; or 2d, In the care of children; or 3d, In professional pursuits. This classification is based on the clinical observations which have been here gathered from litera- ture, and has been educed synthetically as the work of collection of the data proceeded. A Table is given of over 7,000 cases of chancre reported by various observers in venereal clinics, to show the relative pro- portion of extra-genital to genital chancres. Another Table has been prepared exhibiting the location of over 9,000 extra- genital chancres, which have been collected from the items given in the Analytical Bibliography. INTRODUCTION Xlll Still another Table, as complete as possible, gives the epi- demics of syphilis which have occurred from the year 1577 to the present time; this contains data relating to over 100 epi- demics, great and small, affecting over 3,000 victims, in addition to the many instances where no definite statistics were given. Accounts are also given of the various endemic diseases which, occurring in different times and countries, and under more than twenty different names, are now recognized as varied manifesta- tions of syphilis. I have made no attempt to include in the text reference to all who have reported cases or written upon the subject in hand, only the more interesting or striking cases or matter were selected; and the Synopsis of Facts and Literature, at the end of the work, as well as also the Analytical Bibliography, should be taken in connection with the text, in order to understand the subject completely. The Analytical Bibliography contains references to over one thousand reporters of cases, several hundred of whom are referred to or quoted in the text. It has been my aim to make this Bibliography complete to January 1, 1893. The originals have been consulted wherever possible, but a certain number of refer- ences are taken at second hand, in which instance the second references are given in brackets; these latter are also often in- serted even when the original has been consulted, as they may prove of value to those desiring fuller information than is here given, and who may not be able to consult the original. I have to express my warmest thanks and acknowledgements for most valuable aid in the preparation of this work to my friends, Dr. Edward Preble, of Cleveland, Ohio, Drs. H. H. Whitehouse, Thomas L. Stedman, B. Lapowski, and Titus M. Coan, of New XIV INTRODUCTION York, and Dr. Valerius Idelson, of Berne, Switzerland; without their active co-operation this essay would have been less complete than it is. Recognizing the limitations of the work, and the necessarily incomplete manner in which some great questions have been con- sidered, the writer hopes that his labors may not be without interest to others, and may contribute to a more perfect knowl- edge of syphilis ; it is thus hoped that it may aid in the advance of medical science and the good of mankind, and may assist in helping to check the innocent spread of the disease. 4 East Thirty-seventh Street, New York, January i, 1894. TABLE OF CONTENTS CHAPTER I. oA „„ PAGE General Considerations. — Syphilis as a Disease. — Definition, An- tiquity, Modes of Diffusion, Present Distribution of Syphilis. . 1-12 CHAPTER II. Forms of Syphilis. — I. As a Venereal Disease (Syphilis Pravorum). II. As a Non-Venereal Disease (Syphilis Innocentium or Insontium). — Divisions of Non-Venereal Syphilis: i. Syphilis Ingenita; 2. Syphilis e Coitu Legitima; 3. Syphilis sine Coitu .... 13-20 CHAPTER III. Syphilis Insontium sine Coitu. — Clinical Considerations. — Modes of Infection: Immediate Contagion, Mediate Contagion. — Location of Primary Lesions 21-34 CHAPTER IV. Clinical Considerations.— Personal Cases. — Chancres of the Lip, Tonsil, Finger, Breast, Tongue, Cheek, Eyelid, Chin, Hand, Nose, Ear, Temple, Neck, Forearm, and Sacral Region . . 35-106 CHAPTER V. Demography of Syphilis. — Causes and Methods of the Spread of Syphilis in the Past and Present. A. Syphilis Pandemica (In- cluding Syphilis Epidemica and Endemica). B. Syphilis Sporadica (Including Syphilis Economica, Brephotrophica, and Technica). 107-112 CHAPTER VI. A. Syphilis Pandemica. — I. Syphilis Epidemica; II. Syphilis Endemica 113-141 xvi . TABLE OF CONTENTS CHAPTER VII. B. Syphilis Sporadica. — I. Syphilis Economica: i. Syphilis Propa- gated in Domestic and Social Relations; 2. Syphilis Communi- cated in Industrial Relations , . 142-157 CHAPTER VIII. B. Syphilis Sporadica (Continued). — II. Syphilis Brephotrophica: 1. Syphilis Communicated in Connection with Nutrition of In- fants; 2. Syphilis Propagated by Attendance upon Infants 158-171 CHAPTER IX. B. Syphilis Sporadica (Continued). — III. Syphilis Technica: i. Opera- tor the Victim; 2. Operator the Syphhlifer; 3. Operator the Medium , 172-195 CHAPTER X. Prophylaxis: Hygienic and Medico-Legal Considerations. — Plan for the Legal Control of Syphilis 196-207 Synopsis of Facts and Literature Relating to Syphilis Insontium 209-240 Analytical Bibliography of Syphilis Insontium' 241-3S6 Index . . , 387-398 SYPHILIS INSONTIUM CHAPTER L GENERAL CONSIDERATIONS. — SYPHILIS AS A DISEASE. — DEFINITION, ANTIQUITY, MODES OF DIFFUSION, PRESENT DISTRIBUTION OF SYPHILIS. Syphilis is one of the most important diseases affecting the human race, and its study has occupied the thought and activity of observers almost more than that of any other one malady, while its literature probably exceeds that relating to any other single disease. The advances which have been made in the knowledge of the course, manifestations, and results of syphilis during the past fifty years are very great, and have done much to limit its extension by innocent means, and have also served to rob it largely of the terror with which it has been surrounded in earlier times. Much, however, undoubtedly remains still to be learned in regard to this protean malady, whose entrance into the system is often so unexpected and whose earliest symptoms are sometimes so trivial, and yet whose later results are fre- quently so disastrous and far-reaching, possibly even to many generations. No attempt will here be made to consider syphilis in all of its many interesting and important aspects ; the subject is one which presents an ever-widening field of study, while research into the literature relating to syphilis opens lines of investiga- tion, and material for thought, almost boundless. The object of the present work is rather to develop the subject of syphilis 2 2 SYPHILIS INSONTIUM of non-venereal origin, which, as will be seen later, offers points well worthy of careful consideration, both from a scientific and a practical aspect, as well as from a hygenic, sanitary, and medico- legal point of view. Syphilis is one disease, however it is acquired ; one poison or virus, whatever it may be, whether a micro-organism or an animal product, is always present in every case, arid is in some manner always transmitted to the person who acquires the dis- ease. The modes and methods by which syphilis has been acquired, other than in sexual congress, are very numerous and varied, as will appear later ; but in every instance it is one and the same disease, which may be again communicated, under proper circumstances, to any number of individuals. Syphilis may be defined as a contagious disease, chronic in char- acter, due to the entrance of a specific virus into the system, which is capable of further propagation and transmission, both by inheritance and by inoculation with the blood and morbid secretions from the affected indi- vidual. In the course of the disease a variety of inflammatory and neoplastic lesions are produced, in a more or less regular and definite order, which may affect every organ and structure of the body. As a rule syphilis can be acquired but once during a life-time. The antiquity of syphilis has been the subject of much research and discussion by able writers, and very divergent views have been entertained in regard to the date when it first existed as a disease, a matter which is somewhat foreign to our present sub- ject. It is, however, accepted by all that in the years 1494 and 1495 there occurred a sudden and very great spread of syphilis in certain countries of Europe, at a date closely following the discovery of America, and about the time of the invasion of Italy by Charles VIII. of. France; and it is further agreed by all that our knowledge of syphilis, as a disease, dates almost wholly from that epoch. Researches of modern times have, on the other hand, demon- strated beyond a doubt that syphilis has existed from the earliest periods of which we have any records ; able scholars have recog- nized many allusions to the disease in the Bible, and according to Dabry, 1 perfect descriptions of chancres and of syphilitic lesions of the skin and mucous membrane are found in Chinese literature, some of it relating to more than 2000 years B. C. A recently 1 Dabry. La medecine chez les Chinois, Paris, 1863, p. 251. A NTIQ UITY OF S YPHIL TS $ discovered Japanese book, dating back to the beginning of the ninth century, is said by Scheube 1 to contain a full description of syphilis in all its forms, and to recognize their constitutional nature, and connection with local sores. Whether or not syphilis existed in Europe previous to the date mentioned of its outburst in Italy, at the close of the fifteenth century, is still questioned by some, but recent writers have shown beyond a peradventure 2 that syphilis was known throughout Europe at a very much earlier period, as a constitutional disease, which was acquired through impure venereal contact. There is also evidence, from bones recently disinterred in France, 3 that the disease had occurred there occasionally before that date, and possibly even in very ancient or pre-historic times. Bones thought to be unquestionably syphilitic have likewise been discovered by Dr. Jones, 4 of New Orleans, and others in the indian graves of the United States, which are also apparently of equal or greater antiquity ; it must be stated, however, that some 6 have doubted both the syphilitic character of the bone lesions, and the pre-; historic origin of the same. How or when syphilis originated is a matter utterly beyond human discovery, nor do we know much more of the dates and methods of its extension over the world, except in reference to certain countries within the last two or three hundred years. From what has been observed within this period, however, we may judge more or less correctly of the modes by which it has been spread in previous times, for in many instances we have very accurate accounts of the manner in which even large communities have been infected, as will appear more fully later. Syphilis is everywhere seen to be a disease more especially belonging to communities, and flourishing most luxuriantly where- ever there is a crowding or massing together of individuals, for the reason that thus the elements for its propagation become more concentrated, and opportunities for its communication more common ; syphilis is, therefore, most abundantly met with in cities, and its frequency is commonly seen to diminish in a pretty direct 1 Scheube. Virchow's Arch., 1883 XCI. p. 448 (Quoted by Hirsch, Handb. der hist.,geogr. Path. Stuttgart, 1883, 2te Abtheil p. 467.) 2 Hirsch. Handbuch der histor.-geograph. Pathologie, Stuttgart, 1883, 2te Abtheil p. 42. 3 Jlllien. Traite pratique des Maladies Veneriennes, 2d ed., Paris, 1886, p. 454. 4 Jones. New Orleans Med. and Surg. Journal, June, 1878, pp. 926-941. 5 Hyde. A contribution to the Study of Pre-Columbian Syphilis in America. Amer. Jour. Medo Sciences, August, 1891. 4 SYPHILIS INSQNTIUM ratio to the suburban or rural character of the people. There are many exceptions to this rule, however, as will appear later in the chapter on epidemic and endemic syphilis; it will there be seen that the disease has at times spread with great rapidity in country towns and among communities where there were none of the causes operating to which its extension is generally attributed ; it is ; still thus increasing among the peasantry of certain districts, as in Russia, where gross ignorance prevails. Prostitution undoubtedly stands foremost as a cause of syphilis, and, far outweighs all other causes together, certainly at the present time. In addition to the ordinary spread of the disease in towns and cities by this means, it is likewise propagated very largely by sailors and soldiers, and consequently is particularly frequent in all seaport and garrison towns. Returning to their homes men of this class are also apt to carry infection with them, even to distant parts, and to communicate the disease to their families, and others, in thoroughly innocent manners; thus syphilis will often gain a foothold, and may even be widely distributed in rural districts. Wars and migrations, as also market-gatherings, fairs, and festivals are frequently, in like manner, the means of spreading syphilis, from the license attending them; statistics abundantly demonstrate this, and it has been recently very clearly shown by MAURiAc/in regard to Paris. Great public works, as the building of the dikes in Holland, 2 have likewise contributed largely to the extension of the disease, through the licentiousness attending the gathering of large bodies of men, unattended with their wives. Even in recent times, especially in Russia, syphilis has been spread by means of pilgrimages, which often occupy weeks or months, and are attended with much laxity of morals; also the intimate mingling of the pilgrims, in an innocent manner, on these occasions serves to propagate the malady. In later years, syphilis has spread along the lines of commercial intercourse, such as railways, rivers and canals ; and manufacturing centres are often seen to afford the opportunity for the diffusion of the disease. With the increase of syphilis by venereal excess there have always occurred necessarily a not inconsiderable number of cases 1 Maukiac. Le9ons sur les Maladies Veneriennes, Paris, 1883, pp. 182-226. * Struve. Ueber die aussatzartige Krankheit Holsteins, Altona, 1820, p. 26. SYPHILIS IN EUROPE 5 where the disease was acquired innocently, the ratio of the one class of cases to the other varying considerably in different locali- ties and under different circumstances. In former times, before the nature of the malady was well known and the dangers of contagion understood, this mode of infection was really very common, and syphilis was repeatedly spread as an epidemic among certain communities; many descriptions of such visitations have been written and some of them will be considered fully in another chapter. From one cause and another, therefore, syphilis has gradually become very widely distributed over the earth, and there is now hardly any portion of the known world where it has not been recognized, modified in certain localities by peculiarities of race, or climate, or soil. The subject has been very fully studied by Hirsch, 1 Lagneau, 2 Lancereaux, 3 Rey, 4 Buret, 6 and others 6 and brief reference may be made to the results of their work in con- nection with this subject. EUROPE. i. Iceland. Syphilis does not flourish here, for although re- peatedly introduced from other countries it has very quickly died out. Thus, in 1756 it found its way to the weavers and spinners of Reykjavik; 7 but in 1763 it was a rare disease, and in 1774 it was extinct. In one or two other localities it has been similarly intro- duced and has in like manner died away. 2. Norway and Sweden. Introduced on the coast of Norway in 1709 or 1 7 10, syphilis soon made great ravages, at first under the name of Radesyge, and has since extended very generally, though in a much milder form than previous^. 3. Russia. According to Leinenberg, 8 of Odessa, Russia has a peculiar though unenviable position among European states in regard to syphilis, where it is so common among the peasantry that it has long been regarded a scourge in the widest sense of the word ; in some villages at least one-quarter of the inhabi- tants are infected. 1 Hirsch. Handb. der histor.-geograph. Pathologie, 2te. Abtheil, Stuttgart, 1883. 2 Lagneau. Recherches comparatives sur les maladies veneriennes, etc., Paris, 1867. 3 Lancereaux. A Treatise on Syphilis, etc. Sydenham Society Ed. London, 1868, I; p. 45. * Rey. De la syphilis suivant les races et les climats. Ann. de Derm, et de Syphilig., 1880, p. 6^2. 5 Buret. La Syphilis aujourd'hui et chez les Anciens. Paris, 1890. 6 Mauriac. Lf 90ns sur les mal. vener, Paris, 1883, p. 236; * * * Jullien. Traite pratique sur les mal. vener, Paris, 1886, p. 472, etc. 1 Iceland, by P. A. Schleisner, M. D., Brit, and For. Medico-Chir. Rev., Vol. 5, 1850, p. 459. 8 Leinenberg. Die Syphilis in Russland, Munchen, 1887, p. 2. 6 SYPHILIS INSONTIUM 4. Turkey. Syphilis is very frequent in different sections of Turkey, known as Frenga in Servia, Spirocolon in Greece, and Boala lumeasca or le mal qui court le monde in Roumania, ' ' where it has made great ravages in all classes of society. Its different forms are met with among almost all the inhabitants, young and old, infants and adults, both in the cities and in the country districts." 1 5. Italy. Since the memorable outbreak of syphilis in Italy at the close of the fifteenth century, the disease has been present almost everywhere in considerable strength, at times appearing as an epidemic, as at Capistrello and elsewliere, or remaining endemically as in the case of the Scherljevo, Facaldina, and Mal di Breno, as will be mentioned in the chapter on Pandemic Syphilis. 6. Spain and Portugal. Syphilis is very common and severe in these countries especially in the southern part of Spain. In Portugal, Ferguson 2 in 181 2 stated that a large share of the popu- lation had become infected, through long neglect; by recent reports from the army records we learn that there are 182 syphilitics in each 1000 soldiers. 7. France. While syphilis appears to be increasing in the large cities of France, and, according to Mauriac, 3 from 5000 to 8,000 persons acquire syphilis in Paris each year, it is relatively in- frequent in the villages and country districts; although a number of epidemics of syphilis insontium have occurred in villages, in times past, as will be noted later. Marseilles seems to be the city where syphilis abounds to the greatest degree at the present time. 8. Belgium and Holland. After the great outbreak of syphilis of the fifteenth century, which extended to the lowlands, a ' ' recru- descence " of the disease was described by Everardus, 4 Blancaard and others, occurring in the island of Seeland, about the middle of the seventeenth century, from the custom of drawing breasts. From this and similar episodes, it is evident that syphilis insontium was not unknown in the Netherlands. Owing, however, to the prophylatic measures in force by the government in Belgium, 5 syphilis has become very much less frequent, so that the army reports show the smallest proportion of all the European states. 1 Rey. La Syphilis suivant les races, etc. Annales de Derm, et de Syph., 1880. 2 Ferguson. Cited by Henry Lee, Lectures on Syphilitic and Vaccino-syphilitic inoculations, London, 1863, p. 214. 8 Mauriac. Cited by Jullien. Traite pratique des maladies veneriennes, 2d ed., Paris, 1S86, p. 477. 4 Die Neu-erweckte Sauger-Seuche in ihrer Vergleichung mit der Frantzosen oder Indianischen- Krankheit, etc. (German transl. of Blancaard, Sylvius, Sydenham, Wyer, and Everardus, Leipzig, 16S9). * Lagneau. Recherches comparatives sur les mal. vener., etc., Paris, 1867, p. 13. S YPHILIS IN E UR OPE 7 9. Denmark. In the Jutish peninsula, an epidemic form of syphilis was recognized and described by Lillie in 1777, and by Van Deurs in 1835, and since that time has been very prevalent in the maritime cities. In Schleswig-Holstein, on the western coast, a separate epidemic arose at about the same time, known as the Marsh- disease, and was confounded in part with leprosy. It was probably brought thither by the dike-builders. 10. Prussia. Endemics along the Baltic coast, especially in Lithuania, occurred at the time of the other endemics, and the disease is said later to have nearly decimated some districts. Syphilis insoniium seems to prevail in Silesia, from the number and variety of cases reported from Breslau. 11. Middle German States. Bavaria and Wurtemberg were favored with numerous large epidemics from cupping, etc., about a century after the first European outbreak of syphilis. The disease has been prevalent there since that time, but was held in check by sanitary precautions, until, by a modification of the police restrictions, in 1861, the number of those infected rapidly doubled in Munich. 12. Switzerland. Like the preceding sections of Europe, Switer- land has been the seat of numerous outbursts of the disease as is witnessed by frequent legislative enactments intended to check its diffusion ; at present syphilis is said to be less common here than in many other European states. 13. Austro- Hungary. The eastern part of the empire was the seat of the first renaissance of syphilis, in 1577, in Moravia, in the shape of the Maladie de Brunn, from cupping. The eastern and southern portions are still more or less scourged by the endemics common to Russia on the one hand, and the Adriatic coast on the other. 14. Great Britain and Ireland. Syphilis first appeared here in 1496, and has steadily increased up to the present time. In the Scotch Highlands it has been known as Sibbens or Yaws, since the year 1690. It now prevails widely in the great cities and ports, favored by the neglect of all restrictions on prostitution. Dr. Holland, 1 in reviewing the literature of prostitution in 1854, and the measures for the control of syphilis in several European cities and states, estimates that in the United Kingdom there were at least a million and a half persons infected with syphilis during l Holland. British and Foreign Medico-chirurgical Review, Vol. XIII, 1854, p. 357. 8 SYPHILIS INSONTIUM each year. There can be no doubt that the disease was greatly diminished during the operation of the ' ' Contagious Diseases Acts," from 1864 to 1881, as shown by official reports from the towns where they were enforced ; 1 since their repeal it is on the increase in seaports and large cities. ASIA. 1. Siberia. Syphilis is frequent and severe among the abo- rigines, and especially so in Kamtchatka. A special endemic has been described as the Berreshoff Disease. 2. Japan. The disease is reported as exceedingly frequent in Japan, under the name of Feu de volupte' and Mai portugias. It has been stated by Eldridge 2 that it is very exceptional to meet a male Japanese who will not acknowledge that at some time he has suffered from syphilis. In 1869, an investigation of the prostitutes in Yokohama revealed 33 out of 100 affected with constitutional syphilis, and generally with grave forms of the disease. Well organized sanitary police measures have, however, since that time greatly diminished the dangers from this disease. 3. China. Both the coast and interior of China are said to be saturated with syphilis, which is relatively mild among the natives, but severe among the unacclimated. The reason for the compara- tively benign character of the disease among the Chinese is undoubtedly found in the protection afforded by previous race infection, the disease having existed here from the remotest period. In 1870, at the general hospital at Shanghai, where the ships of all nations send their sailors, syphilis formed 19 per cent, of all cases, and in Hong Kong, 16 per cent, of all cases were of syphilis, while in the French hospital at Tien-tsin in 1861, almost 30 per cent, of all cases were of this disease. 4. Farther India. Some interior tribes of aborigines are said to be exempt from syphilis, but on the coast, certainly among the Europeans, if not among the natives, syphilis is very common and grave. At Singapore sanitary restrictions have caused the disease, which was previously very frequent in this seaport, to diminish to a very great degree. 5. Malay Archipelago. In some of these islands the disease is extremely common and severe, both among natives and whites. • 1 History and working of the Contagious Diseases Acts, by H. C Sluggett, Tottenham, 1882. 2 Eldridge. Pacific Med. & Surg. Journal, Oct. 1881. N. Y. Med. Journal, March, 1882, p. 335. S YPHILIS IN ASIA AND A FRICA 9 The special features in this section of the world seem to be the severity of the general outbreak, and the prevalence of hereditary- taint. 6. India (Hindostan). There is evidence here, as in China, of the great antiquity of the disease. It seems, however, to be diminishing in frequency in late years, so that while the average number of those infected with venereal diseases in the army in 1859 was 267 per 1000, in 1873 it was but 167 per 1000. 7. Arabia. Syphilis is said to be rare here, except along caravan routes, and at the seaports. 8. Western Asia. The inhabitants of the table-land surface comprising Afghanistan, Beloochistan, etc. , are said to have syph- ilis extensively, but in a mild form. The exceptions to the latter are stated to be Armenia, where it is especially grave, and Persia, where syphilis is not very widely spread, and is said to present a remarkably benign character. 9. Asia Minor. Along the entire litoral, syphilis is prevalent and grave. The sedentary Mohammedans, coast-dwellers, etc., suffer far more than the nomads and inland-inhabitants. It is reported that it has affected the mountain districts of Syria only since the passage of the armies of Ibrahim Pacha. AFRICA. 1. Morocco. " Syphilis is spread here among all classes; one cannot go far without meeting those exhibiting the marks of small-pox or syphilis. " - 2. Algiers. A special form of syphilis is that affecting the Algerine Arabs, known as the Lfyre Kabyle; in 1868, out of 1000 patients in the hospitals of Algiers 113 were syphilitic. The disease is usually neglected and presents very grave conditions. 3. Tunis. Syphilis also prevails here very extensively; "those who do not have it are the rare exception;" 1 the notion of any venereal or scandalous element connected with the disease is, however, not present. It is, moreover, benign in character. 4. Egypt. ' ' The disease here attains an extraordinary fre- quency, and is met with in all forms ; the primary sores are quite as abundant as the secondary and tertiary lesions. From Alexan- l Rubatel and Tirant. Lyon Med. 1874, II. p. 249 (Hirsch Handb. der hist-geograph. Path. Stutt- gart, 1883, 2 te Abthcil p. 54.) io SYPHILIS INSONTIUM dria to the second cataracts it is very wide-spread, and even to Kartoum, where there have occurred true epidemics of the malady." 5. Nubia. Although syphilis is prevalent in Nubia there seems to be more effort towards prompt, systematic treatment of the disease by the natives, and it is relatively mild. 6. Abyssinia. Syphilis is very wide-spread here 1 and Dr. Blanc estimates that nine-tenths of the Abyssinians are affected in different degrees ; it is here mainly known as the Mai or Lepra Kabyle. According to Hirsch, syphilis was not introduced into the deeper valleys until the present century, and the inhabitants of Gallas have been free till within a few years. 7. Eastern Africa. In Madagascar some tribes seem to present a singular immunity from syphilis, even in spite of constant exposure, while others are much affected, even the children. In Zanzibar and the neighboring mainland syphilis is said to be so common that half of the patients applying for treatment are affected with some form of the disease. 2 8. South Africa. The natives here are believed to be contami- nated in proportion to dealings with Europeans. 9. Western Africa. In Senegal, Sierra Leone, etc., syphilis proper is very common and grave on the lit oral. Among the natives, however, in past centuries and at present, there is the widely spread endemic of Yaws and Plan, and, while the pure African exhibits a certain immunity from venereal syphilis, he has a predilection for the disease yaws, to which the Caucasian is refractory. 10. Central Africa. As far as is known, the inhabitants are free from syphilis in proportion as they are of unmixed blood; those of mixed blood suffer in proportion to their admixture of European blood. Livingstone states that syphilis seems incapable of permanence in any form in persons of pure African blood any- where in the center of the country.' 11. Sahara, Soudan, etc. Conflicting reports are given from the oases and isolated regions explored. Some report lesions par- taking of the nature of the Mai Kabyle of Abyssinia; others report a mild, wide-spread epidemic prevalence of ordinary syphilis. 1 Rev. Annales de Dermatologie et de Syphiligraphie, 1880, p. 688. 2 Hirsch loc cit p. 53. S YPHILIS IN A M ERIC A 1 1 NORTH AMERICA. i. British America. About a century ago, the litoral of the great lake chain was the seat of a grand epidemo-endemic of syphilis (Maladie de la Baie de St. Paul), in which Indians and whites, of all ages, suffered severely. In 1874 it was reported by Maurin that the cases of syphilis were numerous and grave among the Indian population. 2. Greenland. Syphilis has never been able to establish itself here ; in Labrador the Mai des Ottawas is now known to be only secondary syphilis resembling the Norwegian radesyge. 3. Alaska. The natives here suffer in like manner with the Kamtchatkans. At Sitka syphilis is not rarely seen, but its character is not severe and it yields easily to treatment. 4. United States. Syphilis, as now spread throughout the States, is a result of infection during comparatively recent years, following in the line of commercial and industrial extension; it now prevails largely in all the great cities, unrestricted by any sanitary regulations, but is comparatively rare in rural districts. There are evidences found by Dr. Jones of New Orleans, as already mentioned, in exhumed bones, that the disease existed here many centuries ago, but it is questionable if the disease as it now exists is in any way traceable to this primeval source. 5. Mexico, The Antilles, etc. Among the highly complex popu- lace of Mexico syphilis is so common that its venereal nature is ignored, and as a rule the malady is extremely grave. Some tribes of pure blood natives are yet free from disease. In the West Indies, the conspicuous form is Yaws, imported by and prevalent among the negroes. In Honduras an affection exists known as Granos, which appears to be syphilis. SOUTH AMERICA. Nearly the whole domain of the Spanish and Portugese con- quest is the seat of widely spread and severe syphilis. The extra- ordinary spread of the disease, wherever introduced by the whites, may be due to the serf -like character of the aborigines and their rapid amalgamation with the colonists. In Brazil it is stated that in one hospital syphilitics composed almost 40 per cent, of the cases treated between the years 1861 and 1866. 12 SYPHILIS INSONTIUM AUSTRALASIA AND OCEANICA. Some portions of these lands are yet free; others have been ravaged by the disease upon its introduction by the whites. In one of the Molucca Islands (Amboyna), a peculiar endemic prevailed early in the eighteenth century. A yaw-like disease (Tonga), has been noted in several localities. HAWAIIAN ISLANDS. Syphilis was first introduced here by Captain Cook's crew early in 1778, although Fornander 1 quotes Captain Cook as giving orders to prevent his men going freely on shore, saying, ' ' that I might do everything in my power to prevent the importation of a fatal disease into this island, which I knew some of our men now labored under, and which, unfortunately, had been already communicated by us to other islands in these seas. " Nevertheless syphilis gained a foothold and at once attained great gravity, and, owing to the very lax ideas of morality prevalent among the natives, the disease spread with very great rapidity; it is thought to have been one of the agencies which contributed largely to the well-known depopulation of the islands. It still exists there to a considerable extent, 2 although, as in so many other countries, it seems in a measure to have ''worn itself out," and is now in a quiescent condition. 1 Fornander. An account of the Polynesian race. London, 1880, p. 161. 2 Gulick. New York Journal of Med., March, 1855, p. 183. CHAPTER II. FORMS OF SYPHILIS.— I. AS A VENEREAL DISEASE (SYPHILIS PRAVORUm). II. AS A NON-VENEREAL DISEASE (SYPHILIS INNOCENTIUM OR INSONTIUM). DIVISIONS OF NON-VENEREAL SYPHILIS: I. SYPHILIS INGENITA: 2. SYPHILIS E COITU LEGITIMA : 3. SYPHILIS SINE COITU. Although the disease is one and the same under all circum- stances, syphilis may be conveniently studied under two grand subdivisions, according as it is acquired, First. In connection with illegitimate sexual intercourse, Syph- ilis pravorum, or venereal syphilis, and Second. As it occurs in a thoroughly innocent manner, Syphilis innocentium (or insontiutn) or non-venereal syphilis. In actual practice these are, of course, very closely related, one to the other, and the person who has acquired the disease from sexual transgressions not infrequently communicates it in an inno- cent manner ; and, conversely, one who receives the disease through innocent means may transmit the poison by venereal contact. As before stated, the disease is one and the same, however acquired; it runs the same course, presents the same symptoms, and requires the same treatment, which matters will not be here considered, as we have only to do with the mode of acquiring the disease. A. Syphilis pravorum. The first division, representing the dis- ease as acquired in illegitimate venereal indulgence, is largely connected with the history of prostitution, and has been abun- dantly considered in the various treatises on venereal disease, as well as in special works on syphilis, and many on prostitution ; in accordance with the plan of this work, this will not now be treated of, except incidentally. B. Syphilis insontium. The second division includes cases where the disease has been acquired in a wholly innocent manner, 14 SYPHILIS INSONTIUM quite unconnected with any venereal transgression, and very frequently apart from any sexual relations. This second or non- venereal aspect of syphilis forms the basis of the present study, and it will be seen later that the disease, even acquired in this manner, occupies a conspicuous place in medical literature, and that syphilis insontium has been the source of untold damage to numberless inoffensive sufferers. It is undoubtedly and sadly true, that in the enormous majority of instances syphilis is acquired in illicit intercourse, and that the cases which shall be referred to later on are relatively rare, when compared to the immense number of instances in which the disease is communicated in the commonly-known manner. Since the date of the sudden and great spread of syphilis, to- ward the close of the fifteenth century, it has been known and classed as a venereal disease ; and, although the exact connection between the initial lesion and the constitutional symptoms was not recognised until many years later, it was constantly observed and remarked, that this new disease, as it was called, was commonly acquired in connection • with venereal transgressions, and earlier writers, as well as the laws of certain countries, contain constant reference to the fact. ! So far, indeed, has this been regarded as its only or main mode of transmission, that syphilis is almost invariably included among venereal diseases, even in the treatises on general medicine and surgery, and the magnitude of its position as one of the most im- portant and serious of the maladies which affect the human race has undoubtedly been undervalued, and its proper study has been retarded and hindered thereby. It may be stated without fear of contradiction, that in the minds of a large majority of persons, both in and out of the profession, the individual with syphilis is looked upon with suspicion, and the occurrence of the disease is still almost invariably associated with sexual errors; and, on the other hand, comparatively few appreciate, if indeed they know of, the various modes and occasions of the entrance of the syphilitic poison, in connection with which the recipient is entirely innocent. From these and other facts it has resulted, therefore, that many afflicted with syphilis have been wrongly suspected, while, again, many cases of the disease have passed unrecognized, simply be- cause of the failure to discover infection produced in the more common manner, in the genital region. How far its venereal FORMS OF SYPHILIS 15 element is its only, or indeed its most important, aspect will be seen in the following pages. • While, as has been stated, syphilis commonly has a venereal origin, it is also true that very large numbers of cases have occurred where the disease has had its origin in a most unexpected and hitherto unknown manner, quite unconnected with any venereal or other error on the part of the person afflicted. The ways and methods by which this has occurred, far exceed anything which could have been imagined many years ago, and it is by no means probable that even now we know of more than a small pro- portion of the instances in which the disease has been thus acquired, nor do we yet recognize all the possibilities of non- venereal infection ; cases illustrating new methods of communi- cation are being constantly observed and reported, and the litera- ture of the subject is very great, and rapidly increasing. In looking at syphilis insontium, or, syphilis in the innocent, we find that the subject may be divided into three distinct heads, according to the mode in which the disease is acquired ; these are : 1. Syphilis ingenita ; or inherited syphilis; 2. Syphilis e coitu legitima ; or marital syphilis, and 3. Syphilis sine coitu ; mainly, extra-genital syphilis. 1. Syphilis ingenita. 1 The subject of the hereditary transmission of syphilis has been so abundantly studied, and the facts concern- ing it are so well known, through the works of Diday 2 , Baerens- prung 3 , Hutchinson 4 , Fournier 5 , and others, that it need not be considered in the present writing, and will only be alluded to incidentally, when bearing upon the subjects under consideration. 2. Syphilis e coitu legitima. Marital syphilis, or that acquired in lawful wedlock, is a subject which is second in importance to none in connection with the study of syphilis insontium, and here, alas, are some of the saddest cases to be observed; it is in the family relations that the physician often stands as a bulwark to protect the health, peace, and happiness of the home, and the sub- ject demands the most careful consideration from everyone who 1 This is a better term than syphilis congenita, inasmuch as congenital syphilis may represent both the inherited disease and that acquired at birth, from any external source : ingenita signifies " inborn," a stronger expression even than '"hereditaria.'' 1 2 Diday. A treatise on Syphilis of New-born Children. New Syd. Soc. Ed., London, 1859. 3 Baerensprung. Die hereditare Syphilis. Berlin, 1864. * Hutchinson. A clinical memoire on certain diseases of the eye and ear consequent upon in- herited Syph. London, 1863. 5 Fournier. La Syphilis hereditaire tardive. Paris, 1886. 1 6 SYPHILIS INSONTIUM at any time may have syphilitic patients under observation and treatment ; for, as will be seen later, a very considerable share of the women who have syphilis have acquired it in this manner. But this subject has been so thoroughly elaborated, through the labors of Langlebert 1 and Fournier 2 and Diday 3 , that there is little further need of work in this line, and it will not be con- sidered especially in the present connection. 3. Syphilis sin a coiiu. The third group of cases belonging to syphilis insontium, namely, such as are acquired in other manners than those alluded to, and the primary lesions of which are commonly extragenital, is perhaps one of the most important of all, and worthy the closest study and most thoughtful attention. The reasons for this are, that, on the one hand, the dangers extend to every one, married and unmarried, and even to innocent children; while, on the other hand, these dangers are but little known and appreciated by the profession, to say nothing of the gross ignorance and consequent carelessness of the laity in regard to the matter. To develop this branch of the subject will be the aim of the succeeding pages. The following table exhibits a classification of the various non-venereal modes of infection which have been actually reported in literature, arranged according to the various aspects of life in which they occur : 1 Langlebert. La Syphilis dans ses rapports avec le mariage. Paris, 1875. 2 Fournier. Syphilis et Mariage. Paris, 1880. » Diday. Le peril venerien dans la famille Paris, 188 1. CLASSIFICATION OF THE MODES OF INFECTION OF SYPHILIS* Syphilis e coitu illicita. ingenita, vel he- reditaria, e coitu legitima. sine coitu. not considered in the present work. SYPHILIS INSONTIUM SINE COITU a o , -t -, . f i . epidemica. A. Syphilis pandemica •< r -, Jr r (2. endemica. B. Syphilis pandemica w- economica. s sporadica I 2 - brephotrophica. U technica. r i. From cupping. 2. " bre ast- drawing. 3- ' ' hand raising of infants. I. 4- " lactation. 5- accouchement. Syphilis 6. 7- ' ' circumcision. ' ' vaccination. Epidemica 8. eating and drinking, and domestic propagation. 9- ' ' tattooing. 10. " glass blowing. ii. " eustachian catheterization. L 12. ' ' application of tongue to eye. r i. Sibbens. 2. Radesyge. 3- Disease of St. Paul's Bay. 4- Amboyna Pustule. 5- Morbus Dithmarensis. 6. Facaldina. II. 7- Scherljevo. 8. Mai di Breno. <» L ' 1 ' 9- Frenga. Syphilis IO. Spirocolon. Endemica ii. Morula. 12. Mai Kabyle. 13- Yang-mey-tchoang. 14- Syphiloid of Courland, Jutland, Lithu- ania, Hesse, Klein-russland, etc. 15- (?) Frambcesia, Yaws, Pian. 16. (?) Aleppo Evil, Biskra Bouton, Chancre du Sahara, Caneotica, Delhi Boil, Scinde Boil, Parangi, etc. ♦The data in the Synopsis of Facts and Literature, and also the material of the body of the Essay, are arranged in accordance with this scheme, and the details of each feature may be found by referring to the same. (See Synopsis of Facts and Literature at end of volume.) 3 B. Syphilis sporadica Syphilis Econom. ica Domestic and Social trans- mission 1. Eating and drinking and the use of Tobacco I 2. Personal and house- hold effects 1. Implements and vessels Tobacco, Troches, etc. i. Spoons, knives, forks. 2. Cups, glasses, jugs. Tobacco-pipes. Cigars and cigarettes (mouth to mouth). Cigars (infected by makers etc.). Troches. i. Shirts, drawers, etc. 2. Masks. 3. Plasters, bandages, etc. lint. 1. Wearing apparel, etc. 2. Bedding \ Pillows, sheets, etc. 1. Towels, sponges, etc. 2. Combs. 3. Tooth brushes, etc. 4. Syringes. ) 5. Sick-chairs, privy seats, etc. I 6. Other methods in family I life. f 1. Handkerchiefs. I 2. Pins. I 3. Canes. L 4. Opera glasses. 3. Toilet articles. 4. Miscellaneous articles r 1. Buccal Active and tem- porary- contact 1. Kissing 2. I Biting 2. L Digital \ 1. Reciprocal. 2. Non-reciprocal. 1. As a caress. 2. For defence or assault. 3. Accidental tooth wounds. Auto-infection (poison con- veyed by own act). Hetero-infection (poison conveyed by another's act). wounds ( 4. Passive contact Industrial trans- mission 1. Buccal 2. 1 Digital By occupation re- quiring use of the mouth 2. By necessary or un- necessary use of the lips. By substances in- fecting the fingers 1. Scratching. 2. Pinching. Contact in sleep. Contact in carrying, porting, etc. 1. Glassblowers (pipes). sup- Assayers (blowpipes). Weavers (spinklers). Musicians (wind instru- ments). Conductors (whistles). Servants (speaking tubes). 1. Cooks (tasting spoons). 2. Furriers (thread). 3. Upholsterers (tacks). 4. Shoemakers (pegs). 5. Clerks (pens, pencils, etc.). 6. Cashiers and others (money, etc.). 7. Druggists (labels, etc.). 8. Artificial flower makers (needles, etc.) Laundresses. Old clothes dealers, rag- pickers. B. Syphilis sporad- ICA (contin- ued) II- Syphilis Brepho- troph- ica Acquired through nutri- tion of infants By lacta- tion 2. By hand- feeding of infants 1. Nurse infected by nurs- ling 2. Nursling infected by nurse or by another nurs- ling Adults infected 2. Infants infected Nursling heredita- rily syphilitic | Nursling having l acquired syphilis 1. Nurse has prim- ary lesion of the breast Nurse has recent syphilis but no chancre of the breast Another nursling L the syphilifer r i. By new-born he- reditarily syph- ! ilitic children S 2. I In weaning child- ren with hered- I itary or acquired L_ syphilis r i. r*- Nurse the mother (ex- ception to Colles Law) Nurse not the mother. Acquired in lactation. Acquired by kissing or otherwise per os. Acquired by vaccina- tion, circumcision, etc. Child infected in lacta- tion. Child infected by kiss- ing and otherwise at nipple. Child infected from mucous patches on nipple. 2. Child infected from a nipple contaminated by soiled fingers, etc. 3. By supposed infection through the milk. * Nipple the medium of transmission. Nursing bottles. Artificial teats. Chewing the food for child. Spoons, cups, and other objects. 2. Acquired in con- nection with at- tend- ance on infants Mediate contact with soiled articles (infant alone infected) By attendants j i 2 - I By other child f os- ^ tered with it Toilet articles f 1. Nursing bottles. J 2. Artificial teats. j 3. Chewing the food. [_ 4. Spoons, cups, etc. By use of same imple- ments, nursing bottles, etc. 2. Direct contact Active, limited ^ contact f 1. Wash water. 2. Sponges, etc. 3. Combs. 4. .Syringes. ( 1. Diapers. . Cradle clothing. 1. Reciprocal 2. Non-recip- rocal. C Adults fants nfected. Is 2. Passive contac. ^ Aerial I In parturition 2. J During slumber i (in bed) Accidental ! Adults tooth wounds j infected. . Adult receives chancre. . Infant infected by at- tendant. Distal infection by own soiled fingers. Infection by infant's soiled fingers. By nail- -/ Adults usually infected. t, wounds ( j By blowing or sputtering / "in infant's face. j Infection per partum (in- j fant alone infected). j Contact in bed (infant or I . adult infected). ^ By contact in arms j 2. Adult infected. Infant infected. *9 B. nica Operator the victim Unnecessary exposure f 1. Manual (digital) j Auto-inoculation | (purely accidental) 2, Neces- sary expos- ure Cephalic, 1. Buccal. Facial. Syphilis sporad- ICA (contin- 2. ued) Operator the III. syphi- Syphilis lifer Tech- Direct contact 1. Digital contact Infecting finger seat of chancre 2. Infecting finger soiled saliva, etc. With a wound. Buccal I contact Without a wound. I Instrumental contact (Instrument soiled with operator's saliva) Operator the medium By means of transplantation and inoculation 2. « By means of unclean "j instruments Cutting instruments i. Operative. 2. Cadaveric. U i: i. Chirurgical manipulations 2. Obstetiical manipulations by Surgeons. Accoucheurs. Dentists. Attendants. Breast drawing. Wound sucking. Inflating lungs of new- born. Applying tongue to eye f i. Infection by own fin- I gers. J 2. Direct contact. I 3. Aerial transmission (coughing in face, I etc.). ( Infection by vaginal anal ■i and other explora- ( tions. j 1. Mother mfected. ( 2. Infant infected. New-born infected (at umbilicus). Infection by raising palate and like pro- cedures. Wound sucking. Office of \ sylle cumcision). (cir- Solid, organiz- ed substances 2. Liquid substances 1. Wound accidental Wound intentional 2. ta Blunt instruments. By means of unclean substances 1. In suspension 2. ^ On bandages, lint, etc. 1. Breast drawing. 2. Removing foreign bodies from the eye. 1. Tattooing (needle). 2. Cupping (as done in Finland). 1. Transplanting teeth. 2. Skm grafting. 1. Vaccination (from pri- mary or secondary syphilised vesicle). 2. Variolation. • 3- Syphilisation. 1. Dental instruments. 2. Infection in razor wounds. 1. Phlebotomy. 2. Minor surgery. 3. Wet cupping.. 4. Leech bites. ■ v 5. Tattooing (needles in- fected from previous subject;. 6. Vaccinatum (soiled in- struments, etc.). 1. Eustachian catheteri- zation. 2. Sounds and specula. 3. Sierres fines, portes caustiques, and other apparatus. 4. Tongue spatulas.' 5. Svringes. 1. Wash water. 2. In local therapeutics. 1. In surgical dressings.. 2. In circumcision. CHAPTER III SYPHILIS INSONTIUM SINE COITU. — CLINICAL CONSIDERATIONS. MODES OF INFECTION: IMMEDIATE CONTAGION, MEDIATE CON- TAGION. LOCATION OF PRIMARY LESIONS. The methods by which non-venereal syphilis may be acquired are innumerable, and relate to every conceivable circumstance and surrounding of life. As each new case or series of cases is re- ported, it becomes more and more probable that the number of instances in which syphilitic infection has thus occurred is far greater than is commonly supposed. With a poison so virulent, and capable of being transported and introduced in so many different ways, endowed with the possi- bility, as far as is known, of being preserved for an indefinite period, the only wonder is, that cases of the non-venereal commu- nication of syphilis to innocent victims are not even more common than they are now known to be. The explanation of the relatively greater frequency of cases of venereal syphilis, is found in the nature of the virus, which requires a broken or abraded surface of skin or mucous membrane for its admission. This solution of continuity may be produced at the time of inoculation, or, infection may take place in the site of an old injury or abrasion; or, sometimes it would appear that the poison may itself cause an erosion of the surface, if long retained between folds of the mucous membrane. When the conditions for its entrance are all present, it will be seen that inoculation rarely fails to take place on any and every portion of the body. But in the genital region the delicate char- acter of the mucous membrane, and the frequent abrasions which occur during coitus, together with those arising from herpes, eczema, or other conditions, afford a ready entrance for the poison, 2 2 SYPHILIS INSONTIUM which is also further favored by prolonged contact, together with heat and moisture. It will not be necessary to discuss here the nature of syphilis, or the physiological and pathological questions connected with its mode of entering the economy and development therein, nor need we enter upon the subject of any possible relationship between the chancroid and the chancre, or initial lesion of syphilis; these topics are somewhat foreign to our subject and have been abun- dantly considered elsewhere. It is here understood that we are dealing with true syphilis, which is a specific infectious disease, always communicated by the direct transference of a contagious principle, of whose real nature we know little, which induces a similar disease in another person. The point of entry of the syphilitic contagion is marked by a sore, called the initial lesion or chancre ; this may and does present a great variety of appearances according to its location, the health of the individual, the treatment employed, and possibly other conditions which cannot be explained. In some instances it presents a striking, ulcerative surface, in others the lesion may be so slight as to have attracted little or no attention • it may remain for some considerable length of time, yielding only slowly to constitutional treatment, or again it may disappear rapidly under even the mildest local measures alone. The only exception to the existence of the local sore as the first manifestation of syphilitic infection, is found in inherited syphilis, where the offspring receives the disease with its life or through its uterine nourishment, and also in the probable, though not wholly proven, infection of the mother through a foetus, which has inherited syphilis from its father. In studying the subject of the communication of syphilis, we find two methods of transference of the poison : First, by immediate infection, or the direct contact of one person with another, and Second, by mediate infection, where the infective principle of the disease is conveyed on some material object, in the same manner as vaccine virus is carried on a quill, or ivory point, or the lancet. By these two methods alone can inoculation take place, and sufficient care in investigation will often, if not always, reveal the exact mode in which the accident has occurred. It is to be re- membered that there is no occult manner in which the disease can be acquired, that it is not transmitted by the breath or through the IMMEDIATE AND ME3IATE INFECTION 23 air, as are other infectious diseases, nor is the disease gotten by anv simple nearness to the affected person, or by contact, unless there has been an actual transference of the poison from one in- diviual to another. 1. Immediate infection. Of these two methods of communi- cating the disease, this is by far the more common, and is the mode in which most cases of venereal syphilis are acquired. Many cases of syphilis in the innocent are also caused thus by direct contact r as in the case of kissing, biting, etc., and also in the infection occurring between nurslings and nurses, and otherwise. 2. Mediate infection. While much less frequent, this method of infection is, in one sense, much more important than the former, because of its insidious character, the source of infection often being unsuspected until long after the disease has become fully developed in the victim. A large number of the cases of syphilis insontium occur through mediate infection, and the time of the de- posit of the virus on the mediate article and its absorption by the victim are commonly unknown; much of the seemingly occult nature of many cases of syphilis may be thus explained. In the greater proportion of instances of non-venereal syphilis, the virus comes from mucous patches, generally from those seated upon the lips and tongue ; in some cases the material is taken di- rectly from a chancre, and in a few instances the source of conta- gion is syphilitic blood : still more rarely the disease is acquired through pus or other products of the syphilitic process. It is not believed that normal secretions, such as the saliva, milk, or tears can communicate the disease : in cases where this is supposed to have occurred, there have probably been mingled with the* secretions some of the products of syphilis, as that from mu- cous patches or possibly blood, which have been the active agents in communicating the disease. In regard to the semen, it is well recognized that this does transmit the poison to the product of conception, so that the child may inherit syphilis directly from the father, without the mother having actively acquired the disease ; it is also an accepted fact that the mother does become in some manner infected or protected thereby, so that she is no longer capable of acquiring syphilis from her own child in nursing or otherwise, even although she may not herself have exhibited any signs of syphilitic disease ; but to this so called "Colics' law" exceptions have been reported. 24 SYPHILIS INSONTIUM It is, however, hj no means proven that the semen can convey syphilis otherwise than through the agency of conception, although certain cases have been reported of the alleged acquiring of the disease in this manner, and Baumler 1 thinks it probable that infec- tion can thus happen ; it seems more likely that in these cases some secretion from a diseased mucous membrane, becoming mixed with the semen, had been the real conveyor of the poison. In cases of immediate contagion the date and circumstances of the communication of the disease may commonly be made out, but in many cases of mediate contagion it is often extremely difficult to determine whence the poison is obtained, or exactly when the poison was absorbed ; a striking illustration of this will be men- tioned later on in connection with circumcision syphilis. Exira-genital chancres. The subject of extragenital chancres has received considerable attention at the hands of many observers, and instances may be found where the initial lesion of syphilis has been seated on every conceivable portion of the body. While the topic under consideration is syphilis inso?itium rather than that of extra-genital infection, which latter, as is well known, may be of venereal origin, it may be well to briefly allude to the statistics accessible in reference to the location of extra-genital chancres, as indicating in some measure the relative possible frequency of syph- ilis insontium. The following table is compiled from cases observed in the venereal clinics in the large cities of Europe, care being exercised to avoid duplication of statistics, which has occurred repeatedly in some of the published tables of like character. Separate special reports in regard to large numbers of cases of extra-genital chan- cres, affecting different regions alone, as on the lips, tongue, throat, eye, etc., have been excluded from these statistics, and will appear in another table (Table III.), as the object now is to show the relative frequency between genital and extra-genital chancres, in ordinary venereal practice. 1 Baumler. Ziemssen's Handb. der spec. Pathol, u Therapie. Bd. III., T. I., 3d ed. Leipzig, 1886, pp. 46, 47. EXTRA-GENITAL AND GENITAL CHANCRES 25 hd hd Cfl O O td H 1 ° P P § * 3 1 • fr A P p "-J p <£ P "-S g.i? H*P r4 CD gp'p s 1 1 2 1 CD 1- 3 S- P- CD p*S P C/q p 2 1 p p 1 p ""* vj p 1 £> rp o>- < • P*o ^ d? ■ •■i G ^ ^ £ o/g. ^ P Cd£ O P 0) ^ p" ?r • p - p - N 2. P CD % • O CD . T C QP " p p w P &3 ^ CD - p p z So 2 n P -• -V8?. cd" W ^ en ' CD ^L a P tn'f> -j 1 -• c> "• "*B 3 p cdp- g 1 • P P- • P P p ? 1*3 8 p- > . p P ■ r 1 * "? f 3 d~. CD ^ •^ <_o ^4 to O co U> U> 8 r^ to to LTl M to en -P> S«"§S ^ --J <_o 4=> u» O -li- O CO to O en Ss" £ s? n "S en U5 (_n to to Oi O H U> ^J -F* co vO ^4 CO — • j^ 3 gL^ > 00 S" r m CO M H ■vj H to w Lips. «Ni r - 45> UX vO O O co 4- to to to "»4 MO H Breast. Oi to Fingers w M O Oi (hand). ^r to UX to co Tongue. cr> to Oi co w Throat. CO - ua Oi - Nose. ~J - O Chin. ^J - « « « - to Eyelids. O - Oi to Cheek. Buccal O Cavity. +* Oi - Neck. U> to - Forehead. to 1 £ Unclassed. 26 SYPHILIS INSONTIUM ■ In this table, comprising 7123 cases, we find the initial lesion is recorded as extra-genital in 353 instances, or almost five per cent, of the entire number, and the chancres are found on almost every portion of the body. But it is to be remembered that extra-genital chancres are really very much more frequent than would be indi- cated by the numbers here presented, for these data are furnished chiefly from venereal clinics, where those go mainly who are sup- posed to have diseases acquired in sexual intercourse. But in addi- tion to the cases of extra-genital chancre which would be thus seen, casually, as it were, there are large numbers of innocent inocula- tions of syphilis, happening in foundling-asylums and elsewhere, in addition to the many which have been observed in special clinics, such as those for the eye, throat, skin-diseases, etc., which would not enter any general venereal statistics: it is probable, therefore, that the real percentage of extra-genital chancres w T ould be very much increased, probably duubled by these additions, so that they would form possibly ten per cent, of the whole. 1 The statistics in regard to the relative frequency of extra-genital chancres are found to vary greatly as given by different reporters, being always very much larger in cases of syphilis observed among females. The reason for this latter' fact is probably found in the circumstance that it is frequently difficult to discover the primary lesion upon the genitals of females, it being often deeply seated, and more commonly overlooked, for various reasons ; so that, the total number of genital chancres actually seen in this sex would naturally be much less than in an equal number of male syphi- litics. On the other hand, extra-genital chancres would, if any- thing, be rather more likely to be complained of and noticed in females. To this must be added the additional risks of infection in the latter, especially in the matter of marital exposure, in lac- tation, and in the care of syphilitic infants. Thus, among 2618 cases of chancre in the male, recorded by Bassereau, Robert, Fournier, Sigmund, Lefort, Pellizzari and Breda, there were 156 instances of extra-genital chancre, or a trifle under six per cent. ; whereas among 926 cases of chancre in the fe?nale, recorded at the St. Lazare, Lourcine, and at Vienna, 1 If any should think that this percentage is too high, let it be remembered that in a considerable proportion of cases of constitutional syphilis which come to any one for treatment, the actual site of the primary lesion is not known with certainty, especially in regard to women ; since the attention of the writer has been especially directed to this subject, for ten years past, he has been greatly surprised at the number of extra genital (and mostly innocent) chancres that have been found Dy a little careful searching in his clinics. EXTRA-GENITAL INFECTION IN FEMALES 27 Florence and Padua, there were no which were extra-genital, or nearly twelve per cent. We have no means of forming an accurate estimate of the pro- portion of non-venereal cases among these 353 instances of extra- genital chancre given in Table I, but from what will appear later it is probable that a very large number were of this nature. Fournier 1 has recently furnished some interesting data bearing on this subject of syphilis insontium, from his private practice, which will aid us in understanding the relative frequency of this form of syphilis. Among 887 cases of syphilis in females, he found that in 842 cases the origin was sexual, and in 45 cases, or 5.07 per cent., the disease was acquired in a non-venereal manner. These cases were as follows : TABLE II. Cases of Non-Sexual Syphilis ill females i7i private practice (Fournier). Cases of domestic contagion, derived from nurslings, children, wet-nurses, or nursery maids with syphilis fall the cases occurring in married women or young children), . .12 Cases of infection transmitted to nurses by children heredi- tarily syphilitic, 3 Cases of hereditary syphilis, 7 Cases of midwives infected on the finger in the exercise of their profession, ........ 5 Cases of syphilis acquired accidentally in infancy, ... 4 Cases of syphilis communicated by vaccination, . . . 2 Cases of syphilis communicated by Eustachian catheteriza- tion, 2 Cases of syphilis communicated by rape, .... 1 Cases of unknown origin, but certainly non-venereal, . . 4 Total cases of syphilis insontium, 45 Among the remaining 842 cases there were 220 married women, and about an equal number whose social position was not recorded, some of whom might have been married : the remainder, 366, were unquestionably public characters. Of the 220 married women there were 56 doubtful cases, who were excluded, as either having contracted syphilis from a lover, or for other reasons, leaving 164 infected honestly and innocently, in their married relations; of the 164 husbands of these women, Fournier found that 82 had contracted syphilis before marriage, 39 after marriage, and in 41 cases the date of infection was not recorded. Thus, after the elimination of all doubtful cases, he found that of all the females 1 Fournier. Annales de Dermatol, et de Syphiligraphie, tome VIII., No. 12 (1887), p. 757. 28 SYPHILIS INSONTIUM consulting him who had contracted syphilis from sexual inter- course, nearly 20 per cent, were married women, infected inno- cently, through no fault of their own. Adding this to the 5 per cent, of the first class, he states that, in his experience, in private practice, nearly 25 percent, of the females contracted the disease innocently and undeservedly. In the discussion on the paper, Ricord stated that the matter had not been at all exaggerated, but that he himself had met with fully the same percentage. My own statistics, although considerably smaller, tell a much sadder story. Taking 5 00 recent cases of syphilis, in private practice, there are found to be 339 males to 161 females, the latter forming about 7,2 per cent. Of these latter there were 120 who were married or widows, and 41 single, or children ; among them were 20 cases of inherited syphilis. Of the 120 married or widowed women 10 had obtained their disease through extra-genital chancres, and two had late hereditary syphilis, leaving 108 to be accounted for by other means of infection. After a very careful examination of the his- tories of the patients, and the exclusion of all doubtful cases, I am positive that in over 50 per cent, of these married women the dis- ease was contracted innocently from their own husbands: in a dozen or more instances the husband was either under my treat- ment or observation for syphilis, and recognized the source of in- fection. Adding together then, the 10 cases of extra genital chancre, 20 of hereditary syphilis, and 54 infected wives, we have 82 cases, or over 50 per cent, of all the females in private practice, in which syphilis was innocently acquired. It will be seen later, that males are also exposed to syphilis insontium, and may acquire the disease quite as innocently as in the instances of females just cited : indeed among the personal cases recorded in Chapter IV. the male cases were actually in excess of the females. In the case of hereditary syphilis, and brepho- trophic syphilis, male children are, of course equally exposed with female children, while in the ordinary domestic exposure males and females are alike liable to contract the disease ; there are even some elements, such as the smoking of pipes and cigars, which in- crease the proportion of the males. Furthermore, many occupations and circumstances render men peculiarly subject to the contagion ; thus, surgeons and accoucheurs are constantly exposed to the infec- tion of syphilis, and a very considerable number, from first to last, have acquired the disease in their profession; many cases have LOCATION OF EXTRA-GENITAL CHANCRES 29 likewise occurred among glass-blowers, as also in some other trades. Syphilis has also repeatedly been given in tattooing, which is rarely practiced in females, while in earlier years it was also not infrequently communicated in circumcision. It would seem therefore that putting these statistics and facts together, there must be at least ten per cent, and possibly a much larger proportion of cases of syphilis which are acquired in a per- fectly innocent manner. The statistics just quoted from Fournier, it is to be remembered, are taken from his private practice alone, and are thus supposed to represent the better and more intelligent classes in Paris; it is altogether probable that among the more ignorant and careless communities of peasants, where the disease has sometimes spread over large districts, there is a very much greater proportion of cases of syphilis insontium, as may be judged from the facts developed in Chapter VI. , in regard to epidemic and endemic syphilis. LOCATION OF EXTRA-GENITAL CHANCRES. We may now briefly allude to the localities where the infecting sore has been recorded to have occurred, and will present some statistics from which may be judged the relative liability of the various portions of the body to be infected. The following Table III. has been prepared by adding together the individual instances of extra-genital chancre reported by different observers in the countries there indicated, as presented in the Analytical Biblio- graphy at the end of this work : the very greatest care has been exercised to avoid any possible repetition of cases, by consulting the original reports of the same, and excluding the statistics which have been at times tabulated by others : the cases here compiled are recorded by several thousand individual observers. It is not sup- posed that all of the cases on record are here tabulated, but enough have been collected to indicate both the large numbers of reported cases of extra-genital infection, and the relative frequency of the sore in different localities. The table presents the analysis of 9058 cases of extra-genital chancre. It would be very much larger if we could include multitudes of cases where the location of the sore is not accurately stated, such as those reported "from eating and drinking, " " from care of children, " and the very large numbers of infants infected in Russia and elsewhere " by means of nursing." 3° SYPHILIS INSONTIUM ^ <3 in r^ r^ _, ON Tf co CI in CO o> o Ol Ol i> CI Cl 'l*)°L *0 01 co 01 a- co r^ ID O ON 'SuiocmBj^ ON 1 01 1 1 1 M Ol 1 | 01 co •uoisp o O O I 01 in f^ 1 | ON •Xuicqoqapqj puBSuiddn^ 1 co 1 1 O CO XT) 01 1 1 1 in <* CO co r-^ O ,_, N CO 1 i t^ p-eaqajo/f 1-1 1 i co •sumQ co in o> Ol 1 Ol vO 1 1 Cl ,J P 3 M CO <*■ •H in •"• - CO 1 1 r- <* •UIJB3JOj[ CO ^f XO CO M <* co 1 m ON in •H^IHJL r^ o 01 On co O xn a i co PUB §3^ CO i r^ •JB3IU3S-U3J 01 o ■ M <* ol CO CO 1 1 •snuy On CO " ">* M <* 1 1 1 t> co •asoj^; CO in CO r^ CO vO r~^ XT) - 1 1 ON O r^ M •o O _ 04 M i o •jjunjjL co -* i o o ON On ON r^ M ,_, 1 Ol in ■3133^3 o M 1-1 1 ^1- CO o O r^ M ID 01 1 1 O • u mo co 1-1 1-1 4-H 1 1 ^f On o i_i o !_, in |_! r^ •anSuojL co M 1-1 in •JBSBU pUB p3JO i>. o o •sijsuox CO in 01 Ol Ol M M 01 1 o co •BApDimfuoo puB spqaAg On. o o co CO O Ol O M ON 01 H co •puBH PUB o o in r^ O XT) ON in N Cl sjaSuij HI rl- •XlTAB3 r- rf in ON r~~ ON 1 CO p3Donq; -* r^ •3|ddip<[ o XT) co O co r~- co co CO 00 CO -* Ol M O CO N *t pus 3SB3.ig o CO vO ON CO •H r- Ol M 0) M TO TO ^ nd* •d o" < c3 TO • TO rr) jn CD •» TO . «5 O ' fa.T2 , to .9 2 TO 4-> o rtU £ 'aJ 3 fc ttf TO CQ , fa fa 7 fa fa f the eruption until his aticiiuon was directed to it. Search was made for the primary lesion, but the geiiita ^gion was found to be free from such, nor was there any evidence of a chancre about the mouth or throat. It was then noticed thar the left index finger was bound up, the man explaining that he had injured it, and it was being treated with salve by a druggist. On examination an ulcerating surface was seen involving all the tip of the finger, and extending beneath the nail, which was long and protruding: the surface was raw, moist, and shiny, but no hardness could be made out. There was very great adeno-pathy at the left elbow and some in the axilla, none in corresponding- locations on the right side. There was no explanation found for the infection ; he had been fishing six weeks previously, and it was sore since that date. The ulcer yielded promptly to vigorous mercurial treatment. Case LXXX. Chancre right ?niddle finger. Mr. W. B., aged 26, injured the skin at the root of the nail of the right middle finger, seven weeks before his visit, by bruising it against a box. The abrasion failed to heal, and soon began to ulcerate, and con- tinued sore until his visit ; he had kept it poulticed much of the time. When first seen, November 21, 1883, the end of the finger was greatly swollen, and the root of the nail was involved in a large ulcer extending well on to the base, rather more on the ulnar side, covering an area of over half a square inch ; the tissues were soft and movable, and no induration could be made out. There was a large, painless gland, just below the right axilla, the size of an almond, and a smaller swelling in the left axilla; inguinal aden- opathy also existed. The entire body was covered with a maculo- papular eruption, developed in some places into large, flat papules ; the palms also were thickly covered. There had been no rheu- matic pains or sore throat. The chancre on the finger proved very rebellious to treatment, and gave a great deal of pain in its further course ; it did not heal for nearly three months, although 84 SYPHILIS INSONTIUM he was faithful in attendance, and active anti- syphilitic measures were employed, in addition to local treatment. The constitutional symptoms were pretty severe and prolonged, but finally all ceased, and when seen lately, over seven years after infection, he was in perfect health ; he had had no treatment for several years. CHANCRE OF THE BREAST. Seven cases of chancre of the breast are here recorded: five of these occurred in nursing mothers, three of whom infected their own nursing children: one case occurred in a very excellent woman, in private practice, who was not nursing, and who prob- ably acquired the chancre from her husband's mouth ; they resided in a distant city, and he was never seen : the other case was in a young woman, on the skin of the breast, away from the nipple, probably from kissing. Case LXXXI. Chancre of the breast. Mrs. W. C, aged 26, pre- sented herself, December 18, 1876, at the Demilt Dispensary, with well-marked chancre of the breast, which was acquired two or three months previous to her visit, by nursing a strange child who had sores about the mouth. Her' own child, eight months old, was also brought at the same time to the clinic, with an abundant macular eruption, similar to that seen in acquired syphilis in older persons. The records are imperfect in regard to this case, and no statement is made as to where her child received the infection, it being only recorded that the child was born healthy, and that the eruption was of very recent development. Case LXXXII. Chancre of the nipple. Mrs. W. D., aged 27, had been bringing her child to the Dispensary at intervals for over a year, for impetiginous eczema, from the time when he was seven months old; she then presented herself, on February 11, 1877, with a well-marked chancre of the nipple. She remained under observation but a short time after this, and notes of the case have not been preserved. Case LXXXIII. Chancre of left nipple. Mrs. W. E., aged 29, a married lady, who had never had any children, was sent to my office on December 6, 1880, on account of a very general eruption of a large, scaly, papular syphiloderm, which was especially profuse and distressing on the face. The eruption had existed fully three months, and had been preceded by great malaise CHANCRE OF THE BREAST 85 and a very bad sore throat, she stating that she came very near having diphtheria. In seeking to establish the mode of entrance of the poison, it was learned that she had first experienced a soreness of the left breast about five months previously, and shortly after this a lump was noticed under the left arm ; this had been treated by poultices and the eruption soon followed. The breast lesion was very small at first, and discharged a little, but it gradually increased until it was an inch in diameter and involved all the nipple, the entire breast also becoming much swollen : the axillary adenopathy sub- sided without suppurating. She had had some specific treatment, as the nature of the disease had been suspected by her physicians. When first seen there was an ulcer, about three-quarters of an inch in width, occupying the site of the left nipple, with sharply- defined edges, and a red, raw-meat looking surface, giving off a sticky secretion. Under active treatment much of the eruption, which was rather a peculiar one, with thick, succulent lesions, disappeared within a few weeks; the chancre also began to im- prove rapidly, and by December 28 was almost entirely healed, when she left for her home in another State : at that time some distinct hardness could be felt in the chancre, but previously this was hardly recognizable. She was seen on later occasions and exhibited palmar and plantar syphilides, throat lesions, etc. It was never discovered exactly how the breast became infected, but it was supposed to be from her husband: he was never seen, as he was much occupied with his business in a distant city. Case LXXXIV. Chancre of the nipple. Mrs. W. F., aged 30, presented herself for the treatment of cutaneous gummata on various portions of the body. Some time previously she had taken a strange child to nurse, from an asylum : three or four weeks later an indurated sore had developed on the nipple, which was followed shortly by symptoms of constitutional syphilis, which were more or less continuous until she applied for treatment. Case LXXXV. Chancre of left nipple. Mrs. W. G., aged 32, a very intelligent patient, was obliged by the sudden death of her husband to take a strange child to nurse, when her own was but a few months old. Fearing contamination she very carefully kept the strange child on the left breast, while she sedulously gave the other alone to her own child. Within some weeks the foundling 86 SYPHILIS INSONTIUM died, with fully developed hereditary syphilis, and the mother then gave both breasts to her own child. A short time afterward, the breast which had nourished the strange child became sore on the nipple, and the nicer resisted treatment for a long time, so that after a while her own child ceased to nurse -from it, and was kept on the other breast alone. Some weeks later she became affected with general symptoms, and when she applied for treatment, September 12, 1878, she had a well-marked papulo- tubercular syphilide. Her child also developed the disease before long, and had vari- ous lesions on the skin, and subsequently suffered much from bone-syphilis, which produced considerable deformity in the tibiae and ulnae. The child has been seen repeatedly, at various times, up to the age of thirteen years, though quite irregularly, and the mother has from time to time come for treatment of late gummy lesions. Case LXXXVI. Chancre of the nipple. Mrs. W. H., aged 35, had noticed a sore on the nipple for some time previous to her first visit, October 13,. 1876, but could give no definite history as to its origin. It was recorded as a typical hard chancre of the nipple, but the notes of the case are scanty. Her child, a girl aged thirteen months, was brought with syphilis, with the history that it was born healthy and had acquired the disease since its mother became affected, but no- further record was made as to the existence of any buccal chancre on the child ; we know, however, that in nursing children these are often very slight, and frequently escape recognition. Case LXXXVI I. Chancre on side of breast. Mrs. W. I., an actress, aged 22, came to the New York Hospital, for treatment, August 24, 1892. On the skin of the left breast, fully an inch from the areola, there was a sharply cut, round ulcer, about three-quarters of an inch in diameter, with a reddish base, giving off a small amount of glairy secretion. When first seen it did not seem hard, but a week later this feature was well marked. She had a pretty general, diffused, small scaly syphilide, with mucous patches about the vulva and anus; mucous patches also in the throat. She attributed the ulcer on the breast to kissing. Case LXXXVI I. {bis). Yet another case of chancre of the breast should be added to this list. Mrs. O. O., aged about 19 CHANCRE OF THE TONGUE 87 years, seen once in consultation, had a chancre of the left breast, just above and to the left of the nipple. The sore had lasted a couple of weeks, presented some hardness, had a red, eroded sur- face giving off a glairy secretion, and already there was some axillary adenopathy of that side. No notes of the case were taken, and nothing could be learned of the source of contagion. CHANCRE OF THE TONGUE. Six cases of chancre of the tongue were met with, all of con- siderable interest. There were three in males and three in females ; in three instances the sore was on the left side of the tongue, in one on the right side, in one the side was not recorded, and in one it was on the back of the tongue. Case LXXXVIII. Chancre of back of tongue. Miss W. J., aged 22, an estimable young lady, was referred to me, July 14, 1893, on account of an unusual papulo-pustular eruption, confined almost wholly to the arms and legs, with a very few lesions on the face. From its many peculiarities, and the absence of concomitant symptoms, it was not regarded as syphilitic, but as a peculiar folliculitis, possibly caused or increased by the iodide of potas- sium which she had been taking from a former physician on the belief that it was syphilitic. She was put upon pretty active non- specific treatment for four weeks, without producing much im- provement in the eruption ; she was then given mercury and chalk, every two hours, with the effect of almost instant improve- ment, and in two weeks the lesions had largely disappeared leav- ing only brownish stains. On close investigation it was found that in February, six months before her visit, she experienced pain on swallowing, which increased greatly, confining her to the house for three weeks ; she then was treated by a competent laryngologist, who said that there was a curious ulcerated patch on the root of the tongue, just to the right of the median line, different from anything he had before seen in that location. This sore lasted for a month more, finally yielding to active local medication, and some mild mercurial treatment, with iodide of potassium ; the glands on both sides of the neck were swollen, and remained enlarged at the time of her visit to me, and thereafter. A month after beginning the throat treatment, and seven weeks after first noticing the sore, the SS SYPHILIS INSONTIUM papulo- pustular eruption appeared; there had been great malaise which was supposed to be from the diphtheria, which her trouble was thought to be. No clue could be obtained as to the probable source of infec- tion ; she was engaged to be married, but for certain reasons her fiance could not be interviewed. Case LXXXIX. Chancre left tip of tongue. Miss W. K. , an intelligent and modest girl, aged 25, a sales-lady in a dry-goods store, applied at the New York Hospital, on October 31, 1888, for the treatment of a sore tongue, which she naturally feared to be cancer. The history was, that about six weeks previously she had first noticed a small ulceration on the left side of the tongue, followed a few weeks later by swelling of the glands beneath the jaw on that side. The soreness increased continually up to the time of her visit, when it gave her very considerable pain in eating and drinking, and even in talking there was much discomfort. When first seen, there was a small induration on the left side of the tip of the tongue, with a fissure through its centre. Two weeks later, when a water-color drawing was made, the lump had increased materially in size, the entire left half of the tongue was much reddened, and a star-shaped fissure was seen, nearly half an inch across, of a deep red, with whitish edges; the mass in the tongue was of a very decided hardness and the size of a hazel-nut. The under surface of the tongue, on the left side, was covered with mucous patches, which also existed in the throat and on the lips. The sub-maxillary glands on that side were greatly enlarged, but there was no general adenopathy, and as yet, no eruption. Later the post-auricular and other glands enlarged, and a ringed maculo- papular eruption appeared around the mouth. Under active treat- ment the sore began to improve, and the mucous patches disap- peared, but it was not until about two months that the ulcer had healed, and the hardness remained for some considerable time longer. After repeated questioning of her alone, I could not discover that she had been in any way exposed to syphilis ; she lived quietly at home, and had no intimate male acquaintances. I was led, therefore, to accept the probability that the poison was conveyed by the means of pins, which injured and inoculated the tongue, as she was in the habit of placing them in that side of the mouth CHANCRE OF THE TONGUE 89 regardless of where she had obtained them; she herself remarked that she must have been poisoned in this manner, as she was con- scious of having thus wounded the tongue. Case XC. Chancre left tip of to?igne. Miss W. L., an in- telligent girl, aged 26, of good appearance, applied on December 20, 1878, for the treatment of a ringed papulo-erythematous syph- ilide about the mouth, with a few patches of slightly scaly syph- ilitic eruption elsewhere, which had existed for two weeks: she complained of the throat, and on examination mucous patches were found on the palate and tonsils. On the left side of the tip of the tongue was found an ulcerating sore, which, on questioning, was found to have existed some little time, and to have been the first lesion to attract attention. This ulcer was somewhere about half an inch in diameter, a little raised, sharply defined and very hard: the anterior cervical glands were much enlarged. She denied utterly having ever had sexual intercourse, and the contagion was traced, in all probability, to a female friend with syphilis also attending the clinic, with whom she had had much to do, using the same utensils, etc. Case XCI. Chanc7-e of left side of to?igne. Mr. W. M., a married gentleman, aged 41, was brought to me in consultation October 6, 1888, on account of a sore tongue, which had refused to heal under ordinary local measures. On examination, there was a small, round mass, hardly one- half of an inch in diameter, on the left side of the tongue, near the tip, which was sharply defined, decidedly red, shiny, and presented a marked, though not very great, hardness; the glands under the left side of the jaw were swollen. There was no other sore any- where, neither on the penis, nor on any other portion of the body. The patient and his physician thought that he had no eruption, but, on stripping, the body was almost entirely covered with a distinct macular syphilide, which must have been of very recent appearance. I learned from his physician that he subsequently had many other manifestations of the syphilitic poison, and had not quite recovered when he passed from his care. The exact source of the inoculation could not be learned. He had broken a bit from the front lower tooth five weeks previously, and the sharp edge had irritated his tongue : he then went to a strange dentist, of not very good practice, and had the tooth filled, and soon after that the sore had developed more prominently. 9© SYPHILIS INSONTIUM But he was also a great smoker, and he had likewise drank, more or less, in tasting beer in his brewery, from the same jug which his brewer had tasted, the latter having had syphilis, with sore throat, not very long before. Case XCII. Chancre of side of tongue. Mr. W. N. , a bricklayer, aged 43, presented himself February 7, 1885, with a macular syph- ilide and mucous patches. At the first visit, no trace of the mode of entrance of the poison was found, possibly from the haste of the examination, but it is recorded that the penis was normal. One week later, on careful examination, a healing chancre was found on the side of the tongue, with a very distinct hardness at its base. No clue was obtained as to the mode of infection ; the patient had been drinking heavily some time before its occurrence. Case XCIII. Chancre right side ofto?igue. Mr. W. O., a gentleman of intelligence and position, aged 60 years, came to me September 11, 1884, on account of a sore on the tongue, which he feared to be a cancer. The history was, that he had first noticed a little point of soreness ten weeks before his visit, which had gradually increased in size, in spite of treatment at the hands of another physician, who apparently had not recognized its character, until, latterly, it had come to give him considerable annoyance, so that he was con- scious of its presence at all times. On examination there was found on the right side of the tongue, about an inch from its tip, a hard, inflamed mass, nearly half an inch in diameter, the centre ulcerating, and the edges somewhat everted, and presenting a little hardness when pinched ; it was not painful except when irritating food or drink touched it. The two upper molars on that side were found to have sharp and rough edges, and he had been wearing a red rubber plate until recently. There was a small, enlarged and painful gland beneath the jaw on that side. Thinking that the lesion might possibly be due to irritating local causes, he was given a soothing mouth-wash and an alkali internally. Five days later there was a marked improvement in the sore, he had had the roughened teeth smoothed off by his dentist, and had left out his set of artificial teeth. The ulcer then had a less angry look, but its edge presented a hardness sugges- tive of parchment, was more clearly defined, and the surface less ulcerated; the glands beneath the jaw were more swollen and hard. CHANCRE OF THE CHEEK 91 The diagnosis of chancre of the tongue was then recorded, and the patient placed upon active an ti- syphilitic treatment. Three days later it was noted that the ulcer on the tongue had improved, had diminished in size, and that the glands beneath the jaw were smaller and more distinct. He then called my attention to cer- tain large, flat, red points on the palms, and these were found to be part of a general, maculo-papular eruption which had just appeared, and which covered much of the body ; it was learned that he had had considerable malaise during the preceding month. The chancre healed rapidly and steadily under the specific treatment, with no local measures, and six weeks later it was recorded that there was only a scar, with very slight hardness at its base, and no swelling beneath the jaw. In searching for the mode by which the syphilitic poison gained entrance, it was learned that during the month or so previous to the appearance of the sore, he had been, through the persuasion of a friend, under the care of a dentist of the cheaper, advertis- ing order, who, he had noticed, was not at all cleanly in his person or instruments. He could not locate the date of injury of the tongue by the dental instruments, but work was done in that locality, and he remembered the instrument occasionally slipping, but did not recall having had the tongue injured. He was a married man, with a family, and had certainly not been exposed in sexual intercourse, nor in any other manner of which he was con- scious ; he was very intelligent and greatly interested in learning how he had acquired the disease. The probability is therefore very strong that the poison was conveyed on the dental instru- ment from some preceding patient who had active syphilitic lesions in the mouth. 1 CHANCRE OF THE CHEEK. Five cases of chancre in this locality, two of which are of very great interest, are recorded here ; all of the cases were in males, and in all but one of the cases the virus probably found entranc • through razor wounds, as also in the cases on the chin. In three instances the sore was on the left cheek and in two on the right. Case XCIV. Chancre of left cheek. Mr. W. P., aged 22, a plumber, applied at the New York Skin and Cancer Hospital, 1 See paper by the author " On the Dangers arising from Syphilis in the practice of Dentistry." International Dental Journal, August and September, 1890. 92 SYPHILIS INSONTIUM January 10, 1893, for the treatment of a flat papular syphilide, very generally diffused over the face, body, and extremities. Three months previously he had had what he called ' ' a pimple " on the left cheek, near the corner of the eye, just below the malar prominence ; this he had squeezed, and it refused to heal. It gradually became large and hard, and very shortly a swelling appeared beneath the ramus of the left jaw. On examination the entire surface was pretty thickly covered with a large, flat, syphiloderm, already becoming somewhat scaly, with some general adenopathy. On the left cheek near the malar prominence was a dull red mass, somewhat oval, nearly an inch in its longest diameter, with the surface glazed, and presenting some hardness on palpation ; beneath the left jaw the glands were fused into a large hard mass. He was most carefully examined, from head to foot, and no other evidence of a primary lesion was found than the one described. The genital region was absolutely free. No clue could be obtained as to the probable source of infection. Case XCV. Chancre of left cheek. Mr. W. Q., a druggist, aged 33, unmarried, came, on March 10, 1882, for consultation in regard to a general eruption of a papulo-squamous character, covering almost the entire body and extremities. Although he had been exposed he had never contracted any venereal disease, and at the time there was no trace of a chancre upon the penis, nor had there been any. But upon the left cheek there existed a sore which at once attracted attention and proved to be a chancre, with the fol- lowing history : He had always been shaved at a barber's shop by different persons, using the public brushes and cups indiscriminately. About two-and-a-half or three months before his visit, his cheek had been cut by a new barber, who, he noticed, was uncleanly in his habits, and who shortly left the employ. A pimple soon formed on the site of the injury, which was again cut from time to time by the razor, and the place covered with court-plaster; the sore enlarged, and the crust was allowed to remain upon it. About two weeks later, the spot had fully developed into an ulcer, he had a chill, followed by pains in the bones, for which he took quinine; he also noticed a lump under the left jaw shortly after the development of the ulcer, and a little later the general eruption appeared with which he presented himself. CHANCRE OF THE CHEEK 93 When first seen there was on the left cheek, not far from the angle of the month, and about an inch from the angle of the jaw, an ulcerated mass about three-quarters of an inch in diameter, circular and slightly raised, and with a raw, succulent surface, in which many hairs still stood, partly covered with a crust; the lymphatic glands under the left jaw were as large as small almonds, and there were also some smaller ones in front of the neck. The entire body, scalp and limbs, were covered with a brownish, papulo-squamous eruption, of very characteristic ap- pearance. The throat was also very sore, especially the right side, from abundant mucous patches. The subsequent course of the disease was very distressing. The patient was obliged to conduct his drug store, with little or no aid at times, and the treatment was often interrupted and imperfectly carried out. Owing to his constant standing, he early had ecthymatous ulcerations on the lower extremities ; he had much trouble with the eyes, choroiditis, quite incapacitating him at times. He also had several very strange nervous attacks ; at one time on leaving my office he became lost, how, he never remembered, and was carried out of town and found himself in New Jersey ; at a later period he exhibited perfect locomotor ataxia, which was removed by active treatment; and for a period of over two years, while under observation, he had as severe symptoms as are often seen, rendering him almost helpless on several occasions, although his symptoms w T ould often yield fairly to well-directed and active treatment. The glands beneath the jaw were noted as still swollen, and the mark of the chancre still present on the left cheek six months after the first visit, or nearly nine months after the date of its first appearance. Case XCVI. Cha?icre beneath left jaw. Mr. W. R.. aged 33, married and the father of two healthy children, was sent to my office, January 21, 1893, for the treatment of a very general maculo-papular syphilide, which had made its appearance about two weeks previously; the eruption was unmistakable and involved the face, trunk, and extremities, the palms and soles having also hard papules on them. The throat had been sore for over a month, and he had considerable malaise, with much nocturnal headache. Although he admitted having been exposed in connection, he had never had any sore, nor was there any trace of an initial lesion on the penis, in the urethra, nor in the genital region. 94 SYPHILIS INSONTIUM A considerable enlargement of the glands beneath the left jaw, of which he complained, drew attention to that region, and on investigation it was learned that he had had a sore just under the left jaw, half way between the angle of the ramus and the centre line of the chin. This had begun about two months previously, as a small pimple which he had lanced and squeezed, but which did not heal for a long time, it remaining hard and sore. There was still the remains of a circular red lesion, about half to three-quarters of an inch in diameter. In regard to the mode of infection, it was learned that he had been shaved on November 24, and had grown a beard since then. He was in the habit of playing on various violins, at his teacher's, and the sore was exactly where the violin rested beneath the jaw; but no clue could be obtained as to the exact source of the virus. Case XCVII. Chancre of right cheek. Mr. W. S., aged 40, a wine merchant, was sent to my clinic from another Hospital, Sep- tember 26, 1883, with the diagnosis of sycosis parasitica on his card, and with the note that he had been applying corrosive sub- limate and sulphide of zinc ointments, without benefit. He then had a sore patch on the right cheek, the lower edge of it just above the edge of the jaw, nearly an inch in diameter, and almost circular. It was elevated, possibly an eighth of an inch, its centre being partly covered with epithelial cicatrization-tissue, and the margin about a quarter of an inch in width, more raw ; the hairs had largely fallen or had been epilated, the sub-maxillary and sub-lingual glands were enlarged. No history of the source of infection could be obtained ; he had been shaved publicly and had noticed a papule on the cheek, which was shaved off, and kept increasing in size up to the time of first observation. As the sore had been greatly irritated, he was given a zinc ointment, and, although the diagnosis was recorded as chancre of the cheek at the first visit, the hairs were submitted to micro- scopic examination, which, of course, yielded negative results. Under the zinc ointment the crusts and epithelial covering came off, and most of the hairs fell out, leaving a red, raw and moist surface. Three weeks later he began to have excessive alopecia, and a general, small papular syphilide covered the entire surface; some general adenopathy also occurred, he having been without specific treatment. Under active medication his symptoms all yielded CHANCRE OF THE EYELID 95 very rapidly, and while then under observation he had very few unfavorable features, except once a dimness of vision of the left eye, possibly from choroiditis, although no ophthalmoscopic exam- ination was made; there was no iritis or external evidence of disease. He was seen again later in my office, almost five years after his chancre, and, complaining still of dimness of vision, the eyes were examined by Dr. Knapp, who found a pigmentary retinitis from chronic choroiditis in both eyes; the sight improved very materially under specific treatment. Case XCVIII. Cha?icre of right cheek. Mr. W. T., aged 30, a seaman, came to my clinic on October 13, 1883, with a chancre on the right cheek, possibly acquired through shaving with the utensils of a comrade with syphilis. Unfortunately the case-paper relating to this case has become mislaid and details cannot be given, other than the record from the Hospital register given above. CHANCRE OF THE EYELID. Four cases are here recorded, three in males, all on the left eye, one on the upper and two on the lower lid ; and one case in a woman, where the history pointed to a chancre of the left lower eyelid, which had been removed for an epithelioma. Case XCIX. Chancre of left upper eyelid. Mr. W. U., a waiter, aged 24, was under treatment for tinea versicolor and gonorrhoea, when, on January 16, 1886, it was noticed that he had a sore on the left upper eyelid. It was situated towards the outer angle of the eye, sharply defined, of a yellowish-white aspect, with a raw surface, and depressed in the centre ; it extended from the edge of the eyelid almost three-quarters of an inch upwards, and was about half an inch in length. Under very active anti-syphilitic treatment, the ulcer rapidly healed, and he had very few syphilitic manifestations, except adenopathy, headache, and, later, asarcocele which was thought to be gonorrhceal, but which yielded promptly to an increased strength of the anti-syphilitic treatment. No source of infection was made out, but the man was of loose habits. Case C. Chancre of left lower eyelid. Mr. W. V., aged about 26, applied at my clinic for the treatment of a maculo-papular syphilide covering much of the body. On searching for the 96 ' SYPHILIS INSONTIUM primary lesion, it was discovered, seated on the outer half of the left lower eyelid. The characters closely resembled those pre- sented by the case just described, a hard, whitish-yellow ulcer, one- half by one-quarter of an inch in diameter, seated directly on the edge of the lid. The full notes of the case are mislaid, but the case is still very vivid in my mind, and was recently recalled to my attention by one of the gentlemen who saw the case with me. Case CI. Chancre of left lower eyelid. Mr. W. W. , aged 28, first noticed a small red point on the lower eyelid three weeks pre- vious to his visit, March 11, 1892. This had the appearance of a stye, and was lanced by an oculist one week before, of course without result ; the sore point continued to enlarge to the time of observation. When examined, the left lower eyelid was seen to be the seat of a tumor the size of a small chestnut, a little to the left of the median line, which nearly closed the eye: this was very hard, and on its surface there was a slight, superficial ulceration, giving it a glazed appearance, of a vivid red, and extending inside the lid. There was very marked pre- auricular glandular enlargement, and the sub -maxillary gland on that side was the size of a pigeon's egg. It was thought that possibly infection took place through a towel, as he was a waiter in a hotel where there were 100 waiters who often used a towel in common; but possibly it occurred otherwise. Case CII. Chancre of left lower eyelid. Mrs. W. X., aged 43, came under my care November 13, 1880, for an ulcerative syph- ilitic eruption on the lower part of the left leg, presenting also scars of other similar lesions on the left forearm and elsewhere: she had also an exquisite pigmentary syphilide on the neck. She gave no history of syphilitic infection, but on close ques- tioning it was learned that she had had a lesion on the left lower eyelid, some four years before, and her description of it answered so closely to the appearances presented by chancre in this locality, that it was believed to have been such, as it had immediately pre- ceded the active syphilitic symptoms ; it had been excised by some one for an epithelioma, after it had lasted some time. There existed a small superficial scar, involving about half of the lower lid, presenting perfectly healthy cicatricial tissue, without the slightest attempt at a return of the supposed epithelioma. The young age of the patient (^8 or 39 years at the time of the opera- CHANCRE OF THE CHIN 97 tion), the perfect results after a relatively slight removal, coupled with the description of the original sore, seemed to leave no doubt but that it was the initial lesion of syphilis in her case : other cases are on record where chancres of the eyelid have been excised for epithelioma. CHANCRE OF THE CHIN. Four cases (one added since the tables were made), are re- corded of the initial lesion on the chin ; three of these were observed directly, and in the other case the history was so clear that it must be accepted as such, although the sore had occurred two years before observation. Case CIII. Chancre on left side of chi?i. Mrs. W. Y., aged 36, applied on January 15, 1889, for the treatment of an ulcer on the left side of the chin which had then lasted nearly two months. She could give no very clear history of the formation of the sore, except that it had steadily increased in size from a small scratch or papule, until the time of her visit ; she had been treated at different dispensaries, and by several physicians, but the sore refused to heal. When first seen the ulcer was somewhat oval in shape, and rather more than half an inch in its longest diameter. The margin was sharply defined, and raised, but the centre somewhat depressed, and covered with a thin, shiny crust, beneath which the surface was raw and secreting; there was some adenopathy on that side ; it is not recorded if there was any hardness to the ulcer. There was a maculo-papular eruption, just appearing on the neck and chest, and soreness of the throat. Under active mixed treatment and a calomel ointment to the ulcer, it healed with remarkable rapidity, although the eruption continued to develop, and she had afterward much periosteal pains and headache. Nothing definite could be learned in regard to infection ; but her husband had recently returned after an eighteen-months' absence in Panama, with an eruption which was supposed to be syphilitic, and it is probable that a scratch became inoculated in kissing. Case CIV. Chancre on left side of chin. Mr. W. Z., aged 39, was sent to my office, February 6, 1892, for a very severe large papular eruption, which was particularly developed about the face, but also 8 98 SYPHILIS INSONTIUM very extensive on the body and limbs ; it had existed for two or three months. Some three or four months before his visit he had noticed a sore on the left side of the chin, three-quarters of an inch below the left corner of the mouth, which was accompanied with swell- ing of the glands beneath that side ; this was soon followed by the eruption. There was no chancre on the penis or elsewhere. The sore had healed under the treatment given previously, leaving a slightly depressed, oblong scar, about three-quarters of an inch in longest diameter, which was still considerably reddened, but not hard. It was supposed that infection took place through a razor cut, but he could never trace the source of the virus. The syphilis ran a very severe course. Case CV. Chancre on right side of chi?i. Mr. V. A., a married gentleman, aged 50, had not been exposed to venereal disease for twenty-five years, and had never had any lesions of the penis. Two years before his visit, September 21, 1887, he had been cut by a barber on the right side of the chin, but could give no particulars in regard to the exact source of infection. The cut point refused to heal and became an ulcer, which lasted six weeks, and finally was cured by local caustic -treatment alone, leaving a depressed cicatrix a third of an inch in diameter ; he stated that he had taken no medicine internally for twenty years and was not conscious of having any eruption of the body prior to that for which he sought relief. This eruption was first noticed about two months before his visit, while bathing in the sea, it appearing first on the right upper arm, the other points following and increasing up to the time of observation. When first seen, there was a characteristic, late, papulo- tubercular syphilide in the right eyebrow, on the right upper arm and thigh, and on the left wrist. The lesions were mostly dis- tributed in circles and broken curves, and were moderately scaly. There was tenderness of both tibiae, and some mouth lesions, although these were rather doubtful, as he was a great smoker. For the few months previous to being seen he had had pain in the front and top of the head, without cause. The eruptions all disap- peared in the course of some months under anti-syphilitic treat- ment, but he was seen again eighteen months later, with large surfaces of quite deep and ulcerated tubercular syphilis, on differ- ent parts of the body. CHANCRE OF THE HAND 99 Case CV. {bis). Chancre on left side of chin. The following case, in private practice was overlooked in making up the preceding tables. Mr. G. F., aged 25, first noticed a pimple to the left of the median line of the chin, on February 22, which became sore, ulcerated, and lasted until May, finally healing under local treat- ment ; when largest the ulcer was the size of the thumb nail. At the same time he had great swelling of the glands beneath the jaw, much malaise and shooting pains, and an eruption appeared about four weeks after the beginning of the ulcer ; the hair then fell and he had sore throat later. When first seen, December 4, 1891, he had the remains of a general, large papular syphilide, with general adenopathy. The scar of the chin chancre presented an oval, depressed surface one- half by one-third of an inch in diameter. There was no lesion on the penis, nor had there been. No source of infection could be found; he was shaved fre- quently by a barber, but knew of no means by which he was infected. CHANCRE OF THE HAND. Two cases occur here, one on the back of the hand, and one at the base of the left thumb. Case CVI. Chancre of back of left hand. Mrs. V. B., aged 25, applied at the Skin and Cancer Hospital on September 1, 1886, for the treatment of a large papular syphilide, chiefly annoying on the forehead and cheeks, with mucous patches on the lips and tongue. There was also headache and alopecia. The initial lesion still existed on the back of the left hand, of the origin of which how- ever, she could give no clue. The history was, that two months previously a small lesion had appeared on the back of the hand, which was treated by her phy- sician with nitric acid, and had gradually enlarged, refusing to heal. When first seen there was a shallow, indurated ulcer, about the middle of the back of the left hand, circular in shape, and about half an inch in diameter: the eruption began to develop about six weeks after the appearance of the ulcer. This patient was the one who communicated syphilis to Mrs. Z. Z. , already mentioned (Case XXVI.), by means of the chancre of the lip. Case CVII. Chancre at base of left thumb. Mr. V. C, aged 24, had been rooming for several months with a young man who had LOFC. ioo SYPHILIS INSONTIUM been under my treatment for syphilis, when he came to my office on August 4, 1892, on account of an ulceration on the hand. Three months previously, while scuffling with his companion, he had struck the part against his teeth and made a cut three- quarters of an inch long ; the wound bled profusely, but refused to heal, and gradually developed into an oval ulceration, one- half by three-quarters of an inch in diameter. By a comparison with my notes of his friend's case I find that just at the time of the injury his lips and tongue were the seat of abundant mucous patches ; he had been warned against giving infection, and, being an intelligent student, thought that his efforts had been successful, until the sore on his friend's hand occurred. When first seen, three months after infection, the ulcer was beginning to heal, being covered with a crust: but it was very hard and sharply defined, and there was marked cubital adenopathy, as also glandular enlargement in the neck and elsewhere, with considerable sore throat, but no eruption, although some appeared later. The chancre healed very rapidly under mercury and chalk, one grain every two hours. CHANCRE OF THE NOSE. Case CVIII. Mr. V. D., aged 38, came to me, October 2, 1888, on account of a very great soreness of the left nostril, with some redness and inflammatory condition of the external tissues. It was learned that about March 2, seven months prior to his visit, he had noticed a collecting and drying of mucus in the nostril, and had applied to a physician, by whom he had been treated frequently, ever since, by means of sprays and ointments ; but the trouble had remained and increased until he presented himself at my office; the external lesions had appeared about three weeks before his visit. He had had no internal medication, as his disease had not been suspected to be syphilis. There was then a great swelling of all of the left nostril, which stood open, and was covered interiorly, on its outer wall, with a dried crust, and on the margin there was some ulcerated surface free from crust ; the outside of the nose was reddened and uneven from small nodular masses. There was no history whatever of preceding syphilis, and the lesion was suspected to be a chancre, rather than a later manifestation of the disease, but the diagnosis CHANCRE OF THE EAR ioi was most difficult to substantiate at the first visit. He was given a mixed treatment with calamine and zinc ointment to be applied freely, outside and inside the diseased nostril. One week later it was noted that the change in the condition of affairs was very great ; much of the external redness and swelling of the nose was gone, and the ulcer within the nostril had healed over. At this visit he was carefully examined, and a fading maculo-papular syphilide was discovered ; there was cubital aden- opathy, and he afterward had mucous patches, etc. Two weeks after his first visit the inflammatory element had about disappeared from the nose, and it was recorded that the left ala nasi presented an ivory-like hardness, which remained dis- tinctly, and was noted each time when he was seen, even six weeks later; the ulceration of the primary lesion on the mucous surface of the ala, healed entirely in a few weeks from the first visit. In searching for a mode of infection, it was found that, being a custom-house broker, he was accustomed to be much with sea- men from the ships, using the same towels, etc. ; it was there- fore supposed that in some manner, in picking the nose, or possibly in wiping it with a towel, he had conveyed the poison to some abraded surface within or at the edge of the nostril. He knew of no other mode of infection, he had no lesions on the genitals, nor had he been exposed in sexual intercourse for two years. CHANCRE OF THE EAR. The following case of chancre of the left ear is interesting, as the man from whom he received the injury was known to have syphilis. Case CIX. Chancre of left ear. Mr. V. E., a printer, aged 33, applied at the New York Hospital, November 24, 1880, for the treatment of a greatly inflamed ear, which had been torn in a fight, three weeks previous to his visit, it having probably been bitten. The man with whom he had fought had early syphilis, with the mouth sore from mucous patches. The surface had been much irritated by basilicon ointment and other applications, and when first seen the entire left auricle was greatly inflamed, with crusted exudation around a large ulcerated surface ; the diagnosis of dermatitis was made, and 102 SYPHILIS INSONTIUM palliative and soothing treatment adopted. Two weeks later it was noted that the lesion had spread greatly, and then occupied a space three inches long by two inches wide, in front of the ear extending down towards the lobule. The surface was ulcerated and irregularly elevated, with considerable tumefaction of the edge ; the ulcerative process extended on to the external auricle, which was red and cedematous, and also into the auditory meatus, which was occluded by the swelling. The pain in the sore was very great, especially at night ; it was ordered to be poulticed, the poultice being made with a lotion of permanganate of potash, and, some laxative pills containing blue mass were ordered. One week later the surface was suppurating freely, with large, florid granulations, but with an improved appearance; the pain was still intense at night, abating toward morning. The diagnosis of chancro was now made, and the poultices were stopped and a mild calomel ointment applied, and internally a mixed treatment given, with a mercurial purge. Three days later the ulcer was recorded as still about three inches long by two wide, with hard, everted borders^ but with improvement in its general appearance; the pain soon lessened under this treatment, and on January 5, six weeks after his first visit, the ulcer was "completely healed, leaving a red, scaly surface. A large papular syphilide had just appeared, covering most of the body and extremities. Later, mucous patches, bone-pains, and other syphilitic symptoms completed the history of constitutional syphilis. CHANCRE OF THE LEFT TEMPLE. Case CX. Chancre of left temple. Mrs. V. F., aged 29, who worked with her husband in making artificial flowers, came to the New York Hospital April 18, 1891, on account of a very general, large, flat, papular syphilide, which was particularly well devel- oped about the head and neck. The history was that about the middle of January, three months previously, there had appeared on the left temple a small pimple, which was scratched, became crusted over, the crust was removed again and again, and the sore beneath it increased in size, almost to the time of the visit. Of late it had become more dry, and was healing over. A few weeks after the sore was first noticed the general eruption had appeared. CHANCRE OF THE LEFT SIDE OF THE NECK 103 On examination a dusky red, slightly raised solid patch, an inch or an inch and a half in diameter, was seen on the left temple, partly within the hairy surface ; there was not very much hard- ness, but the edges could be very distinctly felt, all around. The post-auricular and anti- auricular glands were large and hard on that side, and some moderate general adenopathy ; mucous patches in buccal cavity. Later on she had double iritis, first on the left side, and also alopecia, etc., the syphilis running a very severe course. In order to eliminate genital chancre I had her most carefully examined by the gynaecologist of the service, and no trace of a primary lesion could be found on the external or deepest parts. No clue was ever obtained as to the source of the infection, although she was an intelligent woman and aided me in my investigations. CHANCRE OF THE LEFT SIDE OF THE NECK. Case CXI. Chancre of left side of neck. Miss V. G. , aged 22, applied at the Skin and Cancer Hospital, September 4, 1891, for the treatment of a sore upon the left side of the neck : it was about the size of a walnut, rather hard, and protruding considerably from the surface, and with a red, slightly excoriated surface, with a little sero-purulent discharge. As the nature of the lesion was doubtful, and suggested strongly a small sarcomatous tumor, excoriated by the dress, she was given a one-per-cent watery solution of fuchsine, to be kept applied to the surface : there was no internal treatment given, as it was desired to wait for further developments. One week later the tumor had softened some and was less elevated. Two weeks after her first visit there was post-cervical aden- opathy on each side, and three days later still, an abundant macular eruption of syphilis appeared on the body : the sore on the neck then appeared very much better, from the use of a mild mercurial lotion which had been given her on her second visit, when the true nature of the lesion had been suspected. On close inquiry it was found that a few weeks before her first visit she had had a bee sting on the neck, which she afterwards scratched, and a lady friend had applied court-plaster to it, wetting it once or twice on her tongue ; the small point had in- creased then steadily in size, up to the time of the visit. It was 104 SYPHILIS INSONTIUM supposed that the infection was thus given on the court-plaster, though nothing could ever be learned in regard to the person applying it. CHANCRE OF THE FOREARM. . In one case, that of a very intelligent gemleman, the evidence pointed very clearly to the acquiring of syphilis by tattooing on the arm, some years before he came under observation. Case CXII. Chancre of right forearm. Mr. V. H., aged 43, came to my office for the treatment of leukoplakia, April 19, 1883: he was a great smoker, and had been particularly troubled with the mouth and tongue during the previous year. When first seen there was little in the mouth to suggest any- thing beyond the condition often observed in those using tobacco excessively : the sides of the tongue, especially the right side, were the seat of pearly white patches, sharply defined, and there were also some patches on the insides of the cheeks. He denied having had syphilis, though he acknowledged a suppurating bubo twenty years before. With a diminution and occasional cessation in the smoking, and with a weak chromic acid solution applied locally, and alkalies internally, the white patches lessened very decidedly, and within three months had about disappeared. When next seen, five months later, he had a well-defined, though not very prominent patch of tubercular syphilitic eruption on the scrotum, and also one on the thigh, and it was then noticed that he had dark stains here and there from what he had called boils, and on the side of the right middle finger there was an infil- trated mass which cracked. He was put upon a mixed treatment, and the lesions disappeared quite promptly, without local measures ; a month later he had again a scattered tubercular eruption, this time on the palms. At later periods he had other scattered lesions. While he had previously considered himself in good health, he now noticed that there had been a marked improvement in his general condition under the use of anti-syphilitic treatment. After establishing the diagnosis of syphilis we endeavored on several occasions to trace the source of infection, without avail, until I noticed a tattoo on the right arm, he having been a sea- captain; on close questioning I learned that about seven years previous to his first visit he had had the tattoo replaced by an old CHANCRE OVER THE COCCYX 105 sailor, as the former one had not been distinct. This second tattoo, he said, behaved differently from the former one, and from others he had seen, and was sore for some time, but his memory was not good in regard to the peculiar local features exhibited. Some three or four months after this second tattooing, he began to have the eruption on the palms, and he had noticed that since that date his tissues had behaved differently than they had previously done, not healing as before, when subjected to injury. CHANCRE OVER THE COCCYX. The following case exhibits the chancre in a most unusual locality and from a most uncommon cause. Case CXIII. Mr. V. I., aged 45, a gentleman with a grown up family, was sent to me in consultation, from a distant city, September 20, 1887, on account of a diffuse maculo-papular syphi- lide, with general adenopathy. He was perfectly positive that he had had no venereal exposure in any manner whatever, and was shocked, as well as indignant, at the suggestion of the nature of his disease, he having only very recently cautioned his own son against sexual transgressions. He had no sore on the penis, and I searched for a long time to find the site of entry of the poison; for the eruption was manifestly of such recent syphilis that I felt confident that the chancre, or its well-marked remains, must be still present. The lips and cavity of the mouth were examined in vain, as also the fingers, and all other portions where one might expect to find such a sore. On questioning still further, as to whether he had not had some ulcerating spot on any portion of the body, he then called my attention to the sacral region, where he said he had had a sore point for a number of weeks, which had been regarded as a simple ulcer, or as an epithelioma by his family physician ; it had, how- ever, been diagnosed as a chancre by a surgeon of prominence in another city, just before his visit, as the eruption had then just appeared. On examining the site, there was found an ulcer just within the fold of the nates, about an inch back of the anus. When the parts were separated,' the ulcer was round, about half an inch in diameter, sharply defined, with red edges and a greyish-white, slightly ulcerating base ; a distinct hardness could easily be made out. This patient was seen again in consultation, some eight io6 SYPHILIS INSONTIUM months after his first visit, and was still suffering from syphilitic lesions, mainly in the month. The supposed and probable mode of infection was very inter- esting. The patient stated that he had long had some itching in that region, even for years, and at times there would be a little fissure along the crack between the nates, which, he said, existed also just before the new lesion developed. Some five or six weeks, perhaps longer, before his visit to me, he had been in bathing, and, quite contrary to his usual custom, he had worn a strange suit of bathing clothes; moreover, on account of the itching in that region he had rubbed and scratched the part vigorously through the bathing trousers. A few weeks after this an attend- ant in a bath had noticed the ulcer forming, which had persisted and increased in size up to the time of his visit. The supposition is that some one, who had worn the bathing suit before him, had secreting mucous lesions about the anus, and had left the clothing soaked with the virus; this was then very thoroughly rubbed upon the already existing fissure, in the effort to obtain relief from the itching, by rubbing and scratching through the clothing. A more perfect opportunity for artificial inoculation could hardly be presented. CHAPTER V. DEMOGRAPHY OF SYPHILIS. CAUSES AND METHODS OF THE SPREAD OF SYPHILIS IN THE PAST AND PRESENT. A. SYPHILIS PANDEMICA (INCLUDING SYPHILIS EPIDEMICA and endemica). B. SYPHILIS SPORADICA (INCLUDING SYPHILIS ECONOMICA, BREPHOTROPHICA, AND TECHNICA). The virus of syphilis is one of the most energetic and certain of animal contagions, and exerts its powers whenever and where- ever it can find a suitable opportunity. When first introduced into a community, it develops and spreads in the most active manner, sparing neither age nor sex, provided it can gain access into the economy; this has been repeatedly shown in the past history of the disease, and will be more particularly described in the succeeding chapters. It will be seen later that whole families have been infected, when, through ignorance of the danger, all have been exposed alike in the intimate relations of family life, especially among the peasantry of certain countries, where household utensils are largely used in common. The reason why any escape, is simply because a sufficient quantity of the active contagious element of the dis- ease has not found access to the system through wounds or abra- sions ; it is questionable whether artificial inoculations would not invariably succeed in producing syphilis, if they were perfectly performed upon those who had not been previously protected by a former attack of the disease, or by hereditary influence, more or less remote. The virus resembles that of vaccinia more closely than any other, and it is expected that this latter can be pro- duced with sufficient care in every newborn infant ; the exceptions only serve to prove the rule. The same would undoubtedly be true of the syphilitic poison if tested in the same manner. 108 SYPHILIS INSONTIUM Such being the case, it is not surprising that the disease has spread with greater or less rapidity, until, as previously stated, it may now be found in almost every portion of the inhabited globe, and appears to be still increasing, certainly in the large cities ; and much of this extension of the disease has taken place in later years, even with the increased knowledge of the pathology and treatment of syphilis, and in spite of the sanitary safeguards which have at times been thrown out against it, here and there, with greater or less vigor. The reasons for the steady spread of syphilis are not difficult to discover. The disease stands alone, and cannot be compared with any other known malady, except, perhaps, leprosy, which many have labored to prove to be but an ancestor or progeny of syphilis. Syphilis differs in very many respects from the other infectious diseases, such as small-pox, scarlet fever, and measles, in its chronic character, wherein lies the source of its great danger. While these latter affections may at times sweep over a community, and attack those who have escaped previous incursions, and pos- sibly a few others, the danger from those infected is ended in a comparatively short time ; the disease runs a definite course, and with proper sanitary precautions, the danger of further spread of the contagion is averted, and after a certain, but relatively short period, the individual can no longer communicate the disease. But with syphilis all is quite different. The patient may be quite ignorant of having acquired the disease, either by venereal relations or otherwise, until the virus has actually been in the system for some time ; it may even be several weeks before the chancre or primary sore is sufficiently developed to render the diagnosis certain. During a part, at least, of this indefinite period, it is quite possible that others may have been inoculated from the already slightly abraded sore. This not infrequently happens in extra-genital chancres, the lesion existing for a very considerable time, and even running its course and being com- pletely healed by local measures, without its true nature being recognized ; indeed, it is often not until the appearance of second- ary symptoms leads to the diagnosis of syphilis, that the point of entry of the poison is found to be some long-continued sore which has just healed. During this period any number of persons may have been most innocently inoculated. Nor is this all, for the danger has only just begun. With the CAUSES OF THE SPREAD OF SYPHILIS 109 development of the secondary symptoms comes the period, often long extended, when the fatal mucous patches, with their virulent, and often abundant secretion, multiply the sources of infection many fold. The period of time during which this danger may last, has never been accurately determined, and perhaps never will be known, and undoubtedly varies in different cases ; but according to the best authorities it may, and frequently does, last at least two years, possibly for a very much longer time in particular instances. In neglected cases, these mucous patches may be very exten- sive, both in the mouth and elsewhere, and when patients are not acquainted with their danger, or are careless, they may and do 1 furnish a prolific source of contagion ; a very large share of all instances of syphilis insontium derive their origin from these mucous patches, as will abundantly appear elsewhere. But it must also be remarked, that cases differ very greatly in respect to mucous patches, and some patients may present very few during the entire course of the disease, while with proper care, they may be kept in abeyance almost entirely. The danger is, nevertheless, ever present, as in Case LXVIL, Dr. and Mrs. X. O., mentioned in the previous chapter, where a physician who had a chancre of the finger, and was fully aware of the danger, finally infected his wife in some manner which was never recognized, possibly through pregnancy. It has often happened that those guilty of sexual transgressions have been the first to introduce syphilis into a community, whereby the disease has gained a footing, and has been spread alike by the guilty and by the innocent. Looked at in its largest sense, however, syphilis cannot, in the light of present knowledge, be any longer regarded as essentially a venereal disease, but as a scourge, ever ready to attack all who may be exposed to its virus. The reason why it is so commonly communicated in the venereal act, is, as already suggested, simply because thereby is fur- nished the most ready and most frequent means of intimate personal contact, during which abrasions of the surface of the skin or of the mucous membrane occur, thus affording the avenue through which the poison gains access beneath the epithelial cover- ing, and is absorbed into the system. The very common location of chancres upon the mucous membrane of the genitals, is also HO SYPHILIS INSONTIUM explained by the great delicacy of the tissues, and their tendency to become abraded, either by friction, or by balanitis or herpes progenitalis or other causes. Finally, patients affected with syphilis are more likely to com- municate the disease through sexual intercourse than are those suffering from other infectious maladies, such as small-pox, scar- latina, or measles, because, it being a chronic affection, and frequently not interfering with the daily life and avocations, they are, from its long period of contagiousness, in a position to trans- mit it to others, with whom they come in contact. If those with the other contagious diseases, were to commit the same acts, these diseases would also be communicated in like manner ; it frequently does happen, for instance, that scabies and the vegetable parasitic diseases of the skin are thus acquired, but they are never even then reckoned among venereal affections. It remains for us now to consider more particularly some of the instances and modes whereby syphilis has been spread to com- munities and individuals, otherwise than by the sexual act. We will first note the occasions on record, where the disease has affected large numbers, or even nations, in such a manner as to entitle it to the designation of a pandemic affection, A. Syphilis pandemic a. We will then consider B. Syphilis sporadica, where it appears only in isolated instances, or in small groups, as opportunities of infection present themselves. These subjects may be further sub-divided as follows, and will form the basis of the succeeding chapters : A. Syphilis pandemica. This term is applied to the disease where it has extended in a short time so widely as to affect many individuals, or even a large part of the population of any district, even as other contagious diseases may become pandemic ; this part of the subject may, for convenience of study, be further sub- divided into epidemic and endemic syphilis. i. Syphilis epidemica. In the instances to be described later under this designation, syphilis has spread with great rapidity, and has affected many persons within a comparatively short time; the disease has often not been recognized at the outset, but later the source of the infection has been discovered, and the epidemic arrested. SYPHILIS SPORADIC A ill 2. Syphilis endemica. In other instances the progress has been more slow, and the disease has seemed to fasten on a people or nation, and to persist for a great length of time, presenting char- acters more or less peculiar, as will be noticed in the succeeding chapters. B. Syphilis sporadica. In the large majority of instances syph- ilis occurs in an isolated or sporadic manner, the virus being communicated to separate individuals ; it is very commonly, no doubt, confined to the person infected , otherwise the number of cases would be infinitely greater, even than at present. As already stated, it is not proposed to consider the venereal aspect of the disease, nor its transmission by heredity or marriage, and our further study of sporadic syphilis will relate wholly or mainly to syphilis insontium sine coitu, or syphilis acquired otherwise than by the sexual act. An examination of the reported instances of the sporadic transmission of syphilis by non-venereal means, or of syphilis sine coitu, shows that the modes by which the disease has been acquired are as varied as are the relations of life ; and yet we find that there is a certain uniformity in these cases, which permits of a very defi- nite analysis, according to the classes of persons infected, and the agent or means by which the virus has been communicated. Thus they may all be grouped in three general classes, as follows : i. Syphilis economica. Here the syphilitic poison is propagated among those having relations in common, through the bonds of common interest, in domestic and industrial conditions. 2. Syphilis brephotrophica. In this class the disease is spread among infants, and those having to do with their care and nourish- ment. 3. Syphilis technica. This group includes those cases where syphilis is communicated in connection with the various forms of body service, medical, surgical, or others of like nature. The sporadic aspect of the disease, is the one which princi- pally concerns us in the present study, because with the advance of knowledge in the recognition of syphilis, it is almost impossible for epidemics, in the strict sense of the term, to occur, and the disease is usually arrested before it has become widely extended in any section, or from any cause ; it will be seen later, however, that even within quite recent times very great ravages have 112 SYPHILIS INSONTIUM occasionally been made, where syphilis has been spread in found- ling asylums, or by a midwife, or among glassblowers, etc. The earlier description of syphilis, and of the epidemics alleged to have been produced by it, are often very confusing, and much thought and ingenuity have been expended in time past in endeav- oring to trace the diseases which were probably confounded with the eruptions caused by syphilis, or which modified its appearances ; on the other hand, in all probability much has been ascribed to syphilis which had no such connection, while much that was caused by it was overlooked. Scabies seems to have been the disease which most frequently masked the lesions of syphilis, while it is certain that leprosy was very commonly mixed up with and mistaken for this disease. As a striking example of the con- fusion existing, it may be mentioned that quite a large volume, 1 published in 1578, purporting to be upon epidemic and contagious purpura, contains descriptions of unmistakable syphilis. The complete demography of syphilis has yet to be written, but from the diligent researches of Hirsch, Lagneau, Lancereaux, Rollet, Rey, Mauriac, Jullien, and others, referred to else- where, our knowledge of the disease as it appears in different countries, has of late years been immeasurably increased. While syphilis has spread steadily, following the ■ tide of human life, sooner or later into almost every region, there is no doubt but that it has in many localities lost much of its severity, and no longer produces the ravages observed in early times. But as a great disease, ever involving new lives, and continually acting as a degenerating force on the human race, syphilis has lost none of its interest for the humanitarian, and to-day, more than ever, calls for sanitary restrictions, which shall diminish the number of its victims. 1 Joannis Coyttari. De purpura epidemiali et contagiosa. Paris, 1578. CHAPTER VI. A. SYPHILIS PANDEMICA. 1. SYPHILIS EPIDEMICA. II. SYPHILIS ENDEMICA. As has been already shown in Chapter I. , syphilis is now a very wide-spread disease, existing- in almost all portions of the earth, in varying severity in different regions, and having existed, in all probability, from the most ancient times known to man. We will now briefly consider some of the modes by which it has thus become diffused, and some of the peculiar forms which it has assumed in different regions and among various communities. Literature contains many accounts of a very wide-spread exist- ence of syphilis in different localities, where it has at times broken out in such a sudden, severe, and general a manner in a community as to give rise to the designation epidemic syphilis, which has been applied to it by many writers. In other countries or sections the disease has spread more slowly and insidiously, and frequently has been recognized to be syphilis only after it had affected very many persons; in many instances the disease has seemed to present features more or less different according to the country and climate where it has taken root. To this latter the name endemic syphilis has been given. Under these two heads we will consider the more or less general extension of the disease. I. EPIDEMIC SYPHILIS. The first general spread of syphilis of which we have record, in a form which at all merits the name of epidemic, was the severe and apparently sudden outbreak, in Europe, at the close of the fifteenth century, of what was looked upon as a new disease, and in regard to which so much has been written. H4 SYPHILIS INSONTIUM As is well known, it was almost universally charged that this "new disease," called variously the Morbus gallicus, Mai francais, Mai de Naples, Mai des Espagnols, Grosse verole, etc. , was imported by the followers of Columbus from the new world, and was carried and spread by the army of Charles VIII. of France, in his invasion of Italy ; certain it is that the malady extended with frightful rapidity and manifested a severity which has hardly been equalled in any accounts of the disease before or since; thus, a writer in 1502, Sabellicus, 1 states that at that time almost one-twentieth of the whole population of that and the surrounding sections suffered from the disease. The extensive ravages of syphilis at this and other times, indi- cate its very frequent communication in an innocent manner, as well as through illicit intercourse; any other view would imply or presuppose an extent of licentiousness quite beyond the bounds of probability. This view is confirmed by the facts about to be alluded to in regard to subsequent sudden developments of syph- ilis in different localities, the instances given being largely, and in many instances wholly, non-venereal. Since the date referred to, the number of occasions in which syphilis has occurred in epidemic form, to a greater or less extent, could hardly be imagined by one who has not especially considered the subject, and as the research extends, the number of instances multiply almost beyond belief. The following table shows a number of these epidemic outbursts of the disease, arranged chron- ologically, giving such data as may be of interest in connection with the same ; the items of this table will be more particularly dwelt upon later in connection with the various modes of acquir- ing syphilis insontium. No attempt has been made to include all the smaller groups of cases, sometimes spoken of as localized epidemics, in this table but some of them are placed with the larger epidemics to show the order in which the different methods of the innocent communi- cation of syphilis have been recognized in different countries. The references to all these, and also to other instances of the sudden outbreak of syphilis, may be found in the Analytical Bibli- ography at the end of this work, and the modes of infection clas- sified in the Synopsis of Facts and Literature. 1 Sabellicus: cited by Lancereaux. A treatise on Syphilis. Sydenham Edit. Vol. i, 1868, p. 24. EPIDEMICS OF SYPHILIS "5 TABLE VI. EPIDEMICS OF SYPHILIS Chronologically Arranged.* First Period, 1577-1654: Central Germany and Switzerland. Chief Source, Cupping. Date. Locality. Reporters. Source of Infection, etc. Number Infected, etc 1577 Brunn. Tordanus. Cupping, bloodletting by wet-cups 180 in the town : (Moravia) Sporisch. and scarificators, in public, by the others from out- (1) Austria. Ozanam. town barber — virus conveyed by unclean cups, etc. lying districts. Zurich, Records of Cupping, sheltering wayfarers, No figures. Switzerland. the Canton. and other modes. Authors cite Meyer- (2) (Meyer- Ahrens, Behrend's Syphilid- ologie). Ahrens, in regard to an episode at Zurich, 1592; but it is evident from numerous prophylactic enactments on record that this was but one of manv epidemics before and after 1592, which were not confined to Zurich alone. x 596 Altorf, (Soldius). Cupping, phlebotomy, etc. but not in Very many; in one (Bavaria) Hornung. public ; apparently from house to place mention is (3) Germany. (Lammert). house, by itinerants ; cases occurred over a large district, — no particular foci, — and the disease prevailed for three years (1596-1599), probably un- explained. made of over 100. J599 Nuremberg, Town- Cupping— Sei/z, the town bathmaster, Over 70 infected. (Bavaria) archives. cupper, etc., was prosecuted and (4) Germany. (Endter). Lammert. punished by the town for allowing his clients to become infected through cupping. 1603 Bamberg, Snit?er. Cupping — in all respects a duplicate of No figures : but (0) Bavaria. Lammert. No. 4. many infected. 1608 Bourgeois. Accouchement— very few particulars, 35 families in- (Rosen de at second-hand. fected. («> Rosenstem). 161s Sommerach, Original Cupping— another instance similar to 14 are prominently Franconia. (Court) the Nuremberg and Bamberg epi- mentioned. (7) (now Bava- ria) archives. Geigel. sodes. 1624 Windsheim, Widmann. Cupping — not stated if from public 70 or more. (8) Bavaria. Horstius. bath, or from itinerant cuppers. 1 The references to the source of information will be found in the Analytical Bibliography, at the end of the work, unckr. the name of the Reporter here given. n6 SYPHILIS INSONTIUM TABLE VI. {Continued). Second Period, 1654-1800 ; Over Most of Europe. Chiefly connected with reproduction of the race } as Breastdrawing* Lactation, Accouchement, Hand-raising of Children, etc. Date. Locality. Reporters. Source of Infection, etc* Number Infected, etc. 1654 (9) 1- Middle- bourg, (Seeland) Holland. Everardus. Breast-drawing— a woman infected many others, recently delivered ; these infected their nurslings ; the latter infected those who tended and hand-fed them, etc. Very many ; Ev- erardus alone treated over 100. §(10) O •a Sorrento, (Naples) Italy. Musitanus. Hand-raising a foundling, which, congenitally syphilitic, was adopted into a convent, and tended and fond- led by the Sisters, many of whom became infected. No figures. 0. u 3 (Not Stated) Vercelloni. Lactation — a congenitally syphilitic infant was wet-nursed by some com- passionate ladies ; the disease was spread, at first by lactation "until the whole village was infected." No figures. 1727 (12) St. Euphemie, France. Bayer. Accouchement— a midwife, first her- self infected digitally, transmitted syphilis to many of her clients, these to their families. 50 parturient wo- men together with 30 or more in their fam- ilies. 1728 (13) Cork, Ireland. Barry. Breast-drawing— a small episode ; some of the infected women transmit the disease to their infants. No figures. J 737 (14) Hungary. Fuchs. Accouchement— like No. 12; no further data. No figures. Alberti. Breast-drawing— said to be related in an essay not accessible, entitled " De osculo morbifero et morbifico." 1746 (15) No figures. 1752 (16) Nerac, (Lot et Garonne) France. Raulin. Lactation — infected nursling; nursing mothers received the disease, and con- veyed it to their families ; epidemic known as " Pian de Nerac." 40 Nurses and nurslings : and members of families. 1770 (17) Leeds, England. Hey. (Lawrence). Breast-drawing— a blind woman, first professionally infected, in turn infect- ed her clients — only a few cases given. Not known. 1775 (18) Paris. Gardane. (Plouquet). ACCOUCHEMENT— a midwife, first pro- fessionally infected, infected her clients. No figures. (?) (19) Stockholm. Bilguer. (Rosen de Rosenstein). Breast-drawing— said to be like the episode of Everardus, but no par- ticulars. 8 infected. 1800 (20) Heinecken. Breast-drawing. No figures. 1844 (21) Montmor- enci, (Seine et Oise) France. Portal. (Lugol). (Moraud and Lassonne). Lactation — a supposed prevalence of scrofula among nurslings, led to an investigation, and most of the nurses were found to be syphilitic. No figures. EPIDEMICS OF SYPHILIS 117 TABLE VI. {Continued). Third Period, 1800-1858 ; Largely i?i Ce?itral Eiirofie. In addition to Modes of Commu?iicatio?i recorded in the Second Period, are found Epidemics from Vaccifiation, Circwncision and Venesectio7i. Date. Locality. Reporters. Source of Infection, etc. Number Infected, etc. 1804 Groningen Munninks. Breast-drawing — subject of a mono- No figures. j (town and graph, but data not accessible, at (22) province), either first or second hand. Holland. 1805 Krakau, Rust. Circumcision— the fact of the myste- No figures — nu- Poland. rious occurrence of syphilis in male merous cases (23) Hebrew infants, healthy at birth and of healthy parents, led to the discov- ery of this mode of transmission ; in this case the psylle or mohel had probably in scattered foci. syphilides in the mouth. 1805 Villages in Wendt. CrRCUMCisiON— this mode of commu- No figures : but j Silesia, nication was recognized by Wendt at victims numer- (24) Prussia. about the same time as above, several small episodes occurring. ous. i8ti jVillage in Wendt ACCOUCHEMENT — not different from Over 50 infected. 1 Silesia, (Walch). previous episodes. (25) , Prussia. (?) Rhine pro- Rust and Circumcision — the cases in Silesia No figures. 1 vinces of Jaffe. and Krakau were only a portion of the (20) Germany : known victims : soon after, cases in towns in some of the Rhine provinces led to an Polandand official investigation : while other epi- Austria. sodes occurred in Warsaw, Wilna, and Lemberg. 18x4 Udine, Marcolini. Vaccination —first authentic cases: No figures : but Austrian Barbantini. vaccinifer had inherited svphilis : nearly all in- fected. (27) Italy or forty vaccinated and a number in- Lombardy fected. 1816 Andernach. Klein Vaccination — began as vaccino-syph- No figures. 1817 (Ruthen- ilis and continued through domestic (28) burg). infection. 1821 Cremona. Cerioli. Vaccination— like No. 28. 40 directly in- (29) 1823 Lombardy. fected. Two com- Settegast Lactation— prevailed some time as an No figures. munes in (Hacker). endemic. (30) j Coblenz, 1 Rhenish Prussia. | 1825 jConde Bourgogne. Breast-drawing and Lactation — 12-14 by breast- 1 (Cotes du (Fournier). nursing mothers infected by first drawing : 5 (31) i Nord), method, nurslings, other nurses and nurses by lacta- | France. their nurslings by second method. tion ; many in- 1826 fants. Wilbedessen Diisterdorf. Lactation — a strange nursling, bas- 23, mostly nursing |(West- (Hufeland). tard of «-t soldier, brought to the vil- women. (32) i phalia) lage by its mother, who could not 'Prussia. nurse it : the nursing-mothers suckled it. n8 SYPHILIS INSONTIUM TABLE VI. {Continued). Third Period (Continued). Date. Locality. Reporters. Source of Infection, etc. Number Infected, etc. 1828 (83) Chavanne- Lure, (Haut- Saone), France. Flamande. (Roller.) Domestic — eating and drinking ves- sels : spread mostly among families allied by blood to the people first in fected : a soldier brought the disease to the first family. 25 and more infected. 1830 (34) Fredricks- borg, Denmark. Ewertzen. Vaccination vaccmifer syphilitic ; all the vaccinnees infected except one midway in the line. 7 infected. 1832 (35) Villages in Schleswick Prehn (Bolsch- wing.) Sheltering Wayfarers— a man with fresh syphilis crossing the country afoot, sharing board and bed with hospitable people, infected some of the latter, who diffused the disease. No figures. 1833 (36) Krakow. Bierkowski. Circumcision : over 100 infants in- fected. Over 100. 1837 (37) Villages in Sicily. Gulli. Domestic — means not stated : the ar- rival of cholera did away for the time with police surveillance of prostitu- tion. Syphilis then spread rapidly and many families were innocently infected. No figures. (?) (38) Circumcision — several episodes are known to have occurred between 1830- 1840, but no data can be furnished. About 1840 (39) Brecker. (Jaffe.) Circumcision. Many infected. 1841 (40) Grumello, Lombardy Tassani. Vaccination— usual features : moth- ers, nurses and others indirectly in- fected : 56 vaccinated, 35 infected and from these mothers and nurses. 64 in all, of these 46 directly. 1841 (41) R , near Luxeuil (HautSaone) France. Alies. Vaccination— (?) causes obscure : pre- vailed two years, and chief lesions genito-anal condylomata. Nearly 80. 1844 (42) Norway. Hjort. Domestic— six families who were allied by blood and marriage visited the clinic in a body. 21 infected. 1847 (*3) Cologne (?) Rhenish Prussia Canetta. B R E A s T-DRA wing — particular i un-l 32, directly inf ect- known. | ed. 1849 (44) Coblenz, Rhenish Prussia Wegeler. Vaccination — revaccination from a healthv child vaccinated for the p xr- pose, from a syphilitic : the vaccinifer was not infected : the vaccinees were infected from its vesicle. Operator veterinary surgeon fined by a tribunal 19, directly infect- ed, others indi- rectly. 1852 (45) Frienfels, Bavaria. Heine. Vaccination — small episode: usual features : operator Hiibner, a homoeo- pathic physician, fined by a tribunal. S, directly infect- ed. 1853 (46) Alsem- bourg, \ Belgium. Joly. Breast-drawing— a nurse, infected by a foundling, infects her 10-year-old son, who drew her breasts, — the son infected a number of nurses, resulting in a lactation-epidemic. No figures : could not be less than a dozen, perhaps many more. EPIDEMICS OF SYPHILIS II 9 TABLE VI. {Continued). Third Period (Continued). Date. Locality. Reporters. Source of Infection, etc. Number Infected, etc. About 1855 (47) Rochecho- nart (near Limoges), (Haut- Vienne), France. Bleynie. (Bardinet). Accouchement — peculiar mode : new- born children only victims. Midwife applied her infected saliva by aid of fingers to stump of cord ; her object being to recover the "lost cord," or to arrest hemorrhage. No figures : but very many. 1856 (48) 1857 (49) Molise and Lupara, Naples. Marone, (Bouvier). Vaccination — special features ; tube- virus used, and numerous indirect transmissions. 23, direct— ir nurses, many others. Rufino, (Tuscany), Italy. Galligo. Vaccination — no especial features. 14, directly infect- ed. 1857 <50) Capistrello, (Abruzzo Ultra), Naples. Government Report : Demarchi and Tan- turri (Rug- giere). Lactation — an infected wet-nurse brought the disease to the place, where it gained a footing by lacta- tion ; it then existed endemically for 8 years, spread chiefly by domestic contagion, and rendered a tenth of the inhabitants syphilitic. 300, in round num- bers. Fourth Period, 1858-18Q2: Over the Whole World. Beside the features in the Third Period there is a reappeara?ice of Cupping as a mode of infection ; and ?iew modes, Glassblowing, Tattooi?ig, etc., etc. Date. Locality. Reporters. Source of Infection, etc. Number Infected, etc. 1858 rod. artificiellement, etc. Paris, 1879, p. 263. 184 SYPHILIS INSONTIUM disease thus, to " a large number of his comrades." Rollet 1 remarks that many military surgeons have cited cases of syphilis from tattooing, observed in Africa, where the practice is very common. In most of these cases, the syphilis has been derived from mucous patches in the mouth of the operator, through the practice of wetting the needles with saliva during the operation, or of using the saliva to moisten the pigment introduced : Geigel, 2 however, in referring to certain cases reported by Poilroux, con- sidered that they were probably caused by the use of the same needles on both infected and healthy subjects, as will be seen to be the case, occasionally, in vaccination. The most complete and interesting account of syphilis commu- nicated by tattooing, is found in the careful and exhaustive report of Maury and Dulles, who give a minute detail of fifteen persons who acquired the disease in this manner from one operator. The man who had pursued the practice had been operating in many cities, and it is supposed that he inoculated a much larger number of individuals ; he was arrested in Philadelphia, and at the time of the report he was detained in the House of Correction; his mouth then presented active mucous lesions, which. had existed for six months or more, as the investigation showed from the records of institutions where he had been treated from time to time. 2. Wet-cupping has, on a number of occasions, been the cause of epidemics of syphilis, sometimes of considerable extent ; this has happened mainly, of course, among the more ignorant, peasant communities of Europe, where the practice was often carried on by itinerant persons, or occasionally in bathing establishments. Tn many of these cases the virus was supplied by the operators, who wet the cups with their mouths ; in others the contagion was given from one person to another, by the scarifying instruments or cups. The celebrated Maladie de Brunn* in Moravia, in 1578, was of this nature, and during the space of two or three months 80 per- sons were attacked in the village, and nearly one hundred in the neighborhood, besides others in the surrounding country. Hjelt 1 describes an epidemic occurring in the village of Hakola, in Finnland, in 1858, where almost 200 persons were infected, the operator being a woman suffering from syphilis ; he also mentions 1 Rollet. Annales de Derm, et de Syph., I. (1S69), p. 403. 2 See Rollet. Traite des Mai. verier., Paris, 1886, p. 459. SYPHILIS COMMUNICATED BY SKIN-GRAFTING 185 several other smaller epidemics, amounting to over 100 more infec- tions, and quotes Dr. Graulund, as having seen many instances of the same. The latter writer believed that the virus was con- veyed by means of the cups, which were made of horn, and which so absorbed the poison that no cleansing could remove it; he, therefore, advocated using glass cups instead. We come now to speak of the third group of cases, in which the operator acts as the medium, conveying the virus on some instru- ment or object from one person to another. in. Operator the Medium of Syphilitic Infection. Here there are three general classes found : 1 st. Where there is some intentional transference of solid or liquid substances, which are found to contain the poison ; 2nd. Where unclean instruments act as the medium ; and, 3d. Where unclean substances act as the medium. 1. Infection by means of transplantation and inoculation. These may be either, 1. Solid, organized substances ; or, 2. Liquid substances. 1 . Solid orga?iized substances, the medium of syphilitic infection. This includes, 1. Transplantation of teeth; and, 2. Skin grafting. 1. Transplantation of teeth has been the means of conveying syphilis, as shown in the cases of Hunter, 5 W. Watson, and others; as this operation may yet occasionally be performed, as reported by Miller 1 and others, these observations are not without practical interest. 2. Skin-grafting is reported by Deubel, as having caused the inoculation of syphilis : A man, 49 years old, had a large ulcerated surface, consequent upon gangrenous erysipelas, and upon this surface, forty-five epidermic grafts were inserted. Thirty-three of these took, and at a later period, forty-three more grafts were applied. The cicatrization proceeded rapidly for a while, when a small greyish spot appeared, an inch in diameter, and very shortly the whole surface became involved in a large ulcer; this remained open for three months, and at the end of this time, an erythema- tous eruption and other syphilitic phenomena appeared; the 1 Miller. Implantation of human teeth : the limits of its success. Journ. Amer Med Assoc. X (1888), p. 354. i86 SYPHILIS INSONTIUM original ulceration then healed under specific treatment. Just before the eruption appeared, the son of the patient, who had furnished some of the grafts, came under Dr. Deubel's treatment for ulcerations at the anus, which were found to be mucous patches. 2. Liquid substances the medium of syphilitic infection. Under this head are included infection in the operations of, i. Vaccination; 2. Variolation; and, 3. Syphilization (so called). 1. Vaccifial Syphilis. The subject of the conveyance of syphilis by vaccifiatio?i, is a very large one, and could alone fill many books, with the data which have been recorded in connection there- with. The memorable debate, in the French Academy of Medicine in 1865, 1 marked an epoch in the development of the subject, which is now well-recognized, and the principles connect- ed with it belong to the common knowledge of the profession. Heyd 2 has made a careful study of the matter, and gives a very full bibliography of the subject; also Kjerner, 3 Petit, 4 Freund, 6 and Fournier 6 have written exhaustive essays upon the same. Freund gives a chronological list of authenticated cases up to the year 1880, with abstracts of the data; the cases foot up to about 400, with a large number of additional infections from them ; he, however, does not refer to any episodes occurring in this country. As will be seen from Chapter VI. , vaccination has at times given rise to many epidemics of syphilis, almost more than those from any other single cause; the first of these occurred in 18 14, since which time groups of cases, from the same cause, have been reported almost to the date of writing ; during the late civil war in this country, syphilitic infection occurred in a large number of instances, estimated even as high as a thousand persons. A number of the episodes were - reported, and the actual cases mentioned amounted to nearly four hundred, as collected by Foster, 1 who has presented the subject very strongly. One of the largest, as well as the most perfectly reported single 1 De la syphilis vaccinale, etc., Paris, 1865. 3 Heyd. Zur Frage der Uebertrag. d. Syph. durch. d. Schutzpockenimpfung, Stuttgart, 1867. 3 Kjerner. Ora Syphilis vac.cinalis, Stockholm, 1866. 4 Petit. Transmission de la syphilis par la vaccination, Paris, 1867. e Freund. Zur Prophylaxe der Impfsyphilis, etc., Breslau, 1880. <> Fournier, Lemons sur la syphilis vaccinale, Paris, 1889 SYPHILIS COMMUNICATED IN VACCINATION 187 epidemic of vaccinal syphilis, is that recorded by Pacchiotti, 1 as taking place in the year 1861 ; this occurred in the town of Rival ta, in Italy, a village of about 2000 inhabitants, where 80 persons were syphilized, either directly or indirectly, through vaccination. The first vaccination was practised on a child named Chiabrera, eleven months old, with vaccine-matter in a tube from the public institute at Acqui ; the child was supposed to be perfectly healthy, but it was afterwards learned that he had been infected with syphilis, two or three months previously, by a woman whose breasts he had drawn, after the death of her own child. This same woman infected her sister's child, in the same manner, and she, in turn, infected her mother. From this first child, Chiabrera, on the 10th day, 46 healthy children were vaccinated, in 39 of whom syphilis developed. One of these children, by name Mauzone, served again as vaccinifer on the 10th day, and from him 17 infants were vaccinated; of these 7 acquired syphilis, and he also gave the disease to his wet- nurse, and himself died from it, within three months. From these 46 children, who were infected in these two series of vaccin- ations, 26 mothers and nurses received the disease, within eight months, together with 3 other children, who had not been vaccinated ; five of the women gave the disease to their husbands, it beginning with a chancre on the penis, a total of 80 up to the time of the report of the Commission; of the infected children 7 died. Put in tabular form, this epidemic stands thus : Liberata Pavone infects by suckling I I Chiabrera Sister's child infects infects (by suckling) i i Its mother. (by vaccination) (by vaccination) (by suckling) Mauzone 38 other children. t Own mother, infects (and dies) infect (by suckling) (by vaccination) Its wet-nurse. 7 other children, infect I Three brothers and sisters. (by suckling and otherwise) (not vaccinated) 26 mothers and nurses. infect I 5 husbands (chancres of penis). i88 SYPHILIS INSONTIUM Another very striking, though smaller epidemic, spread largely by vaccination, is that reported by Adelasio, 1 which occurred near Bergamo, in Northern Italy, in 1862. Six children were vaccinated from a child, GirolamaCarenini, who, although apparently healthy, had had a very mild eruption, which was afterwards regarded as syphilitic ; of these six vaccinees, five had syphilis, and from them six nursing- women acquired chancres on the nipple, and four other persons were infected in various ways. Four husbands were sub- sequently infected by their wives, besides three other children, from nursing; one of these again communicated syphilis to another nursing mother, a total of twenty-three persons from the original vaccinifer. In tabular form, these cases appeaf as follows : Girolama Carenini infected (by vaccination) C. L. (aged 5 mos.) infected D. M. (aged n mos.) M. M. (aged 8 mos.) R. L. (aged 2 mos.) infected I Mother, (chancre of nipple) Sister, (by spoon). (by suckling) C. L, (Aunt, chancre nipple) infected infected (by suckling) I Mother (chancre of nipple). infected I Husband (chancre penis). (by nursing) Own child. (by nursing) A. L., Nephew infected I (by suckling) J L., its mother. infected I (by suckling) Mother infected I Husband (chancre penis). J. V. (aged 6 mos.) infected Mother Brother infected (aged 4 yrs.) I (by spoon). Husband. C. C, Nurse (chan- Mother ere of nipple) (chanc. nipple) and S. C, (her son) infected (from same dishes). | Her own infant (by nursing). Husband (chancre penis). Space forbids ou * entering fully upon the various points in connection with the transmission of syphilis by vaccination, which have, indeed, been fully discussed by many, and which find full elaboration in certain works on syphilis, notably that by Fournier, 60 on " Syphilis Vaccinale. " It may be remarked, however, that a study of the cases which have been carefully reported by many observers, shows that vaccino-syphilis differs in some respects from syphilis transmitted in other ways, and may, in a measure, throw light on the disease as it occurs endemically, under various forms and with different names. It appears to be somewhat influenced by the many elements SYPHILIS COMMUNICATED IN VACCINATION, ETC. 189 of race, climate, and other causes, so that sometimes it has not been recognized until after long and patient study, in the light of later observations. In vaccino-syphilis the incubation of the disease is certainly hastened, so that, as appears also in the epidemics cited, the vesicle, even by the eighth day, can develop syphilitic virus sufficient to inoculate many others, and this again on the eighth day may repeat the process. Again, the syphilis may be so latent that the child may appear to be in blooming health and still serve as a syphilifer. 2. Variolation. The operation of inoculating for variola, has been charged with conveying also syphilis, 1 but no authentic cases are accessible. 3. Syphilization, in the strict sense of the word, namely, the inoculation of an individual free from syphilis, with the blood or morbid secretions from a syphilitic person, will almost, if not quite invariably, be followed by a development of the disease; it is this, of course, which takes place in every case of infection. Occasionally this has been done intentionally, as in the well- known experiments some years ago, in the study of syphilis, by Wallace, Waller, Pkllizzari, Bidenkap, and others. Occasion- ally the poison has been introduced accidentally in the so called process of syphilization, or the repeated inoculation with chan- croidal virus, which was advocated so strongly some years ago, by Sperino 2 and Boeck. An interesting case was reported by Danielssen, 3 where a leper had been inoculated with "virus of a soft chancre, to the extent of nearly four hundred inoculations, when the secretion of an indurated chancre was accidentally inserted. The inoculated point healed, but a month afterwards an indurated sore appeared, followed by unmistakable signs of secondary syphilis." 2. Infection by means of unclean instruments. Under this cate- gory we find cases where infection took place : 1st. By means of cutting instruments; and, 2nd. By means of blunt instruments. 1. Infection by means of cutting instruments. Two classes of cases may be found here, according as 1. The wound is accidental; and, 2. The wound is intentional. 1 De la syphilis vaccinale. Communications a l'Acad. de med., Paris, 1865, p. 209. 2 Sperino. La Sifilizzazione studiata qual mezzo curativo, etc. Torino, 1853. 8 Danielssen: cited by Lee. — Lectures on Syphilis, etc., Phila., 1875, p. 164. 190 SYPHILIS INSONTIUM 1. Infection by accidental professional wounds. The only instances which have been found of this description, are those relating to dentists' instruments, and those given by the razor in shaving. 1. Dental instruments. In Chapter IV. an original case, No. XCIIL, is given, where a chancre of the right side of the tongue resulted from a wound by a dentist, the poison being almost cer- tainly furnished at the same time. 1 Leloir 15 mentions the case of a man with infecting chancre of the gum, in which the contagion seemed to have been produced by the process of preparing and filling a decayed tooth; Lancereaux 8 relates a case of chancre of the gum in a woman, after extraction of a tooth and other dental work, and Giovannini, 2 of Bologna, has reported a chancre of the lip apparently from a dentist's instrument; Otis 5 speaks of a case of a chancre just within the angle of the mouth, on the right side, appearing characteristically about three weeks after a morning spent in a dentist's chair; and Dulles 2 has reported the case of a "woman who was inoculated with syphilis of the most malignant type while under a dentist's hands." Roddick, 6 of Montreal, Canada, a most careful and competent observer, has recorded a very interesting case of chancre of the gum, resulting from infection by means of dental forceps, whereby the gum had been much lacerated, in the extraction of a tooth. The patient was the wife of a physician, aged about 30, and a careful study of every detail led to the conclusion that, "in all probability the instrument used by the dentist was made the vehicle of contagion, by being brought into contact with a mucous patch in the mouth of a syphilitic person, previously operated upon. " 2. Razor wounds. While these have been frequently reported to be followed by the initial lesion of syphilis, no case has been found which proves that the infection occurs by means of the razor itself, indeed, it is most probable that such is never the case ; the frequent sharpening and cleansing of the razor would suffice to effectually remove any adhering virus. The inoculation possibly either takes place in the subsequent manipulations by the hands of the barber, from the towel, or from other means at the time, or, more frequently from a later introduction of the poison. In Chapter IV. will be found characteristic illustrations of infection received through this means (Cases XCV., XCVL, XCVII., 1 Bulkley. — Dangers from Syphilis in Dentistry. Internat. Dental Jour., 1890. IXFECTION IN MINOR SURGICAL OPERATIONS 191 XCVIIL). Nearly fifty different observers have reported cases of this kind, the first, perhaps, was that of Vallauri, in 1836. La- doire-Yver reports the case of an officer, in whom the barber of the regiment, in order to check hemorrhage from a razor-cut, pressed firmly on it with his thumb, and a chancre developed on the cheek in the site of the cut; " when examined, the barber pre- sented a chancre of the same kind as the victim." In many or most of these cases, the shaving was done at a public establishment. Allen 2 has recently mentioned a case, where a man cut himself while shaving with a razor borrowed from a friend, and in the site of the cut a chancre developed ; the friend had an eruption on the face and body, and was said to be suffering from syphilis, but there was no confrontation. 2. Infection by intentional professional wounds (phlebotomy, minor surgery, wet-cupping, tattooing, vaccination, etc.). 1. Phlebotomy. In view of the great frequency of bleeding in former times, and the recklessness with which it was done, often in large numbers together and in succession, it would not be at all strange if syphilis were .often conveyed to the wound. We find, however, but little reference to the subject. Bonorden mentions having seen a case, where a large chancre developed in a wound made by a lancet; an instance is quoted from Adam a Lebenwald, where five healthy persons were bled with a lancet, which had been recently used on a syphilitic, and all five were infected; there is some doubt, however, in regard to the infection here, as it is stated that all the five died, which could hardly be expected from syphilitic infection. 2. Minor surgical operations, have sometimes been followed by syphilitic infection. Lang 1 reported a case, where a gentleman, aged about 40, had a furuncle on the forehead which was incised ; instead of healing, a chancre formed, followed by constitutional symptoms; Kobner 10 mentions a case, where the opening of an axillary abscess was followed by a chancre, and another, where the operation of scarifying the scrotum, for " gonorrhceal hydro- cele," was succeeded by an indurated chancre, with constitutional syphilis. Robinson ! relates the case of a boy, six years of age, of healthy parents, who was circumcised for congenital phymosis, and who developed thereon an ulcerating lesion, followed by a mucous patch on the tongue, and a rose-colored rash. Homolle states that the incision of a furuncle on the buttocks, and the 192 SYPHILIS INSONTIUM excision of vegetations, have both given occasion for the entrance of syphilitic poison. Moes has reported a chancre of the eyelid following the incision of a stye. i. Wet-cupping, tattooing and vaccination, have been already treated of, and need not be again considered ; they are mentioned here in connection with instruments, as the virus has been some- times conveyed in this manner. 2. Infection by means of blunt instruments (Eustachian-catheters, surgical sounds and specula, serres-fines, porte-caustiques, syringes, and other apparatus). i . Eustachian catheterization. One of the most interesting and deplorable instances of the communication of syphilis profession- ally, is by this now well-known method of infection. The first published case was by E. Fournie, in 1862, and Ricord, who was called in consultation, stated, that he had seen four similar cases previously. Since this date, nearly forty observers have reported cases, amounting in all to more than 100 victims; of these over 60 were said to have been traced to the practice of a celebrated ear specialist, Dr. B., in Paris, now dead. Others have been reported in Germany, Austria, Russia, and in this country, as seen in the Synopsis of Literature, and Bibliography. The method of infection in these cases is easy to understand; the insertion of the sound, or catheter, into the throat of one person after another, without proper cleansing, can most readily convey the poison from the freely secreting mucous membrane of an occasional syphilitic patient, to the readily abraded mucous mem- brane of a healthy subject. From the description given of the lesions of the throat, in many of these cases, (there often being a vast ulcer, occupying much of the vault of the pharynx), some- thing may be learned, regarding the earlier epidemic and endemic extensions of syphilis, such as Sibbens and some of the Syphiloids occurring along the Baltic Sea, and other places, where much stress is laid upon the throat lesions. The descriptions given of some of these Eustachian cases, resemble very greatly those of the affections referred to, in that they exhibit unusual severity and precocity, with absolute loss of any distinction between primary, secondary, and tertiary lesions; in some cases there occurred periostitis, destructive ulcerations and perforations, almost from the start. The primary lesion in these cases, is generally seated on the posterior pillar of the fauces, or on the INFECTION BY CAUSTIC HOLDERS, ETC. 193 upper surface of the soft palate, or, on the posterior wall of the pharynx, near the fossa of Rosenmuller, or finally, at the edge of the Eustachian tube. 1 1. Surgical sounds and specula, are accredited by many with hav- ing been the means of transmitting syphilis, but no definite state- ments, or cases illustrative of this, can be found; Tardieu, 8 however, alludes to "a most regretable case, which made a great stir, where syphilis was transmitted by means of a speculum." The same author mentions a case where a young man, who had never had sexual intercourse, was inoculated with syphilis by means of serres fines, which were used after an operation for phymosis. 2. Caustic holders, etc. Leloir 16 narrates a case, where the syph- ilitic poison was supposed to be transferred, by means of nitrate of silver, which had been previously used to touch buccal lesions ; a chancre developed upon a slight burn which was touched with the same. I have been told by a physician that he believed, that he had communicated the disease in this same manner; he remarked, however, correctly as I believe, that the disease was probably not conveyed by the caustic itself, but by the holder ; the piece of nitrate of silver was very short, and he supposed that the holder touched the parts and conveyed the poison. Taylor 20 has recently recorded a similar case. C. Pellizzari 20 reports a case where a chancre, on the leg of a child with infantile paralysis, w T as produced by the employment of an electric brush ; the lesion was at first thought to be tropho-neurotic, but the later phenomena proved it to be the primary sore of syphilis. The transmission of syphilis by means of syringes, has been already considered, under domestic syphilis, in Chapter VII. 3. Infection by means of unclean substances. A case is reported by Moty, where a man acquired a chancre on the left upper eyelid, which was attributed to using the same wash-water which had been used by venereal patients; the man had conjunctivitis, and dipped the cloths used to moisten his eyes in the water. Another instance of supposed infection by wash-water is mentioned in the previous chapter, under brephotrophic syphilis. Mention has already been made of the fact, that in certain cases of circumcision-syphilis Hutchinson concluded that the poison had been conveyed by means of the lint, soaked in the blood of the prepuce, which had been removed. 1 Baratoux. De la Syph. de l'oreille. Paris, 1886, p. 77. 14 194 SYPHILIS INSONTIUM Pellizzari 25 records a case where infection took place in a. remarkable manner. A woman, who had been syphilitic but a few months, but cured of any active manifestations of the disease, was operated on for piles. The overseer of the infirmary, a man aged 65, held the fragments of tissue removed in a rag, collecting and holding them during the operation, his whole right hand becoming covered with blood. Some time afterward, a small wound was noticed between the nail and the pulp of the right index finger; this was not recognized at first, but soon became a deep and livid sore, with axillary engorgement, and was followed by constitutional syphilis, and four years later he had hemiplegia. Profeta 7 published an observation which is considered very probable by Jullien, where a chancre was situated in an inter- digital space of the right hand, and which the most minute research seemed to point to an acarus scabiei as the mode of con- veying the syphilitic contagion. Diday is quoted as having been the first to call attention to this method of transmission of syphilis by parasites. In view, however, of more recent cases reported by du Castel, 1 Fournier, 67 Feulard, 2 Lallier,- 2 and Pollaesik, of chancres occurring on the arms and elsewhere in patients who were under treatment for scabies, it would seem more probable that the poison gained entrance during the manipulations, from uncleanli- ness, rather than from the conveyance of the virus by the insect : at any rate this illustrates and explains the very frequent occurrence of scabies and syphilis in some of the epidemics and endemics of syphilitic infection, where, from the descriptions given, scabies appears certainly to have been present. We have seen in this chapter that syphilis may be acquired by the person rendering a professional service ; further, that the dis- ease may be communicated from the operator to others ; we have also seen that the operator may only act as the agent, transferring the disease from one person to another by means of his own per- son, or by instruments or objects bearing the virus. Undoubtedly further research would disclose a yet greater variety in the forms and methods of infection than has been presented in these pages, and in the accompanying Synopsis and Analytical Bibliography, and unquestionably further experience will add new data with each successive year. SYPHILIS IN THE INNOCENT 1 95 No amount of human wisdom could possibly have foreknown, or even have suspected, many of the facts which have been detailed in this and preceding chapters, nor could any reasonable amount of care have prevented many of the sad events here recounted. The syphilitic poison is an agent whose effects are known only after the damage has occurred, and thus, prophylaxis becomes of the utmost importance, greater, if possible, than in reference to any other disease known to man. A short consideration of the means of controlling the unneces- sary spread of a disease which can cause such damage to innocents, would, therefore, seem appropriate in this connection. CHAPTER X. prophylaxis: hygiene and medico-legal CONSIDERATIONS. PLAN FOR THE LEGAL CONTROL OF SYPHILIS. From what has preceded it may readily be understood that syphilis is a disease which inflicts great injury upon the public health; for it imperils not only those who have been guilty of sexual transgressions, but also those who are quite innocent. While an exaggerated idea of its perils might be obtained from the material presented in the preceding chapters, it is impossible to shut our eyes to the fact that it presents a real and considerable danger to the innocent," as is evidenced by the thousands of cases referred to in this book. No amount of reasoning or argument can do away with the facts which I have cited from the highest medical authorities, and from my own recorded cases. Not only does this infection occur in the daily intercourse and occupations of life, but also in the most varied relations, in the care of children, in industrial pursuits, and in professional callings. Our considerations, therefore, in regard to its prophylaxis, including the legal control of the disease, will be largely based upon the dangers relating to its innocent transmission and the necessity of arresting the progress of a malady which is capable of doing so much harm. Although the present work has to do mainly with syphilis insontium as acquired by extra-genital infection, it may be well to consider very briefly two other aspects from which a legal control of the disease is demanded : these relate to marital syphilis and hereditary syphilis. The subject of marital syphilis has been very fully discussed by a number of writers, and all acquainted with the subject know well MEDICO-LEGAL CONSIDERATIONS 197 that this mode of infection stands prominent in connection with the innocent acquiring of the disease. While men occasionally con- tract syphilis in lawful wedlock, even, indeed, from wives who have acquired it in nursing or in some other innocent manner, it is principally the wives who suffer from the sins of their husbands, before or after marriage, and on them falls a large share of the burden of " innocent syphilis. " Reference has already been made to the studies of Fournier, who came to the conclusion that fully 25 per cent, of all females affected with syphilis acquired it honestly, in lawful marriage relations: also that Ricord thought that this proportion was too low. Among the married females in Fournier's private practice, in 75 per cent, the disease was unmistakably traced to the husband. I stated also that in my own private practice fully 50 per cent, of the females with syphilis, acquired it in a perfectly innocent manner, while among the married females the percentage would be 85, or more. Surely then there is reason in the plea that something should be done to prevent the wholesale infection of these innocent victims of marital syphilis. But if this aspect of the subject seems dark, that of hereditary syphilis is yet darker, and calls even more strongly for relief. The literature of hereditary syphilis is very large and the facts related thereto are well known and accepted by all ; the pages of this book contain references indicating abundantly both the hereditary aspect of the disease and the dangers arising from contact with the child inheriting syphilis. We may for a moment refer to the effect of the poison upon the viability of children born of syphilitic parents. I cannot do better than to refer to some very striking tables given by Sturgis in an appendix to Diday's work on infantile syphilis 1 ; they are from the records of births of syphilitic children at the Moscow Hospital, Russia, from i860 to 1870. During these years there were 2,002 births, and 1,425 deaths, or, 71 per cent, of the children born there of syphilitic parents died. Kassowitz 2 gives the per- centage of still-births of syphilitic parents at 33.6, and that of infants dying within six months at 24.3; these two make almost 58 per cent, dead born, or dying within six months after birth. 1 Diday. Syphilis in New-born Children, etc. New York, 1883, p. 265. 2 Kassowitz. Die Vererbung der Syphilis, Wicn, 1876, p. 122. 198 SYPHILIS INSONTIUM It is to be remembered also, that just as syphilis can diminish the viability of the product of conception, and cause the death of the child, just before or soon after birth, so it causes loss of life earlier in conception, giving rise to abortion, even in the very earliest periods of utero-gestation ; in the same manner, going further back in the life-history of procreation, it is also a not infrequent cause of sterility, both in the male and in the female. If, therefore, the effects of syphilis were limited solely to a destruction of life in the new-born, or in the products of concep- tion, there would be strong reason for the introduction of measures to check the spread of the disease, from its loss to the State. But this is only a portion of the ills wrought by syphilis in connection with generation, and it would be better that children of syphilitic parents should thus fail of life, rather than be born with an inheritance which often proves such a curse. Tarnowsky x has recently, in writing on the subject, given us many interesting facts, among which the following may be men- tioned. In three families, born of syphilitic parents, there was a total of twenty- two births : of all these there came only one healthy adult man. Of thirteen who survived some years, eight were inca- pable of self-support, from mental or physical defects, and the other five were weakly, nervous, and totally unfit for further procre- ation. He states that the families in which this occurred belonged to the intelligent class of society, with no other cause than syphilis for these disastrous results. He quotes further from Tschistjakow 2 the case of a man who had severe syphilis in early life, destroying the palate, of whose nine children two were idiots, one was deaf and dumb, and one died in infancy. The works of Hutchinson and many others give abundant testimony as to the direful effects of syphilis on the progeny of those thus affected. Thus the army of innocents swells in size and pleads for the restriction of a disease, which, it is now believed, may sometimes be inherited even to the third generation. What the later effects of syphilis may be, in producing some of the conditions commonly known as scrofula, and in inducing race-degeneration, cannot now be answered positively; we know, however, that it 1 Tarnowsky. Prostitution und Abolitionismus. Hamburg und Leipzig, 1890, p. 164. 2 Tschistjakow. Ueber die Syphilis in der bauerlichen Bevolkerung. St. Petersburg, 1884, p. 55. PREVALENCE OF SYPHILIS IN THIS COUNTRY 199 has at times decimated our Indian tribes, and has wrought un- speakable havoc in Russia, in the Hawaiian Islands and elsewhere. The individual with syphilis, therefore, is not only in danger of communicating the disease in marital relations, and constantly does so, but is also likely to transmit more or less of the taint to the offspring, if they survive. He is likewise a constant menace to society, by virtue of the contagious character of the disease, in some of its manifestations, even for a long time, as has abundantly appeared in the preceding chapters. It is quite true that the dangers of infection from syphilis and of its hereditary transmission, are greatly diminished by careful and proper care and treatment; but every one who has had much to do with the disease in hospital and dispensary practice knows how commonly it is neglected as soon as there cease to be annoy- ing symptoms. There are continually hundreds of syphilitics with contagious lesions, who are either ignorant or careless of the dangers to which they are subjecting others in their daily lives; and this is even seen in private practice. Innocent extra-genital infection is much more common than is generally supposed. Physicians are constantly meeting with cases of syphilis where the origin of the disease is a mystery; as the facts relating to innocent infection come to be more generally recognized, the mystery attending many cases will pass away. It has been already shown, in preceding chapters, that syphilis is now very widely diffused. It is undoubtedly on the increase, owing to the utter lack of sanitary control over it in the greater part of the world. There are no data obtainable to show its relative prevalence in different countries, except those relating to the armies of various nations, some of which have been already referred to. In many instances even these returns are not avail- able, inasmuch as they frequently report "venereal diseases" in general, and not syphilis distinctively. In this country, as I learn from the Surgeon-General's office, no reliable information exists in regard to the prevalence of syphilis : our army even furnishes no data. According to Sturgis 1 , however, there were in the army, in the Department of the East, in the five years from 1870- 18 74, 1488 cases of syphilis, or 4.22 cases per 100 men : in the mercantile marine of the United States, during 1872 and 1873, there were 3,779 cases of 1 Sturgis. Relations of Syphilis to the Public Health. Trans. Amen .Med. Ass'n., 1877. 200 SYPHILIS INSONTIUM syphilis, or 15.33 per cent, of all sailors treated in the hospitals : while in the city of New York, 16.19 P er cent, of all cases of sickness in the mercantile marine service were syphilitic. From the data furnished by the books of a number of dispensaries and hospitals in New York city during the year 1873, Dr. Sturgis estimates that the number of patients treated for syphilis during that year cannot be far from 50,000. Some idea of the frequence of syphilis in this country may be learned from the statistics collected by the American Dermato- logical Association, from different cities in the United States during the past fourteen years. Fully one tenth of the cases reported were those of syphilis, it coming next to eczema in frequency. In some respects this presents, perhaps, one of the best means from which to judge of its comparative prevalence; for, as syphilis rarely fails to manifest itself on the skin at some period during its course, cases of this disease are more likely to be observed and studied in dermatological practice than in other departments of medicine. These data were collected from private and public dermatological practice, and not from venereal clinics. - Syphilis is a disease worthy of the most serious thought and consideration by the physician and sanitarian. ' It stands second to none in pathological importance. The fact that in so large a share of cases it happens to be communicated through sexual contact, and in so great a proportion of these it is from unchaste venereal relations, by no means warrants its relegation wholly to a class of affections the very mention of which is to be tabooed in good society. In regard to the means of prophylaxis against syphilis, these relate, first : To the protection of the individual ; and, second, To public measures, or the legal control of syphilis. I. INDIVIDUAL PROPHYLAXIS Individual safety will result from a better and more widespread knowledge, on the part of the profession and the laity, of the manifestations of syphilis, its dangers, and the modes b} r which the disease has been transmitted. In the history of all epidemics of this disease, large and small, it is constantly stated that the true nature of the difficulty was not recognized, or that the dangers of infection were not known or appreciated until large numbers were affected. As PROPHYLAXIS OF SYPHILIS 201 our knowledge of syphilis widens, and as the synthetic history of the disease is formed, so much less will be the danger of its communication by innocent means. A glance at the clinical history of syphilis insontium, as given in the preceding pages, shows this very conclusively. Thus, the dangers of its communication by vaccination were never thought of until a considerable number of cases of vaccinal syphilis had been reported; and undoubtedly multitudes of other cases had occurred which were never known. The possibility of inoculation by means of Eustachian catheterization was not suspected, until a considerable number of cases of syphilis from this cause were traced to the practice of one physician in Paris. Ritual circumcision had been practiced for thousands of years before it was demonstrated that syphilis could be communicated in the operation; and so on. Now, however, that the many dangers are more or less widely recognized, we no longer have so many of these lamentable events to record as are found in earlier years. Infection by lactation and by other recognized accidents is yearly becoming less frequent, and in most countries such general out- breaks of syphilis as the Maladies de Brunn, de St. Euphemie, de Chavanne-Lure, the Pian de Nerac, and many others which have been mentioned, are now well nigh impossible. Yet if we should conclude that innocent syphilis is really becoming less frequent of late years, we should make a serious mistake. Such is not the fact. In Chapter IV., of this essay I have recorded over one hundred original cases of extra-genital infection ; and these do not include the scores or rather hundreds of cases of innocent infantile and marital syphilis that I have seen. The same may also be learned from the multitudes of recent cases of syphilis spo?-adica, or scattered and isolated instances of innocent syphilis, detailed or alluded to in other chapters, and in the Synopsis and Bibliography. The ground, therefore, upon which personal safety from syphilis must rest, has yet to be reached; for, while the disease is allowed to spread freely by venereal contact, so long will cases of syphilis insontium continue to abound. This is evidenced by the innumer- able instances where the disease has been acquired, both in neces- sary and unnecessary contact with those thus diseased. A single instance of this may be recalled from the first portion of 202 SYPHILIS INSONTIUM the preceding chapter. In this instance a syphilitic man infected his wife, she infected the breast-drawer; through her ten others "became infected, and several of them died from syphilis. How much farther the disease spread was not recorded, but it is very certain that it could not have ended there. Many, yes hundreds or thousands of instances could be found where one guilty member of a family has introduced syphilis into the home, and where there have been numbers of innocent victims; these have been both among those belonging to the family and those having social or industrial relations with them. II. LEGAL CONTROL OF SYPHILIS While syphilis commonly occurs as a " venereal" disease, its prophylaxis, or legal restraint, by no means relates entirely to the restriction of venereal diseases; the limitation of the spread of syphilis should be considered from a much broader and higher standpoint, namely, from that of defending the public health and that of individuals against a malady which affects the innocent and guilty alike, and which comes not only when its dangers are anticipated, but also when they are the least suspected. In the matter of legal protection against syphilis, therefore, the subject of prostitution becomes a secondary considera- tion. The first question is not one of "regulating prostitution," or of inspecting, licensing, or legalizing the "social evil, or of protecting those engaged in it. The legal control of syphilis has a much higher aim, namely, the prevention of the unnecessary extension of a disease which produces a vast amount of sickness, misery and death, not only among the guilty, but also among the perfectly innocent. That the spread of syphilis can be checked is self-evident, as has been conclusively proven by the fact that all the epidemics, large and small, which have been mentioned above, were arrested when the cause was recognized, and sufficient measures introduced to prevent the further transference of the poison from one person to another. It is also abundantly shown in those instances where foreign governments, in certain cities or localities, have enforced stringent measures looking in this direction. We know positively that the virus does not develop de novo, but that it is always communicated from one individual to another. We know also that within a certain period the disease ceases to be LEGAL CONTROL OF SYPHLLLS 203 contagious in each individual; so that, if no new infection is intro- duced into a community, and the members of that community are guarded against acquiring the disease from one already infected, until that safe period is reached, the malady will cease to exist. Such precautions are exercised both by the public and by indi- viduals against other contagious diseases, such as small-pox, scarlatina, measles, diphtheria, yellow-fever, etc. ; is it not emi- nently proper that syphilis should be placed in the same category, and protection should be afforded against it? Syphilis counts its victims by thousands, where other diseases count hundreds. More deaths are ultimately caused by syphilis than by small-pox, while the injury to health and interference with life-work is much greater in the former than in the latter. The conclusion is absolute; syphilis should be placed, like other contagious diseases, under the control of the health authorities. Literature is full of matter relating to the medico-legal aspect of venereal diseases, and of syphilis in particular, and even a brief abstract of the subject would occupy much more space than can be given here; while a transcription of the laws and enact- ments bearing thereon, in other countries, would fill volumes. The subject of the legal control of syphilis is indeed a most difficult one to handle, and one which has occupied the attention of many able physicians and jurists. It has been studied especially in France, Belgium, and Germany, and it is in these countries that the most effort has been made by the governments to stay the progress of the disease. In Paris there is a certain police inspection of public women, and statistics show 1 that from 1877 to 1881, between 800 and 1,200 women were each year sent to the prison-hospital of St. Lazare with syphilis. The number of individuals who might be infected from these syphilitics can hardly be computed. In many cities in Europe 2 there is exercised a certain control over public women infected with syphilis, and a varying amount of protection from the disease is afforded. In England, as is well known, a reaction took place against the "Contagious Diseases prevention acts," and they were finally 1 Vibert. Nouveau Diet, de Med. et de Chirury. prat., Vol. 34, 1893, p. 916. 8 Parent-Duchatelet. De la Prostitution clans la Ville de Paris, 1857. VoL II , p. 195 i Mireun 7-a Syphilis et la Prostitution, etc. Paris, 1875 ; Reuss. La Prostitution au point de vue de l'hygiene, etc. Paris, 1889. 204 SYPHILIS INSONTIUM repealed, in 1886, as already mentioned; and no effort is now made there, I believe, to control the development of syphilis. In this country, as far as is known, there are no sanitary safe- guards against the spread of syphilis, and there are very few hospital advantages for those thus affected. While in most cities in Europe there are large accommodations for this class of cases, amounting in Paris to between one and two thousand beds, New York has but a relatively small service at the City Hospital, while the vast majority of syphilitic patients are treated at the dispensa- ries, and are allowed to go about, often with lesions of a most dangerously infective character. It would be difficult to convey any idea of the carelessness and indifference of some of these patients when informed of the dangers attending their disease. Many, indeed the far larger share of them, disappear from treat- ment long before their syphilis is cured ; and generally, even, long before they have ceased to have lesions which may convey the disease to others. The amount of damage a .single unrestricted syphilitic patient may do, can be judged from a recent statement by Tarnowsky, 1 of St. Petersburg. He says that a syphilitic woman, who had come under his observation, had succeeded in contaminating with syphilis no less than 300 men, within a period of ten months. This represents merely the primary transmission of the disease; its later effects on others can hardly be computed. Imagine one small-pox patient being allowed to give the disease freely to three hundred individuals ! The republican ideas of this country would probably never endorse or submit to such sanitary police inspection and restraint as is exercised in certain European cities; but the question naturally arises, if there is not some way in which the end can be reached, of arresting the spread of this dangerous disease ? Can there be no safeguards thrown out which shall prevent its exten- sion here, as it has spread in certain countries in Europe, notably Russia, where, as we have seen, whole communities have been syphilized, and Portugal, where the disease is almost universal ? The first step toward accomplishing the legal control of syphilis would undoubtedly be found in placing it among other contagious diseases which come under the jurisdiction of the health officers; legitimate means could then be devised and executed to check its 1 Tarnowsky. — Cited in N. Y. Med. Record, Mar. q, 1889, p. 279. LEGAL CONTROL OF SYPHLLIS 205 spread, as in the case of the contagious diseases ordinarily recognized. The late J. Marion Sims alluded to this subject, in his address before the American Medical Association 1 , some years ago, using these words: "There can be no difference of opinion among us, regarding the two following propositions. 1st. We want a system of sanitary inspection and control, which will enable us to prevent the importation of syphilis from abroad. 2d. We want a system of sanitary inspection and control, which will enable us to take charge of the subjects of syphilis at home, and prevent them from spreading it through the community." The profession is undoubtedly unanimous, in regard to the desirability of having such a restraining influence exercised upon syphilis, as is here indicated. The only question is — what is the best method of carrying it into effect ? If syphilis were first recognized as one of the great contagious diseases, against which it is the duty of the government to protect the community, the details of that protection would follow with time ; and as the public became aware of the dangers arising from the disease, and the benefits accruing from its restriction, there would be no difficulty in securing proper laws relating to the subject. It would be out of place here to present any detailed plan of operation, for the subject is of such vast importance, that it could not be compassed within the limits of this essay, even if the writer were prepared to formulate such a scheme. The suggestion, however, is most earnestly put forward, that the time has certainly come, when the dangers of syphilis, and especially the dangers to innocent persons, should be fully recognized. It is too late in the history of science and of humanity to stigmatize the disease as "venereal," and on that account to withhold scientific protection from thousands of innocent sufferers. Among babies, nursing women, persons infected in dental or surgical operations, and in dozens of other manners, syphilis can no more be described as a "venereal" affection than any other contagious disease. The time has come to place it under the control of the proper health officers, and to make it quite as criminal to tra?ismit syphilis willingly as it is to communicate small-pox, scarlatina, or diphtheria. It would then become the public duty of each one to guard against the disease, and, as now in the case of the other contagious 1 Sims. Trans. Amer. Med. Assoc, 1876. 206 SYPHILIS INSONTIUM diseases mentioned, those would be culpable who were the means of disseminating the same. The hotel proprietor who wittingly allows a small-pox patient to infect others, or who should not exercise due precautions after a patient with scarlet fever had occupied a bed or room, would receive punishment. The keeper of a brothel, as I understand the existing law, would be subject to like punishment, if his guest were allowed to sleep in a bed previously occupied by a patient afflicted with small-pox, scarlatina, or diphtheria, without subsequent sanitary precautions. If, now, syphilis were included with these infectious or contagious diseases, something would certainly be accomplished toward checking its extension ; for such a person would then see that all the inmates of the house were free from syphilis, and would also be very careful that no one entering the place should introduce the disease. If the males did not carry syphilis into houses of ill-repute, the disease would not appear in them. The plan of making it criminal, or a misdemeanor, to be instrumental in communicating syphilis, would operate favorably in many ways. It would do away with the necessity of officially examin- ing, inspecting, or licensing any one, for it would be for each one's interest to keep free from the disease, lest at any time legal action should be taken against them. Instead of examining the women publicly, those connected with the nefarious business would see that they were already in a healthy condition. They would then examine the men. This again would operate advantageously. For many would hesiiate against going to houses of ill fame, if they knew that they were to be thus examined: and those that were syphilitic would exclude themselves. Furthermore, this would operate more or less against clandestine prostitution. For not only would every one fear lest they should acquire the disease (because it would be known that outside women would be more likely to be syphilitic), but the men would fear that, if they infected others outside, they would be subject to legal penalties. I believe, therefore, that such a law would not only greatly diminish the frequency of syphilis, but would also be in the direct line of breaking up licentiousness When the step is once taken of placing syphilis among the contagious diseases, subject LEGAL CONTROL OF SYPHILIS 207 to law, the details necessary to enforce such a law will natur- ally follow. The force of the argument rests on the necessity of examining the men instead of the women ; for any proposition looking - to the latter has always met with resistance at the hands of many classes in every community, who urge the degrading character of police inspection. That a person may legally be held liable for communicating syphilis is abundantly shown by the many cases occurring in the lit- erature of foreign countries. The works of Tardieu, 1 Fournier, 2 and others are full of accounts of legal action taken, and fines and imprisonment imposed, for the willful or careless transmission of syphilis ; and in some instances the actions were against physicians who had exercised every possible precaution. In our own country syphilis has sometimes been the subject of judicial action; in a recent case before the Court of Appeals, of Kentucky, 3 it was decided that syphilis pleaded in answer to an action to recover damages for breach of promise of marriage, is a complete defence ; this followed the decision of the Supreme Court of North Caro- lina, in which the same defence was interposed and sustained in a similar action. One of my own patients recently received five thousand dollars from the man who infected her with syphilis ; in this instance the case did not come to court, though it was settled through legal counsel. How far the matter can be carried in regard to the restraint of syphilitics from exposing others, cannot now be decided. Much enlightenment of the community is yet necessary in regard to this subject, and much thought will be requisite to deter- mine exactly the best methods of checking the slow but steady extension of syphilis which is now taking place. These matters can safely be left to future consideration. The first step is now to be taken by the legal recognition of syphilis as one of the contagious diseases which are dangerous to the life and health of the nation — as a pest against which society has the same right as in the case of other contagious diseases, namely, to protect itself by scientific treatment and by legal penalties. 1 Tardieu. Etude Medico-legale, etc., Paris, 1879. 2 Fournier. Nourrices et nourrisons syphilitiques, Paris, 1878. 3 Journ. of the Amer. Med. Assoc, Oct. 8, 1892, p, 445. SYNOPSIS OF FACTS AND LITERATURE* RELATING TO SYPHILIS INSONTIUM ARRANGED IN ACCORDANCE WITH THE CLASSIFICATION OF MODES OF INFECTION (Sg* Pages i j to 20) Syphilis pravorum = e coitti illicita " (venereal syphilis) Syphilis insontium ingenita (hereditary syphilis) Syphilis insontium e coitu legitima (marital syphilis) not considered in present work. SYPHILIS INSONTIUM SINE COITU. A. SYPHILIS PANDEMICA. I. SYPHILIS EPIDEMICA. The various kinds of epidemics are given in a chronological order, relating to the successive appearance of new modes of transmission. After the re- porter's name is placed the year of the epidemic, or of its observation. Indi- vidual cases illustrating many of these will also be found later on under proper headings.* 1. CUPPING. Geigel 1 (1615). Hardh, J. O. (1S72). Hjelt 1 , 2 - 3 (1858, 1858, (?) i860). HORNUNG (LAMMERT) (1596-g). HORST 3 (SnITZKK) (1603). JoRDANUS (i 577). LAM- mert 1 (1599, 1603). Meyer- Ahrens (1592). Poliataieff (1890). Spoof (1873). WlDMANN (HORST 4 ) (1624). *The full references to these facts are found in the succeeding Analytical Bibliography, under authors' names, alphabetically arranged. The small figures relate to the number of the separate observations, chronologically arranged. 15 2io SYPHILIS INSONTIUM 2. breast-drawing. Alberti (1746). Barry (1728). Bilguer (Rosen von Rosenstein) (1775 ?). BOURGOGNE 1 (FOURNIER) (1825). CANETTA (1847). EvERARDUS (1654). HeIN- ecken (1S00). Hey (1770). Joly (1S53). Leloir 7 (1880). Leo (1892). Loder 2 (1798). Munninks (1804). Ricordi l (1863). 3. HAND-FEEDING. Musitanus (late in 17th century). Ricordi (1862). 4. LACTATION. Balducci (1S67). Bardinet (1841). Barry (1728). Bertherand 2 (1873). Bouchacourt (1S41). Bouchut 3 (1867). Cantilona (1867). Demarchi (1S58- 67). Depaul 1 (1849). Durante (Demarchi, Tanturri) (1S67). Dusterdorf (1826). FACEN (1849). FRIEDLANDER 1 (1884). GlBERT x (1837). LuSITANUS (1554). Pancritius 3 (1SS1). Pellizzari, C 8 (i882). Portal (Morand and Lassonne, Lugol) (1844). Raulin (Rollet) (1752). Ricordi 4 , 5 (1S63, two 6 , 1S64 7 , 1S65). Ruggiere (Demarchi, Tanturri) (1S67). Selli (Demarchi, Durante, Ruggiere, Tanturri) (1867). Settegast (Hacker) (1823). Snell 1 (1882). Tanturri 1 . 2 (1867). Vercelloni (late in 17th century). Viani (Depaul) (1849). 5. accouchement. Bardinet 6 (1873). Bayer (1727). Bleynie (Bardinet 7 ) (1855). Booth (1883). Boudinet (1878). Bourgeois, or Burgesius (Rosen von Rosenstein) (1608). COHANSEN (1744). COLLES 5 , 8 (HEALEY) (1S37). DuTSCHINSKI (1889). Fuchs(i737). Gardane 1 (1775). Hime (18S3). Price, J. H. 4 (Gross) (1S86). Swediaur 2 (1S01). Wendt 1 (Walch) (i8ii). Wigglesworth 2 (1879). 6. circumcision. BlERKOWSKI (KOSINSKI, LUBELSKI 1 , MaTLAKOWSKI) (1S33). BrECKER (JaFFE) (1S40). Kedotoff (1S84). Hutchinson 23 (Macnamara) (1886). Nowakowski (KOSINSKI, LUBELSKI, MATLAKOWSKi) (i 864-5). VON PlTHA (JaFFE) (1S67). Ricord 23 (1S52, 1S62). Rust 3 , 4 (1805). Solomon (in Hamburgh) (1846). Wendt 2 (1805). 7. vaccination. Adelasio ] > 2 (Quarenghi, Viennois) (1862). Alies (doubtful : 1S41). Ben- nett, J. E. (1S63). Cerioli 1 (Barbantini ', Viennois) (1S21). Clary and Guary 1 (1866-7). Depaul and Roger 6 (Closmadeuc) (1S66). Desjardins (Layet) (tSSi). Dunn, Eulenberg (Freund) (1872). Ewertzen (1S30). Freund (1S76). Gallia (18S5). Galligo ' (1S57). Glatter (1S62). Grancint and Dall' Acqua (Sormanni) (1S73). Heine (Escherich, Heyfelder, Hubner) (1852). Hutchinson (1S79). Jones (Foster, Hubbard) (several episodes during the civil war 1S61, 1S66). Klein 1 (Rutiienberg) (1816-17). KObner 14 (table of principal vaccinal epidemics). Koceyar (1S69). Lacheze (1S62). Marcolini (Barbantini l , Viennois) (1S14). Marone ' (Bouvier ] ) (1856). Millard ' (1865). Mori (1870). Otterson (Foster) (1S62). Pacciiiotti » (Cerisi) (1861). Peola (1873). Percival (Jones, Foster) (1866). Polin (1882). Signorini (1888). Tassani (Cerioli 2 , Viennois) (1S41). Wegeler (Viennois) (1849). SYNOPSIS OF FACTS AND LITERATURE 211 8. EATING AND DRINKING AND DOMESTIC PROPAGATION. Bassereau 2 (1852) (family). Bataschoff ] (1890) (local epidemic in Rus- sian villages). Boeck, W. 2 (1852) (family). Cazenaye 9 (1850-1) (family). Cold '. 2 (1859) (family). Cusack 1 (1837) (family). Demarchi (Ruggiere, Tan- turri) (1857) (family). Depaul 1 (1865) (family). Dron 6 (iS 70) (family). Est- lander (1870) (family). Flamande (Rollet) (1828) (eating and drinking). Fournier 30 (1880) (family). Friedlander 8 , 9 (18S4) (family). Garson (1848) (family). Gulli (1837) (family). Guntz" (1883) (family). Hjort (1844) (family). Hoffmann 2 (1739) (family). Jarotsky 2 , 3 (1891) (family). Kobner 8 (1862) (family). Lagrange (1S63) (family). Lang 6 (1884) (family). Meyer- Ahrens (1844) (sheltering wayfarers). Morgan 4 (1872) (family). Pare (1585) (family). Poray-Koschitz 2 (1881) (family). Prehn (Bolschwing) (1832) (shel- tering wayfarers). Roussel 2 (1 881) (family). Rust ] (1823) (family). Simon 2 (1858) (family). Steffens (1S41) (family). Sturge 2 (1S77) (family). Taylor 25 (1891) (family). Velten (1830) (family). 9. tattooing. Arthur 2 (Wilcox) (1886). Barker, F. R. (1888). Josias (1879). Maury and Dulles 1 (1878). Petry (1S58). Whitehead (1889). IO. GLASS-BLOWING. Dechaux (Guinand 2 ) (1867-9). Guinand (1863). Heiberg (1883). VlEN- nois 12 (Guinand) (1862). 11. eustachian catheterization. Blauchet. Burow (1S86). Fournier and others (1 862-1 882). Martin 3 (1876). 12. APPLICATION OF TONGUE TO EYE. Tepljaschin 1 (1S86). II. SYPHILIS EXDEMICA. The endemic affections now recognized as syphilis are given in the order of their appearance ; the names of the most authentic and accessible authori- ties are appended. 1. sibbens. Adams, J. 1 (1S07). Bell, B. 2 (1792). Gilchrist (1769). Hacker 2 (1851). Hibbert (1826). Milton (iS7q). Rollet 17 (1SS1). Skae (1844). Wille- moes (1S10). Wills fiS44). Wright (1855). 2. radesyge. AxoNYMous 2 a (Beiirend) (1837). Arbo(i792). Bang(i778). Boeck, W. 7 a (i860). Bonneyie (175S). Cederskjold (1S14). Craigie (1836). Hacker 2 (1851). Hkxsllr (1799). Hjort 1 (1S40). HCnkfeld (1S28). LANCEREAUX 5 a (1869). Munk (1799). Rollet 9 a (1866/ Sprakel (1864). Steffens (1774). 3. amboyna pimple. Bontius (1718). 212 SYPHILIS INSONTIUM 4. disease of st. paul's bay. Adams (1807). Cochran (1854). Fuchs' 1 (1840). Stratton (1835). Swediaur 4 (1S01). 5. MORBUS DITHMARENSIS. Brandis (1813). Duhrsen (1S32). Francke (1838). Genters (1878). HELWEG (l82l). HtJEBENER (l82l). MlCHAELSEN (i 842). STRUVE (1S20). 6. facaldina. Facen 2 (1849). Hacker 2 (1851). Marcolini 2 (1839). Sigmund 8 * (1855). Valenzasca (1840). Zecchinelli. 7. scherlievo. Boue (1814). Cambieri (1812). Hacker 2 (1851). Jenniker (1819). Lor- ENZUTTI (1830). LORINSER (1865). MlCHAHELLES (1833). MOULON (1834). Ozanam. Pernhoffer (1868). Sigmund (1855). Zeissl, M. 2 (] 8. mal di breno. Anonymous 13 (Lancereaux). Michahelles (1833). Sigmund (1855). 9. FRENGA. Gamberint (1871). Sigmund (1855). Wibmer - (1841). io. spirocolon. Hacker (1851). Lancereaux (1868). Olympios (1840). Pollis (1842). Quitzmann. Wibmer 1 (1 841). ii. morulus (button scurvy). Corrigan (1835). Wallace (1838). 12. mal kabyle. Arnould (1862). Vincent (1862). 13. yang-mey-tchonang. Dabry (1863). 14. syphiloid of jutland, lithuania, hesse, and esthonia. Albers(i836). Bolschwing(i839).' Hacker 2 (1 851). Ilisch (1822). Lillie (1777). Otto (1839). Schnur (1837). Tiling (1833). Van Deurs (1835/. 15. ? yaws, pi an, framboesia. Adams (1807). Charlouis (1SS1). Christie (1887). Fox, T. (1876). Hacker 2 (1851). Hibbert (1826). Lancereaux (1868). Maxwell (1S39). Mil- ROY (1873). PONTOPPIDAN (1882). l6. ? ALEPPO EVIL. (DELHI BOIL, BOUTON DE BISKRA, CHANCRE DU SAHARA, CANEOTICA, ETC). Altounyan (1885). Bertherand (1854). Carter (1876). Fox, T. (1S76). Geiskr (1S75). Rigler (1S54). Russell (1S56). Willemin (1S54). SYNOPSIS OF FACTS AND LITERATURE 213 B. SYPHILIS SPORADICA.* I. SYPHILIS ECONOMICA. This section has two main divisions, relating to, A. Infection in domestic and social life ; and, B. Infection in industrial pursuits. A. Infection in domestic and social relations, including, 1. Infection by- eating and drinking and use of tobacco, etc. ; 2. By personal and household effects; 3. By active and temporary contact ; 4. By passive contact. 1. Infection by eating and drinking and by means of tobacco, etc. 1. By implements and vessels; 2. By smoking, etc. 1. Infection by eating and drinking utensils, a. By spoons, knives and forks; b. By drinking vessels. (The majority of individual cases recorded fall under Section II., Syphilis brephotrophica). a. Infection by spoons, knives and forks. Bolschwing 2 . Diemer 6 . Froelich 5 , tonsil. Gluck 4 , lip. Krowczynski 1 , palate. Lee, H. 6 , tongue. Neumann 27 , tonsil. Poray-Koschitz 35 , tonsil. Pospelow 13 , fauces. Roddick 3 , tonsil. Viennois 4 , tonsil. b. Infection by drinking vessels : cups, glasses, jugs, faucets, flasks, etc. Arthur 3 (Fitz), lip (faucet). Boeck, C. 9 , tonsil (glass). Botallus, lip (glass). Bryce, lip (flask). Buchholz (glass). Cooper, A. 6 , lip (cup). Cull- erier, A. 8 (Hillairet), lip (glass). Dixwell (vessel). Fournier 56 (bottle). Girode, gum (glass). Gottheil, lip (cup). Griffin 1 , lip (pail), 8 lip (flask). Gruner (glass). Guibout 1 (Ory) 8 , lip (glass). Guntz ] , lip (glass). Jullien 6 (Verneuil), tonsil (glass). Kogan, lip (glass). Lasch, chin and lip (glass). Lydston 5 , lip (cup). McGuire 1 , lip (vessel). Mra^ek 2 , tongue (vessel). Pel- izzari, C. 13 , lip (glass), 1( lip (public fount). Polotebnoff 7 (cup). Ricord 2 , fauces (glass). Taylor 8 , mouth (cup), 12 lip (cup). Vidal, E. (Ory) 7 , lip (glass). c. Eating and drinking, in a general way, with or without express proof of individual cases or utensils employed. Bell, B. 1 (drinking ware) 2 " Sibbens." Bell, J., tongue (pipe or dishes). Boeck, C. c , tonsil (table-ware). Bolschwing 1 , lip (cup and spoon) 9 "Syph- iloid." Buchanan, throat (spoons and pipe) "Sibbens." Cullerier, M. (Re- nard), (cup and spoon) references unknown. Danielssen also (Hjort, Cold, Si 11 1 en), probable infection by eating and drinking. Demarchi, epidemic at Capistrello and Castellafiume, eating and drinking utensils chief agents. Everardus, also (Blancaard), in an account of " Lues nova recrudescens." in Seeland (see epidemics), mention eating and drmking-ware categorically. Flamande, account of the Mai de Chavanne-Lure spread by eating and drinking. Clatter (family utensils). Graarud, tonsil (glasses or pipes). Heisler 2 , tonsil (eating or drmking-ware). Hjelt, description of promiscuous drinking among the Finns. Lanz, tongue (table-ware). Leidenberg, Syphilis among Russian peasants, largely by eating and drinking. Manassein, lip (mess * In attempting to make an analytical synopsis of tlie facts and literature relative' to various modes of transmission, it is of course impossible to exercise any critical judgment in regard to the correi tness of the statements made ; the alleged methods of infection arc given for the convenience of those wishing to make further studies in any one direction. 214 SYPHILIS INSONTIUM utensils). Neumann 17 , tonsil (table utensils), 22 (table-ware). Newsky, tongue (table-ware). Ostroumoff (utensils). Pellizzari, C. 11 , lip (utensils). Plu- mert 2 , lip (eating or drinking- ware). Prehn (by wayfarers, eating and drink- ing). Profeta 3 (utensils). Weinberg 3 (utensils). Zakharevitch, fauces, etc. (spoons, tumblers, etc.). 2. Infection by means of smoking, and substances taken into the mouth, a. By tobacco pipes; b. By cigars infected by mouth; c. By cigars infected other- wise; d. By cigarettes; e. By chewing gum, etc. ; /. By other substances. a. Infection by tobacco pipes passed from o7ie to another. Arthur 6 . Barling, lip. Baum 2 , lip. Behrend 6 . Besnier 6 , tonsil. Boeck, W. 14 , tongue. Bolschwing 7 . Bumstead 6 . Denis-Dumont 1 . Diemer 5 . Guignard 3 , tongue. Hufeland. Keyes 3 . 6 , lip. Lancereaux 2 . Lloyd 2 , lip. Ohmann-Dumesnil 1 , palate. Otis 4 , mouth. Pellizzari, C. 15 , lip. Profeta 5 . Quinquaud and Nicolle 1 , lip. Roddick 1 , lip. Wallace 3 , lip. b. Cigars, passed from one to another, often from stumps picked up. Ambrosoli ] , fauces. Campana 3 , buccal cavity. Drysdale 6 . Engelsted 2 , lip. Finger 3 , lip. Froelich 8 , lip. Gamberini 2 , lip. Kirkpatrigk, lip. Neumann 23 , corner mouth. Price, J. H. 2 . c. Cigars infected indirectly by various methods. Behrend 4 (cigars bitten off and returned to the box). Bulkley 1 (infected on lips in manufacture). Gottheil (same). Henning 2 (same). Kluge (infected by the hands in manufacture). Maunsell, lip. Rizat 1 , lip (cigar punch). d. Cigarettes infected by previous sjnoker. Budugoff 1 , lip. Conte, lip. Jakoleff 2 (corner mouth). Kreundel, lip. Lewy and Goldberg 8 , lip. Neumann 34 , lip. Popoff 3 . Serduckov 2 , tonsil, 3 palate. Tchistjakoff 5 , inside cheek. Tzitrin. e. Chewing-gum , troches, etc., passed from mouth to mouth. Evmenieff (meats, breads, sweets, etc.). Griffin 2 , tonsil (candy). Hardy 1 , tonsil (lozenge). Leloir 13 , lip (chewing-gum), 1( lip (candy). Neumann 10 , tonsil (candy). Taylor 20 (chewing-gum). Valcourt, tonsil (lozenge). f. By other substances. Giovannini 3 , lip (gnawing a bone after a syphilitic). 2. Infection by personal and household effects; a. By wearing apparel, etc. ; b. By bedding ; c. By toilet articles ; d. By miscellaneous articles. I. Infection by wearing apparel, a. By shirts, drawers, trousers, etc. ; b. By masks; c. By plasters, bandages, etc. a. Infection by wearing apparel proper. Acton 3 (pantaloons). Albinus, Barbantini - (mother's chemise). Bell, B. 3 , scrotum (trousers). Bondkt, scrotum (trousers). Botallus, Bulkley (bathing suit). Calderini (31 infected through unclean linen). Clerc 3 , scrotum. Dzondi, groin (under-garment). Fracanzianus, genitals (under-garment). SYNOPSIS OF FACTS AND LITERATURE 215 Henning l (hat band). Hild anus l (pantaloons, 3 stockings). Jullien 1 , neck. Leloir 10 , eye (from glove). Polailon, foot (from shoe). Profeta 10 , foot (from shoe). Taylor 20 (bathing suit, drawers). b. Infection by masks. Ricord. Robert, M. c. Infection by plasters, bandages, etc. , in do??iestic use. Bjorken \ hand (plaster). Bulkley, neck (court-plaster, original case No. CXI.). Fournter 46 . Gltgnard 5 , forehead (dressings). Pellizzari, C. 1S , cheek and subclavicular region (plaster). Ricordi 2 , nipple (dressings). Righter, ear (court-plaster). Taylor 20 (plaster). 2. Infection by bedding, a. By pillows ; b. By other bedding. a. Infection by pillows, drenched with saliva or pus. Jullien 3 , neck. Salsotto 4 , cheek. Sauvages, head. Taylor 20 . b. Infection by sheets, or anything except pillows. Danielssen. Guyon. Massa 5 . Popoff 31 . Puche 2 (Acton) 2 (prison cot). 3. Infection by toilet articles. . a. By towels, sponges, etc. ; b. By combs and brushes ; c. By tooth-brushes ; d. By syringes ; e. By privy seats, etc. Infection by towels, sponges, etc. Arning 2 , nostril (towel). Barker, E. (towel). Baum 6 , eyelid (towel). Blanc 2 , cheek (towel). Fenwick, eyelid (towel). Froloff, eyelid (towel). Hill 3 , gum (towel). Hutchinson 7 , finger (towel). OsTROUMOFFf (towels). Pospelow 18 , nose (towel). Price, J. H. 6 (Sims 3 ), eye (towels and basins). Rona 4 , eyelid (towel). Sigmund 7 , labia (sponge). Stanley, lip (towel). Taylor 9 . 2) (towel). b. Infection by combs and brushes. Bourgogne 3 (comb). Elliotson (comb). Horteloup, P. 4 (brush). Pro- feta 9 , scalp (comb). Tzitrin (combs). c. Infection by tooth brushes, etc. Baxter (tooth brush). Blumenbach (tooth brush). Bumstead 4 (tooth brush). Haslunu ', tonsil (tooth brush). Knight *, tonsil (tooth powder). Mackay (toothpick). Penny 2 , gum (tooth brush). d. Infection by syringes. Fournier 9 . Jullien 2 . Leloir 12 . c. Infection by privy seats, etc. Fallopius, buttocks. Fitzgibbon 2 , thigh. Loder 1 . Marc 2 . Roddick 10 , penis. Taylor 21 . 4. Infection by miscellaneous articles of convenience, a. By handkerchiefs, napkins, etc. ; b. By pins, etc. a. Handkerchiefs, napkins, aprons, etc. Agasaroff (handkerchief). Atkinson 6 , nostril (handkerchief). Leloir 1 , commissure (handkerchief). Petersen", lip (napkin). Pospelow " ; , eyelid (apron). Taylor 20 (handkerchief). 216 SYPHILIS INSONTIUM b. Infection by pins, etc. Bulkley, tongue (original case No. LXXXIX). Koch, finger (drawing instrument soiled with saliva). c. Infection by canes. Otis a (mention of such mode of infection). d. Infection by opera glasses. Falcone, eyelid. e. Infection by other methods in fa7nily life. Evmenieff (playthings). Galippe (toys). Griffin- 5 , lip (rouge). Kleiner^ lip (vaseline). Profeta 6 (bread, etc.). Other instances of domestic infection, in which the methods are not specified. Anonymous q, m . Atkinson 4 , cheek (from parents). Belousow 1 , breast, lip, tongue, soft-palate, tonsils 2 , 3 , 6 , 10 . Biett 2 (infant infects mother). Boeck, C. 5 . Boeck, W. 3 (by mother) 4 . Bronson 1 , tonsil (from mother). Bryant \ lip (from father). Chambay (child by mother). Colles 4 , lip, breast (family epi- demic). Drysdale 2 (room-mate). Eltzina 1 . Emser. Faguer, tonsil. Feularu 6 , cheek (from uncle). Fournier 46 , 51 . Fox, T. C, lip. Gemma 1 . Griffin 7 , lip (from husband), 9 tongue (from husband), ]1 lip (from husband). Hauner 3 (from father or mother), 4 (from grandmother). Hayward 4 (grand- mother). Henrot (mother from infant). Herzenstein l . Hoffman i , nose (from servant). Jarotsky 1 . Jelzina 1 . Junquet 2 , 3 . Karamanenko 2 . 3 » 4 . Kaverin 3 . Kolokolow, lip. Lazansky. Leblanc 1 . Lee, H. 4 , 5 . Lubin- sky 1 ) 5 . McGuire 4 , tonsil. Marjoline. Marlow, eyelid. Marmisse. Massa 4 . Mauriac 3 . Michel 1 , eyelid. Mikhailoff 2 , Monnet 1 , 2 , 3 , cheek, lip and mouth (by mother). Morgan ] , mouth. Nasse 2 , gum. Neumann 1 , tongue. Ory 7 . Pacchiotti 4 , tonsil. Pellizzari, C. 3 , tonsil, 4 , 7 angle of mouth, 12 ' 16 . Petersen 3 , lip. Petrini 12 . Polotebnoff 1 . 4 , 5 > 6 . Pontet 5 , lip. Popoff 1 . 3 . Poray-Koschitz 7 , tonsil, 10 lip, 13 mouth, 15 tonsil, 17 palate, 29 buccal, 32 > 33 » 34 fauces. Pospelow 10 , fauces, tonsil. Price, D. Price, J. H. 1 . Rafinesque. Reiche. Robert, A. Roche 2 ? 3 . Roger 1 . Rollet 8 , tonsil. Romanoff. Roussel 4 , throat 9 , 10 . Sabinin. Schnur. Selenew 1 , tonsil. Shand 2 , mouth. Sims 2 . Soler 2 , lip. Sotchara. Ssabinin. Stein. Stoll 1 ' 2 ' 3 . Sturgis 3 , cheek. Tardieu 9 . 10 . Taylor 2 , lip 23 . Theobald ', lip. Toujan 2 , lip (from husband). Trevisanello 1 , tonsil. Van Dugteren and Van Walsem 2 , tonsil (from father), 3 lip. Van Harlingen 2 . Verneuil 5 . Viennois V 9 . Wallace 2 , throat. Waller' 2 , 7 . Weil 2 . Wildbore. Wild- hagen 2 , lip (room-mate). Wilson 1 . 3. Infection by active and temporary contact, in domestic and social life; i. Buccal; 2. Digital. I. Buccal infection, by contact in domestic and social life; I. By kissing; 2. By biting. 1. Infection from active and limited contact, in kissing; a. Reciprocal; b. Non- reciprocal. a. Infection from reciprocal kissing, lip to lip. Alberti ("de osculo morbifero, etc.," known only by title). ANONYMOUSa, mouth. Arthur 5 . Atkinson 1 , lip. B.erknsprung 2 , lip. Barduzzi 3 , lip. SYNOPSIS OF FACTS AND LITERATURE 217 Bassereau 3 , lip. Baum 4 , lip. Bell, B. 1 . Bertherand 1 , tonsil. Biett 4 , 5 (Cazenave), lip. Boeck, C. 4 , tonsil. Botallus. BCdugoff 2 , tonsil. Bulkley. Bush, lip. Capuron 4 , lip. Cassidy, lip. Cazenave 6 , fauces. Chisholm, lip. Chrestien 3 (Simoneau), tongue. Colles 1 . Cullerier, M. 2 , lip 3 (Cazenave), lip. DeMeric, tonsil. Draper, lip. Drysdale", lip. Elliot, fauces. Erichsen 1 , tongue 2 . Eustachius 3 , tongue. Fabre, fauces. F aught, gum. Fernelius 2 , lip. Fox, G. H. s , lip. Froelich 9 , lip. Gabalda, lip. Galligo 2 . Gamberini 1 , lip. Gay, A. H. 3 . Gibert 6 , tonsil. Gluck 6 , tonsil. Gratia 1 , lip. Griffin 6 , n > 12 > 13 , lip. Gross 1 , lip 3 . Guntz 7 , 1 \ lip 16 . Haslund 3 , tonsil. Heisler 1 , chin. Henry 1 , lip. Hu lot, gum. Jakoleff 1 , lip. Keyes 2 * 5 , lip. Lallemand 4 , lip. Lang 7 , lip. Langenbeck. Langlebert 3 , lip. Lavergne and Perrin 8 , lip. Lee, H. 6 , tongue. Lefeuvre, lip. Lewin 3 , lip, 5 . 6 lip. Lindestolpe. Lydston 3 , tongue. McGltre 3 . Manganotte, lip. Marc 1 (Roux), tonsil. Margontner 1 , lip. Mauriac. Minot, lip. Morgan 2 , lip. Mracek 1 , lip. Neumann 21 , lip, 22 lip. Notta, lip. Ory 6 (Lailler), lip. Ostroumoff f . Otis 3 , 8 , lip. Pancritius 5 , lip, 6 tonsil. Partridge, lip. Petersen 6 , gum. Popoff 3 . Poray-Koschitz 8 , lip. Porter, W. H. (Pratt), tonsil. Pospelow 11 , fauces. Price, J. H. 3 (Gross), 4 lip. Renard, tonsil. Reumont, lip. Ricord 22 , lip. Roddick 4 , lip. Rollet 6 . Saleneuve, tongue. Schlegel. Schneider (Plouquet), " per salivam osculum". Shoemaker, lip. Sigmund. Stirling 1 . Stukowenkow 1 , tonsil. Sutton. Temple, lip. Thomas 1 , lip. Van Harlingen 4 , lip, 7 tongue. Victorius, lip. Vidal, E. 4 , tonsil. Viennois 3 , lip. Walter 2 , 3 , lip. Willi. b. Non-reciprocal kissing, lips to other parts. Abadie (Viguier 2 ), eyelid. Alexander 1 , eyelid. Audoynaud 2 (Fournter), breast. Ayres(De Beck), eyelid. Barduzzi 4 , cheek. Benson, eyelid. Bloom 2 , angle jaw. Boucheron 1 , eyelid. Bryant 5 , nipple. Bumstead 2 , nipple. Davis (nurse, nursling). Dupre, eyelid. Fournier 1 ', nipple. Gratia 1 , eyelid. Herard 2 , nipple?. Johnson 1 , nipple. Lavergne and Perrin 7 , breast. Leloir 1 , toes. MacKenzie, W. 2 , conjunctiva. Mracek 4 , behind ear, 8 nipple. Neumann 24 , cheek, "chin, 31 nipple ?. Pospelow 3 , chin. Renault, neck. Riciion, eyelid. Ricord 11 , breast. Salsotto 4 , eyelid. Sattler (De Beck), conjunctiva. Tenneson, cheek. Touchaleaume, eyelid. Watson, S. 1 , cheek. Wecker 2 , conjunctiva. Zabolotski, eyelid. Zeissl, H. 5 , cheek. Zucker, ear. 2. Infection from biting: a. Asa caress; b. In defence or assault ; c. Acci- dental tooth wounds. a. Biting as a form of caress. Baum 7 , cheek. Blasciiko, lip. Boyer 2 , nipple in male. Browne, check. Buzenet 2 , tongue. Clements, lip. Dunn 2 , lip. Fournier 1C , neck. Froelich 7 , nipple. Gamberini 4 , cheek. Herard'-, nipple?. Kaposi 1 , lip. Neumann- 1 , lip, 31 nipple?. Rollet', 10 , lip, tongue. Taylor 14 , nipple in male, 21 lip. Van Harlingen 1 , 2 , lip, 6 mouth. ° nipple. Zeissl, H.°, breast. b. Biting in defence or assault. Arthur 7 , lip, chin. Baratoux, car. Beauvais 1 , finger, *(Gery), hand. Berbez (Guignard 7 ), finger. Blaciiez, neck. Brinton (Rohe >), nose. Brown, 218 SYPHILIS INSONTIUM F. T., finger. Bucci, finger. Bumstead (Sturgis ] ), cheek. Campart 5 , eyelid. Carriere, thumb. Finger 4 , nose, ear, thumb, toe. Froelich 6 , wrist. Gam- berini 4 , neck, 7 (Buccj), finger. Giovannini 10 , finger. Guignard 4 , nose. Henry 3 , cheek. Horteloup, P. 2 (Simonet) \ cheek. Hutchinson, J. 29 . Jones, S.,hand. Kaposi 4 , chin. Lavergne andPERRiN 2 , cheek, neck, ear, arm, finger. Lesage 1 (Fournier), thumb, 3 (Brouardel 3 ), finger, 6 (Fournier, Lavergne and Perrin), cheek, 7 (Hermet, Lavergne and Perrin), ear. Molliere (Jullien), finger. Morel-Lavallee 2 , eyebrow, 5 (Fournier), cheek. Neumann 4 , thumb, 9 hand, 30 hand or finger. Pellizzari, C, chin, cheek, neck. Petersen 4 , cheek, 8 finger. Poray-Koschitz 3 . Profeta ] , 2 , cheek. Robbins 4 . Roddick 3 , neck. Salsotto 4 , cheek. Soler 3 , cheek. Tarnowsky 3 , hip. Tchagin 3 , cheek. Vvedensky ] , finger. Walter 1 , lip. Zeisse, chin. Zeissl, H. 8 , thumb. c. Tooth-wounds accidentally inflicted. Bulkley, hand (original case No. CVII.). Chochlow 2 , finger (blow on teeth). Fournier 38 . Gazet, forehead (from dog-bite). Hutchinson, J. 3 , knuckle (fighting) 28 . Lesage 2 (Fournier), finger (policeman). Lunkevitch, finger (fighting). Maclaren *, finger. Speransky x , nose (fighting). Viguier 4 , cheek (in play). Wood l , knuckle (blow on tooth). 2. Digital infection in domestic and social life ; i. By contact; 2. By nail wounds. i. Infection by contact of finger; a. Self inoculation; b. Inoculation of others. (Many of these cases are found also in other sections). a. A uto-inocidation by means of finger. Bryant 6 , finger (direct contact). Galezowski 5 , eyelid. Gratia 2 , eyelid (venereal). Hunter 1 , lip. Lang 10 , thumb (from own penis). Lawrence 4 , thumb (direct contact). Lee, H. 10 , finger (direct contact). Leloir 10 , eyelid. Lustreman, eyelid. Morfan, septum nasi. Marston (Lee, H. 6 ), face. Mazet, eyelid (from own penis). Michel 3 (Stellwag von Carion), eyelid. Moure 1 , septum nasi. Neumann 6 , finger. Ohmann-Dumesnil 2 , lip (from own penis). Peter 2 , finger (from own penis). Popoff 2 . Ricord 4 , eyelid. Sigmund 6 , finger (direct contact). Suchanek 5 , lip. Taylor 24 , finger. Wood 2 , finger (in barber). b. Inoculation of others by means of finger. Plumert 7 , breast (scratch by brother). Tchistiakoff 14 , head (wound infected by barber). 2. Infection by nail wounds ; a. Scratching; b. Pinching. a. Infection by scratching. Allen, C. W. 7 , behind ear. Bryant 7 , cheek. Cooper, A. 4 hypogas- trium. Niece, elbow. Roddick 7 , forehead. Rollet 15 , chin. Taylor 26 , forehead. Vaughan, scalp. b. Infection by pinching. Weinberg 1 , cheek. SYNOPSIS OF FACTS AND LITERATURE 219 4. Infection by passive contact in domestic and social relations; a. Contact in sleep ; b. In carrying or supporting. a. Non-venereal contact in bed. Bergh 2 , gluteal region. Bertherand 3 (Guyon). Broich 12 , thigh. Caze- nave 7 (Lagneau, Lucas-Championiere, Biett). Colle. Corrigan ("button scurvy"). De Beck 1 , eyelid. Drysdale 2 , vulva. Friedlander 3 . Hauner 6 . Hildanus 2 . Horst 1 . Hulot, trochanter. Lancereaux 4 (Rayer 2 ). La- vergne and Perrin 4 , thigh. Mauriac 4 , back. Mracek 7 , wrist. Osiander. Pospelow 19 , chin. b. Contact in carrying, supporting, etc. Fontanus (mere contact). Fournier (Jumon 5 ), front thigh (holding woman in lap). Pellizzari, C. 19 , sub-maxillary region (contact with chancre of chin), 26 tonsil, neck, cheek, arm, chin, chest, mouth, anus (all from contact). Rizat 4 (Si.monet 2 , Chipier), nucha (carrying woman), 6 abdomen (contact;. Tarnowsky 3 , arm (contact with chancre of hip). B. Infection in industrial relations; 1. Buccal infection; 2. Digital infection. 1. Buccal infection in industrial relations; i. By occupations requiring the use of the breath; 2. By necessary or unnecessary use of the lips. 1. Industrial infection by occupations requiring the use of the breath; a. Glass- blowers; b. Assayers; c. Weavers; d. Musicians; e. Conductors;/. Housemaids. a. Infection of glassblowers. Anonymous , lip. Aubert 1 , lip. Bazin 2 . Bernard, A. 1 . Besnier 3 a, 3 1> . Chassagny. Dechaux (Gltnand 2 ). Deffernez. Desmet 2 . Diday 10 , I2 , lip. Dron 7 , lip. Gailleton. Gamet 1 . Gromier, lip. Guinand 4 , 5 . Heiberg. Hervier. Lagrange. Mason 2 , lip. Niobis. Perroud 1 , lip. Ravogli and Rasori 3 . Roddick 8 , lip Rollet 5 , lip 12 . Sigmund 11 , lip (four cases). Vien- nois 2 , lip, 8 lip, 9 tonsil, 10 fauces ». . Villard, lip. (Statistics of Hosp. Antiquaille, Lyons, from 1858 to 1872, furnish 82 cases; many included in the above. Besnier, Dron, Gailleton, Perroud, Rollet). b. Infection of assayers by use of the blowpipe. Margoniner 2 , palate (goldsmith's blowpipe). Sigmund n a, lip (three cases, two of them infected from same person). c. Infection of weavers. Behrend ' (entire family infected by mouth sprinkling-pipe). d. Infection of musicians from wind instruments. Greenleaf, lip (cornet). Guntz 6 . Lesage 4 (clarionette). Mason 3 , lip (cornet). Pospelow 6 , gum (clarionette). Roussel 5 (cornet). Sigmund. Tedenet, lip (cornet). Viguier 7 , inside cheek (cornet), 8 tonsil (flute). e. Infection of conductors of street conveyances or others using signalling whistles. Gros, lip, (bus conductor). Taylor 2 '. 220 SYPHILIS INSONTIUM f. Infection of domestics or others using speaking-tubes. Martineau 2 , lip. Vidal, E. 2 , lip. 2. Buccal infection in industrial relations, from the necessary or unnecessary use of the lips : a. Cooks ; b. Furriers ; c. Upholsterers and Shoemakers ; d. Clerks ; e. Cashiers ; f Other occupations. a. Infection of cooks front the ?ise of the tasthtg-spoon. JuLLiEN 4 t>. Rollet 7 , lip. Schirajew ] , tonsil. Tchistiakoff 6 , inside of cheek. b. Infection of furriers fro7n common use of thread in mouth. Poray-Koschitz l , lip (three men infected from a fourth). c. Infection of upholsterers and shoemakers from tacks or pegs held in mouth while at work (the surplus being thrown into the common receptacle). Pospelow 7 , tongue (from shoemakers' pegs). Spillman 2 , lip. Steele, lip. d. Infection of clerks and others, by writing implements, etc., held in the lips. Bangs (Fox, G. H. 7 ), gum (pencil). Calmette, tonsil (pencil). Cullerier, A. 6 , lip (pencil). Daehne, lip (quill-pen). Fournier (Jumon 4 ) (paper-knife). Gluck 5 , lip (pencil). Morel-Lav allee 6 , tonsil (pencil). Otis 6 , lip (pencil). Richerand (quill-pen). Ricord 18 , lip (quill-pen). Rohe 2 , tongue (pencil). Sigmund (brush-holder). e. Infectioit of cashiers and others from corns and bank-notes held in the lips. Desnos 1 , tongue (bank-notes). Fitzgibbon 1 , lip (bank-notes). Robinson, T. 2 , lip (coins). f Buccal infection in other occupations. Audry, lip (gunsmith). Besnier 2 a, lip and tongue (from brush of work- man). Guntz 6 , lip (flower maker). Karamanenko 2 (fieldwork). Popoff 3 (military service). 2. Digital infection in industrial relations: a. Laundresses; b. Dealers in old clothes, ragpickers and others. a. Infection of laundresses and chambermaids. Anonymous i , finger. Boeck, C 1 , finger. Bottey, hand. Dornig, eye- lid. Froelicii 3 , arm. Guntz 12 . Hamande, eyelid. Maclaren 2 , thumb. Neumann 16 , arm, 30 hand. Roddick 9 , wrist. Tchagin 1 , eyelid. b. Infection of handlers of old clothing and ragpickers. Coyttarus (two sisters from cast-off clothing). Fournier (Bouilly *), finger (in a rag-sorter). SYNOPSIS OF FACTS AND IITERATURE 221 II. SYPHILIS BREPHOTROPHICA. This section, relating to the acquiring of syphilis in connection with infant life, has two great subdivisions : A. As acquired by the child or others, through nutrition ; and, B. As acquired in connection with the care of infants, either by them or by others. Some of the subdivisions will be found to be the same as in the preceding section, and some references are interchangeable. A. Infection in connection with nutrition of infants, subdivided into, 1. Infection by lactation ; and, 2. Infection by hand-feeding. 1. Infection by lactation, relating to, a. Infection of nurse ; b. Infection of nursling. a. Xurse infected by nursling; 1. From nursling with hereditary syphilis; 2. From infants with acquired syphilis. 1. Infection of nurse (one or more), by a nursling with hereditary syphilis; including, a. Mother infected (exception to Colles' law) ; b. Nurse infected by nursling. a. Mother infected by own child with hereditary syphilis (exception to Colles' law). Bertin 5 . Cazenave 11 . Guibout 5 . Merz 2 (Zingalis). Pellizzari, P. (Jullien 12 ). Ranke. Scarenzio 5 . Tommasi-Crudeli. Zeissl, M. 1 (Luth). b. Nurse {not the mother) infected by nursling with hereditary syphilis. Abernethy 1 (Watson of Stourport). Acton 5 (family infection and law suit). Albers 3 . Ambrosoli 2 . Appay 3 , 4 (Fournier) ] , 2 > 6 (Le Dentu) Arcari 2 . Audoynaud ' (Fournier) 3 , 7 (Broca 2 ), 5 (Bazin 1 ), 8 , (Triboulet) 9 , (Sim onet 3 ), I0 (Charpentier), 6 (Siredey). Auxias-Turenne 1 . Bardinet 2 , 3 » f Barillier. Barnes. Baum 10 . Baumes 1 - 2 . Behrend 2 , 3 . Bell 2 . Bergeret Bertin 4 ! 6 (Leblaxc). Blondeau. Boeck, C. 1 . Boeck, W. 1 . 6 . Boerhave 2 , 3 , Bouchut 1 (Rayer '). Boyer *. Breda 1 , 2 . Bulkley. Bury. Byrne. Cam pana 1 . Campbell. Caradec Carle. Caspary ', 2 . Cazenave 2 , 10 , Chabrely. Chadzynski. Chrestien j (Niel), 2 (Menard *), 5 (D almas). Clary andGuARY 2 . Clerici. Colles 2 . 7 . Cullerier, M. 1 . Cullerier (nephew) (Lucas-Championniere *), (Diday 2 ). Cusack 1 *. Danielssen h 7 . DeAmicis 3 . Dease. Delore (Fournier 28 ). Devaux 2 . Dron h 2 > 3 » ■". 5 . Drysdale 4 i 8 . Dupuytren (Rognetta), also eyelid. Durkee ] (Bennett, J. H.) 2 . Ebrard. Egan 1 * 2 . Engelsted 4 , s. Farre. Forestus. Fortin. Fournier (earlier cases of 13 Appay, 8 Audoynaud, 2r) Hulot, etc.) 48 , 51 . Gamet 3 (Guinand '). Gardane 2 . Gauthier. Gavin. Gilbert (Vassal 3 ). Guillery. Haase'j 2 . Habenstreit. Hebra, F. von. Herzenstein >. Hjort 2 . Hofmann 2 . Hunter 2 . Hutchinson, J. 14 . Joiy. Keyes 4 . Klink. Kortum 2 . Lagneau, G. 1 , 3 (Defaucambourge). Lallemand ', 2 (Souciiier). Lawrence b . Lee, H. 8 . Leloir 3 . 5 . Leonesio. Letorsay. Lewin 4 i 8 i 8 . Lowdell 1 . LuzinskyV, 6. Manning. Marmissk. Mensinga. Monteggia. Mora and Sorksina ', 2 . Morgan 3 . Neumanns 1 "-, 31 . O'Connor ] , W\ Ory 10 (Lailler). Pellizzari, C.i, 4, 5, e, 2i # Pellizzari, P. fl (Roster 2 ). Petrini '. Plumert '- s . Poi \k. Pospelow 5 . Price, D. Profeta. Putegnat '. 3 . Ravel. Ricordi k , u , 15 . 222 SYPHILIS INSONTIUM RlZAT 7 . RlZZI. ROLLET J . SADOUL. SHERWELL 2 . SlGMUND 3 , 5 > 14 > 1S . SMITH, J. L. Sperino \ Sturge ». Suchanek ] > 2 . Tardieu h 2 , 6 > 7 > 8 , 9 , 10 , n , 12 . Taylor 3 , 4 > 5 . Thiry 3 . Trousseau 2 . Tchistiakoff 7 > 12 . Valery. Vassal h 2 , 3 . In the following class of cases, nurse {not the mother) infected by nursling, it is impossible to ascertain whether the infants in each case were subjects of hereditary or acqtiired syphilis. Anonymous l, m , r . Anstie. Archambault 1 (Pontet 4 ). Axenfeld. Bard- inet 1 . Belousow 2 , 3 . Berger. Berti. Beurmann. Biett 3 . Bigelow 1 . bottex. bouchut 2 . boys-de-loury. broick 3 . capuron 1 . cataneus. Chaboux 1 . Cheminade 2 . delChiappa 1 . Clarke, A. Cocchi. Cullerier, A. 1 . DeAmicis 1 . Des Molines. Diday \ 2 . Ellis. Eltzina 1 . Fernelius 1 . Foucart. Fournier 18 > 19 , 20 , 21 > 22 , 26 , 2S , 44 , 56 , 59 , 68 . Fredet 1, 2 . Froelich K Gail- leton. Galezowski l . Gemma 1 , 2 . Giovannini 4 . Guerrier. Hamerton 1 . Hardh, C. W. Hayward 1 . Hebra, H. Henri-de-Saint-Arnould. Her- zenstein 3 . Horteloup, E. and P. Jacquet. Jelzina 1 . Johnson 2 . Junquet 1 . Karamanenko \ Kehrer. Kobylin. Komin 1 , 2 . Langlebert 1 . Lee, H. 7 , 13 . Lefevre. Lewi 1 , 2 . Lindstrom 2 . Linne. McCraith 6 . Manassei. Mari- anelli 2 . Merz 1 . Michel, J. Mikhailoff 1 . Moore 3 . Musitanus. Oedmans- son. Pacchiotti 2 . Parker 2 . Perroud 2 . Petersen 7 . Petreni. Plinatus. Poggio. Polotebnoff 2 , 3 > 4 (Stein), 5 (Sotchara). Popoff 3 , 5 . Poray-Kos- chitz 19 > 23 > 24 . Quinquaud 1 . Rabl. Ravogli and Rasori 2 . Razumoff 1 , 3 . Reiche. Reichebach 2 . Rhodius. Ridley. Riverius. Roche '. 2 , 3 » 4 . Rod- dick 2 . Roger 4 . Sabinin. Salsotto 3 . San Juan. Sartorius. Scarenzio 1 . Skinner. Soffiantini. Soler 2 . Speransky 6 . Stepanoff J , 2 . Tanturri 3 . Torella. Townsend. Trevisanello 4 . Tuilier (Bardinet). Turati. Ussas 4 . Velschius. Verneuil 1 , 4 , 6 . Viennois. 1 Violet 2 . Waller 4 , 7 , 8 (Suchanek). Weil 2 . Wildhagen 4 . Wiltshire. Zarewiez (Gluck j ). 2. Infection of nurse by a nursling with acquired syphilis : including infant acquiring syphilis: a. From lactation; b. From kissing, etc.; c. From vacci- nation, etc. a. The infant's syphilis acquired in lactation. (In this section belong many cases in essential lactation-epidemics, where nurslings infect their own mothers and other nurses, and but few separate references can be made). Brassavola (nurse mother). Friedlander 2 (?). Gibert 3 (nurse mother). Lees (nurse mother) (Hutchinson 18 ). Obedenare (?). Pease 1 (nurse mother). Pospelow 5 (nurse mother). Schmalz 2 (nurse mother). Soler 5 (nurse mother). Wilson 2 (nurse mother). b. The infant's syphilis acquired by kissing or otherwise per os. Guenzberg 2 . Kilian 3 . Lewi 3 . McCraith 2 . Payne 2 . Poray-Koschitz 20 . Ricordi 10 , 12 . Rupp 2 . Taylor 7 . Theobald 2 . Tuholske. c. The infant's syphilis acquired by vaccination, circumcision, etc. (In this section belong those cases found in epidemics of vaccination, SYNOPSIS OF FACTS AND LITERATURE 223 circumcision, etc., where the children have infected mothers and nurses, and few separate references can be given). Albers 2 (circumcision). Clary and Guary (vaccination). Depaul 7 . Friedlander 2 (?) (vaccination). Glatter (vaccination). Laroyenne ] (vaccina- tion). Middleton 2 (vaccination). Moseley (vaccination). Perrin 3 (vaccina- tion). Poray-Koschitz 21 > 22 (vaccination). Rodet 3 (vaccination). Solomon, J. V. 3 (vaccination). b. Nursling infected by nnrse or other nursling; 1. Nurse has chancre of breast; 2. Nurse has recent syphilis, but no chancre of breast; 3. Nipple serves as medium, from another nursling. 1. The nurse, having been infected in lactation, has a chancre of the nipple. a. Nursling infected directly from nipple. Ambrosoli 2 . Baumes 2 . Behrend 3 . Boeck, W., 6 lip, 7 lip, 8 , 9 lip, 11 tongue. Bottex. Bouchut 2 . Bulkley. Caspary K Colles 2 . Cullerier (nephew) (Lucas Championniere 1 ). Danielssen 1 . De Amicis 2 . Dron 4 Engelsted 5 . Fournier 44 . Galezowski 2 , lip. Hayward 2 . Karamanenko 1 Lagneau, G. 1 . Lewin 4 , 9 . Lowdell 2 . Luzinsky 2 . McCraith 3 , 5 MONTEGGIA 1 , lip 5 . POLOTEBNOFF 5 . PoNTET 4 (ArCHAMBAULT 2 ). PRICE, D Ricordi 9 , 13 lip, 16 tongue. Rollet 3 , lip. Tanturri 3 . Trevisanello 4 , 5 Verneuil 2 . Waller 5 . Weil 2 . 2. The nurse has recent syphilis but no chancre of breast. a. Nursling infectedfro??i mztcous patches 071 breast. Agostini. Alison. Arning 1 . Barillier. Bergeret. Boerhaave 2 . Brassavola. Bruneau. Capuron 2 . Cerasi 2 , 3 . Chrestian 1 (Menard 2 ). Coote 1 . De Amicis 4 . Diemer 3 . Donne. Eustachius 1 (?). Forestus. Fournier 25 , 30 ! 49 lip 52, 58,59, ci_ Friedlander 2 (?). Gibert 2 , lip. Guenzberg 1 , tongue 3 . Hamer- ton 1 . Heister. Hill 2 , 4 . Lanoix 1 . Lee, H. 12 . Legrand 1 . Lister. Luzinsky 1 , 3 * 6 . Meyer (in Mindeni). Mikailoff 3 . Monteggia 2 , 3 . Moore 5 . Obtulowicz. Pare. Pellizzari, C. 2 , 4 , c > 7 , 10 . Portal. Putegnat 2 . Roger 5 . Rosen v. Rosenstein 1 . Roster 3 . Schirajew 2 . Schmalz 1 . Shand. Sigmund 12 , lip. Soler 4 , tongue. Stahl. Stoll 3 . Thiry (Charpentier). Tchistiakoff 7 . Van Swieten. Venot. Vidal-de-Cassis. Waller 1 . Winters 1 . b. Nursling infected from nipple contaminated with soiled fingers, etc. Cullerier, A. (Ricord), (nurse contaminates nipple with finger from vulvar syphilides). c. Nursling infected by supposed transmission through the milk. Cerasi 1 . Manssurow 2 . Nunn 2 (Morris). Steinberger. 3. Nipple the medium, another nursling the syphilifer. a. Nipple of the nurse the medium of transmission. Bertin 3 . Stoll 2 (nurse had not syphilis herself, but one child infected by another through the same nipple). (2 24 SYPHILIS INSONTIUM 2. Infection by Handfeeding: relating to: a. Adults infected ; b. Infants infected. a. The attendant is infected by the child ; including i. Handfeeding of new born infants, generally with hereditary syphilis ; and 2. Weaning of children, generally with acquired syphilis ; considered together. a. Infection from the nursing bottle (by tasting it in connection with feeding the child). Appay 5 (Gondonin), tonsil. Bolschwing 3 , fauces. Drysdale 3 , throat. Fournier 3 (Hillairet). Hutchinson 32 . Gibert 4 . Kobner 5 . Lang 8 , tonsil. Lesser 1 . Macdonald, tonsil. Ryan, C. S. 2 , lip. Spillman 1 , tonsil. b. Infection from the artificial teat. Plumert 5 . Polotebnoff 3 (sucking horn). c. Infection from chewing child's food. Bataschoff 2 , lip. Boeck, W. 15 . Cold 2 . d. Infection from spoons, cups, etc. Bardinet (Did ay). Bertherand. Kobner 1 , pharynx (spoon). Lagneau, G. 4 (spoon). Loret, family epidemic (spoon). Lucas-Championniere 2 , family epidemic (spoon and cup). Monteggia 6 (spoon). Rollet 11 , tonsil (spoon). Roussel 2 ^, tonsil (spoon). Todd, throat (spoon). b. Infection of infant during feeding ; including, 1. Infection by a syphilitic attendant; and 2. Infection by children fostered with it. 1. Infant infected by syphilitic attendant, through handfeeding. a. From tasting the nursing bottle. Anonymous c. Audoynaud 4 (Fournier). Ostroumoff*. b. From tasting and inserting the artificial teat. Plumert 5 . Polotenboff 3 (sucking-horn). c. From chewing infant's food. Boeck, W. 15 . Boettger. Chaboux 2 . Kilian 2 . Rosen von Rosenstein 2 . Wolf l . d. From warming its pap in the mouth. Van Deurs. e. From feeding with spoon or cup alternately with self. O'Connor 3 (spoon). Vidal-de-Cassis (tin cup). Wilson 3 , fauces (spoon). 2. Infant infected from other infants fostered with it: (by common feeding- spoon, cup, sugar-bag). Sigmund. SYNOPSIS OF FACTS AND LITERATURE 225 B. Infection by attendance on syphilitic infants (other than in connection with nutrition) : referring to, 1. Mediate contact; 2. Direct contact. 1. Infant infected by mediate contact, chiefly from its attendant, in connection with its toilet, clothing, etc., relating to, i. Toilet articles; 2. Coverings. 1. Infection by toilet articles: including, a. Washwater; b. Sponges; c. Combs; d. Syringes. a. Washwater. Kobner 3 . b. Sponges. Chaumier, anus. Cullerier, A. 2 , vulva. Fournier 24 (Pontet 1 ), vulva. Hauner 5 , anus. Huguier 2 , pudenda. c. Combs. Pellizzari, P. (Pellizzari, C 9 ), scalp. d. Syringes. 2. Infection by clothing, bedding, etc. a. Cloths, napkins, etc. Diday (Jullien 4 a), anus (towel or napkin). Lavergne and Perrin 6 , near anus. Pellizzari, C. 3 u2 , anus. Peter », vulva (diaper used as towel by father). b. Bedding, etc. Bolschwing 5 (cradle clothes). Cusack 4 (adult infected). Pellizzari, C. 22 , eyelid (pillow). Pellizzari, P. 2 , eyelid (pillow with saliva). 2. Infection by direct contact, in care of children ; divided, as in Syphilis economica, into 1. Active; and 2. Passive contact. 1. Infection by active and limited contact; divided into, a. Buccal; b. Digital; and c. Aerial. a. Infection by buccal contact, {lips, tongue, teeth): including, 1. Kissing and fondling ; and 2. Dental inoculation. 1. Infection by contact in hissing and fondling, divided into a. Reciprocal; and b. Non-reciprocal. a. Reciprocal hissing, lip to lip. a. Adults infected from children. Boerhaave 1 (several women from one child). Davis. Eichman. Lee 3 , lip. Le Gendre 3 , tonsil (Hulot). Lydston 1 , lip. Musitanus (nuns in con- vent). Neumann h 7 , chin ». Pellizzari, C. 13 . Rollet 9 , lip. Stoll 3 . b. Children infected by adults. Baum 1 . Berlin 1 . Bryant 8 , lip. Capuron 8 , lip. Charrifre. Coote 1 . Dieterich, lip. Feulard 5 , lip. Fox, G. H. 1 , tongue. KObNer 4 . Koit, C. 2 . Lavergne and Perrin 5 . McCraith ', lip. Mireur. Neumann 1 . Payne*. Pellizzari, C. 12 Roger 2 , lip. Romanoff 1 . Stirling 3 , lip. Stoll. Szadlk 3 , tonsil. Taylor 7 . Tuholske, lip. 16 226 SYPHILIS INSONTIUM c. Children infected from children. Coote 2 . Griffin 3 . Gueniot (Pontet 2 ). Neumann 1 . b. Non-reciprocal kissing, lips to other parts. a. Adults infected. Egan 3 , neck (infant's lips to site of pin-scratch), 4 tongue (kissing about nates). b. Children infected. Breyer (Cunier 1 ), eyelid. Cunier 4 . Despagnet 2 , eyelid. Eltzina 2 , finger. Kudriashoff, penis. Mackay, eyelid. ' Ryan, J. P., forehead. Schurig. Thomas 2 , forehead. 2. Infection by dental inoculation. Drysdale 2 , lip (bite of child). Snowball (Bird 1 , Ryan, C. S. 1 ), nose (bite of nursling). b. Infection by digital contact: including, i. Simple contact; 2. By nail wounds. 1. Infection by simple contact (attendant or child infected). a. Adults receive chancre of finger. Schuller 1 , finger, 2 hand. Sigmund (a number of cases in old attendants). Ussas J , palm of hand. b. Infants infected by attendants. Baudry 1 , eyelid (saliva on attendant's finger), 2 eyelid (saliva on mother's finger). Bertin 2 , vulva (bathing with saliva by mother). Cullerier, M. 2 , lip (bathing with saliva). Leloir 4 , groin (from wetting with saliva). Pellizzari P. 2 , eyelid (saliva of mother). Sigmund 10 , mouth (by finger of midwife). Wecker 4 , eyelid (mother's saliva). c. Distal infection by own soiled fingers. d. Infection by child 'j soiled fingers. Biett 7 (Cazenave), lip (forcing secretion of mucous patches upon fingers into mouth of six-year-old brother). Fournier ( Pontet 3 ), tongue. Sturge 2 , lip, tongue. 2. Infection by nail wounds. Denti, eyelid (in nurse from scratch of nursling). c. Aerial transmission by blowing or atomizing saliva. Solomon, J. V. 1 , eyelid (child infected by aunt, sputtering in the face). 2. Infection by passive contact ; 1. In parturition; 2. During slumber; 3. By contact in arms, etc., as in Syphilis economica. I. Infection of infant from mother during parturition. Bell, B. 1 . Carreras-y-Arago, eyelid (?). Grunfeld 1 , scalp. Guibout. Poncelet. Thiry 6 . Weil \ nose. SYNOPSIS OF FACTS AND LITER A TURF 227 2. Infection from contact in bed. Acton 4 . Bryant 9 . Colles 6 . Cooke 2 . Diemer. Friedlander 3 . Hauner 7 . Lesser 3 . Luzinsky 6 . Neumann 32 , umbilicus. Peatson. Pellizzari, C. 29 , inguino-scrotal fold. Pellizzari, P. 2 , eyelid. Swediaur 1 . Trousseau *, buttocks. Violet 1 , vulva. Voege. Waller 3 . 3. Infectio7i from contact in carrying children; a. Attendant infected; b. Infant infected. a. Attendant infected. Cusack 3 , thumb. Dowse, forearm. Ford, shoulder. Hardy 5 , forearm. Hulot, eyelid. Keyes \ arm. Pacchiotti 5 , forearm. Pellizzari, C. 4 *- 2 , cheek. Soler 6 , arm. Waller 6 , cheek and neck. b. Infant infected. Hulot, neck (from nurse). Richet (Ricord 2 ) (contact with hand of nurse). Roger 3 . Miscellaneous instances of brephotrophic infection; a. Attendants infected; b. Infants infected. a. Adults infected by children. Baum 8 , chin. Boeck, C. 8 , tonsil. Boeck, W. t , lip. Breda 1 , tonsil. Broick 4 , palate. Bucholz, tonsil. Castelnau (Robert). Colles 3 . Cripps 2 , eyelid. Cusack 2 , peri-anal. Dantelssen 5 , tonsil. Dron 8 , lip, tonsil. Dusterdorf (case in epidemic) (Hufeland). Edlefsen. Fournier 53 , lip. Friedlander 4 , tongue 5 , 6 . Grigorow, tonsil. Gurovitch j , lip. Haslund 2 , tonsil. Hunter 3 . 4 . Hyde, thumb. Joly (case in epidemic). Jullien 1 . Kobner 7 , palate. Komin 3 , mouth. Lancereaux 3 . Lecoq 2 , tonsil. Lee, H. 1 , lip. Lemonnter. Lipp 3 , eyelid. Luzinsky 1 ,-, 3 , 5 . 6 . Mannino. Manssurow 1 , lip. Mentzel. Morgan 4 , mouth. Neumann ] , tongue. Pospelow s , tongue, 12 fauces. Ricordi (cases in epidemics). Rinecker 1 . Rust 1 . Schirajew 3 , tonsil. Snell 2 , eyelid. Stark, tonsil. Tchistiakow 2 , throat. Thoma- SCHEWSKY 1 , tonsil. WlLDHAGEN 3 . b. Children infected by adults and by one another. Boeck, W. 7 , lip, "tongue. Bolschwing 6 (father syphilitic). Bulkley (mother syphilitic). Dantelssen 6 , mouth. Diemer 3 . Engelsted 6 . Feulard \ anus, 4 (Grancher) cheek. Fournier 23 , tongue, 46 (statistics in 42 cases: 19 from parents, 8 from nurses, 4 from attendants, 2 from other children), Friedlander 10 , lip 11 . 12 . 13 . Garson (four children infected by parents) Guntz 14 . 17 . Hauner 2 . Henrot. Hjort 2 . Holm. Kayerin V 2 . Kobner 6 Krowczynski 2 . Luzinsky ''-, 3 , W ; . Menard 2 . Moore 4 . Paul, lip. Pel lizzari, C. 1 . Peterson 1 . Popoff 3 . Rollet 3 , lip. Rosen von Rosenstein \ a Rupp >. Scarenzio 2 > 3 » 4 . Secheyron K Sturgis 2 , eyelid, 3 cheek. Tchis tiakow 4 , forehead. Trousseau 4 . Vere-Delisle, anus. Wallace '. Wal- ler 1 , 2 , 4 » 5, 7 . 228 SYPHILIS INSONTIUM III. SYPHILIS TECHNICA. This section, relating to the acquiring of syphilis in connection with body- service, has three great divisions : A. Where the operator becomes the victim of syphilitic inoculation ; B. Where the operator, being syphilitic, conveys his own disease to others, in body-service ; and C. Where the operator, or his instruments, serves as the medium of syphilitic inoculation, from one patient to another. A. Operator the victim: i. From unnecessary exposure ; 2. From neces- sary exposure. 1. Infection from unnecessary exposure: a. In performing surgical operations ; b. In making post-mortem examinations. a. Operative, received in course of surgical operations. Abernethy 2 , finger. Auspitz (Zeissl, H« 13 ), self, finger. Brush, thumb. BulkleYo Bumstead 7 , finger. Cavazzani 2 , finger. Cazenave 3 . Coote 3 , 4 , self, finger. Delpeche 1 (Lawrence j ), finger. Galvin, finger. Hardie, finger. Lydston 2 , finger (case of Dr. Nott). Otis 2 , finger. Pellizzari, C. 25 , finger. Scarenzio e , self. Schnitzler, finger. Wilks, finger. Williams, A., finger (operation of fistula in a horse ? ). b. Cadaveric, from post-mortem examinations. Hourmann (Lagneau, G. 2 , Cazenave, Vidal-de-Cassis). Howard, hand. Morgagni. Paulini (pulverized bone). Rumpf 3 (Vogel). Sommering. Swe- diaur 2 . Taylor 20 . 2. Infection from necessary professional exposure; a. Manual infection; b. Cephalic infection. a. Manual (digital) infection ; chiefly -from exploration of cavities, etc. ; a. Surgeons; b. Accoucheurs and Midwives; c. Dentists; d. Attendants. a. Infection of surgeons, in manipulative procedures. Arthur 8 , finger. Augagneur 2 , finger. Bell, B. 1 . Bloom 5 , finger, 6 thumb. Brandis, finger. Broick 2 , finger. Bulkley. Buret 3 , back (auto-inoculated by finger). Cairns, finger. Churchill, thumb. Coesfeld, finger. Cooper, S., finger. Gascoyen, thumb. Goodell 1 , finger. Gross 2 . Guntz 4 . Holt- house, finger. 'Jullien 13 , finger. Jumon 3 (Fournier), hand. Lawrence 2 , thumb. Lee, H. 2 , 9 ] - 2 , finger. Mason 5 , finger. Morgan 5 , finger. Ory 4 , finger. Otis L 7 , finger. Paget, J. 2 , finger 3 . Pancritius 1 , finger. Pelliz- zari, C. 24 . Poray-Koschitz 25 , thumb, 26 hand. Ricord 6 , finger. Rosenthal 1 (Lewin), hand. Rumpf 2 , hand (Pierson). Sigmund 4 , finger. Sims 1 , finger. Swediaur 2 . Symonds, finger. Tail, finger. Taylor 23 , finger. White, J. C.* Zeissl, H. 2 , arm. b. Infection of accoucheurs and midwives. Anonymous h, finger 15 . Atkinson 3 , thumb. Bardinet 6 . 7 . Bayer. Bell, B. 1 . Bernard, A. 4 , finger. Biett 6 . Borgarutius, finger. Boudinet, finger. Bourgeois. Brambilla, finger. Broick 2 , finger, 9 finger. Campana 2 SYNOPSIS OF FACTS AND LITERATURE 229 (Mayer). Cazenave 4 > 5 (Biett). Clowes l (Lee, H.) ". Cohansen. Cohn. Dawosky ] , finger. Denis-Dumont 2 , finger. Devaux 1 , finger. Engelsted 1 , finger. Fernelius 3 , finger. Fuchs 2 . Galligo 3 . Gallus (Lecoq). Gardane 1 . Glatter, arm. Goodell 2 , finger 3 . Guntz 3 , 15 . Hamerton 3 , palm of hand. Hardy 3 (Ory) 12 . Hutchinson 2 , thumb. Kobner 9 , finger. Kopp, J. H. Lawrence 3 . Minkevitch, finger. Neumann 3 , hand. Palfyn. Pellizzari, C. 23 , hand (of P. Pellizzari). Pettman, finger. Pick 1 , finger. Plumert 6 , thumb. Pospelow 2 , finger. Protzek, finger. Riedlin. Saulsay, finger. Schubert 2 . Sigmund 9 , finger. Simon 1 . Suchanek 3 , finger. Swediaur 2 . Taylor 25 , finger. Wedekind. Wendt \ finger. White, J. C. 2 , finger. Wolff (Weiger), finger. c. Infection of dentists. Anonymous d, finger. Bumstead 3 . Fournter (Lesage 5 ). Hutchinson. Neumann 8 , finger. Taylor 11 . d. Infection of attendants, students, etc. Bronson 2 , thigh. Burtzeff, hand. Diemer 4 . Kaposi 3 , finger. Leloir 2 . Thomaschewsky 3 , tonsil. Vyshogrod, finger. Zeissl, H. 6 , finger. b. Cephalic infection; including 1. Buccal; 2. Facial. 1. Buccal Infection ; a. By breast-drawing ; b. By wound-sucking; c. By inflation of lungs of new-born ; d. By applying tongue to eye. a. Infection from breast-drawing. Alberti. Barry. Bigelow 2 * 3 , throat (Durkee 3 ). Bilguer (Rosen von Rosenstein). Bourgogne j (Fournier). Canetta. Everardus. Hamerton 2 , lip. Heinecken. Hey, lip. Joly (Seutin). Lawrence 6 , lip. Leloir 6 , lip 7 . Leo. Loder 2 . Marone 2 , lip and tongue. Munninks. Ricordi *. Rupp 3 , fauces. Viennois l . b. Infection from wound-sucking. Leloir. c. Infection from inflating lungs of new-born. WlGGLESWORTH », tonsil. d. Infection from applying tongue to eye. (In many of the instances quoted on page 231, the operator had first acquired chancre of the tongue in the practice referred to). 2. Facial infection; a. By own fingers; b. By direct contact; c. By aerial transmission. a. Infection by ownflugers, etc. Anonymous g, eyelid. Binet 2 , cornea. Bouciieron 2 , eyelid. Buret 2 , eyelid. Campart 2 , eyelid. Dki. Montk '» 2 , eyelid (Sbordone). Desmarres 2 , eyelid. Dietlen, eyelid (Michel). Esof (amniotic fluid). Hardy 7 , eyelid, nostril, lip. Hutchinson, lip (inoculation of a scratch). Mek.iian 2 , eyelid. Mason, lip. Rasori 2 , nostril. Ricord 7 , cheek. Stanley, lip. Tarnovvsky 4 (amniotic fluid). Vvedensky 2 , temple. Watson, S. 3 , nostril. 230 SYPHILIS INSONTIUM b. Infection by direct contact. Wendt 3 , cheek. c. Infection by aerial transmission, coughing in the face, etc. Alexander 2 , eyelid. Desmarres l (Michel 4 ), eyelid. Fournier 15 (Saw), eyelid. Hardy 6 , eyelid. Leloir 9 , face. B. Operator the syphilifer ; 1. Infection by direct contact; 2. Infection by instrumental contact. 1. Infection by direct contact, without the intervention of instru- ments : including, a. Digital contact ; b. Buccal contact. a. Infection by digital contact; a. Infecting finger seat of a chancre; b. Infecting finger soiled by saliva, etc. a. Infecting finger seat of a syphilitic primary lesion ; 1. Chirurgical manipula- tions ; 2. Obstetrical manipulations. 1. Infection by chirurgical manipulations. a. Vaginal, anal, and other examinations. Coste (in Berlin), rectum, Hutchinson, anus (examination for hemor- rhoids). 2. Infection by obstetrical manipulations ; a. Mother infected ; b. Infant infected. a. Mother infected by accoucheur' 's hands. Anonymous 15 . Dawosky 2 . Fournier 51 , 56 . Hutchinson 24 . Leloir 17 . Mauriac 12 . (See also Epidemics, Accouchment). b. New-born infected by accoucheurs hands. Bardinet 6 (Some of the children showed syphilis before their mothers, in the epidemic of Brive). b. Infecting finger soiled with saliva of operator. a. Obstetrical iufection. Bleynie (Bardinet 7 ) (A midwife infects a number of children by apply- ing her saliva on her finger as a haemostatic to the stump of the divided cord). b. Medical and surgical infection. Anonymous p (Clossius 2 ) (a woman who was a sort of lay practitioner infects a patient in " raising the uvula " which had probably been "swallowed." Broick 7 , nose (application of saliva to an erysipelas). Krelling 2 , nose (application of saliva to heal an erysipelas). b. Infection by buccal contact; 1. With a tround ; 2. Without an open wound. 1. Buccal infection through an open wound; a. In wound-sucking; b. In circumcision. SYNOPSIS OF FACTS AXD LITERATURE 231 a. Infection by wound-sucking. Anderson, cheek. Fournier (Jumon 1 ), calf of leg. Hill 1 , cheek. Meighan 1 , eyelid. Robbins \ hand. Van Harllngen i:i , eyelid. b. Infection in circumcisioii. Albers 1 . Bierkowski. Jaffe. Kedetoff. Kosinski. Lubelski. Mattlakowski. Multanowski. Xowakowski. Robbins 2 . Rust. Solomon (in Hamburgh). Taylor l . Wendt 2 . (See last section, and also Epidemics.) 2. Infection without an open wottnd; a. In breast-drawing; b. In remov- ing foreign particles from the eye, by the tongue. a. Infection by breast-drawing. Alberti. Barry. Bilguer (Rosen yon Rosenstein). Bloch. Bourgogne 1 (Fournier). Canetta. Eyerardus. Gailleton (Roussel). Heinecken. Hey. Joly. Kyll. Lanzoni. Leloir 7 . Leo. Loder 2 . Munntnks. Parker 1 . Ricord 11 . Ricordi \ Rollet-. Sydoyv Taylor 10 . Winslow. b. Infection by application of tongue to the eye, to remove foreign bodies, etc. Andrews, eyelid. Buch, eyelid. Edes, eyelid. Galezowski 6 , eyelid. ( 7 Layergne and Perrin), eyelid. Lee, C. G. , eyelid. Montgomery, conjunc- tiva. Murzin, eyelid (to cure stye). Pospelow 1T , eyelid. Szokalski, con- junctiva. Tepliaschin (Langlebert 4 ). 2. Infection by instrumental contact (instruments soiled with operator's saliva), a. By tattooing needle ; b. By cupping instruments. a. Infection by tattooing; needle or pigme7it moistened with i7ifected saliva. Arthur- (Wilcox). Barker, F. R. Carleton. Hutin. Josias. Leckie and Carlton. Maury and Dulles. Moffet ] , 2 , 3 . Petry. Porter, R. Robert. Robinson, F. Rollet. Stirling- 4 . Tardieu. Trotter. Viennois c . Whitehead. b. Infection by cupping. In several of the Finnish epidemics it is stated that the cupper (a woman) was syphilitic — once at least that the disease was professionally received — and that the transmission was by means of saliva on the finger, used each time to clean the cup, etc., before using. Hardh, J. O. Hjelt W ! . Resiiktmkoff, neck. Spoof. c. Operator the medium; 1. By transplantation and inoculation; 2. By unclean instruments; 3. By unclean substances. 1. Infection by transplantation and inoculation; i. Of solid sub stances; 2. Of liquid substances. 1. Infection by transplantation of solid substances; a. Of teeth ; b. Skin grafting. a. Infection by transplantation of teeth. Hamilton 1 . (Lettsom 2 ). Hunter 5 . Ki'tin (Lettsom- 1 ). Lettsom 1 . Watson, W. (Hunter, Swediaur). Besides the above, FRANK, J. a Merkel, and others less known, wrote on the subject. 232 SYPHILIS INSONTIUM b. Infection by skin grafting. Deubel (Fereol). 2. Infection by inoculation of liquid substances ; a. Vaccination ; b. Variolation ; c. Syphilization. a. Infection from vaccination. Adelasio 2 . Amoroso. Auxias-Turenne 2 > 3 , 4 . Bardinet 8 (Depaul). Bohn. Boudais. Caillard. Carter, R. B. Ceccaldi. Cerioli 3 . Chas- saignac. Cheadle l . Clement (in Frankfurt). Cory (Hutchinson 22 ). Coste (in Paris). Crawford. Creighton. Demaux (Laroyenne x ). Depaul 2 , 3 . 4 (ZALLONIS 5 ), (VlCHERAT 6 ). DEVERGIE. DrYSDALE '. EULENBERG 1 ' 3 . FEU- lard 1 . Foster 1 . Fournier 46 , 51 > 56 > 62 > 63 > 64 > 65 . Frankel. Frezoul. Fried- lander 2 (?). Gautier. Guevin \ Hauff. Haydon. Herard ». Hervieux (?). HERZENSTEIN 2 . (TCHORZNICKI, TCHISTIAKOFF, VUKOLOFF). HOUGHTON. Hutchinson, J. 4 , 8 , 10 , » (Tay), 12 , )3 , 14 , 15 . Kobner 12 , 13 . Korver. Lang 5 . Langenbeck, B. von. Lanoix 2 . Laugier. Lecoq ] (Guyenot). Lee, H. 9 . Leppmann. Lever. Lodge (?). Lotz. Mason 8 . Middleton l . Monell. Morax (Bouvier 2 ). Moseley. Nayler ] > 2 . Ollier (Bouilly 1 ). Orlandini. Parola. Passant. Pellizzari, C. 17 . Perrin 2 (Zuriaga). Pitton. Pol- lock. POPOFF 2 . PORAY-KOSCHITZ ' 2l > 22 . POUMEAU-DELILLE. PrETTYMAN. RlCORD 21 . RlCORDI 3 . RlNECKER 2 . ROBERT, M. 3 . ROBERT, P. ROBINSON, E. (?). Rodet 2 . Rosenthal 2 . Salsotto 2 . Scott (Purdon). Sebastian (Blot). Smith, T. Solomon, J. V. 3 Startin 1 , 2 (Nayler). Trousseau 3 (Sistach). Vanmerris. Viani. Vidal (Ory 3 ). Whitehead (in Manchester). (See also Epidemics, 7 vaccination, p. 210). b. Infection by inoculation of variolus pus. (Introduced into Europe in 1721, it is said by Depaul to have been accused of transmitting syphilis —no references nor cases given). c. Infection from the so-called syphilization. (In performing auto-inoculation for the purpose of so-called syphilization, as a cure, it has occurred that patients who previously had only chancroids became inoculated with syphilis). Lee, H. 12 j - 2 (Danielssen). 2. Infection by means of instruments soiled by previous use. a. By- cutting instruments ; b. By blunt instruments. a. Infection by sharp or cutting instruments; I. Wound accidental ; 2. Wound intentional. 1. Infection by accidental wounds with sharp instruments ; a. By dental instru- ments ; b. By razor wounds. a. Infection in %vounds by dental instruments. Barclay, lip. Bulkley 4 , tongue. Dulles 2 , lip. Giovannini'-, lip. Lancereaux 8 , gum. Leloir 15 , gum. Lydston 4 , gum. Otis 5 , angle of mouth. Pease 2 . Roddick 6 , gum. SYNOPSIS OF FACTS AND LITERATURE 233 b. Infection in razor wounds. Agasaroff. Allen 2 , cheek. Anonymous 16 . Albert 3 chin. Bovero. Broick », chin. Brousse. Bllkley. Carre (Martin 4 ). Cheminade ] , neck. Choclow 1 , cheek. Chudnqski", chin. Cripps 3 , chin. Delpeche 2 , chin. Despres (Cochez), chin. Fedchenko-, chin. Feibes, cheek. Fleischer, chin. Fournier 37 , chin (Dubreltlh in Paris, Zwetitch, Morel-Lav allee 5 ). Gio- vannini 6 , cheek. GlCck 3 (naso-labial fold). Goldenberg 4 , cheek. Henry 1 , lip. Idelson, chin. Koltschewski, chin. Ladroire-Yver, cheek. Mauriac 6 , lip, cheek. Morel-Layallee 5 , cheek. Morrow 1 , chin. Neumann 25 , chin. Nikolski, D. P. 1 , angle of jaw. Oestreicher, cheek. Pellizzari, C, (in- clined to accuse lather brush). Penny 1 , lip. Robbins 3 . Tarnowsky 1 , chin. Taylor 13 , chin 20 . Tchudnowsky, chin. Tzitrin. Vallauri. Van Har- lingen 8 , face. Viguier 9 , chin. Windheuser, chin. 2. Infection by intentional wounds ; a. In phlebotomy ; b. In minor surgery ; c. In wet cupping ; d. In leech bites ; e. In tattooing (needles infected from previous subject); /. In vaccination wound (soiled instruments). a. Infection in phlebotomy. Bell, B. 1 Bonorden. Daguerre (Cazenave 8 ). Lebenwald. Ricord 3 (Acton l ). b. Infection in scarification and other minor operations. Bassereau 4 (Jumon 2 ). Behrend 5 . Diemer 2 . Fournier 9 . Fritze. Ho- molle, scrotum. Kobner 10 , axilla (cutting furuncle), n scrotum (scarifying). Lang 1 , forehead (opening furuncle). Maes, eyelid (incision of stye). Robin- son ', penis (phymosis operation). Sperino 2 . Swediaur 3 . c. Infection in wet-cupping. Cornarius. Geigel ] . Hornung (Lammert). Horst 2 , 3 (Snitzer). Jor- danus. Lammert 1 . Meyer-Ahrens. Poliataieff. Rona 6 . Widmann (Horst 4 ). d. Infection in leech bites. Anonymous 14 . Steinbacii, temple. e. Lifection in tattooing (needles infected from previous subject). Poilroux (Geigel 2 ). /. Infection in vaccination wound (soiled instruments, etc.). Bonniere. Bourdon (Ory 2 ). Jenkins. Lorain. Taylor 6 . b. Infection by blunt instruments; a. Eustachian catheters; b. Probes, sounds, catheters and specula; c Serres-fines, porte-caustiques, etc.; d. Tongue spatulas ; e. Syringes. 234 SYPHILIS INSONTIUM a. Infection by Eustachian-sounds and catheters, Belhomme and Martin 3 . Blauchet. Bousquet. Brouardel 1 , 2 (Bucquoy 1 , Cullerier). Bucquoy 2 (Danyon, Cullerier). Burow. Cohen. Cou- tagne, tonsils. Cozzolino 2 , nose. Diday 9 . Fournie, pharynx. Fournier 5 , tonsil 6 > 10 > 45 > 51 > 56 . Gosselin 3 (Jullien 7 ). Gubler 2 (Soucher), 3 (Ricord). Hardy 2 , tonsil. Hillairet h 2 » 3 . Laboulbene l . Lailler ', nostril and throat. Lancereaux ' (Besanqon 7 ). Le Gendre 7 , tonsil. Lortet. Moure 2 (Dupond 1 ). Muller. Pujol. Raynaud (Lancereaux »). Secheyron 2 (?). Seweke, tonsil. Solis-Cohen. Tardieu 5 (Ricord). Vadja 2 . Vigla. Zeissl, H. 3 , fauces. Zewecke, tonsil. b. Infection by probes, sounds, catheters and specula. Tardieu 3 (vaginal speculum). c. Infection by serres-fnes, porte-caustiques, etc. Del Greco (Pellizzari, C. 20 ), leg (from brush electrode). Fournier (Tar- dieu 4 ) (serres-fines). Leloir ]6 , finger (porte-caustique). Taylor 20 , (caustic holder). d. Infection by tongue spatulas, laryngoscopes, etc. Jumon 4 (tongue spatula, physician infected himself), (Fournier). Taylor 20 (tongue scraper). e. Infected by syringes {^vaginal). Fournier. Jullien 2 . Leloir 1 ' 2 . 3. Infection by means of unclean substances ; 1. In suspension ; 2. On bandages, lint, etc. 1. Infection by virus in suspension ; a. In wash-water ; b. Local therapeutics. a. Infection by wash-water. Moty, eyelid. Neumann 28 , ala nasi. b. Infection in connection with local therapeutics. Castel du\ arms (in treatment for scabies). Fournier 67 , penis (scratch- ing in scabies), 69 (Feulard) ' 2 , arm (treatment for scabies). Lailler 2 , penis and scrotum (treatment for scabies). Pollaesik (after scabies). Profeta 7 , between fingers (in scabies). Rona 3 , forehead (in eczema; hospital infection). 2. Infection by virus on bandages, lint, plaster, etc.; a. In surgical dressings; b. In circumcision. a. Infection in connection zuith surgical dressings. Bernard, P., arm. Hutchinson, j. Jr.', occiput, 2 heel. Sigmund 8 , neck and shoulder. SYNOPSIS OF FACTS AND LITERATURE 235 b. Infection through lint, etc., in connection with circumcision (many unexplained cases are inserted here). Biett 1 (Albers 1 ). Brecker (Jaffe). Fischer (Jaffe). Goldenberg 2 . Jaffe. Kaposi 2 . Kessler. Klein 2 . Kotzyn. Lewentauer. Lubelski-. Obalinski (Jaffe). Poray-Koschitz 6 . Rollet (statement of the probable presence of circumcision syphilis in the Mahometan races of North Africa). Segel (Jaffe). Sonsino. Taylor 1 . Vaxier. (See also Epidemics, 6 circumcision, p. 210). Note : As there are names in literature whose cases cannot be discovered, so there are vague references to places, the seat of epidemics for whom no authors can be found. Jaffe speaks of cases at Vilna, Warsaw, and Lemberg, soon after the episodes of Rust and Wendt. Leppmax (1883) of one recently present at Neisse, in Silesia, and one in the suburbs of Paris in 1867. SUPPLEMENTARY INDEX. Reported cases (hot included in preceding) where location is stated, but not the mode of infection ; also statistical reports. Cephalic. Arcari 3 . Caby (Fourxier). - del Chiappa 4 (multiple). Dubreuilh in Bordeaux (Bracquehave) (multiple). DuPoxt. Kiliax ' (multiple). Lalle- maxd 3 . Pacchiotti 3 (multiple). Stourme. Thiry 1 (Spaack). Scalp. Gluck 2 . Kaposi 6 . Lloyd 3 . Forehead. Paliard. Pauly 2 . Poray-Koschitz 18 . Ricord 8 . Trivet (Fournier). Eyelid and Conjunctiva. Adams, J. E. (Alexander). Arlt (Wiethe 2 ). Astruc 2 . Albert 4 (Stolrme). Badal 1 . 2 . Barthelemy 2 (Fournier). Baudon. Bernard, E. Brinchen. Brocq ' (Parinald 2 ), (Besnter). Broick 6 (Krellixg '). Bllklev - { h. Bull. .Bumstead 6 . Campart '» 3 i 4 . Castelo. Claeys. Clerval. Closa. Cooper, J. F. Critchett. Clllerier, A. 3 > * (Mackenzie, W. 1 ). Clxier 3 . Dardel (Clerc). Delapersonne 3 (Barthelemy *). Demets. Desmarres 3 . Despagnet '. De Vincentiis (Profeta). Dixon. Doe (De Beck). Dubreuil. Dulles 3 . Fano 2 (Touchaleaume). Fenwick (Cline). Fernandez. Fienzal. Fitzgerald. Fonseca. Forti mauls. Galezowski 3 , 4 . Gay, A. H. 3 . GlOVANNINI 8 . GOLDENBERG 3 . GosSELIN 2 (GlIGNARD c ). GRAIL. GRANDMOND. Gratia 3 . Griffith. Gubler l (Ricord 13 ). Hairion (Cunier 2 ). Hock 236 SYPHILIS INSONTIUM (Boeck). Holmes 1 . 2 . Horand (Jullien). Horteloup, P. 1 . Huguier 1 . Hutchinson, J. 6 , 23 . Juler (DeBeck 3 ). Knapp. Laskiewiez. Lavergne and Perrin 3 . Lawrence 7 . Lawson. Leber (De Beck). Lesser 4 (Krel- ling x ). Lipp 2 . Loring' 1 (Sturgis 2 ). Lurinsky \ 2 . Mackenzie, W. 1 (Michel 2 ). Mason 4 (Lee, H.). Mastin. Mauriac n . Michel 6 (Ricord). Mittasch. Moura. Nagel (De Beck). Nelaton (Laroyenne 2 ). Nettle- ship 2 . Neumann 23 . Neves-da-Rocha. Noyes. Ottava. Panas (Delaper- sonne h 2 ). Pfluger h 2 . Pospelow 15 . Randall (De Beck). Ricord 9 > 13 i 20 . Ring. Robert, M. 2 . Rollet 13 . Rona 5 . Sabolotsky. St. Martin. Seeley (De Beck). Serdukov >. Smith, W. P. Streatfield ^ 2 (De Beck). Thiry 2 . Ussas 5 . Valentine. Viguier 1 . Watson, S. 4 . Wecker j (Michel 5 ). Wherry. Wiethe ' (wound in dance). Wolfe. Zeissl, H. 7 . Ear. bulkley 3 j. Rasori \ Cullerier, M. 4 . Guranowski, middle of ear. Jullien 5 . Cheek. Atkinson 2 . Barthelemy 3 (Zwetitch 3 ). Bulkley 3 ^ Caramitti 3 . Clem- ent in Lyons. De Amicis 5 . During 1 . Farriols. Fedchenko 3 . Fournier 50 . Friedlander 14 . Gay, A. H. 3 . Giovannini 6 . Gould. Guignard 2 (Vincente). Hutchinson, J. 36 . Kaposi 7 . Leprovost (Horteloup). • Loring 2 (Sturgis 3 ). Marey (Fournier). Marianelli 1 . Mitchell. Monnet K Pauly l , 2 . Poore. Rollet 16 . Roussel 8 (Aubert). Sheild 2 . Stukowenkow 2 . Treves (White, J. W.). Nose and nares. Aubert 2 (Stourme). Baumes 3 (Ricord). Bierchen 1 (Rosen v. Rosen stein). Biett 8 (Martins, Ricord). Bird 2 . Bonnet (Rollet 14 ). Boulangier BULKLEY 31 . CARAMITTI 2 . COOPER '. CUTTER. FOURNIER 32 . FrOELICH 2 Gay, A. H. 3 Gemy '. Gibier-de-Savigny. Gosselin 1 (Dulac). Gueyin Jullien 9 (Hillairet), 10 (Lailler). Laurent. MacCarthy. Morel-Lavallee (Fournier). Morrow. Moure 4 . Nettleship ] . Neumann 21 *. Poncet 1 Prewitt. Quinquaud and Nicolle 6 , also temple. Ryan, C. S. 1 (Bird l , Snow ball). Viguier 3 . Lip. Adams, J. 2 . Allen 1 * 3 > 5 . Anonymous U k. Aubert 1 (Stourme). Barduzzi 2 . Baum 3 , 5 . Bayle. Besnier 1 , 2 t>, 2 c (Horteloup) 4 . Bierchen 2 (Rosen v. Rosenstein). Bjorken 3 . Blair 1 . Blanc 1 . Bloom 4 . Bloxam. Boeck, W. 12 . Bourcy (Mauriac). Boys-de-Loury and Casthilhes. Broca (Fournier). Broick 1 . 8 . Bryant 1 . 2 . 3 . BuLKLEY 3 a. Buret 1 (Soler y Buscalla). Buzenet 1 . Calvo. Caramitti. Cayla. Cazenave 1 (Biett). Cehak. Cenas ] (Stourme). Chartier. Chauvet (Ballet). del Chi- appa 2 . 3 . Chiari 1 . Clarke, B. Cooke 1 (Mason). Coote Corcelet (Diday). Cordier (Stourme). Couper. Cullerier, A. 7 . Cunier a . Demange. Dickinson. Diday S c (Gorcelet) 7 > s , (Bodet) i2 . Dolbeau. SYNOPSIS OF FACTS AXD LITERATURE 237 Dubois, H. Dubois, P. During 1 . Fano 1 . Farlow. Finger 1 (Zeissl, H. 10 ). Fisher. Fournier 3 * 4 , », 32 , 42 , 60 . Fox, G. H. 3 . Froelich 2 , 3 . Gamberini 5 . Garreau. Gaudichier. Gay, A. H. 3 . Gemy. Gilbert 4 . Giovannini 1 . Gue- YIN 2 . GUIBOUT 2 (ZWETITCH 1 ). GuiNAND 3 , 6 . GuNTZ 2 * 8 , n . GuTTCEIT. HARDY 4 (Ory 11 ). Harsant. Henry 2 . Heurtaux. Heylen-de-Herenthals. Hulke. Hutchinson 16 , 21 , 34 . Kaposi 8 . KortCm 1 . Labbe (Ory 13 ). Lacroze. Lang 3 , 4 . Langlebert 5 . Lefort (Jullien). Leonard. Lesser 2 . Lewix 7 . ,n i ". Lewy and Goldberg 1 . 4 < 5 , 6 , 10 . Lindstrom 1 . Lindwurm. Lipp 1 . Lorut (Fournier). Lucas. MacCarthy. McGuire. Marianelli 3 . Mason 1 (Wat- son, S. 2 ). Maunder *. Mauriac ] , 5 . Massarosh. Mikulicz and Michelson. Millard 2 (Budor). Moffat. Monnet 2 . Moore 2 . Morel-Layallee 4 (Four- nier). Morozoff. Morpian. Nassans (Fournier). Nasse l (Ruthenbfrg). Neumann 2 , 12 i 13 > and nose 14 . Nunn 1 . Ory j (Besnier) 15 (Lailler). Owen. Pajet, J.' 2 . Pancritius 4 . Pauly 1 . Pellizzari, C. 27 . Pellizzari, P. 4 . Perroud 1 , 3 . Petersen 9 . Pick 2 . Piogey (Arnal). Plumert 4 . Poisson 1 . PORAY-KOSCHITZ 9 , 1! ) l2 , 14 , 2T ) 2S . PoSPELOW 9 . PoSSELT (WALTER 4 ). PrOTO- popoff. Proust (Chauyet). Quain. Quinquaud andNicoLLE 1 . Rabinovitch. Rayogli and Rasori 1 . Redner. Regoby 2 (Martineau). Reichebach 1 . Ricord 10 , 17 . Rizat 2 . Rodet ] (Diday). Roussel 3 . Rumpf ] , 4 . Sarda (Chrestien 4 ). Serdukov 4 . Sherwell 1 . Sigmund 1 , 2 , 16 > 17 . Soler 1 . Som- MERBRODT (CHIARI 2 ). SpERANSKY 2 . STANCH. STIRLING 2 . STRAUSS. STURGIS 4 . TARNOWSKY 2 . TcHAGIN 1 , 2 . TCHISTIAKOW 10 » »i 13 > 17 , 19 . TOUJAN 1 . ToURNER. Trevisanello 2 . Turner. Vadja 1 . Van Harlingen 5 . Viguier 3 , 5 . Ville- neuve. Waller 10 . Wildhagen l . Woillez 1 (Ory). Zeissl, H. 1 , ». Zeleneff 2 . Chin. Augagneur 1 (Stourme). Barduzzi 1 . Baum 9 . Beyran. Bulkley 3 s. del Chiappa 1 . Cooper, A. 5 . De Amicis 6 , also nipple. Fournier 39 . Gam- berini 3 . Gay, A. H. 3 . Giovannini 5 . Ladriet-de-Lacharriere. MacCarthy. Marianelli 3 . Mauriac 1 , 10 . Mr.ac.ek 3 . Ory l (Besnier). Pellizzari, C. ]v S 19 . Plumert 5 . Quinquaud 7 . Regoby l (Tillaux). Rizat 3 . Taylor 17 . Trelat. Zeissl, H. 4 . Zwetitch 2 (Fournier). Neck, Fedchenko 1 . Fournier 17 , 50 . Hermet (Fournier 43 ). Langlebert 6 . Le Gendre 10 (Fournier, Hulot). Viguier 10 , ». Throat. Aubert 5 (Stourme). Belousow 5 , 6 , 10 . Besnier 1 . Cavazzani 1 . Cul- lerier, M. 5 , 6 . Daxielssex s . Dufour (Fournier). Fournier 32 , 41 . Gay, A. II.' Krisiiaber. Lagxeau, L. V. Lewy and Goldberg 2 . Moure 5 (Dupond). Oesterlen. Ory 9 (Vidal). Poray-Kosciiitz 4 , 31 , 3 ' 2 . Pospelow ", 14 . Spe- raxsky 3 , 4 . Buccal cavity. Belousow 7 , R , 12 . Cexas 2 (Stourme). Fournier •V v V , \ Fox, G. II.'. Guibout 4 . Jakoleff 3 . Lloyd 1 Lorenzo. MoNNET 3 . Poray-Koschitz ». Sheild '. Van Harlingen 3 . 238 SYPHILIS INSONTIUM Guru. Cayla 2 . Cordier (Stourme). Fox, G. H. 2 . Gilleeert. Kinsman. Mac- Carthy. Poncet 2 . Salsotto 4 . Palate — hard and soft. Anonymous]'. Astruc 1 . Aubert 6 (Stourme). Barthelemy 1 (Le Gendre 14 ). Belousow 9 . Lancereaux 5 . Lewi 4 . Neumann 26 . Tchistiakoff 16 . Tonsil. Allen 6 . Anger, B. (Morel-Lav allee ] ), (Le Gendre 11 ). Anger, Th. (Le Gendre 3 , Brocq 3 ). Belousow 11 . Boeck, C. 2 , 3 > 7 > 10 . Borovsky 1 . 2 . Broick 10 . Bulkley 3 d. Bumstead 1 (Knight' 2 ). Colombini. Cordier (Stourme). Cul- lerier, A. 5 (Le Gendre). DeMeric. Diday 3 , 13 . Donaldson. Duguet (Le Gendre 8 , Lannois). During 2 . Favier. Foster 2 (Fox, G. H. 6 ). Fournier 34 (Guignard 8 ). Gauducheau. Gay, A. H. 1 . Gibert 5 (Putegnat). Gilles-de- LA-TouRETTEandHuDELo. Glauert. Goodell 4 . Guibout 3 (Le Gendre 11 ) Haslund 4 , 5 ). Hutchinson, J. 2n . Inell (Malm 2 ). Jadassohn. Jakinovitch Laboulbene 2 (Le Gendre 2 ). Le Gendre 4 (Merklen) 9 , 10 > 13 (Fournier, Hulot) 15 (Mauriac, Rizat). Letnik. Lewy and Goldbergs u . Lindstrom 3 . Malm 1 , 3 Martel (Le Gendre 5 ). Martelliere 1 , 2 . Mauriac 8 . Molenes. Neumann 18 , 27 Ohmann-Dumesnil 3 . Pean (Hue, Le Gendre 6 ). Pellizzari P. 3 . Petersen 5 PlRANDRAN. POLOTEBNOFF 8 . PORAY-KoSCHITZ 16 . QuiNQUAUD and NlCOLLE 3 Rabitsch. Razumoff 2 . Reynier (Sardon). Rizat 8 . Rona 1 . Schirajew 1 Selenew 2 . Sturgis 5 . Szadek 1 ,-. 5 . 6 . 7 . 8 . Taylor 15 > 16 > 19 . Tchistiakow 3 * 8 * 9 (Lewy). Thiry 5 . Thomaschewsky 2 . Trevisanello V Tur. Ussas 6 . Vig- uier 8 . Yakimovitch. Zeleneff 3 . Tongue. Blair 2 . Bulkley 36 . Buzenet 3 . Cooper, A. 3 . Fournier 35 . Grunfeld 2 . Hutchinson, J. 9 > 19 . Jullien 8 (Horteloup, P.). Kaposi 5 . Kenny. Kolo- mensky. MacCarthy. Mauriac 7 . Maurin (Vidal). Mra^ek 2 . Musset. Pajet, J. 1 . Pospelow 2 . Quinquaud 2 . Quinquaud and Nicolle 6 . Tchis- tiakow 15 . Thiry 4 . Tillaux (Rizat). Vidal, EJ1 3 . Viguter 6 . Weinberg 2 . Zeissl, H. 12 . Shoulder. Puche 3 . Suche. Bryant 4 . Bulkley 3 !. Fournier 35 , 70 . Gay, A. H. 3 . Goldenberg 1 . Pellizzari, P. 1 . Quinquaud and Nicolle 8 . Ricord 19 (Trousseau). Tar- dieu 13 . Fingers and hand. Allen 4 . Anonymous e. Bird 3 . Bloom 3 . Bulkley 3 b, 3k. Castel du 2 . Coyttarus 2 . Fournier l2 > 32 . Gay. Gay, A. H 3 . Hallopeau 2 . Henry 4 . Holsten. Horteloup, P. 3 . Hutchinson, J. 5 > 17 i 26 » 33 > 35 . Jelzina 2 . Lang 9 . SYNOPSIS OF FACTS AND LITERATURE 239 Lewin 12 . MacCarthy. McGuire. Maunder 2 . Mauriac 9 . Mracek 5 > 6 . Neumann 30 . Ohmann-Dumesnil 4 . Pajet 2 . Pancritius -. Pellizzari, P. 5 . Pospelow J > 2 . Price, J. H. 5 (Sims). Ravogli j > 2 . Ricord 5 . Rizat 5 . Russell, C. P. Sigmund 13 . Sirski. Solovioff. Stevens. Symonds. Taylor 22 . Thomaschewsky 5 . Trevisanello 3 . Viguier 12 . Zwetitch 4 (Mauriac). Trunk {in general). besnier 5 . bogoslovsky. bulkley 3m . fournter 50 . gay, a. h. 3 . Giovannini 9 . Mason 6 . Mauriac 13 . Moore 1 . Mraqek 9 . Ricord 16 . Tchistiakow 18 . Breast and nipple. Bloom 1 . Bulkley 3 c. Claude. Cooper, A. 2 . De Amicis 6 , also chin. Desmet 1 . Dimey. During 3 . Fournier 32 . Gay, A. H. 3 . Lewy and Goldberg 3 ' 9 . Marianelli 3 . Morel-Lavallee 7 . Pellizzari, C. 28 . Profeta 8 . Quinquaud and Nicolle 18 . Taylor 18 . Perineum ) anus, and picdetida. Fournier 50 . Gay, A. H. 3 . Hallopeau ] . Hutchinson, J. 30 . Mauriac 13 . Milbank. Moore 6 . Roussel 7 (Dron). Viguier 12 . Buttocks. Hutchinson, J. 3 . Marianelli 3 , Mracek 9 . Leg and thigh. Gay, A. H. 3 . Giovannini 7 . Klotz. Leloir 8 (Fournier, Lavergne and Perrin). Mason 7 . Mauriac 2 > 13 . Mracek 9 . Quinquaud 4 . Rona 7 . Viguier 12 . Foot. Hutchinson, J. 27 . Poisson 2 . Statistical Reports. Abelin. Anonymous n, q, r. Arcari K Arthur 1 . B^erensprung 1 . Barnes. BAssereau. Belousow 2 , 3 i 4 . Bergh '. Besnier 3 ^ Bidenkap *, 2 . Boeck, C. 1 . Boeck, W. 10 . Bogolubow 2 . Bohn. Bonnaric (Carriere). Breda 1 , 2 . Bureau. Calderini. Clerc >, 2 , 3 . Cripps ] . Desnos 2 . Diday 4 , n . Diemer 1 . Dimey. Dron 5 , 7 . Eltzina 1 . Engelsted 6 . Evmenieff. Feulard '» 3 . Fournier ', 2 , 7 , 4C , «, 56 , 57 . Groedinger (Petersen). Herzen- stein *. Hulot (Fournier). Jarotsky l . Jelzina 1 . Klink. Kopp, C. 1 . Lang 2 . Lavergne and Perrin 1 . Luzinsky 4 . Mackenzie, M. Manassei. Martin 2 (Burlet). Martineau 1 (Binet 1 Des Molines). Migneco. Mik- hailoff >i 2 , 3 . Morel-Lavallee 5 (Fournier). Nikolsky 2 , D. P. Nikolsky, V. J. Nivet 1 * 8 . (Fournier). Nodet. Ostroumoffs, b, c, d, e, f. Pavlov J » 2 » 3 , 4 . Pellizzari, C. 1 . Peter 1 (Lassar). Petersen 2 . Popoff h 2 . 3 » 4 » 5 . * 240 SYPHILIS INSONTIUM Pospelow 4 . Protzek. Puche ' (Fournier). Rassler 1 . Razumoff 1 . Ricord 1 . Robert, M. 1 . Rona 2 . Roster 1 . Roussel 1 . Sabinin. Salsotto >. Schu- bert 1 . Sigmund 5 , 17 , 18 . Speransky 5 > 6 . Sperck. Ssabinin. Stourme. Suchanek 4 . Tchistiakow '. Thomaschewsky 4 . Van Dugteren and Van Walsem ». Veslin >. WlRPSCHA. Infection per os. Bogolubow J. Bolschwing 4 . Broick 5 . Cordier j . Kobner 2 . Lewin », lip and throat 2 . Popoff 5 . Sabinin. Schubert 3 , fauces. Ussas 2 > 3 . Wolf 2 . Coitus preternaturalis . Buzenet 1 , lip, 3 tongue. Descroizilles, anus. During 4 , anus. Four- nier 46 . Griffin 4 , tonsil. Hartley, rectum. Massei, tonsil. Peter 1 , mouth. Plumert 3 , lip. Reynolds, tonsil. Solari, Eustachian tube. Waller 3 , anus. ANALYTICAL BIBLIOGRAPY OF SYPHILIS INSONT1UM* Abadie. Case, chancre, inner angle of eye, from kiss (see Viguier 9 -). Abelin, H. Stockholm. Children's Hospital and Poliklinik. Nord. med. Ark., Bd. xi , 1879, No. 1. (Viertelj. f. Derm. u. Syph., xiii., i88i,p. 158). Statistics, 1 868-1 878, incomplete — 17 cases of acquired syphilis. In Hospital, under 1 year, 2 cases acquired syphilis (11 2 congenital). In Hospital, over 1 year, 8 cases acquired syphilis, (1 congenital). At Poliklinik, with bone disease, 7 cases acquired syphilis (15 congenital). Abernethy, J. London. Surgeon to St. Bartholomew's; formerly assistant to John Hunter. 11 Surgical and Physiological Works," 6th ed., London, 1825. 1) Case, lactation syphilis of Watson, of Stourport. (Vol. I., p. 188). 2) Case, finger inoculation in a medical student. (Vol. I., p. 194). Acton, W. London. Islington Dispensary; a former assistant to Ricord. "A complete practical treatise on venereal diseases, etc." London, 1841. (Abstracted also in Behrend's Syphilidologie, Vol., III., 1841). 1) Case of Ricord's, chancre at site of venesection, p. 227. 2) Case of Puche, infection from a prison-cot, p. 229. 3) Case of Hildanus, infection from wearing another's pantaloons. Proceedings Westminster Med. Soc, Apr., 1844. (Cazenave's Annales des mal. de la peau, etc., t. ii,, 1845, p. 95). 4) Case, syphilis in 8-year-old girl, probably contracted by innocent con- tact in bed. Lancet, London, Aug. 3, 1846, p. 127. 5) Case, nurse infected by syphilitic nursling. Adams, J. London. Observations on Morbid Poisons, Chronic and Acute. 2d edit., London, 1807, p. 181. 1) Syphilis, Yaws, Sibbens, Elephantiasis, etc. Lancet, Nov. 12, 1861, II., p. 474; and Mason, q. v. obs. iv. 2) Case, chancre of the lip, mistaken for epithelioma. * The larger share of the articles here quoted have been examined individually ; where the refer- ence is taken from another, credit is given ; in instances where there is question as to the correctness of the reference, an asterisk * has been inserted. 17 242 SYPHILIS INSONTIUM Adams, J. E. London. Ophthalmologist to London Hospital. "Trans. Ophthalmol. Soc. United Kingdom," 1883, Vol. III., p. 4. (Cited by Alexander, " Syph. und Auge," Wiesbaden, 1888, p. 22). Case, chancre of upper eyelid, source unknown. Adelasio, G. I. Bergamo, Northern Italy. Vice-conservator of Vaccine. "Relazione sopra casi di sifilide, letta al consiglio provinciale di sanita," Bergamo, 1864. ("Syphilis Vaccinale," by Acad, de Med., Paris, 1865). 1) Epidemic, Torre del Buse, near Bergamo, 1862 ; five cases of vaccino-syphilis, and 19 others infected (p. 303). (See Epidemics). 2) Three cases, two of vaccino-syphilis, at Alme, near Bergamo (p. 308). Admiralty Commission of the Army and Navy of Great Britain. Report on Venereal Diseases. London, 1867. (The material and evidence collected in reference to syphilis insontium, is presented in this Bibliography under the names of those testifying). Agasaroff, B. G. Proceedings of the Caucasian Med. Soc. for 1888. Numerous cases of extra-genital chancres from common use of handker- chief, shaving by syphilitic barber, etc. Agostini, A. Milan. " Stranguria quae venerea dicitur mercurii potest esse aliquid effectus." Venetiis, 1753. (Girtanner. " Abhandl. iiber die vener. Krank- heit." Gottingen, 1793, Vol. III. Bibliography, No. 1239). Case, infection in infancy from a wet-nurse. Albers, J. F. H. Bonn. Assistant at the Medical Clinic of the University ; formerly with Biett, Hop. St. Louis, Paris. "Ueberdie Erkenntniss und Kur der syphilitischen Hautkrankheiten." Bonn, 1832. 1) Case, of Biett's, syphilis occurrirg from ritual circumcision (p. 17). 2) Case, lactation, infant with acquired syphilis infects mother (p. 17). 3) Four cases, nurses infected, without details (p. 17). "Ueber das Vorkommen der Lustseuche in Ostpreussen und Litthauen." Med. Zeit'g vom Verein f. Heilk. in Preussen, 1836, No. 22 und 23.* 4) Description of Syphiloid of Lithuania. Alberti, M. Halle, Magdeburg. Professor of Medicine. "Systema Jurisprudentiae Medicae." Halae. 1723-1747; also with J. Heut- schel. " Dissertatio de occulo morbifico et morbifero," Halae, 1746. (Girtanner, Nos. 849 and 992, and Rust, " Helkologie, " Berlin, 1842, p. 246). Cases of infection by kissing : brief reference by Lancereaux. ' ' Treatise on Syphilis," Vol. II., p. 236. Also breast-drawing. (See Epidemics). Albinus, B. Frankfurt a. d. Oder. Professor of Medicine, ob. 1721. (Cited by Oelffen in Clossius, "Ueber die Lustseuche," 2d ed., Tubin- gen, 1799, pp. 41, 42, note). Case, infection of a child through wearing-apparel. Alexander. Aachen. Eye Institute, Director. "Syphilis und Auge," Wiesbaden, 18S8. 1) Case, chancre, inner angle of eye, from a kiss (p. 6). 2) Case, chancre of lower lid, in a physcian, from spraying a patient with syphilitic ozcena. AH6s. Luxeuil. "Memoire sur une epidemie de pseudo-syphilis." Gaz. med. de Paris, 1844. (Rev. med. de Paris, Jan. 15, 1865). Epidemic near Luxeuil, 1840 and 1841, 80 infected (p. 154). (Probably through vaccination). (See Epidemics). Alison, R. H. Philadelphia. Infirmary for Nervous Diseases, services of Dr. Weir-Mitchell. ANALYTICAL BIBLIOGRAPHY 243 "Syphilitic Choiea." Amer. Journ. Med. Sci., 1S77, ii., p. 75. Case, girl of 7 years, infected as infant from mother's nipple. Allen, C. W. New York. Surgeon to Charity Hospital. Journ. Cutan. and Vener. Dis., New York, 1885, p. 65. 1) Two cases, chancre of the lip, origin unknown. 2) Case, chancre of the cheek, in site of a razor cut. Journ. Cutan. and Vener. Dis., New York, 1888, p. 314. 3) Case, chancre of upper lip, unmarried woman, 38 years old. Journ. Cutan. and Yener. Dis., New York, 1889, p. 147. 4) Case, Chancre of ring finger, man, 35 years old. New York Med. Record, Jan. 2, 1392, pp. 7-8. 5) Case, chancre of lower lip, in 19-year-old girl, origin not stated. 6) Case, chancre of tonsil, in young married woman, origin not given. Trans. N. Y. Derm. Soc. 218th Meeting. Journ. of Cutan. and Genito- Urin. Dis., Vol. XL, 1893, p. 29. 7) Case, chancre behind the ear at border of hair, probably inoculated by scratching with an infected finger. Allingham, W. H. London. Surgeon to St. Thomas' Hospital. " Communicability of Secondary Syphilis," Med. Times and Gaz., 1864, ii., P- 6 33- Two cases of supposed infection by semen ; proof very defective. Altounyan, A. A. Journal of Cutaneous and Venereal Diseases, Vol. III., 1S85, p. 61. An article on Aleppo button in which the author does not consider it identical with syphilis. Ambrosoli, C. Milan. Surgeon to the Ospedale Maggiore, Venereal Division. " Di una maniera non ancora descritte, etc.", and " Trammenti di clin. Sifil." Giorn. ital. di malattie veneree e d. pelle, 1867. 1) Two cases, chancre of fauces, from cigar stumps (p. 259). 2) Case, lactation, nurse infected by nursling, infects own infant (p. 35). Amoroso, G. Naples. Docent in Medicine, University. " Contribute alia trasmissione della sifilide.'' II Morgagni, Feb'y. 1881. Case of vaccino-syphilis (p. 99). Anderson, W. London. St. Thomas' Hospital. British Journal of Dermatology, Jan. 1889, p. 73. Case, chancre under right eye, from a friend, through wound-suction. Andrews, J. A. New York. Charity Hospital, Surgeon. Journal of Cutaneous and Venereal Diseases, New York, 1891, p. 217. Case, chancre of right lower eyelid, from attempt at removal of foreign body by the tongue. Andronico, C. Messina. Archiv di patologia, inf., Napoli, 1SS6, iv., p. 49.* Acquired infantile syphilis. Anger, B. Paris. Surgeon to Hop. Lariboisiere. Case, chancre of tonsil (see Morel-Layallee ' and Le Gendre"). Anger, Th. Paris. Surgeon to Hop. Cochin. Case, chancre of tonsil (see Le Gendre 3 and Brocq 3 ). Anonymous. 1) Noveau Traite des Maladies Veneriennes. Amstelod, 1751, Vol. I., p. 183. a) Case, infection in mouth, in r2-ycar-old girl, from kissing. 2) Fronep's Notizen, Weimar, June, 1829, No. 525. b) Case, nurse infected by nursling, infects a second nurse. c) Case, chancre of fauces ; a four months' old foundling, infectedby a 12- year-old girl by tasting the bottle (see Ruthenberg, Obs. x.and xi.). 2a) Edinb. Med. and Surg. Journ., 1837, p. 133 (Beiirend's Syphilidologie, 1840, Vol. 2, p. 449). 244 SYPHILIS INSONTIUM Extract of an official report upon Radesyge and Syphilis by the physicians in the Swedish hospitals. 3) Boston Med. and Surg. Jour., 1859, Vol. 59, p. 38. d) Case, chancre of middle finger, dentist from operation. 4) Westminster Hospital. Lancet, London, i860, I., p. 573. e) Case, chancre of right middle finger, followed by buboes at the elbow and axilla, papular eruption; source unknown. 5) Rendiconto Setti mestre dei mal. ven., etc. — Dispen. di Lorenzo in Napoli — Giorn. ital. d. mal. ven., etc. Milan, 1866, I., pt. 11., p. 91. /) Case, chancre on the right angle of the lip, in a child of 4 years. 6) Revista Med. Quirurg. de Mexico, 1883, I. (Prensa Nacional, Review of Native Works, Seical), Nos. 11-14. g) Case, chancre of eyelid, in a physician, from pus of a bubo (said to be the only case of chancre of eyelid known in Mexico). h) Case, chancre of finger, in a midwife. i) Case, chancre of finger, in an attendant in hotel, from soiled garments. J) Case, chancre, velum palati, cause unknown. k) Two cases, chancre of lip. /) Several cases, chancre of the nipple in wet-nurses. 7) A report of Zemsky medical men on " Syphilis in the Vladimir Gov- ernment" (Russia), 1884, P- 2 3- m) Among 333 cases of syphilis, 213 were infected per os; 57 through family life; 8 through suckling; 26 by heredity; and only 29 by coition. 8) Trans, of the third General Meeting of the Sarator Zemsky (Russia) Medical Men, in 1887. n) Statement: the proportion of syphilitic patients (infected chiefly in a non-venereal way) amounts to from 8-10 per cent, of total number of patients observed. 9) "Societe des Sciences Med. de Lyon." Journ. des Mal. Cutan. et Syphilis, Paris, Vol. II., 1890, p. 355. o) Case, chancre of lower lip, in a glass-blower; the same workman had previously infected three others. io)Ausziigeaus dem Tagebuch eines ausiibenden Aerztes, Theil I., p. 40. p) Case, infection of patient by finger moistened with saliva of oper- ator (an old woman) used to raise a fallen uvula. 11) Report of District Medical Society. The Simbirsk Zemstro Herald, 1890. q) Statements: In the district of Simbirsk, East Russia, syphilis is acquired through family life and other non-venereal ways in males, 71.6 per cent, of cases, in females, 73.4 per cent. ; inherited in males, 7.6 per cent, of cases, in females, 11. 1 per cent, of cases ; per coitum in males, 20.8 per cent, of cases, in females, 15.5 per cent, of cases. 12) Propagation of syphilis by nurslings in Italy. British Med. Journ., Feb. 28, 1891, p. 499. r) The Italian Minister of the Interior sent a circular, dated Feb. 6, 1 891, to all the prefects of the kingdom, calling their attention to the fact that ' 'cases of the diffusion in communes of the kingdom, of syphilitic infection, epidemic in character, depending on the suck- ling of nurslings suffering from that disease, are of not infrequent occurrence." 13) Oester. Med. Jahrb., v., Heft ii., p. 21* (quoted by Sigmund; Lan- cereaux Traite, etc. , p. 42). s) An account of "Mal di Breno." 14) " Ansteckung (syphilitischej durch Blutegel." Westphalischer Au- zeiger. Froriep's Notizen, Weimar, 1827, No. 3S1.* t) Syphilitic infection by means of a leech. 15) " Mittheilung von der syphilis an und durch Hebammen." General- ANALYTICAL BIBLIOGRAPHY 245 bericht d. k. rheinlandischen Med. Colleg., uber d. Jahr, 1828. Froriep's Notizen, Weimar 1832, No. 757.* u) Syphilitic infection of and by midwives. 16) " Syphilisinfection beim Rasiren." Wiener Med. Blatter, 1886, ix., P- I339-* v) Syphilitic infection by shaving. Anstie, F. E. London. Westminster Hospital. Med. Times and Gazette, 1862, p. 534. Case, nurse infected by nursling. Appay, C. Paris. ' ' Transmission de la syphilis entre nourrices et nourrissons syphilitiques, et notamment par 1' allaitement, avec considerationes medico-legales." Paris, 1S75, pp. 4S-66, and 9S-115. 1) Case, forensic, arret de la cour de Lyon, 1852 (p. 93). Nurse in- fected by nursling, damages recovered from nurse-bureau. 2) Case, forensic, arret de la cour de Dijon, 1868, (p. 94). Nurse infected, physician in charge not mulcted. 3) Case of Fournier's (Michel), Lourcine, 1874, (Obs. I., p. 98), chancre of breast in a wet-nurse. 4) Case of Fournier's, Lourcine, 1874, (Obs. II., p. 102), chancre of breast in a wet-nurse. 5) Case of Gondonin, of Argentan, 1867, (Obs. V., p. 105), chancre of tonsil in a wet-nurse from bottle. 6) Case of Le Dentu, Hop. St. Louis, 1869 (Obs. VII., p. 113). Nurse infected by nursling. (Other cases previously published). Arbo, N. Afhandl. om Radesygen eller Saltflod. Kjdbenh.,1792. Translated from Danish by Hensler, Altona, 1799. Arcari, A. Milan. Ospedale Maggiore (special division for venereal diseases) ; Institute di St. Corona (syphilitic out-patient service). "Lamedica- zione di Smirnoff nella cura della sinlide." Giorn. ital. d. mal. vener., etc., 18S6, p. 266. 1) Statistics of 71 cases, during year October, 1885-1886. 2) Four cases, chancre of breast in nurses. 3) Two cases, cephalic chancre. Archambault. Paris. Hop. des Enfants-malades. 1) Case, nurse infected at breast by nursling. 2) Case, chancre of lip (infant of above) (see Pontet 4 ). Arlt, Ritter von. Vienna. University Prof, of Ophthalmology. Case, chancre of conjunctiva (cited by Wiethe 2 , q. v.). Arnal, Jean. Paris. Compte rendu de la Soc. Med. du 2^ Arrondissement, May nth, 1854 (Union Medical, 1854, p. 508). Case, chancre of the upper lip (case of Piogey). Arning, E. Hamburg. " Mittheilungen aus der Universitatsklinik u. Poliklinik fur Hautkrank- heiten u. Syphilis,'' des Prof. Neissek. Viertelj. f. Derm. u. Syph., 18S3, Vol. XV., p. 95. 1) Case, infection of nursling by its mother. 2) Personal communication ; chancre of nostril from towel, used in common with brother, with abundant mucous lesions. Arnould, J. Dermatologie Africaine. La Lepre Kabyle, Paris, 1862. Arthur, G. A. U. S. Naval Service, Surgeon. " On the Infrequency of Secondary Syphilitic Infection," New York Med- ical Record, Dec. iS, 1S86, p. 674. 246 SYPHILIS INSONTIUM 1) Statistics comprising the experience of 175 physicians in military, naval, and civil practice; of 37,000 cases of syphilis treated, but 41 instances of secondary contagion were reported. 2) Facts of Wilcox ; epidemic of tatooing, 26 infected. (See Epidemics). 3) Case of Fitz, transmission by a drinking faucet. 4) Case of Greenleaf, transmission by a cornet. 5) Four cases, transmission by kissing. 6) Two cases, transmission by pipes. 7) Two cases, inoculation by bites. 8) Case, chancre of finger in a physician. Astruc, J. De morbis veneris libri novem. Venetiis, Vol. I., 1760, (Annal. de Derm, et de Syph., 1888, p. 719). 1) Mention of a sore on the palate, p. 285. De morbis veneris libri novem. Venetiis, Vol. I., 1760. (Allegem. Wien. Med. Zeit'g, 1877, p. 309). 2) Mention of a sore on the eyelid, p. 291 . Atkinson, J. E. Baltimore. Prof, of Pathology, and Clinical Prof, of Der- matology, University of Maryland. "Extra-genital infecting chancre," Maryland Medical Journal, 1883-4, x., p. 2. 1) Case, chancre of lower lip, in young woman, from kissing. 2) Case, chancre of cheek, in 48-year-old man, no cause stated. 3) Case, chancre of thumb, in a physician, midwifery. 4) Case, chancre of inner surface of cheek, in 6-year-old child, acquired from her parents. 5) Case, chancre of nostril, in an old woman who was in the habit of wiping the nose of a syphilitic grand-daughter with her own hand- kerchief. Aubert. Lyons. Hosp. de l'Antiquaille. Cases reported by Stourme, q. v. pp. 76-82. 1) Twelve cases, chancre of the lips, two in glass-blowers. 2) Case, chancre of the nose. 3) Case, chancre of chin, after shaving. 4) Case, chancre of eyelid. 5) Case, chancre of the throat. 6) Case, chancre of the soft palate. Cases reported by Roussel, q. v. About a dozen cases of acquired infantile syphilis during 1878-9. Audoynaud, J. H. Paris. " Etude de la syphilis communiquee par l'allaitement, avec considerationes medico-legales." These de Paris, 1869. 1) Case, Fournier's, 1863, nurse infected (Obs. I., p. 14). 2) Case, Fournier's, chancre, female breast, from a kiss. (Obs. II. p. 17). 3) Case, Broca's, Hop. d. 1. Pitie, nurse infected. (Obs. III., p. 19). 4) Case, Fournier's, infant infected by nurse, through bottle. (Obs. IV,, p. 21). 5) Case, Bazin's, Hop. St. Louis, 1868, nurse infected. (Obs. V., p. 22). 6) Case, Siredey's, Hop. Lariboisiere, nurse infected. (Obs. VI., p. 25). 7) Case, Broca's, Hop. d. 1. Pitie, nurse infected. (Obs. VII., p. 26). 8) Case, Triboulet's, Hop. St. Eugenie, nurse infected. (Obs. VIII., p. 28). 9) Case, Simonet's, Hop. du Midi, nurse infected (p. 29). 10) Case, Charpentier's, nurse infected (p. 29). Audry. Reported by Stourme, q. v., p. 57. Case, chancre lower lip, left side, in a gunsmith. ANALYTICAL BIBLIOGRAPHY 247 Augagneur, V. Lyons. Reported by Stourme, q. v., p. 57. 1) Case, chancre of chin, cause unknown. These de Lyon, 1879, P- 94 (Roussel " Pe la syph., tertiare," etc., 1881, p. 127). 2) Case, chancre of finger in medical man, from professional exposure. Auspitz, H. Vienna. Poliklinik, venereal service. Obituary notice of H. von Zeissl. Viertelj. f. Derm. u. Syph., XVI., 1884, p. 547. Case, Prof. Zeissl, chancre of finger, auto-inoculation in opening a bubo. Auxias-Turenne. Paris. Proces-verbaux de la Societe Med. du Pantheon, Seance Feb. 13, 1856. 1) Case, forensic, nurse infected by nursling (p. 19). Courier Medicale, Mai 30, 1863. 2) Three cases of vaccino-syphilis in infants, in 1852. 3) Case, vaccino-syphilis, from a pustule at the eleventh day. " Observations et Experiences de Syphilis Vaccinale," in " Syphilis Vaccinale," by the Acad, de Med., 1865, p. 385. 4) Two cases of vaccino-syphilis in adults. Axenfeld. Paris. Hop. St. Louis, interne, service of Cazenave. Notes of a group of lactation syphilis (cases published by Cazenave, q. v.). Ayres, S. C. Cincinnati, U. S. A. Case, chancre of eyelid, from kissing (see De Beck). Badal. Bordeaux. Faculty Professor of Ophthalmology. Mem. et Bull. d. 1. Soc. Med. et Chirurg. de Bordeaux, 1886, p. 242. 1) Case, chancre of lower eyelid. "Syphilis Oculaire," Journ. de Med. Bordeaux. 1 891, p. 379 (Viertelj. f. Derm. u. Syph., Vol. 24, 1892, p. 166). 2) Four cases, chancre of the eylid. Baerensprung, F. von. Berlin. Charite Hospital, University Prof. " Mittheilungen aus der Abtheilung u. Klinik f. syphilitische Kranke." Third Report, i860, p. 71. 1) Statistical, 15 cases chancre of lip, in six years. 2) Case, chancre of upper lip from kissing. " Ueber hereclitare Syphilis." Berlin, 1864, pp. 151-179. 3) Numerous cases of acquired syphilis in children. Bajanoff, D. N. Syphilis in the Tscheriugov government (South Russia) Russkaja Medic, 1888. Statements: "Syphilis is a family disease," "infection mainly extra- sexual," "women and children infected more frequently than men," " the proportion steadily increases." Balducci, A. Florence. " Rapporto al Sindaco di Montecatini di Val di Nievole sui Casi di sifilide per allattamento in una sezione di quel commune, etc." Florence, 1868, (Notice in Giorn. ital di mal. ven., etc., 1868, II., p. 382). Epidemic of lactation-syphilis caused by adoption of foundlings from the Florence Brefotrofio. (See Epidemics). Ballet. Paris. Hop. Lariboisiere. (Interne). Case, chancre of the lip (See Chauvet). Bang, L. Member of the Royal Commission appointed in 1778 to procure efficacious measures against Radesyge in Norway* (quoted by Bocck, " Traite d. 1. Radcsyge, etc.," i860, p. 10). Bangs, L. B. New York. Case, chancre of gum, from lead-pencil. (See Fox, G. H.). 248 SYPHILIS INSONTIUM Baratoux, J. Paris. " Syphilis de l'oreille." Paris, 1886. Case, chancre of external ear, from a bite, (p. 56). Barbantini, N. Lucca. " Del contagio venereo, trattato istorico-teorico-pratico." Lucca, 1820-24. 1) Said to contain first reported cases of vaccino-syphilis, those of Mar- colini and Cerioli. 2) Case, infection of a little girl from her mother's chemise (cited by Profeta, "Trattato pratico," etc., 1888, p. 417). Barclay. Pittsburgh. Soc. Proceed. Allegheny County Med. Sou, Dec. 15, 1891. Journ. of the Amer. Med. Ass'n. Vol. XVIII. , 1892, p. 167. Case, chancre of lip, in young girl, probably from dental instrument. Bardinet. Limoges. Professor of midwifery. " De la Syphilis hereditaire et de satransmissibilitie," Paris, 1852. (Bull, de l'Acad. de Med., 1852, xviii., p. 274, and article in Journ. de Med. de chirurg., etpharm., 1S53, p. 611). 1) Case, forensic, at Tulle, 1841, nursling infects two nurses. 2) Case, nursling infects nurse. 3) Case, same. 4) Case, same. 5) Small, lactation-epidemic. " Syphilis communiquees par le doigt d'une sage-femme," Bulletin de l'Acad. de Med., Paris, 1874, p. 15. 6) Obstetrical epidemic at Brive, 1873. 7) Obstetrical epidemic at Rochechonart, about 1855, facts by Bleynie. (See Epidemics). " Un Vaccinifere Syphilitique,'' Revue Medicale de Limoges, 1869, No. 5. 8) Discussion on vaccinal syphilis by Depaul, q. v. Barduzzi, D. Pisa. University Clinic for Skin Diseases and Syphilis. "Se iniezioni ipodermiche mercuriali nella cura della sifilide," Giorn. ital. del mal. vener. e del. pel. 1884, p. 84. 1) Case, chancre of chin, male, age 47 years (Obs. II. p. 89). 2) Case, chancre upper lip, soldier, age 35 years (Obs. III., p. 89). " Sulla sifilide ereditaria." Giorn. ital. del. mal. vener. e del. pel., 1887, P- 134. 3) Case, chancre of lip, in husband, causing 4) Case, chancre of cheek in wife. Barillier. Bordeaux. Hop. des Enfants. Journ. de med. de Bordeaux, i860. (Tardieu; Etude medico-leg., 1879, p. 211). Group ; two nursing women and three nurslings infected by lactation. Barker, Edgar. . Med. Times and Gaz. London, 1857, p. 594. Case, chancre lower lip, from a towel. Barker, F. R. Portsea. Surgeon British Army. British Medical Journal, May 4, 1889, p. 985. 12 cases of chancre of the forearm, in soldiers, from tatooing, all by same operator who had mucous patches in the mouth and used the saliva to wet the needles and mix the colors. (See Epidemics). Barling, G. Birmingham. Birmingham General Hospital, Assistant Surgeon. Birmingham Medical Review XXVII, 1S90, p. 169, and British Medical Journal I, 1890, p. 428. Case, chancre of lip, in man, 26 years old, supposed infection from tobacco-pipe. ANALYTICAL BIBLIOGRAPHY 249 Barnes, R. London. St. Thomas Hospital, Accoucheur. Report of" -A rmy and Navy Commission on Pathology and Treatment of Venereal Diseases, 1867, pp. 475-480. Statistical, personal experience ; had seen syphilitic children of parents who seemed wholly free ; in a few cases, children seemed to have infected their wet-nurses. Barry, E. Dublin (Professor of Medicine) and London. "Account of a malignant lues venerea, etc.," Med. Essays of Edinburgh, 1735 and 1752, 8°, III., pp. 297-304 (Colles' Pract. Observ. on the Vener. Dis. and Mercury, London, 1837, p. 19). Epidemic from breast-drawing and lactation, Cork, 1728 (See Epidemics). Barthelemy, F. Paris. Physician to Hop. St. Louis. Annales des malad. de l'oreille et du larynx, VI., January, 1880, p. 316. 1) Case, chancre of fauces; source unknown (cited by Le Gendre, 1884, q. v.). Archiv. d'ophthal. 1881. 2) Case, chancre of eyelid (from service of Fournier). Cited by Zwetitch, Obs. V., q. v. 3) Case, immense chancre of cheek, in a female. Bassereau, L. Hop. St. Louis et du Midi. (Interne). Traite des maladies de la peau, symptomatique de la syphilis. Paris, 1852. 1) Statistics of own observations, total about 372, of which 20 were extra-genital; labial, 13; lingual, 4; gum, cheek and thumb, each 1. 2) Family epidemic (p. 201). a) Case, chancre of lip and tongue, in a man. b) Case, chancre of lip, in his mistress, from her husband. c) Case, chancre of lip, in 7-year-old daughter of above. 3) Case, chancre of lip, in a man, from kissing (p. 326). 4) Case, chancre upon site of incision by foul instruments (see Jumon 2 ). Bataschoff, J. S. Talojina. " On Non-venereal Syphilitic Infection in Country practice." Meditzin- skoie Obozrenie, No. I., 1890, p. 18. (London Medical Record, May 20, 1890, p. 187). 1) Local epidemic of syphilis in Russian villages. Meditzinskoie Obozrenie, No. 12, 1892, p. 1121. 2) Case, chancre, middle of upper lip in woman of 50, from grand-child to whom she fed chewed food with her finger. Baudon. Nice. Recueil d'ophthalmologie, Paris, Nov. 1885, p. 673. Case, chancre of conjunctiva bulbi, source unknown. Baudry, S. Lille. Professor of Surgical Pathology. "Contrib. a l'etude d. chan. d. paupieres." Archiv. d'ophthalmologie., V., No. I., 1885, p. 172. (Cited by G. De Beck, q. v.). 1) Case, chancre of eyelid, 2-year-old child, from saliva on attendant's finger (p. 55). 2) Case, chancre of eyelid, 4-year-old child, from saliva on mother's finger (p. 58). Baum, S. Prague. Prof. Pick's Division, Skin Diseases and Syphilis of the Poliklinik. " Zur Kenntniss der Extra-genital Sclerose." Viertelj. f. Perm. u. Syph- ilis, 1885, pp. 97-116. 1) Case, chancre of lower lip, from kissing (Obs. I., p. 98). 2) Case, chancre, lower lip, from a pipe. (Obs. V., p. 100). 3) Four cases, chancre, lower lip, cause unknown. (Obs. II. . III., IV., VI). 4) Case, chancre, upper lip, from kissing. (Obs. VIII., p. 102). 5) Case, chancre, upper lip, cause unknown. (Obs. VII., p, 102). 6) Case, chancre, eyelid, from a towel. (Obs. IX., p. 103). 250 SYPHILIS INSONTIUM 7) Case, chancre, cheek, from a bite (?). (Obs. X., p. 104). 8) Case, chancre, chin, from tending an infant. (Obs. XI., p. 105). 9) Case, chancre, chin, cause unknown. (Obs. XII., p. 105). 10) Five cases, chancre of breast, from lactation. (Obs. XIII. -XVII. ). Baumes, P. Lyons. Surgeon-in-Chief to the Hosp. Antiquaille. " Precis theorique et pratique sur les malad. vener." Paris, 1840. 1) Case, nurse infected by nursling, at nipple (p. 169). 2) Case, nurse, infected as above, infects her own nursling (p. 171). 3) Case, chancre of the nostril, cited by Ricord. Baumler, Chr. Handb. der chronischen Inf ectionskrankheiten ; Erster Theil — Syphilis. Leipzig, 1886. Speaks of the identity of syphilis and radesyge, syphiloid, Sibbens, skerljevo, etc. Baxter, E. B. London. Blackfriars Skin Hospital. Lancet, May 31, 1879, p. 769. Case, syphilitic inoculation, child, 3 years old, by tooth brush. Bayer, J. J. Altorf (?). Acta. Nat. Cur. III., obs. 26. Epidemic, obstetrical, known as "Mai de St. Euphemie." (See Epi- demics). Bayle. " Observations sur un ulcere chancreux a la levre inferieure." Journ. de med., chir. etpharm., Paris, 1767, XXVL, pp. 256-260. Case, chancre of lower lip. Bazin, X. Paris. Hop., St. Louis. 1) Case, nurse infected by nursling. (See Audoynaud 5 ). 2) Two cases, of glass-blowers syphilis. (See Viennois 2 ). Beauvais, A. G. Paris. Soc. de med. de Paris. Lyon medicale, 1866, p. 209. 1) Case, chancre of finger, from a bite: amputation. 2) Case of Gery, man inoculated his mother by biting her hand. Behrend, F. J. Berlin. Behrend's " Syphilidologie," Leipzig, 1839-1846. 1) Family epidemic, industrial, weavers, from use of sprinkling tube. (Vol. III., 1 841, p. 512). 2) Case, lactation, nursling infects nurse. (Vol. IV., 1843, p. 621). 3) Case, nursling infects nurse, at breast, and she her own child. (Vol. I. , new series, 1858, p. 326). 4) Case of infection through cigars held in the lips, but replaced in dealers stock. (Vol. IV., p. 325). 5) Statement, undocumented, of infection by lancets. (Vol. V., 1844, p. 164). 6) Statement, "has seen many cases of transmission by pipes." Belhomme, L. Paris. (See Martin, A.). Bell, B. Edinburgh. University Professor of Surgery. " Treatise on Gonorrhoea Virulenta and Lues Venerea," 1792, American edition. Albany, 1814. 1) Statements, undocumented, of infection per partum; infection of midwives; auto-inoculation of surgeons; infection by kissing; by drinking-ware ; and by blood-letting with a lancet, used previously to open a bubo. (Part II., p. 9). 2) Statements of eye-witness, but also undocumented, of infectiousness of Sibbens, its diffusion among families, between children, etc. (Part II., pp. 268-281). 3) Case, chancre of scrotum, from soiled trousers. ANALYTICAL BIBLIOGRAPHY 251 Bell, J. Hong Kong. Lancet, Aug. 4, 1888, p. 241. Case, chancre of tongue, from pipe or dishes. Belousow, P. Odojew, Russia. Medicinskoie Obosrenie, 1887, No. 21 (Abstract in St. Petersburger Med. Wochenschrift, No. 11, 1888, p. 97). 1) Family infection; 3 cases, chancre of mamma; 1 of lower lip; 1 of upper lip; 2 of the tongue; 1 of soft palate; and 3 of the tonsils: total, 11. Zeitschr. f. Gericht Med. u. Allgem. Hyg. Bd., IV., 1885 (Russian). (Archiv f. Derm. u. Syph., 1889, p. 236). 2) Statistics of 334 cases: family infection, 77 per cent.; lactation, 1.8 per cent. ; hereditary, 10.12 per cent. Arbeiten des II., Congreses Russischer Aerzte in Moskow, 1887, p. 20. (Archiv f. Derm, u, Syph., 1889, p. 236). 3) Statistics of 2765 patients: family infection, 66.3 per cent. ; lactation, 2.2 per cent. ; hereditary, 5.4 percent; per coitum, 26 per cent. 4) Statistics, in Rjasan; extra-genital infection, 74 per cent. Trans, of the 2d general meeting of Russian medical men at Moscow, 1887, Vol. II., Div. 5, p. 20. 5) Three cases, chancre of fauces, father and sons 8 and 6 years, source unknown. 6) Case, chancre, left faucial arch, in a woman from her syphilitic child of 1 1 months ; the latter infected by a syphilitic relative. 7) Case, chancre, mucous membrane of mouth, near angle of lips, in man of 22 years. 8) Case, chancre, mucous membrane of mouth, near angle of lips, in boy of 8 years, whose father and sister were syphilitic. 9) Case, chancre of uvula, in 18-year-old boy, from his nephew. 10) Case, chancre, left faucial arch, in 22-year-old woman, from her i-year-old boy; the latter infected by a cook. 11) Case, chancre, left tonsil, in married woman of 23, from neighbors. 12) Case, chancre, near corner of mouth and on both lips in a boy of 12 years ; living with syphilitic laborers. Bennett, J. E. Fort Smith. Arkansas. Southern Practitioner, 1883 p. 103. Epidemic of vaccino-syphilis at Fort Smith, 1863 — hundreds of soldiers and civilians inoculated from pustules upon one another. (See Epidemics). Bennett, J. H. Edinburgh. Journ. of Med. Sciences, Edinburgh. (Vol. XIV., 1852, p. 570). Two cases of syphilis acquired by two nurses from the same infant. Benson, A. Dublin. Transactions Academy of Medicine, of Ireland. (Vol. I., 18S3). Case, chancre of eyelid, from kissing (p. 367). Berbez. Paris. Hop. Cochin, interne, service of Despres. Case, chancre of little finger, from tooth inoculation. (See Guignard 7 ). Berger, F. H. " Do pseudo-syphilide," Inaug. Dissert., Gryphise, 1S32. Case, nurse infected from nursling. Bergeret. Paris. Moniteur des hopitaux, Nov. 29, 1853-. Group: three nurses and two nurslings, infected, scria/im, the first nurse from an heredito-Syphilitic nursling. Bergh, R. Copenhagen. Physician to General Hospital, Division for Skin diseases and Syphilis. " Ueber Anst. u. Ansteckungswcge bei Syphilis," Monatsh. f. prakt. Derm., 1888, p. 197. 2 5 2 SYPHILIS INSONTIUM i) Statistics ; from 1872-1886, among 252 chancres m prostitutes, there were only 5 extra-genital; of these, lip 3, breast 1, calf 1 2) Case, chancre gluteal region, from sleeping with comrade, with general pustular syphilide. Bernard, A. Liverpool. Lock Hospital. Liverpool Med. Chirurg. Journ., Jan., 1885. 1) Four cases of syphilis in glass-blowers (pp. 183-6). 2) Personal communication : case, chancre of finger in a phvsician obstetrical. r J Bernard, E. Amiens. Bullet, de la Soc. Med. d' Amiens, 1875, XIII. , XIV. pp. 104-8. Case, chancre of the eyelid. Bernard, P. Lyons. Chief of Clinic for Skin Diseases and Syphilis Journ. des mal. cutan. et syph. Pans. (Vol. II., p. 339). Case, chancre of left arm, in site of wound by a piece of stone, which was dressed by compresses which had been in use previously by others. Bertherand, A. Paris. Chief Physician, French Armies. " Precis des Maladies Veneriennes," 2d. ed., Paris, 1873. 1) Case, chancre of tonsil, from kissing (p. 204). 2) Small lactation epidemic, Paris, (p. 335). (See Cazenaves). 3) Case of Guyon's, transmission by contact in bed (p. 20). Bertherand, E. L. Lille. Notice sur le chancre de Sahara. Gaz. des Hop., 1854, pp. - >Q , o OI A discussion concerning the nature of " Biskra button/' Berti, G. Bologna. Maternity Hospital. '' A°roh- de T i0n /r at J Ch ? d 'i gien v int ° rn ° -Hasifilide da allattamento. " Archiv. di patol. infant. Napoli, iP% „ / DD tok . 11q) Seven nurses infected by lactatv „ ' 3 (PP " 5 9) " Bertin, X. Paris. Hop. des ? r : • "Trait' rl 1 1 . v enenens, Surgeon. enceintes ™^ ' ' • jn ® r - cnez l es enfants nouveaux-nes, les femmes 1) Case c>*'' e '^ s nourrices <" Paris, 1810. 2) Cs r ' •' ijL11 ^" i n f ec ted by mother, through kisses, or dishes (p. 27). J r .^e, infant infected at vulva by bathing with saliva (p. 7S). j) Case, nursling infected mediately by the nipple, nurse, who was suckling an infected baby, escaping infection (p. 149). 4) Case, nurse infected by nursling (p. 152). 5) Case, infant infects mother's nipple (exception to Colles' law) (p. 163). 6) Case, of Leblanc, nursling infects nurse (p. 187). Besancon, M. Paris. Hop. de la Pitie. (Interne). Case, Eustachian sound inoculation. (See Lancereaux). Besnier, E. Paris. Physician to Hop. St. Louis. Cited by Ory, q. v. "Syph. malig. precoces." These de Paris, 1875. 1) Three cases, labial and faucial. Journ. de med. et de chirurg. pratique, 18S0. (Annales de Derm, et de Syph., 1880, p. 566). 2) Three cases : a) Double chancre of lip and tongue, in workman, from fellow work- man, through brush used in common. b) Chancre, lip, in young girl. c) Case of Horteloup's, eleven chancres, labial and genital. Bulletin de l'Acad. de Med. de Paris, XIV., 1885, p. 12. 3) Report of committee on the award of the Prix Vemois, Besnier, chairman, recommending work "Syphilis des Verriers," of Guinand's of Rive-de-Gier, Paris, 1881. a) Two cases, syphilis, in glass-blowers through medium of the tube. l>) Statistics, 41 glass-blowers treated for recent syphilis in theHosp.de l'Antiquaille, Lyons, from 1874-1882 ;from 1882-1885, nota single case. ANALYTICAL BIBLIOGRAPHY 25, Annales de Derm, et de Syph. Vol. X., 1SS9, p. 101. 4) Case, chancre, middle of upper lip. Annales de Derm, et de Syph. 1889, No. 5, p. 463. 5) Case, chancre in subclavicular region in a man, whose wife had mucous patches in mouth and on genitals. Journ. de med. et de chirurg. pratiques, LXL, 1890, p. 496. 6) Case, chancre of tonsil in a man, infection probably from common use of a tobacco-pipe. Beurmann. "Chancres mammaires communiques a des nourrices par leurs nourris- sons." Annales de Derm, etde Syph.. Vol. I., 3d series, 1890, p. 424. Three cases, mammary chancres, all wet-nurses at 1' hospice des Enf ants- Assistes. Beyran, T. M. Paris. " Paralysis syph. d. motor-ocul. ext." Bulletin de 1' Acad, de Med., i860, t. XXV., p. 363. Case, chancre of chin, cause not stated. Bidenkap, T. L. Christian ia. Rigshospital. Klinisk Aarbog, for 1886. 1) Statistics, etc. , on non-venereal syphilis. 2) Statistics, negative, on vaccino-syphilis. Bierchen, P. Stockholm. President College of Physicians of Sweden. (Cited by Rosen von Rosenstein 3 , q. v., p. 752). 1) Case, apparently a primary lesion of nostril, in 20-year-old youth. 2) Case, chancre of lip, in a twelve year old girl. Bierkowski, L. J. Krakow. "Choroby syfilityczne czyli weneryczne oraz sporoby ich leczenia," Krakow, 1883. (Orignal account cited by Kosinski, 1867: the latter's account again in 1880, by Lubelski, and also by Matlakowski, q. v.). Circumcision epidemic, Krakow, over 100 infants infected. Biett, L. T. Paris. Hop. St. Louis, Senior Physician. (Cited by Albers, q. v.). 1) Case, syphilis from ritual circumcision. 2) Case, infant with acquired syphilis infects its mother. 3) Four cases, nurses infected at the breast. (Cited by Cazenave, q. v.). 4) Case, chancre of lip, in a man, from kissing, infects next case, 5) Case, chancre of lip, his niece, 12 years old. 6) Case, midwife infected in calling. 7) Case, chancre of lip, in 6-year-old boy, from 8-year-old brother. (Cited by Ricord, from work of Martins). 8) Case, chancre of nostril. Bigelow, H. J. Boston. Prof, of Surgery, Harvard University. Boston Med. Journ., Jan. 6, 1859. (Also in Durkee, "Treatise," etc., 1864). 1) Case, nurse infected at nipple, infects 2) A woman, who drew her breast, and also 3) Her 14 year-old-daughter (both in the throat). Bilguer. Berlin. Prussian Military Service, Surgeon-General. "Traite de l'hypoehondrie," pp. 71, 75. (Rosen von Rosenstein, 1769-98, p. 728). Epidemic, or cases from breast-drawing. (See Epidemics). (Episode said to resemble that described by Everardus). Binet, P. Paris. Hop. de Lotircine. (Interne). "Contribution a 1' etude du chancre infectant du vagin." La France Medical, 1SS1, I., pp. 38-50. 254 SYPHILIS INSONTIUM i) Statistics, of Martineau, Hop. Lourcine: 128 cases; lips 8 ; vault of palate 1 ; tonsil 1 ; breast 1 (double chancre, one on nipple). " Du role de la syphilis dans le cecite." These de Paris, 1883. 2) Case, chancre of cornea, in a medical student. Bird, F. D. Melbourne. Australian Medical Journal, July 15, 1S86, p. 304. 1) Case, of Snowball, q. v., and Ryan, C. S. 1 , q. v. Australian Medical Journal, 1889, XI, No. g, p. 427. 2) Case, chancre of nose, no particulars given. 3) Case, chancre of finger, dorsal aspect of inter-phalangeal joint, source unknown. Bjorken, T. Upsala. Univ. Prof, of Surgery. " Syphilidolog. Antekningar" Upsala lakar, Forh., 1869. (Review by Bergh, in Virchow u. Hirsch Jahresbericht, 1869, II., p. 560). 1) Case, chancre, back of hand, from a plaster previously worn on a syphilide. 2) Numerous other non-venereal cases, not given by the reviewer. " Primar. Syphil. im undrelappen" Upsala lakar, Forh., 1878, XII., p. 452. (Virchow u. Hirsch Jahresbericht). 3) Known only by above title. Blachez, E. Paris. Surgeon to Hop. Lourcine. "Deux cas de chancre du cou" by Fournier. Annales de Derm. et de Syph., 1S76, p. 66. (Notes by Blachez). Case, chancre of neck, from tooth inoculation. Blair, L. E. Albany. Swinburne Dispensary. Detroit Lancet, I883-4, N. S. VII. , p. 305. 1) Two cases of chancre of lip, in men 24 and 26 years old. 2) Case, chancre of tongue. Blanc, H. W. Tennessee. New York Med. Journ. Vol. LV., 1892, p. 287. 1) Three cases, chancre of lip, two on lower and one double, on upper and lower. 2) Case, chancre, right cheek, in female, probably from soiled towel. Blaschko, A. " Ein Fall von Lippensyphilis." Berlin, klin. Wochenschr., 1890, No. 27, p. 620. (Viertelj. f. Derm. u. Syph. Vol. II., 1890, p. 185). Case, chancre of upper lip, right side, patient 31 years old, from a bite. Blauchet, M. Paris. Quoted by Robbins, in Phila. Med. News. Vol. LX., 1892, p. 263. Author infected 27 individuals by Eustachian catheterization. Bleynie. Prof, d'accouchements a l'Ecole de Limoges. (See Bardinet). Bull, de l'Acad. de med. Paris, 1874, p. 319. Several infants infected by a midwife, rubbing umbilical cord with fingers moistened with saliva. (See Epidemics). Bloch, M. E. Berlin. "Geschichte einer Ansteckung durch Aussaug. d. Brust." Med. Bemerk., Berlin, 1774 (Girt anner). Case, chancre from breast-drawing. Blondeau, L. Paris. " Un cas de syphilis congeniale." Gaz. des Hop., 18S6, No. 71. Case, lactation, nursling infects nurse. Bloom, I. N. Louisville, Ky. Dermatologist Louisville City Hospital. "Extra-genital and other chancres." Medical Progress, 1891, VI., p. 2870 1) Case, chancre, mamma in widow 46 years old, source unknown. 2) Case, chancre, angle of jaw, in lady 22 years old, from a kiss. 3) Case, chancre, left index finger, in man 22 years old, source unknown. 4) Case, chancre, upper lip, in a prostitute, source unknown. ANALYTICAL BIBLIOGRAPHY 255 *>) Case, chancre, left index finger, in a physician, source unknown. 6) Case, chancre, right thumb, in a physician, source unknown. Blot. Case of vaccino-syphilis. (See Sebastian). Bloxam, J. A. London. Lock Hospital, Surgeon. Session Med. Soc, London, Jan. 24, 1887. British Med. Journ., 1887, I., p. 212. Case, chancre of both lips. Blumenbach. Gottingen. University Prof, of Medicine. Blumenbach's " Bibliothek fur Aerzten," 2> te - Bd., p. 197. Case, infection of a chamber-maid, by a tooth-brush. Boeck, C. Christiania. University Clinic for Skin Diseases and Syphilis. Tidskrift f. prakt. Med., 1883, No. 2. (Archives of Derm., 1883, XV., p. 665). 1) Statistics, lactation, from 1375-S ; four nurses, chancre of nipple. Tidskrift f. prakt. Med. 1S83, No. 13. (Archives of Derm., 1883, XV., p. 647). 2) Case, chancre of tonsil, virgo intacta. 3) Case, chancre of tonsil, simple mention. 4) Case, chancre of tonsil, from kissing. 5) Case, chancre of tonsil, from common table-ware. 6) Case, chancre of tonsil, from common table-ware. 7) Case, chancre of tonsil, simple mention. Tidskrift f. prakt. Med., 1SS5, No. 15-16, (Monat. f. prakt. Derm., 1885, P- 456). 8) Case, chancre of tonsil, from tending a syphilitic child. 9) Case, chancre of tonsil, from a drinking-glass. 10) Case, chancre of tonsil, source unknown. (Cited from Homolle). 11) Case, chancre of finger, in young girl who washed her infected brother's linen. Boeck, W. Christiania. Rigshospital. Norsk. Mag. Vol. VI. (Gunezberg's Zeitschr. f. klin. Med., Bd. V., Hft. II., p. 137). 1) Case, nurse infected by nursling. "Klinisk over Hudsygdome og Syphil. Sygdome, for 1852." Reprint from Norsk. Mag., Vol VII. 2) Family epidemic; seven infected (pp. 74-76). "Syphilisationsforsog," 1853. 3) Case, syphilis in child of 15, infected, by mother, at 6 (p. 28). 4) Case, syphilis in woman of 24, infected when 8 years old (p. 36). " Syphilisation studieret ved Sygesengen," 1854. 5) Two cases, Obs. IV. and XI., evidently non-venereal. "Syphilisation as a mode of treatment, etc." Behrend's Syphilidologie, 1858. 6) Case, nurse-mother, infected by nursling, transmits to own child a chancre of lip (Obs. XLV., p. 567-572). 7) Case, nursling infected by strange nurse, with chancre of the lip, transmits labial chancre to mother (Obs. LVI., p. 577). Traite de la Radesyge (syphilis tertiaire), Christiania, i860. Contains much of the literature of this subject. " Ueber Syphilis der Kinder." Behrend's Syphilidologie for 1862. 8) Case, nursling, infected by a nurse (p. 515). 9) Case, nursling, infected by a nurse, chancre of lip (p. 516). " Recherches sur la Syphilis, etc." Christiania, 1862 (in French and Norwegian). 10) Statistics ; several thousand cases of chancre. (Many cases of syphilis 256 SYPHILIS INSONTIUM insontium are detailed, but it is difficult to distinguish them from those already reported). " Ueber syphilitische Infectionweisen,'' etc. Archiv f. Derm. u. Syph., 1869, p. 168 (cites cases from his work, 4 ' Recherches," and adds) 11) Case, chancre of tongue, in nursing infant, from mother's breast (p. 171). 12) Case, chancre, lower lip, male, 36 years old (p. 175). " Erf ahrungen iiber Syphilis." Stuttgart, 1875. 13) Case, chancre of tongue, in an infant, mother syphilitic (p. 108). 14) Case, chancre, tip of tongue, from a pipe (p. 109). 15) Case, child infected by nurse, who chewed its food (p. 137). (Quoted by Hock, q. v. 2 ). 16) Case, chancre lower eyelid. Boerhaave, H. Leyden. Professor of Medicine. " Praelectiones Academicse de lue Venerea." Franquerae, 1751 (p. 6). 1) Small epidemic among women, who kissed an infected infant (§ XL). 2) Case, a mother and her nursling infected, through the latter having had the breast of a strange woman (§ XIV.). 3) Case, lactation, nursling infects a nurse (§ XV.). Boettger. Dresden. Memorabilien, II., 1878, xxiii., p. 63. Case, child 9 years old, with tertiary acquired syphilis, infected by syphilitic nurse, who chewed its food. Bogolubow, N. F. Cronstadt. Marine Hospital, Surgeon. Med. Pribav. k. Morsk. Sbornikii Med., May, 1884, pp. 51-58. (Archiv f. Derm. u. Syph., 1889, p. 237). 1) Five cases of syphilitic infection per os. Med. Pribav. k. Morsk. Sbornikii Med., 1885, Nos. 3, 4. (Same reference). 2) Statistics, 753 cases of syphilis: lips 2; eyelid 1 ; tonsil 1. Bogoslovsky, G. I. Meditzinskia Pribav. k. Morsk. Sbornikii Med. (British Journ. of Derm., Sept., 1889, p. 383). Case, chancre of abdomen, near navel, inoculated through an abrasion. Bohn, A. Konigsberg. Private Docent to the University of Konigsberg. Schmidt's Jahrbiicker, 1863, CXX, pp. 97-109. General review of vaccinal syphilis; Cases of Ceccaldi, Cerioli, Glat- ter, Haydon, Hubner, Lee, Marcolini, Pacchiotti, Pitton, Rine- cker, Viani, Viennois, Waller, Wegeler, Whitehead, etc. ; of a total of 312 persons vaccinated, 219 were infected with syphilis. Bolschwing, T. von. Dorpat. Hospital at Riga. " Ueber Syphilis und Aussatz." Dorpat, 1839. 1) Case, chancre of lip, common use of cup and spoon. (Obs. 4, p. 55, 56). 2) Case, infection per os, common use of spoon. (Obs. 5, p. 56, 57). 3) Case, infection per os, fauces (?), from a nursing-bottle. (Obs. 6, p. 57). 4) Case, infection peros, exposure to syphilitic relative. (Obs. 7, p. 58). 5) Case, infection in infancy, through common use of cradle. (Obs. 8, P- 59)- 6) Case, infant infected, father syphilitic. (Obs. 9, p. 60). 7) Case, infection per os, from a pipe. (Obs. 10, p. 62). 8) Seven other observations, comprising numerous cases of family syphilis, which could equally be of venereal and hereditary nature (p. 62-74). 9) A treatise on the relation of the Syphiloid of Lithuania, Jutland, etc., to Syphilis and Leprosy. Bondet. Lyons. Prof, of Internal Pathology. Rollet. "Traite etc.," 1866, p. 617. Case, chancre of scrotum, from infected trousers. ANALYTICAL BIBLIOGRAPHY 257 Bonnaric. Lyons. Hosp. de l'Antiquaille, female service. Rollet. "Traite, etc.," 1S65, p. 705. Chancre; Statistics collected by Carrier, interne, for Rollet' s treatise. See Carrier and Rollet. Bonnet, J. Lyons. Cited by Rollet. "Traite des mal. vener.," 1S65, p. 693. Case, chancre of nose. Bonne vie, H. Appointed in 175S to study Radesyge in Egersund and Stavanger (quoted by Lancereaux "Treatise on Syphilis (New Syden. Soc. 1S6S)" Vol. I., P- 35)- Bonniere. London. London Lancet, June iS, 1S70. Case, vaccino-syphilis, from soiled needle. Bonorden, H. F. Berlin. " Syphilis/' Berlin, 1S34. Case, chancre at site of incision for venesection (p. 41). Bontius, J. Medicina Indorum., Lugd. Batav., 1718 (quoted by Rayer "Traite theor. et prat. d. mal. d. 1. peau.," 2d edit., Paris, 1835, Vol. III., p. 864; and by Rollet, " Traite, etc.," 1866 (p. 481).* An original account of Amboyna pimple. Booth. Sheffield, England. " Epidemic of Syphilis caused by a midwife." Fortschritte der Medicine, March 1, 1S83, Beilage 5 (p. 34). A midwife had a chancre of the finger, and, in spite of a command to the contrary, continued to practice, covering the finger with a glove. She infected a great number of lying-in women, who in turn gave the disease to their husbands and children. The midwife was condemned to 1 2 months, at hard labor. Borgarutius, P. Paris. Physician to Henry II. of France. " Methodus de morbo Gallico." Patavii, 1566. Case, chancre of finger, in a midwife. Borovsky, V. K. Kiew. Vratsch., 1892, No. 11. p. 274. 1) Case, chancre of left tonsil, in a man, source unknown. 2) Case, chancre of both tonsils, in a man, source unknown. Botallus, L. Piedmont. "Von der Fran tzosen-Krankheit und ihrer Cur." Nurnberg, 1676; from the latin ed. of 1563. Case, chancre of lip, from a drinking-glass (p. 41). (Mentions also infection by clothing, kissing, etc.). Bottex, P. Lyons. Hosp. de l'Antiquaille. Behrend's Syphilidologie, Vol. I., 1S39, p. 536. Case, nursling infects nurse, and she her own child. Bottey, F. Paris. Interne du Hop. Midi. Annales de Derm, et de Syph., 1SS3, II., Ser. IV., p. 435. Case, chancre back of hand, from washing linen of patients. Bouchacourt, A. Lyons. Faculty Professor. " Consultation medico-legale sur vine cas de syphilis communiquee de l'enfant a sa nourriee par rallaitcment." Revue med francaise et etrangere (Cayol), 1841, t. II., pp. 228-235. Family epidemic from lactation. Boucher, de la Valle-Jossy. Paris. Hop. du Midi. (Interne). (Contributor to Fournier's statistics, in the " Etude sur le chancre cephalique," 1858, q. v.). 18 258 SYPHILIS INSONTIUM Boucheron. Paris. L'union medicale, 1879, No. 6, Vol. XXVII. 1) Case, chancre, eyelid (plica semil.) from kissing (p. 529). 2) Case, chancre, eyelid, in prominent surgeon, from auto-inoculation with the fingers (p. 533). Bouchut, E. Paris. Hop. des Enfants-Malades. 11 Memoire sur la transmission de la syphilis des nouveaux-nes aux nournces." Mem. de la Soc. de biol, 1849. (Gaz. med. de Paris,. 1850, p. 296). 1) Two cases, nurses infected by nurslings (Rayer, q.v.). " Traite pratique des maladies des nouveaux-nes," 5th ed., Paris, 1867. 2) Case, lactation, nursling infects nurse, she her own child (p. 1057). 3) Case, epidemic of lactation-syphilis (p. 1058). Boudinet. Bulletin de 1' Acad, de med., Paris, 1878. (Cited in Archiv f. Derm. u. Syph., 1889, p. 237). Case, midwife with chancre of finger, infected lying-in women. Boue. Essai sur la maladie de Scherlievo, Paris, 18 14.* Bouilly, G. Paris. Hop. Beanjon, Prof. Agrege. Arthropathies, rheum., scrof. , et syph. These d' aggregation, Paris, 1878. 1) Sequel of case of vaccino-syphilis, reported by Ollier, q. v. 2) Case, rag-picker infected on right little finger. (See Fournier's " Lecons tabes d'orig. syph.," p. 414). Boulangier. La Clinique, Bruxelles, Jan. 26, 1888, p. 51. (Monats. f. prakt. Derm.,. 18S8, No. 8, p. 387). Case, chancre of the nose. Bourcy, P. Cited by Mauriac. " Syphilose du rein," Paris, 1887, p. 21, without references. Case, chancre of upper lip in a man of 23 (Obs. 21). Bourdais, Eugene. Contrib. a l'hist. des accid. grav. consec. aux vaccinations faites par une sage-femme. These de Paris, 1869, p. 36.* (Cited by Roussel. "Syph. tertiaire," Paris, 1881, p. 205). Bourdon. Paris. Hop. d. 1. Charite, Physician. Cited by Ory. q. v., pp. 26-7. Case, Charite, 1875; vaccino-syphilis in female, age 53 years, scarifier was not cleaned, blood carried from one to the other. Bourgeois, Madame Louise (Burgesius). Paris. Midwife to Marie de Medicis. "Traite des accouchements," 160S, II. , 42. (Rosen v. Rosenstein "Kinder- krankheiten." Gottingen, 179S, p. 72S). Epidemic of obstetrical syphilis, thirty-five families infected. (See Epidemics). Bourgogne, F. (pere). Lille and Brussels. " Contag. des mal. verier, des enfants trouvees et leur nour." Lille, 1825, and " Consid. gen. touchant les dif. modes de contag. et de transm. accid. de la mal. vener (syphilis)." Journ. de med. de Bruxelles, 1866, pp. 97, 217, 322. 1) Epidemic at Conde. 1822-4. (See Epidemics). a) Nurse, from hospital foundling, infected b) Breast-drawer, she infected c) Fourteen nursing women, these infected d) Their fourteen nursing infants, these infected i) Five nurses, these infected f) Five of their own children. ANALYTICAL BIBLIOGRAPHY 259 2) In addition to the above. a) Nurse, from adopted foundling, who then infected b) A second adopted foundling. c) Two nurses, infected by adopted foundling. 3) Case, young lady, infected by a comb, used by syphilitic friend. (Note: These cases are referred to by Guntz. ("Verhiitung d. Syph." pp. 26-62, as of recent date, but correspond to the epidemic at Conde). Bousquet. Canstatt Jahresbericht, 1865 (Zeissl; " Lehrb. der Syph.," 3d. edit. 1875, pt. II, p. 37). Three cases of Eustachian sound infection. Bouvier. Paris. "Syphilis vaccinale." Acad, denied., Paris, 1S65, pp. 162-172. 1) Epidemic, Marone's, of vaccino-syphilis, at Lupara, 1856. (See Epidemics). 2) Case of Morax's, vaccino-syphilis. Bovero, Rinaldo. Giorn, ital. d. mal. ven. e della pelle XXVII., Mar. 1892, p. 37. Case, chancre from cut by razor, in man of 41 years. Boyer, P. Paris. Hop. St. Louis, Surgeon. Gaz. med. de Paris, 2d series, VIII., Nov., 1840, pp. 753-769. (Behrend's Syphilidologie III., 1841, pp. 299-322). 1) Case, chancre of nipple, in a paraplegic woman, infected 23 years before by a nursling (p. 322). 2) Case, chancre of nipple, in a male, by a bite (p. 317). Boys-de-Loury, J., and Barthelemy. Annal. d' hyg. pub. et de med. leg., Paris, 2d ser., 1869, XXXI., pp. 423- 430. Case, nurse infected by nursling. Boys-de-Loury and Costhilhes. Gaz. med. de Paris, 1847, 3d ser., II., p. 275. Case, chancre lower lip in a girl, source unknown . Brambilla, G. A. Gaz. med. ital., Lombarda. Milano, 1877, 7th ser., IV., No. 24. Case, chancre of finger, professional infection of a midwife. Brandis. De morbo in Holsatiae nonnulla regione grassante contagioso ex genere leprae observationes. Hall. Allg. Litt. Zeitung, 1811. Bibliothek for Laeger, 1813, I. (Quoted by Boeck " Traite d. 1. Radesyge," etc., i860, p. 46).* Treats of the morbus Dithmarensis. Brandis, B. Aachen. Geh. Sanitatsrath. "Grundsatze bei der Behandl. d. Syph.," 3d ser., 1886. Case, chancre of finger, in a medical man (p. 37). Braquehaye, J. Bordeaux. Prof. Dubreuilii's clinic for Skin and Venereal diseases. Annales de la polyclinique, 18S9, p. 124. Case, multiple chancre of face ; one each on cheek, lip, and chin. Brassavola, A. M. Ferrara. Tractatus de morbo Gallico, 1551. (See Aphrodisiacus). Case, nursling, infected by a nurse, infects its mother. Brecher, G. "Die Beschneidung der IsraDliten," etc., Wien, 1S45, S -; 1-2 Bogen. (Cited in Jaffe, "Die rituelle circumcision," 1886, p. 31). Case, circumcision-syphilis, one of many infected together. (See Epidemics). 260 SYPHILIS INSONTIUM Breda, A. Padua. University Clinic for Skin diseases and Syphilis. " Rendiconto clinico." (May, 1878 to Dec. 1880). Giorn. ital. d. mal. vener., etc., 1881, p. 27. 1) Statistics ; lip 3, tongue 1, buccal cavity 2, tonsil 1, cheek 1, nipple 5. =13. Of these, six were in nurses, five with chancre of nipple, and one chancre of tonsil, all from nurslings. " Manuel de Malattie Vener. e sifil." Padua, 1887, p. 239. 2) Statistics, from Dec. 1880 to May 1886; lip 11, cheek 2, neck 3, nipple 11=27. Grand total from May 1878 to May 1886=40. Breinlinger, Konrad. Impf syphilis. Inaug, Dissert. Wiirzburg, 1882, p. 22.* Breyer, J. F. Brussels. Cited by Cunier, q. v., in his " Annales d'ocul." Case, chancre of eyelid, girl 31-2 years old from fondling and kissing. Brincken, von. Angeln. " Ulcus durum auf der Innenflache der oberen Augenlider." Zehender's klin. Monatsbl. f. Augenheilk., Stuttgart, 1884, XXII., p. 371. Case, chancre, inner surface of upper eyelid. Brinton, W. Baltimore. Case, chancre of nose, bite-inoculation, reported by Rohe, q. v. Bristowe, J. H. London. St. Thomas Hosp., Senior Surgeon. " Report med. off. Gov't. Board, 1883, XII., p. 46. Official report of Commisssion on Dr. Cory's Auto-inoculation. See Cory and Hutchinson. Broca, P. Paris. Hop. de la Pitie, Physician. 1) Two cases, chancre of lip, in Fournier's " Chancre cephalique," 1858. 2) Two cases, lactation syphilis for Audoynaud, q. v. 3 , 7 . Brocq, L. Paris. Annales de Derm, et de Syph., 1883, p. 362. 1) Two cases, chancre of conjunctiva. (Service of Fournier). Annales de Derm, et de Syph., 1887, p. 209. 2) Case, chancre of lachrymal caruncle, left eye ; boy 2 years old. (Service of Besnier). 3) Two cases, chancre of the tonsil. (Service ' of Th. Anger and Laboulbene). See Le Gendre. Broick, J. Bonn. Prof. Doutrelepont's University Clinic. "Ueber extra-genital Initialsclerosen." Inaugural Dissertation, Bonn. 1888. 1) Eight cases, chancre of lip, six females and two males. 2) Six cases, chancre of finger, 3 in surgeons and 3 in midwives. 3) Three cases, chancre of nipple, nurses from nurslings. 4) Case, chancre, left arch of palate, in female, from infected foster child. 5) Case, infection per os, in a male. Reported by Dr. Krelling, q. v. in Dr. Lesser' s clinic. 6) Case, chancre, inner canthus of eye, in a male, source unknown. 7) Case, chancre of nose, from infected saliva, in an eysipelas abrasion. 1 * Ueber extra-genital Syphilisinfection." Archiv f. Derm. u. Syph. Vol. 22, 1S90, p. 497. Statistics : 215 cases of syphilis 1 1 of which were extra-genital. 8) Seven cases, chancre of lip, five females and two males. 9) Case, chancre of finger, in a midwife. 10) Case, chancre of tonsil, in a female. 11) Case, chancre of chin, from a razor cut. 12) Case, chancre, inner surface right thigh, from sleeping with syphilitic. Bronson, E. B. New York. Journal of Cutaneous and Venereal Diseases, 18S9, p. 67. ANALYTICAL BIBLIOGRAPHY 261 1) Case, chancre of tonsil, 8-year-old girl, from mother. Trans. N. Y. Dermatol. Soc, 218th meeting. Journ. of Cutan. and Genito-Urin. Dis. Vol. XL, 1893, p. 28. 2) Case, probable chancre, front of thigh, in hospital nurse, who attended syphilitic patients, and inoculated herself presumably by her soiled finger, through a scratch. Brouardel, P. Paris. Physician to Charite. Clinique medicale de la Charite, 1874. 1) Two cases, Eustachian infection, in children, one fatal. 2) Case of Eustachian infection, reported by Bucquoy, q. v. 3) Cases of chancre from bites, reported by Lesage, q. v. Brousse. Montpellier, France. L' union medicale, 1S90, Vol. L., p. 450. Case, seven hard chancres on the face, man 32 years old, presumably from razor cuts. Brown, F. T. Journal of Cutaneous and Genito-Urin ary Diseases, Vol. X., June, 1892, P- 235. Case, chancre of ring finger, right hand, in young man, from a bite. Browne, Lennox. Brit. Laryngolog. Ass'n. Revue de Laryngol. (Journ. des mal. cutan. et syph., Vol. IV., 1S92, p. 211). Case, chancre of cheek, in girl of 18, from bite by a man with a sore throat. Bruneau, E. Paris. " Transmission d. 1. syphilis d'un nourrisson." Gaz. des Hop., 1864. Case, nursling infected by wet-nurse (p. 150). Brunelli. Rome. (See Cerasi). Brush, E. N. Philadelphia, U. S. A. "Session Phila. Neurolog. Soc, April 26, 1887." Phila. Med. News, July 9, 1887 (Vol. LI., No. 2). Case, chancre of thumb, in a medical man, later developed nervous syphilis (p. 49). Bryant, T. London. Guy's Hospital. " Chancres in adults and children, in unusual situations." Lancet, 1868, P- 525. 1) Two cases, chancre, upper lip, source unknown. 2) Two cases, chancre, lower lip, source unknown. 3) Case, chancre, angle of mouth, source unknown. 4) Case, chancre, forearm, source unknown. 5) Case, chancre, nipple, in a female from kissing. 6) Case, triple chancre of finger, direct contact. 7) Case, chancre of cheek, from finger-nail wound. 8) Case, chancre of lip, boy of 7, from his father by kissing. 9) Two cases, children, boy slept with infected relative. 10) Case, infection, child of 4 years, source unknown. 11) Two cases, chancre of lip, aged 7 years and 10 months, father syphilitic. Bryce, C. A. Richmond, Va. Editor of the Southern Clinic. "Syphilis from accidental causes. " .Southern Clinic, 18S3, VI., p. 266. Case, chancre, lower lip, in young man, from drinking repeatedly from a whiskey flask, after a man with constitutional syphilis. Bucci, A. Bologna. Osped. di St. Orsola. Giorn. ital. d. mal. ven. etc., 1885, p. 267. Case, chancre of finger, from a bite. 262 SYPHILIS INSONTIUM Buch, M. Finland. Findska Lakares. Handb., 1888, No. 6, p. 303. (St. Petersburg, med. Woch. 1888, No. 30, p. 261). Three cases, chancre of upper eyelid, from application of tongue or finger moistened with saliva to the eye, by a female quack. Buchanan, G. Glascow. Professor of Surgery. "Case of Sibbens." London Med. Gaz., 1836, XIX, p. 44 Infection in throat after using same pipe and spoon with infected person (corresponds exactly with description of cases of Eustachian infection and throat chancre) . Buchholz, W. H. S. Hofmedicus at Weimar. Annotations to Loder's translation of Rosen v. Rosenstein's work on diseases of infancy, 6th ed., Gottingen, 1798. Case, infection per os, from a drinking glass (p. 728). Bucholz, I. Tidskrift for prak. Med., Kristiania, 1888, p. 305. (Archiv f. Derm. u. Syph., 1891, p. 328). Case, chancre of tonsil in old woman who had cared for a syphilitic child. Bucquoy. Paris. Hotel-Dieu. L' union med., 1865, XXVII., p. 189. 1) Case, Eustachian infection, in a youth of 21. (This case also under observation of Brouardel and Cullerier). 2) Case, of Danyon's and Cullerier' s, Eustachian infection; patient infected her husband. Budor, G. Paris. Hop. Beanjon. (Interne). Service of Millard. "Paraplegie syphilitique." Annal. de Derm, et de Syph., 1887, p. 188. Case, chancre of lower lip, followed by tabes dorsalis (see Millard). Budugoff, A. I. St. Petersburg. Vratsch No. 1, 1892 (St. Louis Med. and Surg. Journ., June, 1892). 1) Case, chancre, lower lip, in man of 23 years, from cigarette smoking. Vratsch No. 10, 1892 (St. Louis Med. and Surg. Journ., June, 1892). 2) Case, chancre, right tonsil, in young recruit, who, in leaving the village, had, as is the custom, kissed every one of the inhabitants. Bulkley, L. D. New York. Skin and Syphilis Clinic, New York Hospital. 1) " Two cases of chancre of the lip, infection from cigars." Archiv. of Derm., 1879, PP- 343, 372- 2) "Non-venereal Syphilis." Trans. New York State Med. Soc. 1886, P- 393- "Syphilis as a non-venereal disease." Journ, Amer. Med. Asso'n, Dec, 1888, p. 865. All cases included in 3) " Unusual methods of acquiring Syphilis." Phila. Med. News, Mar. 2 and 9, 1! a) Chancre of the lip, b) c) d) « e) /) " g) h) i) J) k) I) m) male 13 female iS total 31 finger, ' ' breast, " 6 tonsil, 2 tongue, " cheek, 3 3 chin, " 1 eyelid, " 2 nose, " 1 ear, " 1 hand, " — forearm, " 1 sacral region, " 1 Total, 34 32 66 ANALYTICAL BIBLIOGRAPHY 263 4) " On the dangers arising from syphilis in the practice of dentistry." Internat. Dental Journ., 1890, May and June. Case, chancre, right side of tongue, man aged 60, from dental opera- tion. 5) "Clinical notes on chancre of the tonsil with analysis of fifteen cases." Trans. Med. Soc. of the State of New York, 1S93. Fifteen cases, chancre of tonsil, among total of in personal cases. Bull, C. S. New York. Amer. Journ. Med. Sciences, Oct., 1878, p. 407. Case, chancre of conjunctival surface of upper eyelid. Bumstead, F. J. New York. " The Pathology and Treatment of Venereal Diseases," New York, 1S61, 4th ed., 1S79, with R. W. Taylor; 5th ed., 1883, by Dr. Taylor, after death of Dr. B. References to 4th edition, representing 1) Case, chancre of tonsil. 2) Case, chancre of nipple, from kissing by husband. 3) Dentists infected in practice of profession. 4) Syphilis, probably communicated by tooth-brush (p. 432). 5) Two cases, chancre under surface of eyelid (p. 695). Humbold Med. Archives? St. Louis, Mo. (Journ. Cut. Med., London, Vol. IV., 1S71, p. 152). 6) Syphilis acquired from smoking a pipe. 7) Case, chancre of finger, in a surgeon, from operation on syphilitic necrosis. See also Knight, Sturgis, and Taylor. Bureau. Paris. Hop. St. Lazare. (Interne). Clerc, Traite pratique des mal. ven., 1886. Statistics: 19 extra-genital chancres among 113 cases. Buret, F. Paris. Journ. des mal. cutan. et syph. Vol. III., 1S91, p. 646. 1) Two cases, chancre of lip, mistaken for epithelioma, from Soler y Buscalla " exposicion de varios casos de sirllis, Barcelona," 1S90. 2) Case, chancre of eye, in a surgeon, after handling a syphilitic. Weekly Med. Review, Feb. 20, 1S92, p. 144. 3) Case, chancre of back in a physician, who, when partly dressed from a bath, examined a friend with a chancre ; he inoculated himself by scratching a pimple. Burgesius. (See Bourgeois). Burlet. Lyon. Hosp. Antiquaille. (Interne). (See Rollet). Burow, J. Konigsberg, Prof, of Laryngology. Monatsh. f. Ohrenheilk., etc., 1SS5, No. 5, pp. 129-138. Small epidemic, six cases, Eustachian infection, traced to one physician. (See Epidemics). Burtzeff, P. A. Meditz. Pribav. K'Moskomii Sbornikii, July, 1889, p. 66. '(British Journ. of Dermatology, Nov., 1889, p. 451). Case, chancre back of hand from washing a syphilitic patient. Bury. Medico-chirurg. Review, London, 1S29, Vol. II.. p. 464. Case, chancre of nipple, nurse from nursling. Burzew, P. (See BCrtzeff). Bush, J. F. Boston. City Dispensary. New York Med. Journ., Vol. XXXII., 1880, p. 29S. Case, chancre of lip, from kissing. Buzenet, J. J. A. Paris. Hop. du Midi. (Interne). Service of Ricord. "Chancre de la bouche," These de Paris, 1858. 1) Twenty-one cases, chancre of lip, source either from abnormal coitus, or undetermined. 264 SYPHILIS INSONTIUM 2) Case, chancre of tongue, from a bite. (Obs. II.). 3) Two other cases, chancre of tongue, one from unnatural exposure, the other undetermined. Byrne, T. Dublin. Lock Hospital. " Report of Army and Navy Commission," etc., London, 1867, p. 484. Case, nurse infected by nursling. Caby, E. Paris. r Hop. St. Lazare. (Interne). Fournier, " Etude sur la chancre cephal.," 1858. Seven cases of cephalic chancre, included in Fournier' s statistics. Caillaud, A. L. " Des accid. syph. consec. a la vaccin., etc." These de Paris, 1863* (Fournier, " Legons sur la syph. vacc," Paris, 1889, foot note p. 144). Cairns. Edinburgh. " On the dangers of obstetricians, etc." Edinburgh Med. Journ., April, 1875, p. 887. _ Case, chancre of finger, in a medical man, professionally inoculated. Calderini, A. Milan. Osped. Maggiore. "Prospetto clinico sopra la malat. vener.," Milan, 1835 (Schmidt's Jahrb.). Statistics, of between 1000 and 1100 patients, thirty- one were infected through unclean linen. Calmette. Case, chancre of tonsil, from a soiled pencil (see Morel- Lav allee 6 ). Calvo. Paris. Fournier, " Etude sur la chancre cephalique," 1858. Case, chancre of the lip. Cambieri. Malattia di Scherlievo. Giorn. di med. prat. ; compilato dal Prof. Breda, Padova, 1812, Sept.-Oct., Fasc. V., p. 167. (Annali universali di med., Nos. 34, 35, 36; 273).* First writer upon Scherlie vo. Campana, R. Genoa. Clinico Dermo-Sifilopatica. " Sifilide e sihlitiche in uno triennio di clinica," 1882. 1) Seven cases, chancre of breast, in nurses (p. 37). 2) Case, chancre in a midwife (case of Mayer) (p. 38). 3) Case, chancre of the buccal cavity, from cigar-stumps (case of Tan- turri) (p. 38). Campart. Paris. Hop. d. Quinze-Vingt. Eye Clinic. Bulletin d. 1. clinique nat. ophthal. d. l'Hosp. d. Ouinze-Vingts. Vol. II., 1884. 1) Case, chancre left upper eyelid, male aged 22, source unknown, (p. 87). 2) Case, chancre inner angle right eye, midwife, professional exposure, female aged 29, (p. 88). 3) Case, chancre right upper eyelid, female aged 33, (p. S9). Bulletin d. 1. clinique nat. ophthal. d. l'Hosp. d. Quinze-Vingts. Vol. III., i885„ 4) Case, chancre left lower eyelid, male aged 20, source unknown, (p. 48). 5) Case, chancre left lower eyelid, male aged 38, from a bite, (p. 49). Campbell, J. Edinburgh. London and Edinburgh Med. Journ., 1844, p. 515. Case, chancre, nursling infects nurse. Canetta. Cologne. Koln. centr. Blatt, 1847, No. 90. (Prag. Viertelj., 1848). Epidemic from breast-drawing, thirty-two nurses infected. (See Epidemics). Cantilona. Cited by Demarchi, L'imparriale, 1S6S, Sept. 1. (Annal. de Derm, et de Syph., 1869, I, p. 158). ANALYTICAL BIBLIOGRAPHY 265 Epidemic of lactation syphilis, at Astragal and Calibera. (See Epi- demics). Capuron, J. Paris. " Aphrodisiographie," 1S07. (Clerc " Traite prat, des mal. ven. 1 ' Paris, 1866, p. 129). 1) Three cases, chancres, nurses infected by nurslings (pp. 276-291). 2) Case, chancre, child infected by the nurse (p. 290). 3) Case, chancre of lip, in a nursling from kissing (p. 276). 4) Case, chancre of lip, in a girl, by forced kissing (p. 113). Caradec, T. Brest. Bullet, gen. de therap, Dec, 1S51, t. 41, p. 505. Case, chancre, nursling infects nurse (published by Debout). Caramitti, A. Bologna. (Prof. Gamberini's Clinic). Giorn. ital. d. mal. ven. etc., 1SS2, p. 129. 1) Four cases, chancre of lip. 2) Case, chancre, naso-labial fold. 3) Case, chancre of cheek, toward ear, woman of 35 years. Carle. Lyons. Lyon med., 1878, p. 417. Case, chancre, nursling infects nurse. Carleton, P. M. Surgeon U. S. Army. British Med. Journ , 1887, No. 12, p. 1379. Case, double chancre of forearm, infected by the saliva of a tattooer Avith tertiary syphilis. Carre, M. Avignon. Gaz. med. de Lyon, 1866, No. 9. Case, chancre developing in a razor cut. Carreras y Arago, L. Revista de med. y cirurg. prac't. Madrid, 1878, II., p. 241-246. Case, chancre inner angle right eye, new-born child. Carriere, G. Montpellier. Gaz. hebdom. d. Montpellier, July 14, iSSS, p. 327. Case, chancre of thumb from a bite. Carter, H. Vandyke. Fox and Farquhar " On certain Endemic Skin and other diseases of India and hot climates generally, including notes on Pellagra, Clou de Biskra, Caneotica, and Aleppo Evil." London, 1876. Carter, R. B. London. Med. Times and Gazette, London, May 23, 1863, I., pp. 532-605. Case, chancre, vaccino-syphilis. Caspary, A. Konigsberg. Article in refutation of the statements of Guenzberg, Vienna Foundling Hospital, that syphilis neonatorum was not transferred to nurses. Berlin klin. Wochenschr, 1S75, No. 41. 1) Case, nursling infects nurse, she her own child (Obs. II.). 2) Two cases, similar, nurses infected (Obs. I. and III.). Cassidy, J. J. Toronto. New York Med. Record, Jan. 29th, 1887, p. 125. Two cases, chancre of lip, in young women, from their fiances. Castel, du. Paris. Annales de Derm, et de Syph., 1S91, p. 404. 1) Case, multiple chancres on arms, following treatment for scabies. Model in Musee de l'Hop. St. Louis. (Annales de Derm, et de Syph., Vol. III., Aug., 1892, p. 946). 2) Chancre of right thumb. ;66 SYPHILIS INSONTIUM Castelnau, H. de. Paris. Hop. St. Louis. "L* observ. et interpret, des faits en syphiliogr." Cazenave's Annales des rnal. de la peau, t. I., p. 8. Case, infant infects its grand-mother and aunt, who tended and hand- fed it. (See Robert, A). Castelo. Revista esp. de obtalmol. syph., etc., Madrid, 1880, I., p. 114. Case, chancre of right upper eyelid. Cataneus, Jacob de. Trat. de morbo gallico, 1505. Also Luisinus " De morbo gall." Lugd. Bat., 1728 (Bouchut, " Malad. des nouveau-nes, 5th ed., 1867, p. 1056). In 1523 Cataneus said: "I have seen many nursing infants infect their nurses." Caubotte. Paris. 11 Observ. sur la contagion des maux veneriens." Journ. de med.de chirurg. et de pharm. , 1781, LV. , p. 227. Cases of syphilis insontium (original article inaccessible). Caudelon, J. F. Paul. " Des diff. modes de transm. de la syph. chez le nouveau-ne." These de Paris, 1852, p. 28*. Cavazzani. La Riforma med. Jan. 1891, p. 171. (Annalesde Derm, et deSyph., 1S91, p. 625). 1) Case, chancre, anterior pillar of fauces. 2) Case, chancre of finger, in a physician, 50 years of age, after operation on syphilitic. Cayla, A. Paris. Hop. Cochin, service of Moutard-Martin. La France medicale, 1881, II., p. 532. 1) Case, chancre of lip. "Deux observ. de l'arthrite syphil. second." Annales de Derm, et de Syph., Paris, 1887, p. 341. 2) Case, chancre of gum, source unknown (service of Fournier). Cazenave, A. Paris. Hop. St. Louis. " Traite des Syphilides," Paris 1843. 1) Four cases, chancre of lip (two of Biett) (pp. 108, 109, 486). 2) Two cases, nurses infected by nurslings (pp. no, 281). 3) Two cases, physicians infected in operations (pp. 81, 491). 4) Two cases, physicians infected in obstetrical practice (pp. 81, 112). 5) Case, midwife infected in obstetrical practice (Biett) (p. 492). 6) Case, probable chancre of fauces, woman from husband (p. 386). 7) Cases, infection from sleeping with syphilitics (cases observed by Lagneau, Lucas Champiomere and Biett) (p. 385). 8) Epidemic, m Switzerland, by charlatan bleeding with lancet cleansed with saliva (Daguerre) (p. 113). Annales des mal. de la peau et de la Syph., Vol. III., 1 850-1, p. 283. 9) a. Nurse, infected by nursling; b. She infects a second nursling; c. This child infects its mother ; and also d. Infects her sister, aged 3 years. Revue de med. de Paris, 1852, p. 409. 10) Case, nurse infected by nursling. (Cited by Diday, " Infantile Syphilis," Sydenh. edit, 1859, p. 179). n) Suspected exception to Colles' law; mother, ulcers on nipples after nursing her own syphilitic child ; father syphilitic. Ceccaldi. Constantine. Rev. medico-Chirurg. de Paris, Feb., 1S53, XIII., p. 121. Three cases, vaccinal syphilis, two children of one family, and a third, from the same vaccinifer, 1S45. ANALYTICAL BIBLIOGRAPHY 267 Cederskjold, P. G. Utdrag ur Sammandrag of Berattelser infran Lakarne i hela Riket om veneriska Sjukdomen dess Forandringar och urarter. Stockholm, 1813.* (Quoted by Boeck, " Traite d. 1. Radesyge,"iS6o. p. 44). A study of Radesyge. Cehak, F. Verhandl. der Wien. Derm. Gesell., Sitz., Mar. 11, 1891. Archiv f. Derm, u. Syph. Vol. XXIII. , 1891, p. 821). Three cases, chancre of lip, two of upper and one of lower. Cenas. Cases reported by Stourme, q. v., pp. 45-47. 1) Three cases, chancre of lip, one in a woman, from husband. 2) Case, chancre, mucosa of cheek. Cerasi, F. Rome. "Communication of syphilis by the milk." Giorn. Med. di Roma, 1S66, (Giorn. ital. d. mal. ven., etc., 1866, II., p, 47). 1) Case, nurse in florid syphilis, infects two nurslings, as author con- tends, through her milk (p, 47, Obs. I. and II). 2) Case, mother recently infected, her nursling gets the disease. (Obs. III). 3) Case of Brunelli's, same nature as foregoing. Lo Sperimentale, 1877, XL., 117. Same subject as above. Cerioli, G. Cremona. Annali universah di med., Milan, 1824 t. XIX. (De la syph.-vaccin. L'Acad. de med., Paris, 1865, p. 222). 1) Epidemic of vaccino-syphilis at Cremona, 1821. (See Epidemics). "Delia possibilita di commun. la sifil. col. mezzo di vaccin," 1846. (De la syph. vaccin. L'Acad. de med., Paris, 1865, p. 222. 2) Epidemic of vaccino-syphilis at Grumello, 1841. (See Epidemics and also Marcolini and Tassani). Gazette med. de Milan, Oct., 1843,* (Quoted by Petit, "Trans, d. la syph. par la vaccin.," 1867 p. 10). 3) Vaccino-syphilis. Cerisi, L. " Syph. commun. par la vacc." L' union med., Paris, 1S61, No. 134, P- 259. " Nouveaux reseignm. sur les accid. de prop. syph. par la vacc a Rivalta." L'union med. Paris, 1862, No. 21, p. 322, and Gaz. hebdom, Paris, 1862, No. 16. Accounts of the vaccino-syphilitic epidemic at Rivalto, reported fully Pacchiotti, q. v. Chaboux, F. Paris. These de Paris, 1875, ° bs - XIII. 1) Case, chancre, nurse from nursling. 2) Case, weanling from preceding, its mother, infected per os, through pre-mastication of its food. Chabrely, B. Bordeaux. Journ. de med. de Bordeaux, Jan., 1859, 2d Series, IV., pp. 19-31. Two cases, nurses affected by nurslings. Chadzynski. Lembourg, Galizia. (Rizat, " Manuel des mal. vener.," Paris, 1882). Case, nurse infected by nursling, acquires multiple chancre of the breast and areola (p. 310). Chambay, E. Paris. "Gaz. des Hop.," Paris, 1S65, No. 178, p. 45. Case, child infected by its mother. 268 SYPHILIS INSONTIUM Charayron, C. Paris. These de Paris, 1877, p. 11. Case, child infected at age of 8 months (service of E. Vidal). Charlouis. Viertelj. f. Derm. u. Syph., 1881, p. 431. On "Yaws." Charpentier. Brussels. (Prof. Thiry). La Presse med. Beige., Bruxelles, 1868, XX., 14. Two cases, nurslings infected by nurses. Charriere. Paris. Archiv. gen. denied., 1862, t. II., p. 327 (cited by Fournier, "Syph. et Mariage," (p. 39). Case, two-year-old child, infected per os, from father, kissing. Chartier. Paris. Hop. St. Louis. (Interne). Service of Fournier. Published in Morin's These de Paris, 1888, p. 87. Case, chancre of lip, at commissure. Chassagny, M. " De la prophylaxie de la contag. des accid. prim, et second, de la syphilis chez les ouvriers Souffleurs de Verre." Gaz. hebdom. de med. et de chir., Paris, 1862, IX., p. 793. Review of subject of glass-blowers' syphilis, no cases. Chassaignac. Paris. Hop. St. Antoine, Surgeon. Bull, de l'Acad. de med. de Paris, 1869, XXXIV., p. 783. Also (Trans. London Obstetrical Society, Vol. V., p. 196). Case, three chancres of arm, in two-year-old child, from vaccination. Chaumier, E. Tours. Le Poiton medical, 1891, No. 5, p. 103. Case, chancre of anus, infant 17 months, from sponge. Chauvet, C. Paris. University Professor Agrege. " Sur l'influence de la syphilis sur les maladies du systeme nerveux cen- trale." These d' aggregation, Paris, 1880. Case, chancre of lip (Proust, Ballet, Lariboisiere, 1879) (p. 64). Cheadle. London. St. Mary's Hospital. (Cited by Jullien, from Lyon medicale, 1872, I., p. 409). 1) Case, vaccino-syphilis. " Three cases of late or tertiary syphilis in children," British Med. Journ., London, 1880, I., p. 204. 2) Case, infection in child. Cheminade, G. Bordeaux. Hop. St. Jean. (Interne). Annales de Derm, et de Syph., 1888, Vol. IX., p. 535. 1) Case, chancre of right lateral cervical region, from razor cut. L'union medicale, 1889, XLVIIL, No. 93, p. 157. 2) Case, chancre of breast, nurse from nursling. del Chiappa, G. B. Pisa. Assistant to the Skin and Venereal Clinic. ' ' II primo triennio della clinica Dermo-sifilopatica di Pisa, diretta dal Prof. Celso Pellizzari." Milan, 1890. (Giorn. ital. d. mal. ven., etc., 1889, p. 139). 1) Three cases chancre of the breast and one of the chin, observed in the clinic during the years, 1885-6-7 (p. 10). In all, eight women were seen who had acquired syphilis from infants whom they were nursing; of the children, four were from private families, and four foundlings (p. 19). Report of cases treated in the Dermo-syph. Clinic in Pisa, in 1880. Riforma med., Nov., 1S91. (Monatsh. f. prakt. Derm. Bd. XIV., No. 8, p. 322). ANALYTICAL BIBLIOGRAPHY 269 2) Case, chancre upper lip. 3) Case, chancre lower lip. 4) Multiple chancre of forehead, lower eyelid, and chin. Chiari, O. Vienna. Prof, of Pathological Anatomy. " Laryngoscop. Befund bei d. Fruhform. d. Syph." Archiv f. Derm, u. Syph., 1882. 1) Case, chancre of lip, no mention of origin (p. 499). 2) Case, of Sommerbrodt's, chancre of lip (p. 500). Chipier. Paris. Hop. du Midi. (Interne). (Rizat, "Manuel prat. d. mal. ven." Paris, 1S82). Case, Simonet's, Hop. du Midi., chancre of nuchal region, from direct exposure in carrying a person (p. 346). Chisholm, J. Baltimore. Maryland Med. Journ., June, 1882, p. 81. Case, chancre of lower lip, in a young girl, from a kiss. Chochlow. (Seen in clinic of Dr. Mauriac.) Vratsch., 1SS1, No. 35, 43. 1) Case, chancre of cheek, from razor cut. 2) Case, chancre of index finger, lcf : hand, from blow on the teeth of an assailant who had syphilis. Chrestien, H. Montpellier. Prof, of Therapy. (These cases cited by Legrand, " De Tor et du mercure," probably from "Lamethode iatroliptique," 1S11). 1) Case, of Niel's, nursling infects two nurses (Legrand, Obs. 129). 2) Case, of Menard's, woman infected in pregnancy; new-born child infects nurse; mother infects her next youngest (Obs. 178-180). 3) Case, of Simoxeau, chancre of tongue, from kissing (Obs. 377). 4) Case, of Sarda, chancre of lips (Obs. 392). 5) Case, of D almas, nursling infects nurse (Obs. 403). Christie, James. McCall Anderson's Treatise on Diseases of the Skin. London, 1887, pp. 285, 393- "Delhi boil," " Framboesia," etc. Chudnoski. Tiflis. Proceedings Med. Soc. of the Caucasus (London Lancet, 1886, II., p. 988). Case, chancre of chin, developing in a razor cut. Churchill. London. Westminister Dispensary. Medical Times and Gaz., 1872, I., 160, 190. Case, chancre of thumb, in a medical student, from palpation of sores. Claeys, G. Ghent. Annales de la soc. med. de Gand, 1883, LXI., p. 206. Case, chancre of eyelid, etiology unknown. Clarke, A. London. Middlesex Hospital, Surgeon. Lancet, London, 1872, Aug. 2, p. 153. Case, nurse infected by nursling, chancre left nipple. Clarke, B. London. St. Bartholomew's Hospital. Lancet, London, 1882, II., p. 702. Case, chancre of lip. Clary and Guary. Bull de l'Acad. imp. de med., 1866-7, P- 1039. (Cited by Fournier, 11 Syphilis Vaccinale," 1889, p. 219). 1) Epidemic of vaccino-syphilis at Cardeillac, 1866: Of 22 vaccinated from one child, 13 acquired syphilis. (See Epidemics). 2) Two cases, chancre of the breast, from above children, one in child s mother and one in a wet-nurse. SYPHILIS INSONTIUM Claude. " Etude sur la syphilis du sein." These de Paris, 1886. (Annal. de Derm. et de Syph., 1886, p. 774). Case, chancre of breast, in 65-year-old woman, removed as an epithelioma. Clement. Frankfurt. Deutsche Klinik, 1853, p. 157. Case, of vaccino-syphilis. Clement. Lyons. Gaz. med. de Lyon, 1865 (XVII), p. 528. Case, chancre of the cheek. Clements, B. A. United States Army Service, Surgeon. Amer. Journ. Med. Sciences, 1861, vol. XLII., p. 40. Case, chancre of lip, husband infects wife by a tooth-wound.' Clerc, F. F. Paris. Hop. St. Lazare. Traite des mal. vener., Paris, 1866. 1) Statistics, St. Lazare; in 113 chancres, 19 extra-genital; lip 11, nose 3, forehead 2, tongue 1, fauces 1, neck 1 (collected by Bureaux). 2) Disp. de salub. publ. ; among 403 chancres, 7 extra-genital ; lip 5, tongue 1, eyelid 1. 3) Personal cases, in 21 years, about 50 extra-genital; lip 30, eyelids 8, tongue 2, chin 2, cheek 1, gum 1, fauces 1, septum nasi 1, scrotum 1 (from wearing apparel). Clerici, G. Milan. Osp. St. Catarina, Director. Annal. univer. di med., Feb., 1885 July, Aug., Sept., 1856 (Schmidt's Jahrb.). Twenty-seven nurses infected by nursing, in Osp., 1854. Clerval. Paris. Hop. Quinze-Vingt. Bull. d. 1. clin. nat. ophthal. d. Hop., 2— V., 1887, V., 90. Case, chancre of eyelid. Cline. Montreal. Canada Med. and Surg. Journ., Aug., 1875. (Report of case of Fen wick, q. v.) Case, chancre of eyelid. Closa. "Chancro sifilitico del borde libre del parpado" — Oftalmol. prat. — Madrid, 1882-3, I., p. 151-153.* Case, chancre of the eyelid. Closmadeuc, G. and Denis. Auray. Dep. of Morbihan. Depaul, Bulldel'Acad. de med., XXXII., p. 1039, and " Examen. crit. des docum. rel. ai'epidemie de syph. vac d' Auray," 1866, Paris, 1871 (Fournier 1 , "Syph. vaccin.," p. 221). Epidemic of Vaccino-syphilis at Auray. Clossius, C. F. Tubingen. " Ueber die Lustseuche," 2d ed., 1799. 1) On p. 41 et seq. are found many references to Albinus, Sommering and others. 2) Case, inoculation by the finger used to raise a fallen uvula (p. 49). Clowes, Wm. London. St. Bartholomew's; Surgeon to the King. ' ' New and approved Treatise concerning the cure of the French Pokes," I575- 1) Three cases of midwives, professionally infected. 2) Case, seemingly of syphilis acquired in infancy. Cocchi, B. Milan. Gaz. med. Lombard, 1858, No. 10. Two cases, nurses infected by nurslings. ANALYTICAL BIBLIOGRAPHY 271 Cochez. Paris. Hop. Cochin- (Service of Despres). (Interne). Paris medicale, 1880, No. 78, also cited in Guignard's These de Paris. Two cases, chancre of chin, each in site of razor wound ; one a triple, the other a double chancre. Cochran, A. W. Notes on the measures adopted by Government between 1775 and 1786 to check the St. Paul's Bay disease. Trans. Lit. and Hist. Soc, Quebec. 1854, IV., 139-148*. Coesfeld. Deutsch. med. Wochenschr. Berlin, 1884, X., (p. 404). Case, chancre of tip of right index finger. Cohansen, S. E. E. Treves. Univ. Prof, of Medicine. "Lues venerea per manus obstet. propagata." Acta Nat. Cur., 1744, VII., 25I (GlRTANNER, No . 987). Epidemic of obstetrical propagation of syphilis. Cohen, J. Solis. Philadelphia. " Diseases of Throat and Nose." Phila.. 1S79, 2 & e &- Case of Eustachian-catheter infection, ending fatally (p. 19). Cohn, H. Breslau. University Professor of Ophthalmology. Schubert, " Syphilit. Augenkrank." Berlin, 1881, p. 82. Case, midwife infected in delivery. Cold. Ugeskrift for Laeger, 1859, No. 24. 1) Family epidemic, involving three infants and four adults, one of them 2) Old woman, infected by chewing food of infant. Colle, J. Padua. University Prof, of Medicine. " Notitia et medela singularis adversus Neotericos, de morbo Gallico . . . et ejus sympt." Venetiis, 1628. Case, one of the counts of Fano, supposed to have been infected by his brother, from sleeping in same bed during his illness. Colles, Abr. Dublin. " Practical observations on the Venereal disease, and on the use of mer- cury." London, 1837. 1) Case, medical man infects his betrothed, by kissing (p. 13). 2) Case, nurse infected by nursling, infects her own infant (p. 271). 3) Case, servant girl, aged 13, from infant. 4) Family epidemic, five infected, four chancres of lip, one of breast (p. 294). 5) Surgeon infects several parturient women, from secondary sore on finger, excited by trauma, (p. 14). (Healey). Dublin Med. Press, Oct., 1844. (Annales de mal. de la peau, 1845, pp. 222, 308). 6) Case, infection of child from sleeping with a syphilitic woman. 7) Case, infection, nurse from above child. 8) Infection of several women from a syphilitic accoucheur, (p. 308) (probably same as 5). Collier, S. R. Wimbledon, England. British Medical Journal, 1889, I., p. 1114. Two cases, mother and sister, aged 12, infected by a syphilitic woman, or her child. Colombini, P. Del sifiloma iniziale dell amigdale. Riform. med., 1892, 50, 51.* (Archiv f. Derm. u. Syph.,. Vol. XXIV., 1892, p. 692). Conte, E. II Progreso medico, Dec. 1, 1889. Case, chancre of the lip, from cigarette, lighted by a syphilitic. 272 SYPHILIS INSONTJUM Cooke, T. W. London. Westminister Hospital. Lancet, Aug., 1857 (also Mason, q. v., Obs. II). 1) Case, chancre of lip. Med. Times and Gaz., i860, I., p. 563. 2) Case, boy, 7 years, infected by mother, who occupied same bed. Cooper, A. London. Surgeon Westminster General Dispensary. "Note on extra-genital contagion." Lancet, 1890, II., p. 866. 1) Case, chancre alse nasi, girl 10 years old, no history of contagion. 2) Case, chancre right nipple, child iy z years old. 3) Case, chancre left side of tongue, man 28 years old. 4) Case, chancre of hypogastrium ; no exposure for 7 months ; had scratched himself there when in public bath, two weeks previously. 5) Case, chancre of chin; alleged re-infection; syphilis seven years previous^. 6) Case, chancre of lip, from drinking beer after companion with mucous patches. Cooper, J. Foster. Guy's Hosp. Reports, London, 1872, 3d series, XVII., p. 257. Case, chancre upper eyelid, in male of 20 years. Cooper, S. London. University Hospital. " Lectures on Syphilis" (Behrend's Syphilidol., L, 1839, p. 358). Case, chancre of finger, in a medical man, professionally exposed. Coote, H. London. St. Bartholomew's Hospital. A report treatment of syphilis, London, 1857. 1) Case, infant infected from nurse (p. 132). 5) Case, girl, aged twelve, infected from kissing sister, hereditary syphilis. Report, Army and Navy Commission on Venereal Disease. London, 1867. 3) Case (Coote, himself), inoculated, right middle finger, opening a bubo (P- 343). 4) Case, own re-infection, twenty years later, left forefinger (p. 343). Clin. Soc. Transactions (Lancet, 1861, I., p. 288). 5) Case, chancre upper lip. Corcelet. Grenoble. (See Diday, "De la reinfection syphilitique," 1862, p. 17). Case chancre of the lower lip. Cordier. Lyons. Hosp. de l'Antiquaille, Surgeon. Cases reported by Stourme, q. v., pp. 71-76. Cases, chancre of the lip 7 ; of tonsil 3 ; of gums 1 ; per os, locality not given, 1. Total 12. Cornarius, J. Frankfurt. Univ., Prof, of Medicine (at Jena and Marbach). " Liber Tonsil, med seq. observ. med." Lipsise, 1595. (Gruner's, " De morbo Gallico scriptores," p. 258). Case, inoculation by wet-cupping, chancre in situ, observed before 1558. Corrigan. Dublin. Physician to the Charitable Infirmary. London Med. and Surgical Journ., 1835, VII., p. 715. Clinical lecture on a case of " button scurvy," said to have been acquired by sleeping with a man with syphilis. Cory, R. Reported by Hutchinson 14 (see also Fournier, "Syph. vaccinale" (p. 15), (foot-note), inoculated himself, after three unsuccessful attempts, with syphilis, with vaccine lymph from syphilitic child. Coste\ Berlin. " Observations pratiques sur les malad. vener.," Berlin, 1760. Case, chancre of rectum, from introduction of an infected finger. ANALYTICAL BIBLIOGRAPHY 273 Coste. Paris. Gazette d. Hopitaux, Dec. 11 and 16, 1873. Three cases of vaccino-syphilis. Couper. London. London Hospital. Lancet, London, 1870, II., p. 603. Case, chancre of lip. Coutagne, E. Lyons. Gaz. med. de Lyon, Mar. 1, 1866. Case of Eustachian infection ; probable chancre of both tonsils. Coyttarus, J. Paris. "De febre purpur. epidem." Parisiis, 1578, cp. III. 1) Case, servant, infected through cast-off clothing of a syphilitic person, (pp. 28, 29). 2) Case, chancre of thumb in her sister. Cozzolino, V. 1) "Sifilosi delle tonsille." Bollett. d. clin., Milano, 1888, V. pp. 97-107.* Riv. clin. dell. Universite di Napoli, 18S9, 1-2. (Archiv f. Derm. u. Syph. Vol. XXL, 1889, p. 598). 2) Chancres of the nose, mostly from unclean instruments, especially from Eustachian catheterization. (No cases given). Craigie, D. Edinburgh. Elements of the pract. of phys., Edinb., 1837, I., 668-726. Treats of Sibbens, Yaws, Radesyge, etc. Crawford, C. H. Medical Times and Gazette, London, 1873, I., p. 531. Case, vaccino-syphilis. Creighton, C. The natural history of cow-pox and vaccinal syphilis, London, 1887. Cripps, H. London. St. Bartholomew s. " Proc. Med. Soc. of London," Jan. 24, 1887. British Med. Journ., 1887, I., p. 212. 1) Statistical, in 1886; saw 14 chancres in unusual sites. 2) Case, chancre of eyelid, one of above, a 70-year-old lady, from her grand- child. British Med. Journ., Apr. 16, 1892, p. 815. 3) Case, chancre face, between lip and chin, in middle aged man, from razor cut. Critchett. London. Moorfield's Eye Infirmary. Med. Times and Gazette, London, Sept. 1857, p. 272. Case, chancre lower eyelid. Cullerier, Auguste (1805-1874), son of F. A. G. Paris. Hop. Midi and Lourcme. " Mem. sur la contag. syph. entre 1. nour. et 1. nourrissons." Paris, 1S54. (Also L' union med., 1854, pp. 459, 463, 471). 1) Case of syphilis alleged to have been contracted from nursing. "Precis, iconograph. des mal. vener." Paris, 1862-1S66 (Bumstead's transl., Phila., 1868). 2) Case, chancre of vulva, from mother, by use of same sponge (p. 43). 3) Two cases, chancre of eyelid (plate 41, figures 2 and 3). 4) Case, chancre of eyelid (seen by Mackenzie in C.'s clinic). 5) Case, chancre of tonsil (reported by Le Gendre, from notes by M ARTEL): 6) Case, chancre of lip, in medical student, from infected lead-pencil (p. 48). 7) Case, chancre of lip. 8) Case, chancre of lip, from drinking-glass (case of Hillairet). (See Beyran, Bucquoy and Martelliere). 19 274 SYPHILIS INSONTIUM Cullerier, F. A. G. (i 782-1 841), nephew of Michael Cullerier. Paris, Hop. des Veneriens, Surgeon-in-Chief. See Lucas-Championniere, who published C's cases in his "Traite, etc." 1836. Cullerier, Michel (oncle, 1 758-1 827). Paris, Hop. des Veneriens, Surgeon-in- Chief. Journ. gen. de med. de chirurg., et de pharm., 1816 (LV), p. 32. (Cited by Roussel: " De la syph. tertiare," Paris, 1881, p. 64). 1) Case, chancre, nurse from nursling (1797). 2) Case, chancre of lip, from an attendant, through kissing or bathing with saliva (181 6), (p. 33). Reported by Cazenave. 3) Case, chancre of lip, from kissing. Also see Renard, Lucas-Championniere ("Traite," etc., 1836), Diday, etc., (Dictionnaire des Sci. med. par une Soc. de med. et chir. Paris, 1813, IV.). 4) Case, chancre external auditory meatus (p. 516). 5) Case, chancre of pharynx with necrosis of vertebrae (p. 527). 6) Case, chancre on thyroid cartilage (p. 528). Cunier, F. Brussels. Founder of the Annales d'oculistique. "Recherches stat. sur les mal. ocul. ," Annales d'ocul. 1) Case of Breyer, chancre of eyelid in child 3^ years old, received from caresses of a woman (t. iv., p. 238). 2) Case of Hairion, q. v., chancre of eyelid. 3) Case, chancre of eyelid in a 17-year-old woman (t. XVI., p. 166). 4) Case, chancre of eyelid in infant from kiss of prostitute with a chancre of the lip (t. XVI., p. 208). Cusack, J. Dublin. Lock Hospital, Surgeon. Dublin Quart. Journ., 1846, p. 337 (also Colles "Treatise," 1837, p, 273^ 1) Family epidemic. a) Case, chancre of breast, from nursling. 3) Case, infant infected by wet-nurse. c) Case, child infected per os, from mother. d) Case, child infected per os, from mother. c) Case, servant-maid, infected per os. 2) Case, chancre, peri-anal, 18-months child, infected by nurse. 3) Case, chancre of thumb, from carrying a syphilitic child. 4) Case, infection through bedding of above child. Cutter, J. C. Philadelphia. Phila. Med. Times. 1879-80, X., p. 299. Case, chancre within nostril. Dabry, P. La medicine chez les Chinois, Paris, 1863, p. 263. Syphilis among the Chinese. " Yang-Mey-Tchonang." Daehne, J. G. Leipzig. " Osservachione pratiche sopra il mal. veneree." German edition. Wien, 1 791 (notes by Cirillo), Case, chancre of lip, from holding infected quill-pen in mouth (p. 9). Daguerre. (Cited by Cazenave, q. v., without references). Group of cases, infected by venesection, scalpel cleansed with operator's saliva. Dall'Acqua. Epidemic of vaccino-syphilis (see Grancini and Dall'Acqua). Dalmas. Montpellier. University Professor. Observation in Chrestien, q. v. and Legrand. (Obs. 403). Case, nursling, congenitally syphilitic, infects nurse. ANALYTICAL BIBLLOGRAPHY 275 Danielssen, D. C. Bergen. Comrrmn Hospital. " Syphilisation anvendtmod Syphilis og Spedalsked." Bergen, 1858. 1) Case, chancre, woman infected by nursling; later, own child receives disease (p. 47-50). 2) Case, recent syphilis in child of 6 years ; parents syphilitic a year before (p. 50). 3) Case, recent syphilis in a young woman, assigned to infected bedding (P- 5o). 4) Case, recent syphilis in young woman ; in service where the people were syphilitic (p. 51). 5) Case, probable chancre of toiisil in an old woman who had been foster- ing an infant (p. 57). 6) Case, infant who infected preceding and had received chancre of mouth from a midwife who first fed him (p. 58). 7) Case, chancre of nipple, wet-nurse of preceding (p. 59). 8) Case, recent syphilis, in servant, began m throat; her mistress syphilitic (p. 61). 9) Case, recent syphilis in i-year-old infant; mother same (p. 63). Danyon. Paris. Case, Eustachian infection (see Bucquoy 2 also Cullerier). Dardel, A. Aix-les-Bains. (Statistics (personal) of Clerc, q. v., "Traite etc., 1866; p. 104). Case, chancre of eyelid. Davis, C. E. Chicago. Chicago Med. Journ. and Examiner. 1876; p. 440. Case, nurse infected by kissing her nursling. Dawosky. Dresden. " Mittheilungen aus der Syphilis Praxis." Memorabilien, Heilbronn, 1876. No. 10. 1) Case, chancre of finger in a midwife (p. 435). 2) Two cases, syphilis from the same midwife above mentioned (p. 433). DeAmicis, T. Naples. University, Prof, of Dermatology and Syphilis. II movemento med. chirurg., 1877 (IX.), No. 33. 1) Case, nurse infected by nursling, infects 2) Case, nursling, her own child. 3) Case, nurse infected by nursling, the child of case 1. " Sulla Syph. ossea e muscolare," etc. II movemento med. chirurg., 1880, II., p. 460. 4) Two cases, adults with bone syphilis infected in infancy by wet- nurse. Annales de Derm, et de Syph., 1881, p. 786. 5) Case, chancre of left cheek. 6) Case, chancre of nipple and chin in same woman. Dease, W. Dublin. St. Nicholas and Catharine Hospitals, Surgeon. " Heilart der Lustseuche," translated by Michaelis, Jena, 1790. Case, nurse, infected by nursling (p. 133). DeBeck, David. Cincinnati. " Hard chancre of the eyelids and conjuctiva," Cincinnati, 1886. 1) Case, chancre, right lower eyelid, from contact in bed with male friend. 2) Tabulated details of 85 cases from literature. 3) Tabulated details of 8 cases, from personal communications, from Ayres, i; Galezowski, 4; Juler, 2; Sattler, i. q. v. Dechaux. Montlucon. Gaz. med. de Lyon, 1867, Nos. 15-T6. Epidemic of glass-blower's syphilis at Montlucon, 1S6S-1869. (Guinand 5 ). Defaucambourge. Gien. Case, nurse infected by nursling. (G. Lagnf.au 3 , q. v.). 276 SYPHILIS INSONTIUM Deffernez. Jumet, Belgium. Bulletin de l'Acad. Royale de med. de Belg., Bruxelles, 1885, 3d series, XIX., pp. 364. and 476. Syphilis in glass-blowers. Deguerre, J. J. S. Essai sur 1' inocul. du virus syph. These de Paris, an. XI. (1803) P- 43-* Delapersonne. Paris, Hotel Dieu, Chief of Surgical Clinic. Archiv. d'ophthalmol., 1880-1881, p. 499. 1) Case, chancre of eyelid, involving caruncle. 2) Case, chancre of left lower eyelid. (Service of Dr. Panas). 3) Case, chancre of right lower eyelid. (Barthelemy 2 ). Del Chiappa, G. B. (See del Chiappa). Del Greco. Florence. Case, chancre of leg, inoculation by an electric brush (see Peliz- zari, C 20 ). Del Monte, M. Naples. Professor Ophthalmology at University. II movimento med.-chirurg., 1882 (De Beck, p. 42). 1) Case, chancre of eyelid, medical man (p. 155). 2) Case, notes by Sbordone, medical man, chancre of eyelid, digital auto-infection (p. 157). Delore. Lyons. Hop. de la Charite. (Fournier " Nourrices et Nourrissons," p. 9). Case, chancre, nurse infected from nursling: nurse in turn infects her husband. Delpeche, E. Montpellier. Univ. Prof, of Surgery. Clin, chirurg. de Montp. , 1826 (Lawrence, " Lect. on Surgery," 1830). 1) Case, surgeon infected on ringer, from rectal operation. (Cited by Oesterlen, " Ven. Contagion," 1843, p. 67). 2) Case, chancre of chin, in site of razor wound. Demange, E. Nancy. Prof, of Medicine. "Chute spontane des dents et crises gastriques— chez les ataxiques." Revue de med., 1882 (Fournier, " Period. preatax. du tabes"). Case, chancre of lip, ataxia 30 years later. Demarchi. L'Imparziale, Sept. 1. 1868. (Annales de Derm, et de Syph., 1369, p. 158, Giorn. ital. d. mal. ven., etc., 1869, I., p. 243). Epidemic of Capistrello and Castellafiume (see also Tanturri, Ruggiere. Durante, Selli, also Epidemics). Demeaux. (See Laroyenne). De Meric, V. London. Royal Free Hospital. "On some peculiar modes of transmitting syphilis in married life." British Med. Journ., Jan. 24, 1874. Case, chancre of tonsil, husband infected from wife. . Demets, A. Ghent. Annales de la Soc. Med. de Gand, 1884 (t. LXII), p. 147. Two cases, chancre of eyelids, etiology unknown. De Molines. See Des Molines. Denis. (See Closmadeuc). Denis-Dumont. Caen. Professor Ecole Militaire. 41 De la Syphilis," Paris, 1880. 1) Case, infection of a military man through a tobacco-pipe (p. 76). 2) Case, chancre of the finger, in a midwife (p. 186). Denti. Annali d'ottalmologia, XII., 1883, p. 567 (De Beck, p. 44). ANALYTICAL BIBLIOGRAPHY 277 Case, chancre of lower cul-de-sac of left eye, from a nail-wound of a syphilitic nursling. Depaul. Paris. Director of vaccine service. " De la Syph. Vacc." Acad/ imper. de med, Paris, 1865, pp. 59, 84, 200. 1) Family and lactation epidemics of Viani, Rodet, Marone, Herard, and Chassaignac, q. v. Bull, de l'Acad. de med., 1S66, p. 1047 (Fourmer, " Syph. vacc," p. 191), 2) Nine cases of vaccinal syphilis. Bull, de l'Acad. de med., Paris. 3) Twenty-three cases of vaccinal syphilis, 1867 (p. 619). 4) Two cases, vaccinal syphilis, reported by Dr. Zalloxis, of Greece, 1869 (p. 1017). 5) Case, vaccinal syphilis reported by Dr. Vicherat, of Nemours. 6) Case, vaccinal syphilis in a child, from nursling, nursed by 7) Case, chancre of breast in mother of last case ; subsequently her hus- band and three other children were infected, 1S69 (p. 1103). Discussion on vaccinal syphilis, defending Bardinet's work on " Un vacc. syph.," 1869 (p. 1171). Depaul and Roger. Bull, de l'Acad. de med. de Paris, XXXI., p. 88S. Epidemic of vaccinal syphilis at Morbihan, 44 infected. (See Epidemics). Descroizilles. La France medicale, 1887, I., p. S3S. Case, chancre of the anus, in boy 12 years old, pederastic. Desjardins. A. Algiers. L'Akbhar. (Journ. d' hygiene, 1SS1, p. 399). Epidemic of vaccinal syphilis, fifty-eight soldiers inoculated from a single vaccinifer. (See Epidemics). Desmarres, L. A. (perel. Traite theorique et pratique des mal. des yeux." Paris, 1854, t. I., p. 621. 1) Case, chancre of eyelid, medical man from coughing of a syphilitic. 2) Case, chancre of eyelid in midwife. 3) Case, chancre of eyelid in an adult; in both, cause unknown. Desmet, E. Brussels. Univ. Prof, of Dermatology and Syphilis. La presse med. Belg., 1S81 (XXXIV) (p. 73). 1) Case, chancre of breast. " Ueber die Syph. der Glasbloser" La Clinique, Bruxelles, 1SS7 (Novem- ber). Monatsh. f. prakt. Derm., 1S8S. p. 3S6). 2) Case, chancre in a glass-blower, infected per os. Des Molines. Paris. Hop. Lourcine. (Interne). (Service of Martineau). Statistics of 128 cases; lips 8, fauces 2, nipple 2 (see Martineau and BlNET). Desnos, E. Paris. L'union mwl, 18S9, I., p. 454. 1) Case, chancre of the tongue, in cashier from infected bank-notes. Diet, de med. et de clururg., prat. VII., p. 149 (Compt. rend. Soc. Med. d. Lyon, 1861-2, pp. 45, 70). 2) Statistics; out of 77 chancres of the mouth, there was only one chancre of the tonsil. Despagnet, F. Paris. Receuil d* ophthalmol., 1881, p. 521, 1) Case, chancre of eyelid. 2) Case, chancre of conjunctiva in a nursling, from adult, kissing. Despres, A. Paris. Lourcine and Hop. Cochin. (See cases reported by CoCHEZ and Guignard 7 ). 278 SYPHILIS INSONTIUM Deubel. Gaz. med. de Paris, 1881, III., p. 628 (Annales de Derm, et de Syph., 2d series, Vol. III., 1882, p. 129). Man 49 years old infected by skin grafts from own son (see Fereol). Devaux, J. Paris. Translation with notes of Musitanus (q. v.) Paris, 1710. 1) Two cases, chancre of fingers, in midwives. " Art de fair e les rapports en chirurg." Paris. (Girtanner gives date 1727; Plouquet, 1743). 2) Case, or cases of lactation-syphilis. (Plouquet). Devergie, A. Paris. Hop. St. Louis. Bull, de l'Acad. imper. de med. Paris, 1862. Vol. XXVIII, p. 664. Case, vaccino-syphilis, in young man, 1 5 years old. De la. Syph. Vacc, Acad, imper. de med. Paris, 1865, p. 136. Discussion on vaccinal syphilis. De Vincentiis. Palermo. Univ. Prof, of Ophthalmology. (Profeta q. v. " Trattato prat. d. mal. ven." 1888, p. 425). Case, chancre of the eyelid. Dibon, R. Paris. 1759. "Effet singul. du mal. ven. sur toute un famille." Journ. de med., chir., pharm., etc. Paris, 1759, X., p. 415 (Girtanner, No. 508). Case of lactation syphilis starting a family epidemic. Dickinson, W. London. St. George's Hospital. Med. Times and Gaz., 1874, I, p. 476. Case, chancre of upper lip. Diday, P. Lyons. Hospice de l'Antiquaille. Traite de la syph. des nouveau-nes, Paris, 1854. (Edit. Wood's Library, 1883). 1) Two cases (personal), chancre of nipple (pp. 150, 185). 2) 25 cases, Bardinet 3; Baumes i; Bertherand i; Bouchut 2; Caze- nave 1; Cullerier 4; Doyon and Dron i; Lallemand i; Loret i; Pare, A. 4; Petrini 4; Price i ; Sperino i. " Etude sur la chancre de l'amygdale." Mem. de la Soc. de Scien. med. de Lyon, 1861-2, t. I., (p. 45). 3) Five cases, chancre of tonsil. "Reinfection Syphilis." Archiv. gen. de med., 1863. 4) Statistics of 60 primary lesions (in 30 cases re-infection), there is mention of 4 extra-genital chancres. 5) Case, personal, chancre of the lip (p. 33). 6) Case, chancre of lower lip (Gorcelet), (p. 40). 7) Case, chancre of lip (Bodet), (p. 41). 8) Case, chancre of lip, re-infection in above case (Bodet), (p. 41). Gaz. med. de Lyon, Aug., 1866. 9) Case, chancre by Eustachian infection. Gaz med. de Lyon, 1867. 10) Case, chancre from glass-blowing (Gamet). " Histoire naturelle de la Syph., Annal. de Derm, et de Syph., 1882, pp. 521, 637. 11) Statistics, 90 cases of recent syphilis; of these 5 extra-genital. 12) Four cases, chancre of lip, 3 of them in glass-blowers (pp. 52S, 640, 641). 13) Case, chancre of tonsil (p. 527). Diemer, L. Aachen. "Abhandlung iiber die Heilwirkung der Aachener Scbwefelthermen." Aachen, 1862, p. 1. 1) Statistics of 257 syphilitics treated by D. at Aachen, 1S54-1S62, nine (about 3 per cent.) were infected innocently. 2) Two cases, inoculated through surgical operations. ANALYTICAL BIBLIOGRAPHY 279 3) Two cases, children, infected by nurses and attendants. 4) Case, attendant, infected by his syphilitic patient. 5) Case, infected through use of a tobacco-pipe. 6) Case, infected on shipboard, through messing outfit, probably knife (p. 2). 7) Two cases, mode of infection unknown. Dieterich, G. L. Die Krankheits Familie Syphilis. Landshut, 1842, vol. 1, p. 1S8. Case, chancre of lip, child 2 years, from kisses of mother. Dietlen, H. Erlangen. " Casuistische Beitrage fur Syphilidologie des Auges." Inaug-Dissert., Erlangen, 1876. Case, of Michel's, chancre of conjunctiva, lower cul-de-sac, in medical man, from auto-infection with fingers, (p. 4). Dimey, J. "Etude sur les chan. syph. du sein." These de Paris, 1891 (Annales de Derm, et de Syph., 1891, p. 895). Among 139 extra-genital chancres, in Paris cliniques, in 4 years, there were 18 of the breast (5 in men). Dixon, T. London. Med. Times and Gaz., May 9, 1861. Case, chancre of eyelid. Dixwell, J. Boston. Boston Med. and Surg. Journ., 1881, CV., p. 482. Case, infection per os, possibly from a drinking vessel. Dolbeau. Paris, Hop. Lourcine, Surgeon. Bullet, de therapeutique, LXXIL, 1867. Case, chancre of lip, in a man of 60. Donaldson, F. Baltimore. Phila. Med. News, 1885, XL VII., I., p. 173. Case, chancre of tonsil. Dohng. "Mothers and Infants, Nurses and Nursing," Boston, 1859, p. 104 (N. Y. Med. Record, Vol. XXX., 1886, p. 511). Case, infection of child from wet-nurse. Dor, H. Lyons. (Personal communication from De Beck to author of this book; source unknown. Nine cases of chancre of the eyelid, seen between 1S68-1883. Dornig, G. Laibach. , Wiener med. Wochenschr. , 1885, XXXV., p. 330. Case, chancre of right lower eyelid in a laundress ; etiology not given, but most likely from soiled clothing. Doutrelepont, H. Bonn. Univ. Professor of Dermatology and Syphilis. Eighteen cases of extra-genital chancre, given by von Broich, q. v. Dowse, T. S. London. Lancet, 1S77. I., p. 482. Case, chancre of forearm in a girl nine years old, from holding a syphil- itic infant. Doyon, A. (See Dron). Draper, W. H. New York. Archives of Dermatology. New York, Vol. II., p. 230. Case chancre of the lip, from kissing, wife infected by husband. Dron, Achille. Lyons. Hosp. de l'Antiquaille (female service). (Doyon, A. and Dron, A.) Gaz. hebdom. de med., Paris, 1854, Nos. 30, 31. 280 SYPHILIS INSONTIUM (Tardieu, "Etude med- legal, etc.," Paris, 1879, p. 226-229). 1) Six cases, nurses infected by nurslings. (Doyon, A. and Dron, A.). Rev. therap. du Midi, Montpellier, 1859, XIII, pp. 373, 401. 2) Cases of transmission of syphilis from nursling to nurse. Annales de Derm, et de Syph. 1870, p. 161. 3) Twelve cases, nurses infected by nurslings. 4) Five cases, nurses become infected, and also infect other nurslings. Lyon medicale, 1870, p. 512. 5) Statistics ; 106 nurses, infected by nurslings, transferred from Charite to l'Antiquaille, 1860-1870. 6) Extensive family epidemic of syphilis. Lyon medicale, 1877, Nos. 26, 28, 30, etc. 7) Statistics of chancre of the lip, 18 70-1 875, chiefly in glass-blowers: 8 to 10 cases yearly. Cited by Rollet, " Traite des mal. ven." Paris, 1866 (p. 617). 8) Case, woman, aged 70 years, infected, lips and tonsils from the care of her grand-child. (Dron's cases have been freely referred to by others, see Audoynaud, Diday, Fournier, Rollet, Roussel, Viennois). Drysdale, C. R. London. British Med. Journ,, Apr. 25, 1S68, (with R. W. Dunn). 1) Case, vaccino- syphilis. Lancet, 1869, II, p. 639. 2) Case, chancre of lower lip, girl, aged 19, from bite of a young syphilitic child; patient then infects her sister, girl, aged 13, chancre of vulva from sleeping with her. Lancet, 1870, I, p. 482. 3) Case, chancre (?) in throat, from nursing bottle. 4) Case, chancre of nipple, from same child. 5) Case, infection (?) of child of case 4. British Med. Journ., Nov. 16, 1872. 6) Case, infection from cigar stump. "Syphilis, its nature and treatment" London, 1872. 7) Two cases, chancre of lip, from kissing. 8) Three cases, nurses infected by nurslings. Dubois, P. Paris. Bouchut. Traite prat, des mal. des nouv.-nes, 1st edit, p. 878. Case, chancre of lip, in pregnant woman. Dubois, Havenith. Brussels. Presse Med. Beige., 1890, XLII, 9, p. 129. Two cases, chancre of lower lip, in a woman 60 years old and her daughter. Dubreuil, A. Montpellier. Gaz. hebdom. de Montp., 1888, No. 9, p. 100. (Annales de Derm, et de Syph., Vol. IX., 1888, p. 597). Case, chancre external angle of right eyelid. Dubreuiih, W. Paris. Hop. St. Louis, service of Fournier. (Interne). Case, chancre of chin from razor cut (see Zwetitcii). Dubreuiih, W. Bordeaux. Case, multiple chancre of face, (see Braquehaye). Dufour, C. Paris. Hop. du Midi. (Interne). Two cases, chancre of fauces, (Fournier " chancre cephalique," 1858). Duguet. Case, chancre of tonsil, see Le Gendre 8 . Diihrsen. Pfaffs Mittheilungen aus dem Gebiete der Med. Chir. u. Pharm., Bd. L, ANAL YTICA L BIBLIO GRA PH Y Hef. 3, 1832 * (quoted by Boeck Traite, d. 1. Radesyge, etc., i860, p. 47). Treats of the Morbus Dithmarensis. Dulac,,P. Paris. Hop. St. Louis, service of Bazin. " Etude sur la syphilis contracte a un age avance. ," 1878, p. 58. Case, chancre, septum of cares (service of Gosselin q. v.). Dulles, C. W. Philadelphia. 1) Cases of syphilis from tattooing (see Epidemics, and Maury and Dulles). Phila. Med. and Surg. Reporter, Jan. 5, 187S, XXXVIII., p. 4 (Amer. Journ. of Med. Sciences, 1878, p. 62). 2) Case, chancre of lip, received from a dentist. Archives of Dermatology, New York, VII, 1881, 144. 3) Case, chancre of eyelid. Dunn, R. W. London. Farrington Dispensary. Brit. Med. Journ., 1S65, II., p. 600. 1) Fifty-three cases of vaccination syphilis. Report of Army and Navy Commission, London, 1S67, p. 506. 2) Case, chancre of lip, man infects sweetheart by a bite (this is un- doubtedly same as Drysdale's). Dupond, G. " Etude sur la syphilis du nez et des fosses nasales," These de Bordeaux, 1887, Paris. 1) Case, Eustachian-sound inoculation. 2) Case, chancre of fauces (both in service of Moure), pp. 22, 32. Du Pont. On the contagiousness of secondary forms of syphilis, and on chancre of the head. Presse med. Beige, Bruxelles, 1859, No. 26, 32*. Dupre, Achille. These de Paris, 1857. Case, chancre of the eyelid, from kissing (p. 11). Dupuytren. Paris. Hotel Dieu, Senior Surgeon. Case, double chancre of breast and eyelid, in a nurse from a nursling (reported by Rognetta, q. v.). Durante. Capistrello. Dispensary Physician. (Notes of the progress of the endemo-epidemic in Capistrello. See Tan- turri, Demarchi, and Epidemics). During, E. von. Monatsh. fur prakt. Derm., XIII, 1891, p. 471. 1) Seven cases, chancre of lip and cheek. 2) Three cases, chancre of tonsil. 3) Case, chancre of right breast. 4) 31 cases in neighborhood of anus from pederasty. Durkee, S. Boston, U. S. A. Boston Med. and Surg. Journ., LIX., 1859, p. 460. 1) Two cases, nurses from same nursling (same as reported by Bennett q. v.). "Treatise on Gonorrhoea and Syphilis," Phila., 1864, p. 278. 2) Case, wet-nurse infected by moribund nursling, at nipple (Massa- chusetts Gen. Hosp , Mar., [853, service of Bigelow). 3) A mother and young daughter drew the breasts of this patient, and each received, beyond all question, chancre of the throat. Dfisterdorf. Willebadessen. District Physician. Hufeland's Journal, 1826, LXII, I., p. 114. Epidemic from lactation (sec Epidemics). Dutschinski, A. A. Staro. Konstantinov. Vratsch, June, 1889, p. 167 (Brit. Med. Journ., 1869, p. 427). 282 SYPHILIS INSONTIUM Epidemic from midwifery inoculation ; 36 infected (13 male, 23 female) in total population of 316. (See Epidemics). Dzondi, K. H. Halle. Prof, of Medicine. " Neue zuverlassige Heilart der Lustseuche " Halle, 1826. Case, chancre of the groin, in a woman 80 years old, infection through an undergarment (p. 5). Ebrard, E. Paris. "Neuroses syphilitiques." Gaz. med de Paris, 1843, Feb. 25, p. 120. (Lagneau, fils "Mai. syph. du syst. nerv." Obs. 123). Case, woman infected by nursling ; cerebral syphilis. Edes, R. T. Boston. Prof. Therapeutics, Harvard University. Boston Med. and Surg. Journal, 1881, CV., p. 250. Case, chancre of eyelid, from application of tongue to eye. Edlefsen. Keil. Prof, in Chiei of the Medical Pohklinik. "Casuis. Beitr. zur Frage von Con tag. der hered. Syph., Berlin, klin. Wochenschr. 1876, No. 5, p. 60. Case, grand-mother acquired syphilis from infant which she tended; site and mode unknown. Egan, J. C. Dublin. Surgeon, Westmoreland Lock Hospital. Dublin Quarterly Journ., May, 1846; London Lancet, Aug. 22, 1846. Cases of extra-genital infection, afterward embodied in "Syphilitic Diseases," etc., London, 1853, p. 296. 1) Case, chancre of left breast, from nursing syphilitic infant. 2) Case, chancre, both breasts, from nursing syphilitic infant. 3) Case, chancre on neck, site of pin scratch, inoculated from mouth of syphilitic infant, (p, 302). 4) Case, infection, probably on tongue, from kissing syphilitic infant in the mouth, and about nates, (p. 304). Eichman. Schmidt's Jahrbucher, LXXXIII., p. 184. Case, woman infected by kissing an infant relative. Elliot, G. T. New York. Skin and Cancer Hospital, Ass't Physician. Journ. of Cutan : and Genito-urinary Diseases, 1888, p. 334. Case, faucial chancre in a young girl, from lover. Elliotson, J. London. "On secondary syphilitic transmission," Med. Times and Gaz., London, Sept. 4, 1858. Case, possible transmission by a comb; first symptoms being a localized syphilide of scalp (such cases have occurred). Ellis, E. London. Victoria Hospital for Sick Children, Physician. "Pract. Man. of the Diseases of Children," New York, 1879 (3d ed., in Wood's Library for 1879). Case, nurse infected by nursling. Eltzina, Z. J. Vratsch, 1882, Nos. 50-51. 1) Statistics from rural districts of Russia: of 55 syphilitic peasants, observed in the Krapivna district, 45 were infected extra-genitally ; 43 through family life; and 2 through suckling (most of the cases were in children) only two by coitus. Vratsch, 1S89, p. 155 (Brit. Journ." of Dermatol., 1889, p. 424). 2) Case, chancre, left little finger, girl aged 13 months; parents and family healthy; infected by caress of stranger. Emser, H. Ulm. Chaplain to George of Saxony, 1504. " Miracula St. Bennonis. . . Acta sanctorum," Rome, 1521, (Fuch's " Die Aelteste Schrifts. u. Leusts." Gottingen, 1843, p. 330). Account of numbers with Morbus Gatiecus, miraculously cured by St. Benno ; among these, many from the same family, and many children. ANALYTICAL BIBLIOGRAPHY 283 Engelsted, S. Copenhagen. Kommunspital. " Veneriske Sygdome." Copenhagen, 1876. 1) Three cases, chancre of finger, in midwives (p. 34). 2) Case, chancre of lip from a cigar stump (p. 33). 3) Case, a two-year-old child, with acquired syphilis, and cerebral soft- ening (p. 239, case 37). 4) Case, an adult heredito-syphilitic, had a hospital record of infecting his wet-nurse in infancy (p. 326). 5) Case, similar, with addition of nurse infecting own child (p. 305). 6) Statistical ; children with acquired syphilis in Comm. Hosp. (p. 324). Erichsen, J. E. London. Westminster Hospital. Surgeon to the Queen. Report of Army and Navy Commission, etc., London, 1867. 1) Case, infection from kissing, probable chancre of tongue (p. 430). 2) Case, similar to above, infection per os, kissing (p. 430). Escherich. " Zur Untersuchung gegen Dr. Hiibner in Hollfeld wegen fahrlassiger Korperverletzung durch Impfang " Arztliches Intelligenzblatt 1S54, No. 25, p. 198. Hiibner inoculated directly 8 children, and 9 indirectly, with syphilis by vaccination (see Hubner). Esof. Vierteljahr. f. Derm. u. Syph., 1889, XXL, p. 253. Case, chancre of eyelid in a woman, from the entrance of amniotic fluid. Estlander, J. Helsingfors. Eye-clinic. Klin. Monatsblatt. Zehender's, 1870, 259. (Hock, q. v.). Family epidemic, discovered through a gumma of conjunctiva in one member, ten years later. Eulenberg. Berlin. " Uebertragung der Syph. durch Vaccination." Berliner klin. Wochenschr., 1872, No. 38 (p. 461). 1) Case of vaccino-syphilis, 7 months after vaccination. (See Epidemics). Handb. des offentlichen Gesundheitswesens, Bd. I, Berlin, 1SS1. (Article: Beschneidung) Archiv f. Derm. u. Syph., 1883 (p. 289). 2) Circumcision syphilis. Tageblatt der Naturforscherversammlung zu Leipzig (Archiv f. Derm. u. Syph., 1883, p. 543)- 3) Vaccination syphilis. Eustachius, Rudius. Padua, Univ. Prof, of Medicine. '' De morbo gallico libri v." Venetiis, 1604. (Edited by Mundinus). (Girtanner., "Bibliogr." and Simon " Die Leustseuche," etc.). 1) Case, nurse infects two nurslings (probably the converse was the case). Lib. I., cp. VIII). 2) Case, chancre of tongue from kissing. Everardus, A. Middelbourg, Seeland. " Die Neu-erweckte Sauger-seuehc in ihrer Vergleichung mit der Frant- zosen oder Indianiscnen Krankheit, etc.," (from the Latin edition of the author : bound with Blancaard, and other Dutch and English authors, Leipzig, 1689). (See also Rosen von Rosenstein " Kinder- krankheiten "Gottingen, 1798, p. 728). Epidemic, afterwards endemic, in Seeland, 1654, which began from breast-drawing. (See Epidemics). Evmenieff, V. A. A report of syphilis in the Ostrogoshsk Voronej Govern., 1 885-1 886 (Med. Beseda, 1S88, p. 7-10). Statement: Among 2653 cases of syphilis observed among the peasants, 1246 or 46.9 per cent, were affected through domestic propagation, 80 by inheritance, 390 by coitus, and in 937 eases, the mode was undetermined. Extra-genital syphilis is especially spread by children, 284 SYPHILIS INSONTIUM with play-things, common meats, breads, sweets, etc. — infection through the mouth is most frequent. Ewertzen. Fredricksborg. District and Batallions Physician. Froriep's Notizen, Weimar, 1832, No. 745, from Danish Bibliothek f. Lager. Epidemic of vaccino-syphilis, Fredricksborg, 1830. (See Epidemics). Fabre, P. Paris. "Traite des malad. vener." Paris, 1775. Case, probably faucial chancre, conjugal, in wife (p. 9). " De la syph. chez les femmes enceintes chezles nour. et chez les enfans." Bibliotheque de med. prat. Paris, 1848, VIII. (p. 610-654). (Proksch, "Die Litteratur iiber die Vener-Krankh. Bonn. 1891, 3te Bd. p. 26). Fabricius de Hilden. Obs. chir. et med., 1716, centur. i, obs. c. (Lancereaux — "A treatise on Syphilis, etc." New Sydenham Soc. London, 1869, Vol. II., p. 246). Case, infection of girl of 15 years from wearing the drawers of a male friend in a carnival. Facen, J. Milan. Gaz. med., Lombard., Mai, 1849 (Gaz. med. de Paris, 1849). 1) Small lactation epidemic. 2) An account of " Facaldina," (No. 21, p. 183). (Quoted by Lancereaux Treatise on Syph., etc., 1868, p. 41)*. Faguer. Four cases, chancre of the tonsil in one family. (See Rollet 8 ). Falcone, T. Naples. " Contrib. di patologia e clmica Dermatosifilopatica." Giorn. ital. di mal. vener. etc., Milano, 1887, XXVIII., No. 3. Case, chancre, inner canthus right eye, from use of an opera-glass (p. 142). Fallopius, G. Padua and Pisa. Prof, of Anatomy. "Tract, de morbo Gallico." Edited by Peter Angelus, Patavia, 1564. (Girtanner, 151). Case, chancre of buttocks in an old man from the privy-seat of a house where several syphilitics were lodging. Fano. Paris. Hop. du Midi. (Interne). Fournier "Chancre cephalique." 1858. 1) Two cases, chancre of the lip. Jour, d'oculistique et de chir., Mar. 25, 1874, (cited by Touchaleaume, q. v., p. 14). 2) Case, chancre, bulbar conjunctiva. Farlow. Boston. Boston Soc. for Medical Improvement, Nov. 2S, 1S92. Boston Med. and . Surg. Journ., Jan. 5, 1893. Case, chancre, upper lip, man, mode of infection not stated. Farre, A. London. Report of Army and Navy Commission, etc., 1867 Cases, no documents, of nurses infected by nurslings, p. 472. Farriols, A. Barcelona. Gaceta san.de Barcelona, 1SS8-9, I., p. 152 (known only by title "Chancro sifilitico en la mejella derecha"). Case, chancre of right cheek. Faught, G. G. Philadelphia. New York Medical Record, 1S91, XL., p. 511. Case, chancre of the gum, in a woman 19 years old, from kissing a man with syphilitic mouth lesions. ANALYTICAL BIBLLOGRAPHY 285 Favier. Lyons. Rollet "Traite d. mal. ven." 1865, p. 617. Case, chancre of tonsil. Fedchenko, N. P. "Three cases of chancre after shaving," Medezinskoje Obozrenie, 1S90. No. 1, p. 19, (Vratsch, 1891, No. 44, p. 989). 1) Case, chancre on the neck, below the left lower jaw. 2) Case, chancre on the chin, in a student, after cutting a comedo with a razor recently bought. 3) Case, chancre on the angle of the lower right jaw. Fedotow, A. A. See Kedotoff. Feibes, E. Aix-la-Chapelle. Berliner klin. Wochenschr., 1889, No. 23, p. 519. Case, chancre of the cheek, in a man 25 years old, after shaving by barber. Fenwick, G. Montreal. Canada Med. and Surg. Journ., Aug., 1875 (Reported by Cline). Case, chancre of eyelid, source unknown, unless from towel used by room-mate. Fereol. Progres med., 1SS1, No. 46, p. 916. (Annales de Derm, et de Syph. 1882, p. 129). Case, syphilis, communicated by epidermic. grafts (Deubel's case, q. v.). Fernandez, J. S. "Observacion clinica di un chancro indurado del parpado superior del lado izquierdo recogida en la sala de Sante Tomas del doctor Lailler" — Anfiteatro anatom. Madrid, 1875, III., p. 433.* Case, chancre, upper eyelid. Fernelius, J. Paris. Physician to the King of France. "De abditis rerum causis, lib. II., 1548, II., cp. XIII. (also Girtanner 152). 1) Nurses infected on the breast by syphilitic nurslings. 2) Infection on the lip, by kissing. 3) Midwives, inoculated on the finger, by professional exposure. Feulard, H. Paris, Hop. St. Louis, Chef de clinique. Annales de Derm, et de Syph, 1890, p. 320. 1) Statistics of extra-genital chancres at clinic in 1889: 34 in all (exclud- ing multiples); lips 19, tongue 3, tonsil 1, chin 1, breast 3, finger 3, arm (vaccination) 2, anus (infant) 1, abdomen and inguinal 1. Annales de Derm, et de Syph., 1891, p. 220 (Soc. de Derm, et de Syph.). 2) Case, chancres on both arms, acquired in hospital, during treatment for scabies (see Fournier). Annales de Derm, et de Syph., Vol, III., 1892, No. 7, p. S05. 3) Statistics from Fournier's clinic, Feb. 1, to Nov. 1, 1891: 75 cases extra-genital chancre, 48 men, 24 women, 3 infants; S6 chancres altogether presented, of these 68 were cephalic as follows: upper lip, 25, lower lip, 14, labial commissure, 7, tongue, 4, tonsils, 6, cheek, 2, chin, 10, the remaining 18 as follows: breast, 5, anus, 4, umbilicus, 1, forearm, 3, fingers, 4, thigh, 1. Trans. Soc. de derm, et de syph., Seance, Nov. 10, 1892 (Annales de Derm, et de Syph., Vol. III., 1892, No. 11, p. 1156). 4) Case, chancre, left cheek, in male infant of 2 years ; infection probably from neighbor in whose care the child was left (service of Granciikr). 5) Case, chancre lower lip, near left angle of mouth in little girl of y/z years, from syphilitic mother. 6) Case, chancre, left cheek, near outer part lower eyelid, in boy of 4 years, infection from maternal uncle. 7) Statement: the last three cases were observed in a period of less than 286 SYPHILIS INSONTIUM 4 months, among n cases of infantile syphilis observed in the clinic since Dec. 1891. Fieuzal, J. Paris. Bullet, de la clin. nationale ophthalmol. des Quinze-Vingts, T. I., Paris, 1883. Case, chancre of eyelid, source unknown (p. 158). Finger, E. Vienna. (Prof. Zeissl's and Prof. Neumann's Clinics). " Ueber ein const, nerv. storung, etc.," Viertelj. f. Derm. u. Syph,, 1881, P- 273. . 1) Case, chancre of upper lip, left side. Aerztl. Bericht. d. k. k. Allg. Krankenh., Wien (1882), 1883, p. 132. 2) Frequency and seat of syphilitic primary lesions. " Die Syphilis u. d. venerische Krankheiten, Wien, 1886. 3) Case, chancre of lip, from cigar stump, p. 14. 4) Four cases of infection from bites ; chancre of nose, ear, thumb, toe. Fischer, H. Breslau. Univ. Prof, of Surgery. Case of circumcision syphilis, (See Jaffe). Fisher, C. I. Supt. State Alms House, Tewksbury, Mass. " Necessity of social and statute recognition of syphilis." Boston Med. and Surg. Journ., July 31, 1890. Case, chancre of lip, in female domestic, cause not stated. Fitz. U. S. Military Service. Case, chancre of lip, in a soldier from a comrade, through drinking from the orifice of a faucet. (See Arthur). Fitzgerald, T. A. Dublin. Dublin Eye Infirmary. (De Beck q. v. personal communication, from Dr. F.). Two cases, chancre of eyelid, personal, and one not elsewhere mentioned, seen 1868, at Lailler's Clinic, Hop. St. Louis. Fitzgibbon, H. Dublin. President Royal Coll. Surg. , Ireland. Pres. address, "Syphilis," Dublin, 1888 (Edinb. Med. Journ., 1889, XXXIV., p. 854. Also London Med. Rec., 1889, No. 15). 1) Case, chancre of lower lip, banker, counting roll of bank bills, stolen by a prostitute and hid in her vagina. 2) Case, chancre of right thigh, in a girl of 14, in the site of chafe from riding saddle, from exposure to seat of a railway water closet. Flamande. Journ. complem. d. Diet. d. sci. med., V., p. 135. Domestic epidemic at Chavanne-Lure, 1828. (See Epidemics). Fleischer, A. Kiew. Prof, in the University. Proceed. Soc. of Physicians of Kiew, 1885-86, p. 73, (London Lancet, 1886, Vol. II., p. 988). Two cases, chancre of chin, in site of razor cut. Fonseca, L. da. Lisbon. " Cancro prim, syphilitico da palpebra," Archiv. ophthalmo-ther. de Lisboa, 1881, II., p. 60. Case, cnancre of eyelid, source unknown. Fontanus, N. Amsterdam. Prof, of Anatomy. " Respons. et curat, medic", 1637 (Girtanner No. 386). Case of syphilitic infection by mere contact. Foot, Jesse. "Important researches upon the existence, nature, and communication of venereal infection in pregnant women, new-born infants and nurses, by the late P. A. O. Mahon. These are contrasted with the new opinions of the late John Hunter upon this subject, together with observations thereon." London, 1808, 8°, pp. IV, 5-1 10*. ANALYTICAL BIBLIOGRAPHY 287 Ford, W. H. St. Louis Med. and Surg. Journ., 1881, XL., p. 158. Case, chancre on shoulder of nurse, from syphilitic child. Forestus, P. Leydem Univ. Prof, of Medicine. "Observ. et cur. med. et chirurg., libri XXXII. ," Lugduni-Batavorum, 1591-1606 (Girtanner No. 146) (Rosex vox Rosexsteix "Kinderk." Gottingen, 1798, p. 728). Case, triple infection, of nature of family epidemic ; nurse from nursling, infecting her own two children. Fortin. Paris. "Transmission de la syphilis d'un nourrisson a un nourrice." L'Union medicale, 1866, 135, 136. Case, syphilis communicated from a nursling to nurse. Fortuniades. " Etude sur le chan. syph. des paupieres." These de Paris, 1890 (Annales de Derm, et de Syph., 1890, p. 83S). Review of subject ; making chancre of eyelids, 3 per cent, of extra-genital chancres. Foster, F. P. New York. Chief of Vaccine Department, N. Y. Dispensary. Amer. Journ. of Syph. and Dermat., Vol. I., 1S70, pp. 189, 293; Vol. II., 1871, p. 40. 1) An able review of the reported cases of vaccinal-syphilis to date. 2) Case, chancre of tonsil (reported by Fox, G. H., 6 q. v.). Foucart, A. Gaz. des Hop., Paris, 1844, No. 11, p. 41. Case, chancre of nipple, from syphilitic nursling. Fournie, E. Paris. Institution for Deaf and Dumb. L'Union med., 1863, XVIII., p. 583. Case, chancre of pharynx, Eustachian infection, first case on record. Fournier, A. Paris. Hop. Lourcine and St. Louis. L'Union med., 1858, and " Lecons sur la chancre," Paris, 1858-60. Appendix. 1) 19 cases, extra-genital chancre, personal, (service of Ricord), (p. 247- 250). 2) 58 cases, extra-genital chancre (Puche, 28, p. 246; Caby, 7, p. 250; and others, 23). " De la contagion syphilitique." Paris, i860. 3) Case, chancre of upper lip, man 23 years old (p. 54). 4) Case, chancre of lower lip, man 21 years old (p. 56). Archiv. gen. de med., Paris, 1863, Ser. VI., Vol. II., p. 237. 5) Case, chancre of tonsil, Eustachian tube inoculation. 11 Soc. med. des Hop.," L'Union med., 1864, XXIV., p. 264; also, ibid., No. 129, p. 216. 6) Two cases, chancre from Eustachian tube inoculation. Dictionnaire de med. et de chirurg. prat., 1867, VII., p. 75, 7) Statistics, of two hundred cases of cephalic chancre. (Reported 1869, by Audoynaud, q. v. These de Paris). 8) Two cases, chancre of nipple, nurses from nurslings. "Legons sur la syph. etud. plus partic. chez la femme." Paris, 1S73 (Clinic of the Lourcine). 9) Three cases, chancre from using syringe and infected instruments (P. 55). 10) Case, chancre in female child, Eustachian tube inoculation (p. 55). 11) Case, chancre of lip (p. 56). 12) Case, chancre of the finger in a girl (p. 52). (Reported, 1875, by Appay, q. v.). 13) Case, chancre of right nipple, nurse from nursling (p. 98). SYPHILIS INSONTIUM 14) Case, chancre of left nipple, female, aged 18 years, from kiss by lover (pp. 60, 102). (Reported 1876, by Saw, q. v. These de Paris). 15) Case, chancre of eyelid, in physician, from saliva (p. 63). Annales de Derm, et de Syph., Vol. VIII. , 1876. 16) Case, chancre of neck, in man 22 years old, from a bite (p. 64). 1 7) Case, chancre of neck, in a female (p. 66). Gaz. des Hop., Paris, 1877, P- 1109. 18) Case, chancre of both nipples, nurse from nursling, patient 27 years old. 19) Case, 23 chancres of both nipples, (16 on right, 7 on left,) patient 26 years old. (Reported by A. Sturge, q. v.) Med. Times and Gaz., London, 1877, II., p. 116. 20) Case, chancre of right nipple, from nursling; A. M. , female, 32 years old. 21) Case, chancre of left nipple, from nursling; E. C. B. , female, 34 years old. 22) Case, chancre of left nipple, from nursling; A. B., 28 years old. 23) Case, chancre of tongue, child from its nurse. (Reported, 1878, by A. Pontet, q. v. These de Paris). 24) Case, chancre of vulva, child seven weeks old, from a sponge (p. 10). 25) Case, chancre in a child, 18 months old., from its nurse (p. 15). " Nourrices et Nourrissons Syphilitiques," Paris, 1878. 26) Case, nurse infected by nursling (p. 9). 27) Case, syphilis in husband of above nurse (p. 9). 28) Case of Delore (p. 9) ; four cases of Dron (pp. 66-67) ; six cases before tribunals, nurses from nurslings. (Reported by HuLOTq. v.) Annales de Derm, etde Syph., Vol. X., 1879^.29. 29) Eighteen cases, from service of Fournier. " Syphilis et mariage." Paris, 1880. 30) Case, nursling, infected by nurse, infecting its mother, grand- mother, and two nursery maids (p. 211). 31) Case of Hillairet (p. 211), infant infects both grand parents by nursing bottle. 32) Nine cases, extra-genital chancre; lip 4, finger 2, nose 1, Eustachian tube 1, breast 1 (pp. 231-264). (Reported, 1880, by Jumon, q. v. These de Paris). 33) Four cases, extra-genital chancre. (Reported, 1882, by Guignard, q. v. These de Paris, pp. 24, 53). 34) Cases, chancre of nose and one of tonsil. Semainemed., Paris, 1882, II., p. 125. 35) Seven cases; tongue 1, forearm 1, and five with site not mentioned. (Reported by Lavergne, q. v.) Annales de Derm, et de Syph., 1884, pp. 332, 380. 36) Statistics; 27 extra-genital cases. (Reported, 1884, by Zwetitch, q. v. These de Paris). 37) Four cases, chancre of chin, presumably from shaving. (Reported, 1885, by Lesage q. v. These de Paris). 38) Two cases, chancre from tooth wounds. " Logons sur la periode preataxique du tabes d'orig. syph.'' Paris, 1885. 39) Case, chancre of chin (p. 331, Obs. 85). 40) Case, chancre of right little finger, man of 43 years (pp. 228, 414). (See Bo u illy). 41) Case, chancre of throat (p. 332, Obs. 8S). 42) Case, chancre of lip, man 21 years old (p. 353, note V). Annales de Derm, et de Syph. Paris, 1886, p. 87. 43) Case, chancre in furrow behind ear in woman of 24 from husband. (Case of Hermet). Semaine med., 1886, No. 49. , ANALYTICAL BIBLIOGRAPHY 289 44) Two cases, infection, nurse from nursling, one infected her own child. H. Belfast. Lancet, July 18, 1846. II., p. 62.* Case, nurse infected by syphilitic nursling (see Egan 4 ). Gay. Boston Med. Soc, Jan. 25, 1858; Boston Med. and Surg. Journ. Vol. 58, p. 163. Case, chancre of the end of finger. Gay, A. H. Kasan, Russia. Protocol, first congr. Russian Phys., St. Petersburg, 1886 (p. 43-45). 1) Two cases of chancre of tonsil, seen in 14 years. "Lectures on syphilitic and venereal diseases," Kasan, 3d ed., 1888. (Viertelj. f. Derm. u. Syph., 1890, p. 501). (See also British Journ. of Derm., Vol. I., 1889, p r 424). 2) Statistics of extra-genital chancre: 8.9 per cent, (males 3.8; females 18.9). 3) Total personal cases 118: lips 39, eyelids 4, nose 4, cheeks 2, chin 2, pharynx 14, breast 13, trunk 32, legs 4, fingers 2, arm 1, anus 1. Gayet. Lyons, Surgeon to Hosp. de l'Antiquaille. Case, chancre of forehead, in site of a dog bite (Jullien, 1886, p. 588). Geber, E. Vienna. Viertelj. fiir Derm. u. Syph., 1875, p. 445. "Aleppo boil" : a term used to represent chronic ulcerative lesions, largely syphilis, lupus or scrofula. Geigel, A. Wurzburg. "Bernard Holzheuscr, etc.," Viertelj. f. Derm. u. Syph., 1S71, p. 397. 1) Epidemic of syphilis from cupping, 1615, at Sommerach, Franconia; reproduction of the forensic documents. "Geschichte, Pathologic und Therapie dcr Syphilis," Wiirzburg, 1867. 2) Cases of PoiLROUX, earliest known of infection by tattooing (p. 223). Gemma, A. M. Verona, Italy. Giorn. ital. d. mal. ven. c d. pelle, 1873, p. 207; 1S74, pp. 22, 344; 1S75, p. 153; 1876, pp. 3, 203; 1877, pp. 141, 235. 1) Twelve eases of syphilis insontium, mainly from nursing and family propagation. Giorn. ital. d. mal ven. e d. pelle, 18S3, p. 294. 2) Case, nurse infected by nursling. 294 SYPHILIS INSONTIUM Gemy. France. Prof. Medical College of Algeria. Annales de Derm, et de Syph. Vol. I., ser. III., 1890. 1) Case, chancre of left nares, source unknown (p. 571). 2) Case, chancre of lower lip, source not stated (p. 579). Genters, W. Der Morbus Dithmarsicus. Dissert. Inaug., Kiel, 1878. Gery. Paris. Case, chancre of the hand, from bite (see Beauvais 2 ). Gibert, C. M. Paris. Hop. Lourcine; Hop. St. Louis. "Manuel pratique des malad. vener." Paris, 1837. 1) Small family epidemic from lactation (p. 325). 2) Case, nursling infected by nurse, chancre of lip (p. 637). 3) Case, nursling bites mother's nipple and a chancre develops; at same time infant shows signs of syphilis (p. 638). 4) Case, syphilis d'emblee in woman, bottle-feeding an infected child; own child, chancre of lip (p. 638). Bull de l'Acad. de med. Paris, Sept. 28, 1852. (Reference of Putegnat). 5) Case, chancre of tonsil, in a pregnant woman. "Traite prat, des malad. d. 1. peau et de syph." 3d ed. Paris, i860. 6) Case, chancre of tonsil, from forcible kissing (p. 14). Gibier-de-Savigny. Paris. Hop. du Midi (Service of Horteloup). L'Union med., t88o. 3d Ser., XXX., No. 127, p. 523, Case, chancre of the septum narium. Gilbert, A. Paris. Hop. des Veneriens. Case, nurse infected by nursling (reported by Vassal 3 , q. v.). Gilchrist, E. " An account of a very infectious distemper prevailing in many places." Essays and Obs. Phil. Soc, Edinb,, 1771, iii., 154-177* (quoted by Boeck, "Traite d. 1. Radesyge," etc., i860, p. 49). A personal account of Sibbens. Gillebert-D'Hercourt, fils. Paris. Annales de Derm, et de Syph., 1880, p. 746. Case, chancre of upper gum, between median incisors. Gilles de la Tourette and Hudelo. Annales de Derm, et de Syph., Vol. III., June, 1892, p. 686. Case, probable chancre of tonsil in man of 37, cause not stated. Giovannini, S. Bologna. Prof. Gamberini's Univ. Clinic for Skin and Venereal Diseases. " Contribuzione alia Statis. dei Sifilomi inizioli Extra-genitali." Lo Speri- mentale, 1889, No. 9 (p. 262). (Archiv f. Derm. u. Syph., Vol. XXII., 1890, p. 276). 1) Ten cases, chancre of the lip. 2) Case, chancre of lower lip, from wound by dental instrument. 3) Case, chancre of lower lip, in woman, from gnawing chicken bone after her syphilitic son. 4) Seven cases, chancre of breast, nurses from nurslings. 5) Four cases, chancre of chin. 6) Two cases, chancre of cheek, one of which was from razor inoculation, 7) Two cases, chancre of thigh. 8) Case, chancre of lower eyelid. 9) Three cases, chancre of the trunk. 10) Case, chancre of finger from a bite. Girode. Paris. Hop. St. Louis. (Service of Lailler). "Chancre syph. developpe sur lis lesiones d' une Gingivite phosphoree," France Medicale, Paris, 188S, I., p. 397. Case, chancre of gum, in 22-year-old girl, working in match factory, from drinking-glass. ANALYTICAL BIBLIOGRAPHY 295 Girtanner, Chr. Gottingen. Abhandl. ii. d. vener. Krankh., Gottingen. Vol. I., 1797 (3d edit.). Vol. II.. III., 1793 (2d edit.). The last two volumes consist of an analytical bibliography of 1912 works arranged chronologically, and numbered consecutively: these numbers are referred to when quoting Girtanner. Glasunowski, V. Wratchebnyja Wiedomosti, 1882, No. 507 (Russian) (Archiv f. Derm. u. Syph., 1889, p. 240). Statement; among 3012 syphilitic patients in the district of Voronesch (South Russia), there were 331 boys and 332 girls, from one to ten years of age affected with mucous patches. Glatter. Oesterr. Zeitschr. f. prakt. Heilk., 1862, VIII. 4. (Schmidt's Jahrb., 1863. Vol. CXX., p. 106). Epidemic of vaccino-syphilis at Csomad, Hungary. Midwife, chancre of arm, infected grand-child : many vaccinated from child became syphilitic, many nursing mothers acquired chancres of breast, and others from family utensils ; finally, 72 persons became syphilitic. (See Epidemics). Glauert. Berlin, klin. Wochen., 1882, No. 49, p. 751. Case, chancre, right tonsil, in man of 25 years, source unknown. Gluck. Cracow. Univ. Clinic for Syphilis. Wiener med. Presse, 1881, No. 32. 1) Statistics, Hop. St. Lazare, 1873-8: chancre, breast, 8 cases. (Service Prof. Zarewicz, q. v.). Wiener med. Presse, 1888, Nos. 27, 28. 2) Case, chancre of hairy scalp, 3) Case, chancre, naso-labial fold, both from shaving by syphilitic barber. 4) Case, chancre of lip, 5-year-old child, from neighbor's spoon. 5) Case, chancre of lip, boy of 9, from chewing lead pencil of class-mate. 6) Case, chancre of tonsil, woman, from kissing female friend. Gnocchi, G. Indipendente, Torino XXXIII. p. 145-157. Epidemic at Romentino di Novara, 1 880-1 (known only by title). Goldenberg, H. New York. Scientific meeting of German Physicians of New York, Nov. 28, 1S90. New Yorker med. Monatschrift, Feb. 1891. 1) Case, chancre of elbow, after trauma. Scientific meeting of German Physicians of New York, Nov. 1891. New Yorker med. Monatschrift, Mar., 1892. 2) Case, chancre, prepuce and glans penis after circumcision. Scieniific meeting of German Physicians of New York, Mar., 1892. New Yorker med. Monatschrift, Aug., 1892. 3) Case, chancre, left lower eyelid, cause not ascertained. Presented at the Scientific Meeting of German Physicians of New York, Sept. or Oct., 1890 (unpublished). 4) Case, chancre, cheek, after shaving. Gondonin, A. Argentan. L' Union med. Paris, 1869 (P- 553)- Case, chancre of tonsil, nurse from nursling (see Appay 5 ). Goodell, Wm. Philadelphia. Prof, of Gynecology, Univ. of Penn. "The danger of Syphilitic Infection by Gynecologists." Annals of Gynecol, and Pediatry, 1890, III., p. 262. 296 SYPHILIS 1NS0NTIUM 1) Case, chancre of finger, in student, acquired while working in ven- ereal wards. 2) Case, chancre of finger, in physician, from delivering a syphilitic woman. 3) Two other cases, syphilis in physicians, from midwifery practice. 4) Case, chancre of tonsil, in a lady, source of infection unknown. Gosselin. Paris. Surgeon to Charite. 1) Case, chancre of septum narium (see Dulac). 2) Case, chancre of eyelid (see Guignard 6 ). 3) Case or cases, of Eustachian-infection, according to Jullien 7 and others ; not known if ever reported. Gottheil, W. S. New York. New York Med. Journ., Mar. 19, 1892, p. 327. Case, chancre, upper lip, in girl of 19 years, cigar finisher, acquired probably in drinking from same cup with another girl with a similar sore on the lip. Both finished the cigars by moistening the ends with saliva. Gould, A. P. London. Lancet, 18S2, II., p. 777. Case, chancre of cheek. Graarud, P. Tidskrift for prakt. med., 1886, No. 20, Aug. 5. (Viertelj. f. Derm. u. Syph., 1887, p. 385)'. Family infection ; a family of three receive each chancre of throat, from pipes or glasses. Grafe-Samisch's Handbuch der Augenheilkunde, 1875, Bd. IV., p. 417. (Archiv f. Derm. u. Syph., Vol. XX., 1888, p. 16). Case, chancre of eyelid. Grancini and Dall'Acqua. "II vaccino ammale ed il vaccino umanizzato," Milan, 1879. (Cited by Sormanni, q. v.). Epidemic of vaccino-syphilis ; 1873 at Bardelle, Bergona and other places. (See Epidemics). Grandmond, G. de. Journ. de Med. de Paris, 1886, No. 12. Case, chancre of conjunctiva, woman 26 years old, source unknown. Gratia, V. Brussels. Hop. St. Pierre (Prof. Thiry). Presse med. Beiges, Bruxelles, XXX., 1878, pp. 257-2S1. 1) Case, chancre of eyelid in woman; husband, chancre of lip, commis- sure — infected by kissing. 2) Case, chancre of eyelid, probably from digital auto-infection after venereal exposure. 3) Case, alleged multiple chancre on different regions of body, one on eyelid. Greenleaf. United States Military Surgeon. Case, chancre of lip in a musician, from mouthpiece of a cornet. (See Arthur 4 ). Griffin, E. H. New York. Reprint from N. Y. Med. Record for Aug. 22d, 1891 and Oct. 1st, 1892 (P- 393)- 1) Case, chancre lower lip near centre in boy of 9 years, drinking from tin beer pail used in common by several workmen (p. 3). 2) Case, chancre right tonsil in 12-year-old brother of above from stick of candy sucked by the former (p. 5). 3) Case, chancre middle of upper lip in 15-year-old sister of above boys from kissing them (p. 6). ANALYTICAL BIBLIOGRAPHY 297 4) Case, chancre of right tonsil in boy of 8 years from unnatural practices (p. 7). 5) Case, chancre lip in actress of 24 years from rouge used in common with fellow-actress with syphilitic sore mouth, it was rubbed on the lips with the finger (p. 7). 6) Case, chancre lip in girl of 18 years from kissing (p. 7). 7) Case, chancre lip in young married woman of 23 years, husband had fever blisters (p. 7). 8) Case, chancre upper lip in man of 42 years, drinking whiskey in common from flask (p. 8). 9) Case, chancre under surface of tongue in female, husband had mucous patches in mouth (p. S). 10) Case, chancre upper lip in married woman of 28 years, from husband by kissing (p. 3). 11) Case, chancre lip in woman, from her husband (p. 8). 12) Case, chancre lip in female cook, from kiss of lover (p. 8). (The above twelve cases were total number extra-genital chancres observed among 1,200 cases of syphilis examined). 13) Case, chancre lip in woman from husband by kissing (p. 15). Griffith, A. H. Manchester, Assist.-Surg. Royal Eye Hospital. " Syphilitic lesions of the eyelids.'' Med. Chron., 1886. Vol. IV., No. 3 (p. 193). (Jahresber. f. Ophth., 1S86, XVII., pp. 250-441). Nine cases, chancre of eyelid. Grigorov, S. W. Moscow, Mjasnitsky Hospital. Protoc. d. Conf. d. Aerzte d. M. Krankenhaus, 188c. Case, chancre of right tonsil, in an attendant. Groedinger, R. Riga. Royal Alexander Hospital. Report of Syphil. Division of the Hospital, Riga, 1885. (Cited by Peter- sex, q. v.). Statistics among 231 cases: chancre of lip 2, of finger 1. Gromier. Givors. (Cited by Guinand, q. v., from original mention in Diday's Gaz. med. de Lyon). Three cases, chancre of lip, in glass-blowers, Givors, 1875. (Seen by Gromier and Diday). Gros, F. Nancy. Prof. Clinical Surgery. " Sur le chancre de la bouche." Rev. med. de l'Estrange, 1S79, XI. (P- 145). Case, chancre of lip, in an omnibus conductor, from use of whistle. Gross, S. D. Philadelphia, U. S. A. Prof, of Surg., Jefferson Med. Coll. Address in Surgery. Transac. Amer. Med. Assoc, Vol. XXV., 1874, P. 255- 1) Case, chancre of lip in young lady, from her betrothed, afterwards husband. 2) Two cases, medical men professionally infected and in turn infected their wives. 3) Statement, without documents; has seen many cases of infection from kissing. 4) See also Price, J. H. Gninfeld, J. Vienna. " Ueber Vererbung u. Uebertrag. von Syph. bei Neugeborcncn, "Wie- ner med. Presse, 1879, XX., p. 1492. 1) Case, chancre of scalp in an infant, mother infected about middle of pregnancy; child infected from mother's parts during parturition. Verb. d. Wien. derm. Gesellsch. (Viertelj. f. Derm. u. Syph., 1892 p. 181). 2) Case, chancre of tongue, man of 45 years. 298 SYPHILIS INSONTIUM Gruner, C. G. Jena. " Die ven. Ansteck. d. gemein. Trinkgesch. , u. durch dengemein. Kelch., etc." Leipzig, 1787 (Rosen von Rosenstein " Kinderkrankheiten," Gottingen 1798, foot-note, p. 729); also Almanach f. Aerzte u. Nichtaerzte, Jena, 1785. Several cases of infection from drinking-glasses. Gubler. Paris. Univ. Prof, of Therapy. " De la syphilisation, etc." Acad, de med., 1853 (p. 284). (Cited by Ricord, q. v.). 1) Case, chancre of eyelid. L'Union med., Paris, 1864, No. 129 (p. 217) (Soc. med. des H6p.). 2) Two cases, chancre, from Eustachian catheterization (one with Sou- chard). 3) Two cases, chancre, from Eustachian catheterization (one with Ricord). Gueniot. Paris. Hop. des Enfants. Case, infant infected by kissing another infant. (See Pontet). Guenzberg, C. Moscow. Royal Foundling Hospital. Oesterr. Jahrb. f. Padiat. II., 1872. (Viertelj. f. Derm. u. Syph., 1873, p. 604). 1) Case, chancre of the tongue in a nursling. 2) Case, another nurse infected by preceding nursling. 3) Three nurslings, infected from a single nurse. Guerrier. Ann. d' hyg., Paris, 1881, 3d Ser., VI., p. 64. Case, nurse infected by nursling. Guevin, A. Paris. Bull, de l'Acad. de med. de Paris, 1869, XXXIV., p. 512. (Gaz. des H6p., July 15, 1869). 1) Case, chancre of the arm in a child from vaccination. . Models in Hop., St. Louis. (See Guignard). 2) Case, chancre of lip, 1868; chancre of nose, 1870. Guibout, E. Paris. Hop., St. Louis. 1) Case, chancre of lip, from a drinking-glass. (See Ory 8 ). 2) Three cases, chancre of lip. (See Zwetitch). 3) Case, chancre of tonsil. (See Le Gendre '). Models, Hop. St. Louis. (See Guignard). 4) Case, chancre, angle of mouth, 1871. "Nouv. Leeonsclin. sur les mal. d. 1. peau," 1879, p. 154. 5) Case, mother infected by own child, hereditarily syphilitic. (Excep- tion to Colles' law). Guignard, C. Paris. "Contribution a 1' etude des chancres syph. extragen." "These de Paris, 1882, No. 97. 1) List of the models of extra-genital chancre at the Hop. St. Louis (p. 15, 21, 24, etc.). 2) Case, of Vicente, chancre in centre of each cheek (pp. 17, 19). 3) Case of Mericamp, chancre of tongue, from a tobacco-pipe (pp. 19, 21). 4) Case of Fournier, chancre of nose, from a bite (p. 24). 5) Case of Mericamp, chancre of forehead in site of wound by a board; probably infected by one who dressed it (p. 26). 6) Case of Gosselin, chancre of eyelid, source unknown (p. 27). 7) Case of Depres, chancre of little finger, from bite (p. 47). 8) Case of Fournier, chancre of tonsil, young virgin, source unknown (P. 53). 9) Case of Martineau, chancre of mouth from speaking-tube (p. 17). ANALYTICAL BIBLIOGRAPHY 299 Guillery. Brussels. Univ. Prof, of Forensic medicine. Gazette Obstetricale, 1879, p. 103. Case, nurse infected by nursling. Guinand, J. Rive-de-Gier. " De la Syphilis des verriers, hvg. et prophyl. par la visite sanit." Paris. 1881. 1) Cases of Gamet of Givors, reported by Rollet, 1867: child of one of the workmen, infected a wet-nurse, who recovered damages, 1500! , at the tribunal St. Etienne (p. 29). 2) Epidemic of Montlucon, cases of Dechaux, q. v.: in 1S6S, new cases appeared, but only in the wives or new-born children, as the com- munity were on their guard (pp. 29-31). 3) Two cases, at Rive-de-Gier, 1872, each chancre of lip: sanitary visits were instituted at this factory and no further cases occurred (pp. 31-33)- 4) Case, infection of glass-blower per os, 1S75, at Rive-de-Gier (p. 33). 5) Three cases of same at Givors, 1875. Dr. Gromier; seen in consulta- tion by Did ay (p. 33). 6) Case, chancre of lip, at Rive-de-Gier, 1879 (p. 33). (See Besnier, remarks when prix Vernois was awarded this essay). Gulli, A. Palermo. " Prostituzione in Sicilia." Vol. I. Palermo, 1863: Vol. II. Torino, 1865. (noted in Giorn. ital. dell. mal. vener. e d. pelle, 1865, I., 157; 1866, I., 286). Epidemic character of Syphilis in Sicily during the cholera of 1837. Guntz, J. E. Dresden. " Bericht iiber die ersten fiinf Jahre des Bestehens der offent. Polik. f. Hautk. u. Syph." Dresden, 1869-1874. 1) Case, chancre of lip, in 6-year-old boy, from drinking-glass. 2) Seven other cases, chancre of the lip. " Ueber Verhiitung der Syphilis," Leipzig, 1870. 3) Case, infection of a gynecologist (p. 59). 4) Case, infection of a physician from a newly-delivered child (p. 59). 5) Case, infection from a musical instrument (p. 90). G) Case, chancre of the lip, in a flower-maker (p. 92). 7) Case, infection by kissing (p. 25). Deutsche med. Wochenschr., June 28, 1879, p. 337. 8) Case, chancre of lip, in a 9-year-old girl. " Ueber die Syphilis der Schuikinder." Memorab., Heilbronn, 1879, XXIV., No. II. pp. 503-507. 9) Eight cases of acquired syphilis in school-boys. *' Chromwasser-behandl. der Syphilis," Dresden, 1883. 10) Case, chancre of lip from kissing. (Obs. 91, p. 125). 11) Three cases, chancre of lip, source unknown. (Obs. 215, 272, 387). 12) Case, inveterate syphilis, ascribed to infection from washing foul linen. (Obs. 223). 13) Family epidemic one of the victims a boy of 13 years, (Obs. 225). 14) Case, child of 4 years, infected 3 years beforeby her sister. (Obs. 299). 15) Case, midwife professionally infected, lung syphilis after 10 Years. [ (Obs. 356). 16) Case, infection of a girl per os, from kissing. (Obs. 361). 17) Case, infection of an infant by its mother, seen 9 years after. (Obs. 369). Guranowski, L. " Przypadek Shankra u uchu Szednim." Gaz. lekarska, Warsaw, 1SS6, 2d Ser. VI., pp. 390-393. Case, chancre in the middle ear (case criticised later by Heiman, Viertelj. f. Derm. u. Syph. 1887, p. 387, as not chancre but tertiary disease). 3°° SYPHILIS INSONTIUM Gurovitch, S- A. Odessa. Meditzinskoie Obozrenie, 1892, No. 6, p. 521. 1) Case, chancre of lip in 19-year-old nurse, from nursling. 2) Statement: observed several cases of acquired syphilis in children. Guttceit, H. von. " Geschichte eines (primar-syphilitischen) Lippen geschwiires." Med. Zeitz. -Russlands. St. Petersb., 1852, No. 41.* Case, chancre of lip. Guyenot, J. F. Lyon. 41 De i'inoculab. de la syph. constitu.'' These de Paris, 1859. Two cases of Lecoq of Cherbourg, Vaccino-Syphilis. Guyon, L. Lyon. "Lemiroir delabeaute," 161 5, T. II. , p. 22(Cazenave, "Traitedes Syph.," 1S43, p. 114). Four apprentices infected from master, through bedding. Haase, C. F. Dresden. "De syphilidis recens natorum pathogenia," Dresden, 1828 (Allgem. med. Annal., 1829, p. 194). 1) Case, nurse receives from nursling lesions which were probably syphilitic (p. 17). 2) Case, nurse infected by nursling (p. 19). (Reported by Ruthenberg, q. v.). Hacker, H. A. Leipzig. 1) " Literatur der syph. Krankh. vom. J. 1794-1829." Leipzig, 1830 (intended as a continuation of Girtanner's Bibliography). Many citations in present Bibliography are on authority of Hacker. 2) "Die Ansteckungsf. Syph. secund Syph. modificata," Schmidt's Jahrb., 1851, LXXIL, p. 103. Treats of various forms of modified syphilis, in different countries; Syphi- loid of Van Deurs, Radesyge, Scherlievo, Facaldina, Frambcesia, Sibbens, Spyrocolon, etc. Hairion, F. Lourain. Prof, of Ophthalmology. "Bubo preauricular, a new diagnostic sign in venereal ophthalmia. '* Ann. d'oculistique, 1846, XV., pp. 156, 236. Case, chancre of eyelid (see Cunier 2 ). Hallopeau. Model in Musee de l'Hop. St. Louis (Annales de Derm, et de Syph.,, August, 1892, p. 951). 1) Case, chancre of anus, developed upon site of hemorrhoids. 2) Case, chancre, back of hand. Hamande. Brussels. Archiv. med. Beiges, Bruxelles, 1879, 3 S,, XV., 194-197. Case, chancre of lower eyelid in a laundryman, employee in laundry of syphilitic ward. Hamerton, C. Dublin. Surgeon to Castletown Dispensary. Dublin Journ. of Med. Science, Mar., 1841, No. 55, p. 34. 1) Two cases, mother and child from nursling and nurse, her sister. 2) Case, chancre of lip, in servant of above, from drawing her breast. 3) Case, chancre, palm of hand, in midwife, during delivery of No. 2. Hamilton. Dublin. 1) Case, syphilitic inoculation by tooth implantation (see Lettsom 2 ). Dublin Med. Journ.. 1848, XX., p. 511. 2) Case, syphilis acquired in infancy. Hardh, C. W. Wadstena. Hosp. for venereal diseases. " Observ. nonnullae medico-pract." Londini Gallorum 1797, Hacker (p. 13). Statement- women and children are infected thrice as often as men, on account of promiscous lactati< n. ANALYTICAL BIBLIOGRAPHY 301 Hardh. J. O. Tavastehns, Finnland. " Nagra Fall of Syphilisinfection genom Koppening" Finnskalak, Sallsk., Helsingfors, 1873, XV., p. 51. Epidemic from wet-cupping, at Tavastehus, 1872, fourteen infected. (See Epidemics). Hardie, G. Surgeon-Major, Army of Great Britain. Report of Army and Navy Commission, 1S67. Case, chancre of finger, in medical man, from operation for fissure in ano (p. 162). Hardy, A. Paris. Hop. St. Louis and Charite. Gaz. des Hop., Paris, 1865, p. 445. 1) Case, chancre of tonsil from lozenge (see Valcourt and Murray). Gaz. des Hop., Paris, 1878, No. 105, pp. 833-835. 2) Case, chancre, ri^ht tonsil, in man 35 years old, probably by Eusta- chian catheterization. (Reported, 1875, by Ory, q. v. These de Paris). 3) Case, syphilitic inoculation of a midwife. 4) Case, chancre of the lip. Traite prat, et descr. des mal. de la Peau, Paris, 18S6. 5) Two cases, chancre of forearm, in nurses (p. 1008). (See Ory 14 ). 6) Case, chancre, inner angle of eye, in physician, from patient with ulcerated throat lesions, coughing in the face. 7) Statement, no documents ; has seen infection at eye, nostril, lip, from pus, etc., on the fingers (p. 118). Harsant, W. H. Bristol. Bristol Medico-Chirurg. Journ. , 1883, L, p. 97. Case, chancre of the lip. Hartley, F. New York. Journ. Cutan. and Gen. Urin. Dis., Vol. IX. 1891, p. 218. Case, chancre in rectum, male, 32 years old, from pederasty. Haslinger, A. Medical Times and Gaz., 1884. Ten cases of extra-genital chancre. Haslund, A. Copenhagen. Kommunhospital. "Syphil. infect, gjennem Svselget." Hosp. Tidende, Copenhagen, 1885, 3 R., III. (p. 629) (Monatsh. f. prakt. Derm., 1885, p. 456). 1) Case, chancre of tonsil, in 20-year-old virgin, from a tooth-brush. 2) Case, chancre of tonsil in 40-year-old woman, from tending heredi- tarily syphilitic child. 3) Two cases, chancre of tonsil, from kissing. Hosp. Tidende, 18S7, V. (p. 217) (Viertelj. f. Derm. u. Syph., 1S8S, p. 642). 4) Case, chancre of tonsil in 11-year-old child, source unknown. 5) Case, chancre of tonsil in a chambermaid, source unknown. Beret, om Kommun. Hosp. (Viertelj. f. Derm, u. Syph., 1888, p. 641). 6) Among 44 syphilitic children, seven had acquired syphilis. Kommunehospitalets 4, Afdeling I., i89o(Archiv f. Derm. u. Syph. Vol. 24, 1 892, p. 108). 7) Nineteen cases of syphilis insontium were treated during the year 1890. Hauff. Besigheim. Hufeland's Journ., Berlin, July, 1S34. Case of Vaccino-syphilis. Hauner. Munich. Children's Clinic. "Ueber Syphilis der Kinder." Behrend's Syphilidologie, New Ser., 1858, (P- 3 76). 1) Statistics: syphilis during decennium, 1845-1855. 2) Three cases of syphilis acquired from foster-mother. (Obs. 5, 6, 60). 3) Four cases, acquired from father or mother. (Obs. 22, 50, 51, 52). 302 SYPHILIS INSONTIUM 4) Case, acquired from grand-mother. (Obs. 45). 5) Case, supposed infection at anus from sponge. (Obs. 16). (All the above from one to three years old). 6) Case, from sleeping with infected person. (Obs. 11). 7) Three cases, children slept with a servant. Haydon, N. J. Bovey Tracey, England. Med. Times and Gazette, London, 1862, L, P- 3*6. Two cases of syphilis, in previously healthy children, after vaccination from a syphilitic child. Hayward, Jr. Boston. Boston Med. and Surg. Journ., Vol. LIX., Jan. 6, 1859, P- 457* 1) Case, chancre of left nipple, nurse from nursling. 2) Case, infection of child of the above. 3) Case, chancre of wrist in the grand-mother. Healey. Dublin. Philosophical Magazine, Vol., XXXIX., p. go. (Colles, q. v. 5 , " Pract. Observ.," 1837, p. 14). Surgeon infects several parturient women, from secondary sore on finger. Hebenstreit, E. B. Leipzig. Translation of Bell's treatise on "Ulcers," Leipzig, 1793, note, pp. 311- 312. Case, or cases of nurses infected by nurslings. Hebra, F. von. Vienna. Allgem. K. K. Krankenhaus. "Dermatol. Abtheilung," Allg. wien. med. Zeit. 1861. Case, nurse infected by nursling. Hebra, H. von. Vienna. Verh. wiener derm. Gesellsch., Viertelj. f. Derm. u. Syph., 1891, p. 831. Case, nurse infected by nursling. Heiberg, J. Surgeon-in-Chief of the Armies of Denmark. Hygien. meddelser (Virchow-Hirsch Jahresbericht, 1883). Epidemic at Aalborg, from glass-blowing, nine infected. (See Epi- demics). Heine, J. Bamberg. "Beitr. zur Lehre von der Syph.," etc., Wiirzburg, 1854, 8°, p. 67. Epidemic of vaccino-syphilis at Frienfels, Bavaria, 1852, the "process Hubner," in which Heine was witness for the state. (See Escherich, Heyfelder, Hubner, and Epidemics). Heinecken. Huf eland's Journal, Vol. VI., 433. Epidemic from breast-drawing. (See Epidemics). Heisler, I. Budapest (Clinic of S. Rona). Orvosi Hetilap., 1S91, No. 8 (Monatsh. f. prakt. Derm. XII., 1S91, p. 419). 1) Case, chancre of chin, in 23-year-old virgin, from a kiss. 2) Case, chancre of left tonsil, in 10-year-old boy, from eating or drink- ing ware. ■ Heister, L. Helmstadt. Univ. Prof, of Medicine. "Compend. Med. Pract." Venetiis, 1763 (Girtanner, 978). Syphilis acquired from a nurse. Heliodore, R. " Des differents modes de transm. de la syph. chez les Nouveaux-nes" These de Paris, 1852, 48.* Helweg. Dissertatio de sic dicta Pseudo-Syphilide, praesertim ea, qua? nonnullis Morbus Dithmarsiensis audit. Acta regise soc. med. Haven, Vol. VI., p. 277 (quoted by Boeck "Traite d. 1. Radesyge" etc., 1S60, P- 47)-* ANALYTICAL BIBLIOGRAPHY 3° 3 Henning, J. Horn's Archiv., 1822, Bd. 42, p. 403 (Hacker, p. 132). (Dieterich "Die Krankheits Familie Syphilis," Landhut, 1S42, Vol. I., p. 137). 1) Case, alleged transmission by a hat band. 2) Case, alleged transmission by cigars, infected by the cigar-rollers. Henri-de-Saint-Arnould. Paris. (Cited by Velpeau, Bull, de l'Acad. de med., 1853). Case, nurse infected by nursling. Henrot, H. Reims. Faculty Prof, of Therapy. Union med. et scient. Nord-est, Reims, 1881, V., p. 243. Case, infant infected by div-nurse; also the mother of infant, from the child. Henry, M. H. New York. State Emigrants Hospital. American Journ. Syphilog. and Dermatol., 1S74, p. 354. 1) Case, chancre of lower lip from kissing, man infected by mistress, site of razor cut. 2) Case, chancre of lower lip, source unknown. 3) Case, chancre of cheek, from a bite. 4) Case, chancre back of hand, source unknown. Hensler, Ph. G. " Geschichte der Lustseuche," etc., Altona, 1783. Hentschel, J. G. "Diss, de osculo morbifico et mortifero." Halse, 1746. (See Alberti). Herard. Paris. Gaz. desHop., 1863, p. 497. 1) Case, chancre at site of vaccination. Annales de Derm, et de Syph,, 1887, p. 36. 2) Case, chancre of nipple, in 63-year-old man, from kissing or bite. Hermet. Paris. Annales de Derm, et de Syph., 1886, p. 87. Case, chancre in furrow behind ear in 24-year-old woman; infection from husband. (Service of Fournier). Hervier. Rive-de-Gier. (Viennois, q. v., "Recherches sur le chan. prim." These de Paris, 1S60, p. 65). Case, of glass-blower, inoculated by comrade through blow-pipe, seen in 1853. Hervieux. Paris. Bull, de l'Acad. de med., 1888, XXII., p. 116 (L'Union med., 1889 (48), p. 226). Five cases of vaccinal syphilis : a later report (La Semaine med., 1889, No. 50; Viertelj. f. Derm. u. Syph., 1890, p. 692), declares that these were not syphilis, but simply ulcerative, with impetiginous sequelae. Herzenstein, G. M. Vratsch. 1891, No. 18, p. 456 (Monatsh. f. prakt. Derm. XIII., 1891, p. 49). 1) Of 2i,So8 nurslings, in foundling asylum, 207 had hereditary syphilis; from 1881-85, 33 nurses acquired chancre of the breast, and S mem- bers of their families became infected ; of 44,728 children in the families sending out the other children to nurse, in became infected extra-gcnitally. "Syphilis in Russia," St. Petersburg, 1885, Vol. I. p. 436. 2) Statement : syphilis is sometimes spread through vaccination. Dr. TcHORZNICKl recently saw a long series of such cases; of 1995 consecu- tive cases of syphilis observed by a physician of Rylsk, 4 were of vaccinal origin ; two cases of the kind were reported by a practitioner of Tatij ; one by Dr. Tchistiakoff ; several by Dr. Vukoloff. The 3°4 SYPHILIS INSONTIUM Svetsch (1882, No. 9) reports the case of an advocate of Kiew who contracted syphilis through vaccination, the vaccinator was fined. Report of Commission to protect nurses and nurslings against syphilis (Vratsch., No. 6, 1891, p. 185). 3) Statement : syphilization of wet-nurses a most common occurrence in private foundling homes in Russia. Heurtaux. Nantes. Gaz. med. de Nantes, 1883-4, H., p. 83. Case, chancre of the lip, removed for epithelioma. Hey, T. Leeds. Medico-Chirurgical Transactions, Vol. VII. Small epidemic from breast-drawing, 1770-71 ; a blind woman acquiring chancre of the lip in her occupation, infected others. (See Law- rence 5 ). Heyfelder, O. Russian Military Service, Surgeon-General. " Uebertragung von Syph. durch Kusse." Heidelberger med. Annalen., 1842, H'ft 4 (Proksch "Die Litteratur iiber die vener. Krankh." Bonn., 1891, Erster Bd., p. 327). (Reported by Heine, q. v.). Episode of vaccino-syphilis at Frienfels, 1852, reported at the trial of the vaccinator Hubner. (See Escherich, Hubner, and Epidemics). "Ulcere syph. des paupieres." Annales d'oculistique, Bruxelles, 1855, XXXIV., pp. 92-100. (Proksch. "Die Litteratur iiber die vener. Krankh.," Bonn, 1891, 3te Bd., p. 351). Heylen de Herenthals. Antwerp. Annal. d. 1. Soc, Med. d'Anvers (Gaz. des Hop., Paris, 1845, p. 315), Syphilis in a four-year-old girl, probable chancre of upper lip. Hibbert. Historical remarks on Yaws and Sibbens, considered as identical affec- tions. Edinb. Journ. Med. Sci., 1826, I., 287-290.* Hildanus, F. Berne. (Cited by Acton, Behrend's Syphilidologie, Vol. III., 1841, p. 513). 1) Case, chancre, acquired from wearing infected pantaloons. (Cited by Rosen von Rosenstein "Kinderkrankheiten," Gottingen, 1798, p. 727). 2) Case, infection from sleeping with a syphilitic man. 3) Case, infection of young chambermaid from wearing stockings of a syphilitic child. Hill, B. London. Lock Hospital, Univ. Prof, of Surgery. Lancet, London, 186^, I., p. 696, also "Syphilis and local contagious disorders," Phila., 1869 (p. 57). 1) Case, chancre of cheek, from inoculation of wound by suction to prevent a black eye. 2) Case, nursling infected by nurse. " Syphilis and local contagious disorders,'' London, 1881. 3) Case, chancre of gum, from using a towel (p. 34). 4) Case, chancre of mouth, nursling from infected nurse-mother (p. 70). Hillairet, J. B. Paris. Hop. St. Louis. Soc. med. des Hop., discussion on Eustachian infection. L'Union med. XXIV., 1864 (p. 216). 1) Case, of Eustachian infection, in a pharmacist. 2) Case, of same in an old lady, over sixty. 3) Three other cases, not particularized. (For other cases of Hillairet, see A. Cullerier, Fournier, and Jullien). Hime. Sheffield. " Extensive diffusion of Syphilis traced to a midwife," Brit. Med. Journ., 1883 (p. 128). About 30 married women infected by a midwife: 9 husbands then ANALYTICAL BIBLIOGRAPHY 305 infected by their wives, and also two infants (the same epidemic in the courts) p. 335. (See Epidemics). Hjelt, O. Helsingfors. Univ. Prof. Legal Medicine and Hygiene. 41 Die Verbreitung d. vener. Krank. in Finnland," Berlin, 1874. 1) Epidemic of syphilis from cupping at Hakola, 1858 (p. 14). 2) Epidemic of same at Topparla, about the same time. 3) Epidemic of same at Uleaborger, i860. (See Epidemics). Hjort, J. J. Christiania. Rigs Hospital. Bidrag til Kundskob om de Endemiske Hudsygdomme. Norsk, mag. f. Laeger, 1840, I., 1-25, (Trans, in Zeitsch. f. d. ges. med., Hamb., 1841, XVI., 1-22, also quoted in Boeck "Traite d. 1. Radesyge," etc., 1860, p. 23).* 1) A full description of Radesyge. Norsk mag. f. Laeger, Vol. IX., 1844, p. 97. 2) Epidemic of famiry-syphilis ; in one da} 7- H's clinic was visited by 21 syphilitics, who were members of six families. Hock, J. Wiener Klinik, 1876, II., Heft 3-4, p. 65-118, Statement by Boeck : among 2344 cases of syphilis there was only one case of chancre of the eyelid. Hoffman, F. Halle. Univ. Prof, of Medicine. " Medicinae Rationalis Systematica?." t. IV., 1739, P- I 73- 1) Boy of 12 years, with recent syphilis, probably chancre of nose, from a man-servant with recent syphilis. 2) A whole family infected from a nurse. Holl, J. S. Halle. (See Stahl, G. E.). Holm, N. Copenhagen. General Hospital. (Service of Dr. Englested). " On the course of temperature in syphilitic children." Hosp. Tidende, 2, R. VII. , 2, 3, 1880 (Viertelj. f. Derm. u. Syph., 1881, p. 148). Eight cases of acquired syphilis in infants. Holmes, E. L. Chicago. Prof. Diseases Eye and Ear, Rush Med. College. Chicago Med. Journ. and Examiner, 1885 p. 296 . 1) Two cases, chancre of upper eyelid, source of infection not known. 2) Case, chancre of caruncle, in young physician, mode of infection not stated. Holsten, G. D. Brooklyn, N. Y. Brooklyn Dermatol, and Genito-Urin. Soc. Meeting, April 1, 1892. (Monatsh. f. prakt. Derm., Vol. XV., 1892, p. 194). Case, chancre, tip of little finger of left hand in a man. Holthouse. London. Westminster Hospital. Lancet, London, 1S60, L, p. 573. Case, chancre of the finger. Homolle, G. Paris. Hop. St. Louis. "Syphilis." Nouveau Diet, de Med. et Chirurg. prat. 1883. Inoculation of syphilis by opening furuncle — by excising vegetations. Names and references not given (p. 672). Horand. Lyons. Chief Surgeon, Antiquaille. (Reported by Jullien, Traite des mal.ven., Paris, 1886, p. 586). Case, chancre of left upper-eyelid. Hornung, J. " Cista medica," 1624, p. 423 (see Lammert). Epidemic of syphilis from scarification, during 1596-99 .about Altdorf. (See Epidemics). Horst, G. Ulm. '' Observ. Medicinal. Surg." lib. II., "de morb. contag.'' Ulm. 1628, (GlRTANNER p. 1 98). 21 306 SYPHILIS INSONTIUM i) Case, a servant-maid, who slept with the mistress of a man, was infected by direct contact or through bedding. 2) Case, a citizen of Ulm, 1622, was infected at a bathing escablishment, by the cup-head or scarificator. " Epistol. medicinal" de malitura scarificationis." 3) Report of epidemic from cupping, seen by Snitzer in 1603. 4) Report by Widmann, 4 q. v. of epidemic from cupping, in 1624; over 70 persons infected. Horteloup, E. and P. Bull, de l'Acad., Paris, 1877-8; 1879, V., p. 64-88. (Ann. d'hyg. pub. et de med. leg., Paris, 1877. XL VIII., p. 126-151). Case, nurse infected by nursling. Horteloup, P. Paris. Hop. du Midi. La France med., Paris, 1881, II., pp. 133,. 146, 157. (See Leprovost). 1) Case, chancre of inner angle of eyelid. 2) Case, chancre of left cheek, from bite. (Simonet). 3) Case, chancre of left thumb. 4) Infection of 3-year-old child by using brush of his father (quoted from " an American Journal," no reference). (See also cases cited by Gibier, Jullien, and Viguier). Houghton, J. H. British Med. Journ., London, 1866, p. 223. Case, syphilis after vaccination in a child 4 months old. Howard, J. London. "Practical Observ. on the nat. hist, and the cure of the ven. disease," London, 1806. Vol. I., p. 156. Case, chancre of the hand in a medical man, from necropsy (on the penis of the deceased body was a chancrous excoriation). Hubbard, G. H. Late Brev't-Col. and Surg., U. S. Army. Med. and Surg. Reporter, Phila. , 1866, XIV., p. 103. Epidemic of vaccinal syphilis; more than 500 soldiers infected. (See Epidemics). Hiibner. Frienfels. " Erfahrungen uber Vaccine an syphilitisch Krankens mit Rucksicht auf die Angelegenheit des Gerichtarztes," Wien, 1855. Nouveau Diet, de med. et de chir. prat., Paris, 1883, Vol. XXXIV., p. 673 (Gaz. hebdom., 1855, May 9, p. 176). Epidemic of vaccino syphilis : 13 children were vaccinated in 1852, of them 8 were infected, and from these their nurses and mothers ; two mothers had chancres of left forearm from contact; several nurses acquired chancres of the breast ; an old servant, chancre of the face ; from one of the non-infected children 25 more were vaccinated and only one became infected. Dr. H. was tried in court and was sentenced to prison for six weeks — the first trial in court of a physician for vaccino- syphilis. (See Escherich, Heine, Heyfelder, and Epidemics). Hue, A. Paris. La France med., 1883 (p. 752). (Annales de Derm, et de Syph., 18S4, pp. 55-57)- Case, chancre of right tonsil in a man (service of Pean). Hiiebener, E. A. L. 1) De morbi dithmarsici natura de indole. Dissert. Inaug., Kilise, 1S21. 2) Erkenntniss und Cur der soganannten Dithmarsischen Krankheit, Altona, 1835. Hufeland, C. W. Berlin. Univ. Prof, of Medicine. "Art of prolonging life," London, 1797 (from the original " Makrobiotik," 1796. Rust, Helkologie Berlin, 1S42, p. 246). Case, syphilis acquired from a tobacco-pipe (Vol. II., p. 103, note). ANALYTICAL BIBLIOGRAPHY 3°7 Huguier, P. Ch. Paris. Hop. de Lourcine. "Lecons sur les malad. vener. chez la femme" (Behrend's Syphilidologie Bd. V., p. 590). 1) Case of bilateral chancre of ocular conjunctiva. Discussion of Soc. de Chirurg. de Paris, Bulletin de la Soc, 1844. (Cited in Behrend's Archiv f. Syph. u. Hautkr. B. I., 1846, p. 157). 2) Two cases of infection of little girls at pudenda, from use of infected sponges. Hulke. London. Middlesex Hospital. Med. Times andGaz., London, 1875, II., Oct. 21, p. 462* Case, chancre of lower lip. Hulot, A. Paris. Annales de Derm, et de Syph., 1879, p. 29. Notes of 19 cases of extra-genital chancre, seen in Fourxier's clinic in 1877: chancre of tonsil, 3; nose, 3; neck, 3; finger, 2; cheek, 1; chin, 1 ; eyelid, 1 ; gum 1 ; external ear, 1 ; breast, 1 ; abdomen. 1 ; over trochanter major, 1. Hiinefeld, L. Die Radesyge oder das scandinavische Syphiloid, Leipzig, 1828. Contains a full bibliography of the subject. Hunter, J. London. St. George's Hospital. " Treatise on the Venereal Disease," with Adams' Commentary; American edit., Phila., 1S1S. 1) Case, chancre of lip (prolabium) in a man, "probably from auto- infection by the fingers " (p. 199). 2) Case, chancre of breast, nurse from nursling (p. 357). 3) Case, nurse infected by child of last case (p. 358). 4) Two nurses and two children infected from one syphilitic child (p. 359). 5) Two cases of infection from transplanting teeth (p. 361). Hutchinson, J. London. Surgeon to London and Royal London Ophthal. Hosp. Med. Times and Gaz. , London, 1S56, Oct. 11, pp. 366-71. 1) Fifty cases of infection from the foetus to the mother. Lancet, London, 1S62, II.. p. 327. 2) Case, chancre of right thumb, in a midwife. Med. Times and Gaz., London, 1871, II., p. 705. 3) Case, chancre of right knuckle, in a policeman, by fighting. Transact. Royal Med. and Chir. Soc, London. Vol. IV., 1871. 4) 19 cases, ten chancres and nine infections after vaccination (pp. 2, 16). Med. Times and Gaz., London, 1872, II., p. 515. 5) Case, chancre of finger, in a man 31 years old. Med. Times and Gaz., London, 1S72, I., p. 432. 6) Case, chancre of right upper eyelid, in a man 27 years old. Med. Times and Gaz., London, Nov., 1872 (Amer. Journ. of Syph. and Dermat. Vol. IV., 1S73, p. 165). 7) Case, chancre of the finger, from using a towel. Med. Times and Gaz., London, 1873, I., p. 126 (also Lancet, 1S73, I., pp. 1 09, 175). 8) Two cases, chancre and inlection after vaccination. Med. Times and Gaz., London, 1877, I., p. 307. 9) Case, chancre of the tongue, in a woman. "Illustrations of Clinical Surgery," Fascic. VI., London, 1877. A masterly presentation of the subject of Vaccinal-Syphilis, reviewing six series of personal cases, with four plates illustrating vaccination chancres. 10) First series; twelve vaccinated, ten infected (p. 115). 11) Second series; many vaccinated, nine infected, suspicious symptoms in six others (under care of Mr. Waren Tay, q. v.) (p. 122). 12) Third series; several vaccinated, one infected; man aged 46 (p. 125). 308 SYPHILIS INSONTIUM 13) Fourth series; three vaccinated, one infected, woman aged 46 (p. 126). 14) Fifth series ; two infants infected, one of them infects its mother at nipple, and she her husband on penis (p. 128). 15) Sixth series; one case, a lady, vaccinated in India (p. 129). Lancet, London, 1879, I., p. 619. 16) Case, chancre of tipper lip. "Syphilis." London, 1887. 17) Eight cases, chancre of the finger (pp. 96, 132, 134, 386, 473). 18) Three cases, chancre of nipple (pp. 101, 118, 120) (Lees' Case). 19) Three cases, chancre of the tongue (p. 101 ; plate 112). 20) Two cases, chancre of the tonsil (p. 101). 21) Two cases, chancre of the lip (pp. 152, 468). 22) About 26 cases, infection after vaccination (pp. 104, 107, 109) (Case of Dr. C). 23) Seven cases, infection after circumcision (p. ii5)(Macnamara's Case). 24) Three cases, infection in lying-in women, by physician or midwife (pp. 101, 105). 25) Two cases, chancre of ocular conjunctiva (p. 101). 26) Case, chancre of palm of hand (p. 101). 27) Case, chancre middle of sole of foot (p. 101). 28) Two cases, infection, policemen from injuries (p. 102). 29) Case, chancre in several places, in a sailor, from bites (p. 102). 30) Case, chancre on one labium, child one year old (p. 118). 31) Case, chancre on one of the nates (p. 134). 32) Case, chancre of tonsil in man from feeding-bottle (p. 382). British Med. Journ., 1888, II., p. 1199. 33) Case, chancre of the knuckle. Archiv. of Surgery, 1890, Vol. I., p. 53. 34) Case, chancre of the lip, in a man 30 years of age. Archiv. of Surgery, 1891, Vol. II., p. 170-237. 35) Two cases chancre of the finger. Archiv. of Surgery, 1892, Vol. III., p. 252. 36) Case, chancre of cheek, a little external to the left commissure of tne lips. Mode of infection, sex, and age of patient not given. Hutchinson, Jonathan, Jr. London. International Med. Annual, 10th year, 1892, p. 481., 1) Case, chancre of occiput. 2) Case, chancre of heel. (Infection in both by means of dressings to small wounds). Hutin, J. M. Felix. Paris. Hotel des Invalids. "Recherches sur les tatouages," Paris, 1853 (p. 10). (Les Comptes rendus de i'Academ. de med. t. XVIII., p. 349). Case, soldier inoculated by tattooer with primary syphilis, at Hop. Val de Grace, 1823. Hyde, Jas. Nevins. Chicago, U. S. A. Chicago Med. Journ. and Exam., 1878, XXXVII., p. 457, Case, chancre, radial border of right thumb in 14-year-old nurse from nursling. Idelson, I. S. Krytchev, Russia. Annual of Med. Sci., 1888, Vol. II., p. 454. 1) Case of Vvedenski, q. v. 1 , three chancres of left fore-finger. Vratsch, 1891, No. 14, p. 374 (St. Louis Med. and Surg. Journ., June, 1S91, p. 365)- . • 2) Case, chancre of the chin, acquired in a barber shop. Ilisch, J. J. "Die gewohnlichen Krankh. des menschl. Korpers, mit besond. Beziehung auf die Landbewohner der Ostseeprovinzen u. d. russ. Reiches." Dorpat u. Riga, 1S22* (HOnefeld "Radesyge etc.," 1S2S). Study of Russian "Syphiloid " ANALYTICAL BIBLIOGRAPHY 309 Inell. Three cases, chancre of the tonsil (see Malm 2 ). Jacquet, B. Laibach. Univ. Prof, of Surgery. Nov. Act. . . . Acad. 'Nat Cur., VI., Norimb., 1778. (Obs. 64, p. 302). (GlRTANXER, No. 1 556). Case, nurse infected by nursling. • Jadassohn. Verhandl. der Schlesischen Gesellsch. f. Vaterland. Cultur, 1890. Archiv f. Derm. u. Syph., Vol. 23, 1891, p. 788. Case, chancre of tonsil, in 2S-year-old patient, source unknown. Jaffe, J. Leipzig. " Die rituelle Circumcision." . . . Leipzig, 1886. Circumcision inoculation: cases of Brecker, Vanter, von Pitha, Solo- mon, Segel, Fischer, and Obalinski (p. 31-32). Jakinovitch, N. N. St. Petersburg. Vratsch, 1891, No. 1, p. 21 (Joarn. of Laryngology, July, 1891, p. 279). Case, chancre of the left tonsil, in man 22 years old, source unknown. Jakoleff, S. S. Verhandl. der russ. syph. -derm. Gesellsch., St. Petersburg. Vratsch, 1S90, No. 18, p. 426 (Monatsh. f. prakt. Derm. 1S90, Vol. XL, p. 69). 1) Case, chancre of lower lip, in 14-year-old girl, from kissing. Verhandl. der russ. syph. -derm. Gesellsch., St. Petersburg, Sitz., Apr. 27, 1 891. Vratsch, 1891, No. 18 (Monatsh f. prakt. Derm. 1S91, Vol. XIII. , p. 48). 2) Case, chancre, left corner of mouth, in 3S-year-old woman, probably from a cigarette. 3) Case, chancre, right corner of mouth, in 21-year-old man. Jarotsky, A. I. Tikhvin, North Russia. Vratsch, 1892, No. 4, p. 74. 1) Statistics; among 2540 miscellaneous cases in 5 rural districts, (total inhabitants 9S79) 1.47 percent were syphilitic, mainly from family life. 2) Small family epidemic of syphilis, introduced by dry-nurses. 3) Cases, laborer infects S of a family, innocently. Jegu, G. Paris. " De la syphilis de l'oreille," These de Paris, 1S84. Case, chancre of the ear. (See Lavergxe and Perrin 2 ). Jelzina, S. Vratsch, 1882, Nos. 50-52; Vratsch, 18S4, Nos. S-9 (Archiv f. Derm. u. Syph., 1889, p. 242). 1) Among Russian peasantry, the spread of syphilis is generally by extra-genital means: thus, of 55 syphilitic women, only 2 were infected by coitus 2 from nursing, 45 from family life, and 2 hereditarily. Russian dermat. and syph. Soc. Jan. 2S, 1889 (Archiv f. Derm. u. Syph., 1889, p. 243). 2) Case, chancre of finger, in a 13-months-old child. Jenkins, J. O. Newport, Ky. U. S. A. Phila. Med. News, Aug. 30, 1.S87. Case of vaccino-syphilis, vaccination with barber's razor. Jenniker. Geschichtlich. administrativer Ilauptbericht liber die Skerljevo Heilan- staltcn zu Fiume trad Portorc. Med. Jahrbuchern des Osterr. Kaiser- staates, 1S19, 1820, Bd. V., 2 St.* Johnson, G. Cambridge, England. British Med. Jour., Aug., i860. 1) Case, chancre of nipple, in woman from kiss by lover (p. 649). 3IO SYPHILIS INSONTIUM 2) Case, nurse infected by syphilitic infant, case before civil tribunal in France (p. 713). Joly, L. Brussels. Journ. de med. de chir. et de pharm. de Bruxelles, 1853, p. 92. Epidemic of syphilis at Alsembourg, 1853. Notes of individual cases by Seutin, including the case of the breast-drawer, a ten-year-old boy, with chancre of the tonsil, from his mother's nipple, she having been infected by a nursling. (See Epidemics). Jones, J. Nashville, Tenn. Prof, of Phys. and Path. Univ. of Nashville. "Researches on Spurious Vaccination," 1867 (Nashville Journ. of Med. and Surg., New Ser., Vol. II., 1867, pp. 1, 81, 161). Three epidemics of vaccino-syphilis, occurring among soldiers of the Confederate armies. Also account of epidemics observed by Perci- val and Hubbard. (See Epidemics). Jones, S. London. St. Thomas Hospital. Brit. Med. Journ., March 1872, I., p. 313. Case, chancre of left hand, from a bite in a man of 42 years. Jordanus, T. Brunn. Archiater of the Province. " Brunno-Gallicus seu Luis novse exortus, etc.," 1578 (cited in Grun- er's "De Morbo Gallico Scriptores," pp. 496-582). Epidemic at Brunn, Moravia, 1577, from cupping, described in the year following the outbreak, (See Epidemics). Josias, A. French Military. (Service of Simonet). Progres Medicale, 1877, p. 205. Epidemic from tattooing, nine soldiers inoculated by a syphilitic tat- tooer. (See Epidemics). Juler, H. E. London. Ophthalmologist, St. Mary's Hosp. and Royal West- minster Ophthalmic Hosp. Two cases, chancre of conjunctiva, in young women (see De Beck 3 ). Jullien, L. Paris. "Traite des malad. vener." 2d ed., Paris, 1886. 1) Statement: He has "seen more than one grand-mother victim of her affection for her grand-child." 2) Case, woman infected from a syringe of a syphilitic friend (p. 506). 3) Case, chancre of neck, from bed clothing. 4) Cases of Diday's, unpublished: a) Two cases of anal chancre in infants from towels or napkins, etc. (P- 507). . . b) Case of infection, by a kitchen spoon, which is parallel with Rollet's case (p. 507). 5) Cases of chancre of external ear; Jullien saw "two or three " at the Antiquaille. 6) Case, chancre of tonsil, service of Verneuil, in an old woman from drinking-glass (p. 583 — woodcut). 7) Case or cases of Gosselin, from Eustachian infection (p. 506). 8) Case of Horteloup's, phagedenic chancre of tongue (p. 581). 9) Case of Hillairet, chancre of nose (p, 584). 10) Case of Lailler, chancre, septum nasi (p. 585). 11) Case, chancre of back of reck, from clothing (p. 507). 12) Case of P. Pellizzari's (unpublished) chancre of breast in mother from own child (exception to Colles' law) (p. 10S6). 13) Case, chancre, finger, in physician, contact with chancre of scrotum (p. 537)- Cited in Tillmann's Lehrbuch der allgem. Chirurg. , Leipzig, iSSS, (Archiv f. Derm. u. Syph., 1890, p. 501). 14) Proportion of extra-genital chancre, 5 to 6 per cent, in men and 25 to 26 per cent, in women. ANALYTICAL BIBLIOGRAPHY 311 Jumon. L. Paris. " Etude sur la syphilis ignoree." These de Paris, 1880. 1) Case of Fournier's, young woman, chancre, calf of leg, in site of wound which was sucked by a youth (p. 26). 2) Case of Bassereau's, chancre in site of wound made in excising gonorrhoeal vegetations. 3) Case of Fournier's, chancre of hand in a physician. 4) Case of Fournier's, infection per os of a medical man, by paper- knife used previously as tongue depressor on a syphilitic (p. 30). 5) Case of Fournier's, chancre of anterior femoral region, from holding a lightly clad woman in lap. Junquet. Montpellier. Gaz. med. de Montpellier, Aug., 1859. 1) Two nurses infected by nurslings 2) One of these infects her mothei in-law. 3) The other nurse infects her husband and child. Kaposi, M. Vienna, Royal Imperial Gen. Hosp. Div. for Skin Diseases. "Syphilis der Schleimhaut," Wien, 1866. 1) Case chancre of lower lip in a girl, from bite of lover (p. 63). Syphilis der Haut und d. angranz. Schleimhaiite, Atlas, Wien, 1873. 2) Two cases, chancre of penis in Jewish infants from circumcision. 3) Case, chancre of finger in hospital attendant. 4) Case, chancre of chin from a bite. (Both latter in Zeissl's Atlas, 1875). 5) Two cases, chancre of tongue, in old woman, and young girl, source unknown. "Pathol, und Therap. der Syph.," Stuttgart, 1SS1. 6) Case, chancre of the hairy scalp (p. 61). 7) Case, chancre of left cheek, in an old man (p. 62). Archiv f. Derm. u. Sj-ph., Vol. XXIV., 1892, p. 842. 8) Case, chancre of lower lip in a man, cause not given. Kapustin. Arbeit des 2 te Gouv. Congr. der Kursk' Landsch., Lief I., Kursk, 1884. Cited by Herzenstein, "Syph. in Russland" (Archiv f. Derm. u. Syph., 1881, p. 243). Largest percentage of extra-genital syphilis is in children from one to ten years of age, or 23 per cent. Karamanenko, S. Odessa, Zemsk. Med. Khersonskoi Guberni, 1888, p. 251. 1) Four women infected through nursing ; one infected own child. 2) Peasant, married man, aged 24, infected by fellow-laborer during field work; he shortly infected his father aged 60, brother aged 11 and three sisters aged, 18, 16 and 6. 3) Above little girl, aged 6, infected a neighbor's child during play. 4) Peasant woman and her two children infected by neighbor's child. Kaverin, V. Uijni. Korotchan, Voronej Gov., Russia. "Concerning public prophylax. of Syph." Meditz. Beseda, 1887, No. 9 (p. 219). 1) Nurse infected two children. 2) Nurse infected one child. 3) A cook infected two children, the latter transmitted the disease to its father and mother. KedotoffA. Cronstadt. Phys. impcr., Russian Marine. Annates de Derm, et de Syph., Paris, 1884, p. 526, Small epidemic of circumcision syphilis; three infants infected, each communicates disease to mother by lactation, Kehrer, F. A. Prakt. Arzt., Wetzlar, 1883, XXIV., p. 49. Infection of nipple. 312 SYPHILIS INSONTIUM Kemme, Johannes Christlieb, and Milloradovics, Petrus Gabrielow. " Dissertation inaug. de innocenti infectione venerea. Hake Magdeburgi- cae, 1767 (p. 24).* Kenny. Melbourne. Australasian Med. Journ., 1889, XL, No. 9, p. 428, Case, chancre on under surface of the tongue. Kessler. Dorpat. Univ. Prof, of Midwifery. Vratsch, No. 34, 1883, (p. 540) (Canstatt Jahrbuch). Case of circumcision syphilis, infant aged 28 days. Keyes, E. L. New York. Surgeon to Charity Hospital. "A practical treatise on and Syphilis." (Van Buren and Keyes), N. Y., 1874. 1) Case, chancre of right arm from carrying syphilitic infant (p. 514). 2) Case, chancre of lip, from kissing fiancee (p. 522). 3) Case, chancre of upper lip, from tobacco-pipe (p. 523). Archives of Dermatology, 1878, p. 126. 4) Case, multiple chancre of breasts, from nursling. "The Venereal Diseases." New York (Wood's Library, 1880). 5) Two cases, chancre of lip from kissing (p. 88). 6) Case, chancre of lip, from tobacco-pipe (p. 88) (same as above?). Journal of Cutan. and Ven. Dis., New York, 1886, p. 22. 7) Case, syphilis accidentally acquired. Kilian. Bonn. Univ. Prof, of Obstetrics. (Published by Ruthenburg, q. v.). 1) Case, nursling, chancre of eyelid and lip, source unknown unless from dry-nurse. 2) Case, nursling infected through dry-nurse, who chewed its food. 3) Case, nurse from preceding nursling, by lactation. Kinsman, D. N. Cleveland Med. Gaz., 1S85-6, I., 494. Case, chancre of gum. Kirkpatrick, Robt. C. Montreal, Canada. Asst. Surgeon, Montreal Gen. Hosp. New York Med. Journ., Vol. LVL, No. 27, p. 745. Case, chancre left side lower lip, in married man of 42 years, from a cigar made by a syphilitic. Klein. Andernach. (Reported by Ruthenburg, q. v., Obs. iv.). 1) Epidemic at Andernach, 1816-17, beginning as vaccino-syphilis, and continued through domestic infection. (See Epidemics). " Die rituelle Circumcision, eine sanitats Frage " Allgem. Med. Central Zeit'g, Berlin, 1853, No. 39, p. 311. 2) Mention of several cases, infection after circumcision. Kleiner, M. New York Med. Record, Vol. XL., 1891, p. 302. Case, chancre of lip, from applying to chapped lip vaseline used upon a chancre. Klink, E. Warsaw, Poland. Gazet lecarska, 1880, No. 1. Statistics: combined figures of hard and soft primary sores, total 2846; breast 24, fingers 4, nose 2, " head " 2, tongue 1, foot 1. Klotz, H. G. New York. Journal of Cutan. and Genito-Urin. Diseases, N. Y., 1891, p. 29S. Case, chancre, front aspect of the lower third of left thigh, in 28-year-old patient, source unknown. Kluge, C. A. F. Berlin. Surgeon-in-Chief and Director of Charite Hospital. (Quoted by Behrend in " Syphihdologie," Bd. IV., 1S43, p. 325). ANALYTICAL BIBLIOGRAPHY 313 Statement: Kluge believed that cigar-makers infected the cigars not by- saliva, but by hands soiled with secretions. (Xo individual cases cited). Knapp, H. New York. Prof, of Ophthal., Coll. of Phys. and Surgeons. De Beck, q. v. "Hard chancre of the eyelids," etc., 1S86. Cases, chancre of the eyelids. (Xo notes given). Knight, C. H. Xew York. Xew York Med. Journal, 1SS4, XXXIX., p. 662. 1) Case, chancre of tonsil, in a woman, from using same dentrifice with her syphilitic nephew. 2) Case, chancre left tonsil (Bumstead). K5bner, H. Breslau. Univ. Clinic for Skin Dis. and Syphilis. "Klin.u. experiment. Mittheil. ausder Dermatol, u. Syph.," Erlangen, 1864. (Reprint of articles in Deutsch Klinik, 1S62, 1S63). 1) Case, chancre, back wall of pharynx ; from spoon-feeding her infant nephew (p. 54). 2) Case, infection per os of a 6-year-old boy, whose mother was suffer- ing from a relapse of former syphilis (p. 58). 3) Case, acquired syphilis in a 2^ -year-old child, from bathing in water used by syphilitic father with intertrigo (mucous patches) of toes (P- 53). 4) Case, infant of 1 year, infected by mother's kisses (p. 61). 5) Case, the above infant infected its grand-mother through bottle- feeding. 6) Case, infant infected by its foster-mother, method not stated (p. 61). 7) Case, chancre of arch of palate, infected by her grand-child (p. 61). 8) Family epidemic of syphilis, occasion of suit for damages (p. 63). 9) Case, chancre of finger m a midwife from professional exposure 10) Case, patient infected by opening axillary boil with soiled lancet (p. 65). 11) Case, patient infected by scarifying scrotum for epididymitis with soiled instrument (p. 65). Archiv f. Derm. u. Syph. III., 1871, pp. 133, 507. 12) Case of vaccino-syphilis, in a young physician (p. 139). 13) Case of vaccino-syphilis, child 2 years old, died 6 months later (P- U4). 14) Table of principal epidemics of vaccinal-syphilis (p. 159). Kobylin, W. A. St. Petersburg. Kalinkin Hosp. (Cited by Petersen, monatsh. f. prakt. Dermat. 1SS8, p. 309). Six cases, chancre of the breast, among 77 cases of recent syphilis seen during 1S80. Kocevar. District-Physician of Cilli, in Styria, Austria. "Zur Impfgeschichte vom S. Marien." Ann. Rep. for 1S69, Allg. "Wien. Med. Zeit'g, 1870, No. 21 (p. 266) (Yiertelj. f. Derm. u. Syph. II., P- 453). Epidemic of vaccino-syphilis in two parishes, remarkable for the num- ber and variety of infections: 31 infants infected, from these 19 mothers and 11 other children were in turn infected. (See Epidemics). Koch. Wiener med. Blatter, 1SS7, Xo. 52, (p. 1644) (Archiv f. Derm. u. Syph., 1888, p. 838). Case, chancre of finger in site of wound made by a drawing-instrument, probably infected by the saliva of some unknown person. Kogan, E. A. St. Petersburg!-). Vratsch, Xo. 40, 1-90, p. 925. Case, chancre of upper lip, in a woman from drinking-glass. Kohn, Moritz. (Sec Kaposi). 314 SYPHILIS INSONTIUM Kolokolow, W. Meditsinskoe Obosr., Moskow, 1888, XXIX., p. 700. Two cases, of chancre of the lip, domestic infection. Kolomensky, A. Moscow. Proto. d. Gesell. Russ. Aerzte, 188S (Archiv f. Derm. u. Syph. 1889, p. 243). Case, chancre of this tongue. Koltschewski, K. Vratsch, 188?, No 45 (Canstatt Jahresbericht for 1883). Case, chancre of the chin, in site of razor- cut. Komin. Trans, of the 2d St. Petersburg Gov. Sanitary Meeting, 1877, pp. 123-140. 1) Case, chancre near left nipple, nurse from nursling (from a "home"). 2) Case, chancre right areola, nurse from nursling, infecting her own boy of 5 years. 3) Two peasant girls aged 12 and 7 years, infected per os, from hand- feeding a syphilitic infant. Kopp, C. Breslau. (Prof. Neisser's Clinic). Archiv f. Dermatol, u. Syph., 1885, pp. 55, 183. 1) Statistics: of 125 cases of recent syphilis, treated by the hypodermic method, four males are mentioned, as having chancre of the lip. 2) Case, child 3 years old, infected by its mother. Kopp, J. H. Frankfurt-am-Main. " Aerztliche Bemerkungen veranlasst durch eine Reise in Frankreich und Deutschland." Frankfurt, 1S25 (Froriep's Notizen, Weimar, 1825, No. 243). Case or cases of infection of midwives. Kortiim, C. G. T. Stolberg. " Beitrage zur prakt. Arzneiwissensch.," Gottingen, 1795, p. 336. 1) Case, chancre of the lip. Hufeland's Journal, Berlin, XX., 1805, St. III., p. 31. 2) Case, nurse infected by nursling. Korver, J. M. Akadem. Proefschrift, Amsterdam, 1880, p. 80.* Vaccinal-syphilis. Kosinski, J. Warsaw. University Prof, of Surgery. Congress of German Surgeons, 1867. Cases of circumcision-syphilis. (See Bierkowski, and Nowakowski). Kotzyn, I. B. Kovno, Russia. Russkaya Meditsina, 1890, No. XXV., p. 391. Case, chancre in a circumcision wound in a child 10 weeks old. (The man who performed the operation was healthy, but it was supposed that the virus was carried on his instruments, which were seldom cleaned). Krelling, M. Leipzig. Prof. Lesser' s Univ. Clin, for Skin and Yen. Dis. Archiv f. Derm. u. Syph., Wien., 1888, p. 9. 1) Case, chancre of the eyelid in a youth from a public woman. 2) Case, chancre on ala of nose, in a woman of 35, from a woman with mucous patches, who applied her saliva to heal an erysipelas. Kreundel. St. Petersburg. Verhand. der russ. syph. -derm. Gesell. in St. Petersburg, Sitz., Apr. 6, 1 89 1. (Monatsh. f. prakt. Derm., Vol. XIII., 1S91, p. 17). Case, chancre of upper lip in a soldier from a cigarette. Krishaber. Paris. " Conferences cliniques sur les maladies du larynx," 1877 (Annales des mal. de l'Oreille, 1877). Case, chancre of the epiglottis (p. 121). ANALYTICAL BIBLIOGRAPHY 315 Krowczynski, J. Lemberg and Cracow. Przeglad lekarski, 1S77 (Virchow-Hirsch Jahresb., 1877, Bd. II., p. 528). 1) Case, chancre of palate from a spoon. Przeglad lekarski, 1887. 2) Case, a man aged 64, infected in infancy. Kiidriashoff. St. Petersburg. Vratsch, 1892, No. 31, p. 783. (Journ. des mal. cut. et syph., Vol. IV., Oct., 1892, p. 577). Case, chancre of penis in boy 2 years and 10 months old, probably infected from its nurse's mouth, the latter being syphilitic. Kiihn. Philadelphia. U. S. A. Case, inoculation from tooth implantation. (See Lettsom 3 ). Kyll, J. B. "Ueber syphilitische Ansteckungen von Wochnerinnen durch Milchsauger- innen." Zeitschr. f. d. Stattsarzneikunde v. A. Henke, Erlangen, 1837, Heft 2.* Syphilitic infection of lying-in women by breast-drawers. Labbe. Paris. Hop. de la Pitie. (Reported 1872 by Ory, q. v. 13 , notes by Coyne, interne). Case, chancre of upper lip, in a man or 52 years. Laboulbeae, A. Paris. Charite Hospital. L'Union med., 1S65, p. 191. 1) Case, Eustachian infection, in an aged clergyman. 2) Case, chancre of the tonsil. (See Le Gendre -). Lacheze. L'Union med., Paris, 1862, No. 112, p. 576. Epidemic from vaccination ; two children and their families. Lacroze. Paris. (Notes furnished Fournier for his study on cephalic chancre, 1858). Case, chancre of the lip. Ladreit-de-Lacharriere. Paris. "Des paralysies syphilitiques," These de Paris, 1861. Case, chancre of the chin (p. 22). Ladroire-Yver, E. Paris. These de Paris, 1S54. Case, chancre of cheek in razor-cut ; officer from camp-barber, following pressure with finger to check hemorrhage. Lagneau, G. (fils). Annales d'hyg. publ. et demed. leg., Paris, 1855, 2d Ser., Vol. V., pp. 21, 68, 241, 298. 1) Case, nursling infects nurse, she her own child. " Malad. syphil. du system nerveux," Paris, i860, p. 508. 2) Case of Hourmann, infected either from a necropsy, or examination of a prostitute (Lagneau, Sr., took notes at the time; the same case also given by Cazenave, Vidal and others). Bullet, de la Soc. de med. legale, Seance April 5, 1875 (Annales d'hyg. publ. et de med. leg., 1875, XLIV., p. 161). 3) Case of Defaucambourge of Gien, nursling infects nurse. Revue d'hyg. et de police sanitaire, 1879, p. 301. 4) Case, infection of a young girl, from spoon-feeding a foster-infant. Lagneau, L. V. Paris. Hop. des Veneriens. " Traite prat, des mal. syph.," 6th Edit., Paris, 1828. Two cases, chancre of the throat (pp. 49, 51). Lagrange, (father and son). Chalous. (Reported by Viennois, 1863; also Guixaxd, 1881). Several cases of syphilis from glass-blowing ; a family epidemic added. 3 l6 SYPHILIS INSONTIUM Lailler, C. Paris. Hop. St. Louis. L'Union medicale, XXIV., 1864, No. 120, 129. 1) Case, woman of 47 years, chancre apparently both at nostril and in throat. (Cited by Jullien, " Traite prat, des mal. ven," Paris, 1886, p. 498). 2) Case, multiple chancre penis and scrotum, acquired while under treatment for scabies. (For other cases see Guignar 7 , and Ory). Lallemand, C. F. Montpellier. Univ. Prof . of Clinical Surgery. Journ. universelle. . . . XXVIL, p. 132. 1) Two nurses infected by the same nursling. (See also Legrand, Obs. 344, 345, 346). 2) Case reported by Souchier, q. v., multiple chancre breast, nurse from nursling. (Cited by Legrand). Clinique med.-chirurg. de Montpellier, 1845, p. 15. 3) Mentions having seen a dozen cases of cephalic chancre. 4) Chancre of the lip in three youths from same woman, by kissing. Lammert. Virch. Archiv., XXIV., 1S62, p. 297. 1) Epidemics from cupping, at Niirnberg, 1599 (unpublished); also sev- eral others of that epoch, published at the time. (See Hornung). 2) Edict in 1C61, of Duke George Frederick, against syphilitics mingling at weddings, feasts, bath-houses, etc., and also against syphilitic chil- dren being nursed by healthy persons, or being allowed in school, etc, Lancereaux, E. Paris. Hop. de la Pitie. "Traite historique et pratique de la syphilis." Sydenham Society Edit., London, 1869. 1) Case, of Raynaud's 1863, Eustachian infection. (Vol. II., p. 244). 2) Case of infection from a tobacco-pipe (Vol. II., p. 246). id) Case of Vercelloni, chancre of hand from contact with genitals. (Vol. II., p. 233). 3) Case, child 6 years old, infected by nurse, infects its mother. (Vol. I., p. 94). 4) Case of Rayer's, a young virgin with recent syphilis; her room-mate was syphilitic. (Vol. II., p. 232). 4«) Epidemic vaccino syphilis, 8 out of 13 infected. (See Hubner and See). 5) Case, chancre of the uvula; no details. 5es published by Friedlander, Kopp, Lesser, Arning and others, q. v.). Nelaton, A. Paris. (Reported by Laroyenne 2 , q. v.). Three cases, chancre of eyelid. Nettleship, E. London. St. Thomas' Hosp., Eye Clinic, Surgeon. British Med. Journ., 1875, II., p. 363. 1) Case, chancre, within the nostril. (Related in Hill and Cooper's " Syphilis," etc. London, 1S81, 2d Edit.). 2) Case, chancre of left lower lid, in child 3 years old. Neumann, Isidor. Vienna. Gen. Hosp., Div. for Skin Diseases and Syphilis. Allg. Wien. med. Zeit'g, 1886, p. 57. 1) Case, child infected by servant's kisses, infects ■ ANALYTICAL BIBLIOGRAPHY 337 a) Its mother; b) its grand-mother, chancre of tongue; c) its sister, aged 4 years. Allg. Wien. med. Zeit'g, 1883. 2) Three cases, chancre of lip (lower, 2 ; upper, 1) (pp. 297, 307). 3) Case, chancre of hand, midwife, professional inoculation (p. 307). 4) Case, chancre ball of thumb, from bite. ( 5) Case, chancre of nipple, nurse from nursling. 6) Case, chancre second finger, auto-inoculation (p. 308). 7) Case, multiple chancre of chin, man from caressing syphilitic infant (P- 297). Allg. Wien. med. Zeit'g, 1884, p. 62. 8) Case, chancre of finger, dentist, from extracting tooth from syphilitic. 9) Case, chancre of hand, from bite (see above, 4). 10) Case, chancre of tonsil, child from candy sucked by a syphilitic. Wien. med. Blatter, 1883 Nos. 18, 19. 11) Case, old woman, infected by kissing grand-child. Atlas der Hautkrankh., Wien, 1885, L., IV., Taf. 55. 12) Case, chancre upper lip in a female. (Plate). Aerztl. Ber. des K. K. allg. Krankenh. zu Wien., 1888 (publ. 1890), p. 103. 13) Case, chancre upper lip and right ala nasi, girl aged 20. 14) Case, chancre lower lip, right side, woman aged 38. 15) Case, chancre breast, wet-nurse from nursling. 16) Case, chancre forearm, woman 24, from washing clothes of syphilitic. 17) Case, chancre left tonsil, married woman of 30, probably from using table-utensils in common with a syphilitic. 18) Case, chancre right tonsil, man aged 35. Wien. klin. Wochenschr., 1890, III., pp. 2S2, 307, 323, 344, 386. 19) Statistics: 613 cases from literature summarized according to location. 20) Statistics: 86 personal cases, extra-genital chancre, during ten years. 21) Cases, chancre, upper lip, 18; one from bite, one from drinking-glass, rest from kissing. 22) Cases, chancre, lower lip, 28 ; three women from kissing, one from table-utensils, one woman from grand-child with inherited syphilis, sucking on her lip, the rest from kissing. 23) Cases, chancre corner of mouth, 8 ; one from smoking old cigar stump. 24) Cases, chancre of cneek, 2 ; both from kissing. 25) Cases, chancre of chin, 5 ; in four, infection probably from a razor. 26) Case, chancre, pharynx and soft palate, source unknown. 27) Cases, chancre of tonsil, 2; in one, from spoon previously used by syphilitic. 28) Cases, chancre, ala nasi, 3 ; in one case a woman, washing a vessel used by a syphilitic for local bathing, frequently rubbed an excori- ated place on the ala nasi. 29) Two cases, chancre of eyelid. 30) Cases, chancre, fingers and hand, 11; one acquired while washing infected linen, one from a bite. 31) Cases, chancre of nipple, 4; one from a bite, one from kiss of a syphilitic man, and two from diseased nurslings. 32) Case, chancre of umbilicus in a child from sleeping with its mother, who had been infected by her husband in eighth month of pregnancy. Verhand. der Wiener Dermatol. Gesell., Sitz. Mar. 23, 1892. (Archiv f. Derm. u. Syph. Vol. XXIV., 1892, p. 855). 33) Case, chancre middle of upper lip in cigarette girl, infection possibly from cigarettes. Neves da Rocha. " Cancro duro da palpebra." O Brazil medico, 3.* (Szadek, " Index bib. Syph.," 4th Jahrg., p. 33). 33% SYPHILIS INSONTIUM Newsky, A. Meditsinskoe Obosren., 1884, No. 21, p. 779. (London med. Recorder, 1885, p. 1 IT). Case, chancre of tongue in virgin, probably from table-ware. Niece, Ch.-de la. Pans. Hop. St. Louis. (Service of Fournier). Annales de Derm, et de Syph., 1886, 2d Ser., VII., p. 225. Case, chancre right elbow, infection probably by scratch with soiled finger. Niel, J. G. Montpellier. (Cited by Legrand, " De l'or et du Mercur," p. 167). . Two cases, nurses infected by same nursling. Nikolsky, D. P. St. Petersburg. Vratsch., 1891; XII., 987. (Monatsh. f. prakt. Derm., 1892, p. 113). 1) Case, chancre right side of face, near angle of jaw, from shaving. 2) Statement: among the peasantry of Russia 50 to 90 per cent, of cases of syphilis are by extra-genital infection. 3) Statistics from literature. Nikolsky, V. J. Tambow Gouvernment. Physician. Vratsch., 1886, No. VII., pp. 735-738. Statistics: five years in peasantry of his district; 15.7 per cent, of all cases of sickness due to syphilis. Niobis. Rive-de-Gier. (Cited by Lancereaux, "Treatise on Syphilis," London, 1869, Vol. II., P- 245)- Ten cases of syphilis in glass-blowers, seen before 1858. Nivet, X. Paris. Hop. St. Louis. (Interne, service of Fournier). " De la treq. relat. des .... chan. syph. extra-genit." These de Paris, 1887 (Annales de Derm, et de Syph., 1887, p. 813). 1) Statistics: 47 extra-genital chancres during year 1886, Hop. St. Louis. 2) Statistics; 595 extra-genital chancres in Fournier' s public and private practice during about 30 years ; lip, 268 ; tongue, 37 ; tonsil, 29 ; gum, 6 ; palate, 3; uvula, 2; pharynx, 1; mouth, 1; chin, 31; eye and eyelids, 15; cheek, 11; nose, 11; neck, 8; ear, 4; face, 2; temple, 1; forehead, 1 ; submaxillary region, 1 ; breast. 34; fingers, 31 ; hand, 5 ; clavicle, 2 ; arm, 1; elbow, 1; forearm, 1; anal region, 50; abdomen, 20; thigh, 12; buttocks, 3; great trochanter, 1; calf, 1; malleolus, 1. Nodet, L. Lyons. Hospice de l'Antiquaille. (Service of Rollet). " Etude sur les div. espec. du chancre." These de Montpellier, 1863. Statistics: of 65 cases of syphilis, there were six extra-genital chancres; lip, 4; eyelid, 1 ; nostril, 1. Noekentved. Franekjser, Denmark. Hospitalstidende, March 1, 1893. 1) Case, chancre lower lip, in a man, whose pipe was smoked by another with mucous patches. 2) Three additional cases of syphilis, acquired probably through the common use of pipes or table-utensils, from the infecting agent in the first case. Nott, J. C. New York. Auto-infection, chancre of finger, from operation. (See Lydston). Notta, M. Paris. La France Medicale, 1885, II., p. 14S6. Case, chancre, upper and lower lip, in a 20-year-old man, probably from kiss. Nowakowski. Warsaw, Russia. (Reported by Kosinski, 1867; Lubelski, 1880; and Matlakowski, q. v. 2 ). Epidemic of circumcision-syphilis, Warsaw, 1864-5. ANALYTICAL BIBLIOGRAPHY 339 Noyes, H. D. New York. Bellevue College, Prof, of Ophthalmology. (Reported by De Beck, "Hard chan. of eyelids and conjunct," 1886, p. 52). Statement: has seen cases of chancre of eyelids, but no notes. Nunn, T. W. Lancet, London, Dec. 26, 1891, p. 1435. 1) Case, chancre of lower lip, near angle of mouth. 2) Case of infection by milk of wet-nurse (Henry Morris, q. v.). Obalinski. Krakow. Univ. Prof, of Surgery. (Reported by Jaffe, q. v.). Two cases of circumcision-syphilis. Obedenare. Bucharest. Proc. Soc. de Chirurg. de Paris, 1875, p. 141. (Cited by Roussel, " Syph. tertiare," Paris, 1881, p. 155). Case, chancre of both nipples, probably infected by own child. Obtulowicz, F. Krakow. Clinic of Prof. Rosner. Virchow-Hirsch Jahresb., 1876, II., p. 545. Case, nursling infected by mother (a case similar to that of Arning, q. v.). O'Connor, D. C. Cork, Ireland. Workhouse Hospital. Dublin Quart. Journ., June, 1846 (Lancet, London, June 20, 1846). 1) Case, infection, nurse from nursling. 2) Case, chancre of nipple, in mother of preceding nursling. 3) Case, infection, child of nurse, through spoon-feeding the nursling. (This episode the cause of a court trial, see Egan, "Syphilit. Diseases,'' p. 294). Dublin Quart. Journ. of Med. Scien., 1858, XXVI., p. 205. 4) Case, chancre of nipple, nurse from nursling. 5) Case, infection of a nurse by nursling. Oedmansson, E. L. Stockholm. Univ. Prof, of Syphilis. Nord. Med. Ark., 1869, I., 4, p. 1 (plate). Case, infection of a nurse by a nursling. Oesterlen, Fr. ' ' Hist, -kritische Darstellung des Streits uber die Einheit oder Mehrheit der venerischen Contagien," Stuttgart and Augsburg, 1836. Case, chancre of fauces, m girl of 18 years, virgin with undeveloped genitals (p. 182). (See Reich and Langenbeck). Oestreicher. Berlin, derm. Verein., Sitz., Nov. 5, 1889; Archiv f. Derm. u. Syph., Vol.. ^ XXIII., 1891, p. 837. Case, chancre of left cheek, from razor-cut, in man of 30 years. Ohmann-Dumesnil, A. H. St. Louis, U. S. A. St. Louis Med. and Surg. Journ., LV., 1888, p. 354 (Annales de Derm. et de Syph., 1888, p. 718). 1) Case, two chancres, hard palate, near gum, man aged 54, from smok- ing a pipe used by others. Monatsh. f. prakt. Derm., 1S88, p. 877 (N. Y. Med. Record, 188S, p. 590). 2) Two cases, chancre of lip, coincident with chancre of prepuce. St. Louis Clinique, Vol., IV., No. 2, p. 67. 3) Case, chancre of tonsil. International Clinics, Oct.. 1891, p. 188. 4) Case, chancre of the thumb. Oilier, L. Lyons. Prof, of Clinical Surgery. "Traiteexperim. et clin. des os," etc., Paris, 1867, Vol. II., p. 46 (Cited by Roussel, "Syph. tertiare," p. 129). Case of vaccino-syphilis (also described in part by Bouilly, q. v.). Olympios. Correspondenzbl. Bayr. Aerzte, 1840, p. 185 * (Lancereaux, "Traite," etc. , p. 42). Speaks of "Spirocolon." 34° SYPHILIS INSONTIUM Orlandini, C. Milan. Gaz. Med. ital. Lombardia, Milan, 1865, No. 18. Case of vaccino-syphilis. Ory, E. Paris. " Contrib. a l'etiol. d. syphilides malignesprecoces," These de Paris, 1875. 1) Three cases of Besnier, St. Louis, 1875; two chancres of the upper lip and one of the chin. 2) Case, Bourdon, Charite, vaccino-syphilis, from unclean scarifier. 3) Case, Vidal, Academy vaccination, malignant syphilis, 1870. 4) Case, chancre of finger, in a physician ; no particulars. 5) Case, Woillez, Lariboisiere, 1873, chancre of upper lip. 6) Two cases, Lailler, fiancees, afterwards married, each chancre of lip, man infected woman. 7) Case, Vidal, St. Louis, 1874, chancre upper lip from drinking-glass. 8) Case, Guibout, St. Louis, 1875, chancre upper lip from drinking-glass. 9) Case, Vidal and Lailler, St. Louis, 1871, probable chancre of fauces, 1863. 10) Case, Lailler, St. Louis, two nurses infected by nursling. 11) Case, Hardy, unpublished, chancre upper lip, near time of confine- ment. 12) Case, Hardy, St. Louis, 1865, midwife infected on hand. 13) Case, Labbe and Coyne, Pitie, 1872, chancre upper lip, man aged 52. 14) Two cases, Hardy, girls, chancre forearm, carrying child (p. 25). Osiander. "Denkwiirdigkeiten," Bd. II., 1, p. 100. (Plouquet). Syphilis insontium " per occubationem in eodem lecto.'' Ostroumoff, Fedor V. "Statistics of Syphilis in the Tcherepovetz Uiezd" (Novgorod Government, North Russia). Tcherepovetz, 1889. a) Syphilis prevails endemically in 90 per cent, of villages. b) Attacks especially garrison soldiers, then follows clergy (16.6 per cent, of the total number of syphilitics). c) Children, under 5 years of age, constitute 15.3 per cent, of total of syphilitics. d) Congenital syphilis more frequent in male than in female infants, all other forms more frequent in women than in men. (?) Syphilis is spread mainly in a non-sexual way. ■/) Little children infected mostly, through feeding bottles, etc. ; sub- jects of other ages from family life , towels, utensils, etc.; clergy through ritual kissing during Easter service, and some other ceremonials, peculiar to the " Orthodox" religion. Otis, F. N. New York. Prof. Ven. Dis. , College of Physicians and Surgeons- "Clin. lect. on phys.-pathol. and treat, of Syphilis," New York, 1881, p. 101 (New YorkMed. Record, Aug., 1878, XIV., p. 128). 1) Three cases, chancre right forefinger in medical men. 2) Case, surgeon, chancre right forefinger, from puncture of spicula of bone, while amputating leg of syphilitic. 3) Case, chancre of lower lip, from fiance, kissing (p 102). 4) Case, chancre, right angle of mouth, physician, from pipe. 5) Case, chancre, angle of mouth, from dentist. 6) Case, chancre lower lip, from lead pencil. " Pract. clin. lessons on Syphilis," etc., New York, 1883, Vol., I. 7) Eight cases, chancer of finger in medical men (including above four) (p. 38). 8) Case, chancre lower lip, man aged 38, from kissing. Ottava, Ignatz. Buda-Pesth. Univ. Eye Clinic. (Assistant). Szemeszet, No. 3, 1882 (Monatsh. f. prakt. Derm., 1887, p. 284). Case, chancre upper eyelid, girl aged 22. ANALYTICAL BIBLIOGRAPHY 34 1 Otterson, W. C. New York Med. Times, 1863, N. S., IV., No. 23, June 6, p. 267. Epidemic of vaccino-sypnilis ; 80 soldiers inoculated out of 300. (See Epidemics). Otto. Trans. Provm. Med. Assoc, 1839, VII., p. 212.* (Hirsch, Handb. der histor. geograph. Path. Stuttgart, 1883, II., p. 74). Report on " Syphiloid" of Jutland. Owen, E. London. Lancet, London, 1881, p. 378. Case, chancre of lip. Owre. Eleven cases extra-genital chancre. (See Moore, W. D.). Ozanam. Traite des mal. epidem., t, IV., p. 282.* (Quoted by Rollet, "Traite des mal. ven.," p. 460). Upon the subject of Scherlievo. Pacchiotti. G. Turin. Surgeon, Univ. Clinic. "Sifil. trasmessa p. mezzo d. vaccinat. in Rivalta," Torino, 1862. 1) Forty-six cases, infection from vaccination (pp. 19-27). (See Epi- demics). 2) Twenty-six cases, infection, nurses from nurslings (pp. 46-48, 66). 3) Case, chancre of lip and tonsil, in boy of 11 years (p. 51). 4) Case, chancre of tonsil, in girl of 13 years, sister of one of above- mentioned vaccinated children (p. 51). 5) Case, chancre of forearm, in girl of 12 years, sister, from carrying one of the vaccinated children (p. 52). Paget, Sir J. London. St. Bartholomew's Hospital. Lancet, London, Oct. 15, 1870, p. 536. 1) Case, chancre of tongue. Report of Army and Navy Commission, etc., 1867. 2) Statement: has seen plenty of cases of chancres on lips and fingers; the latter especially in medical men (p. 395). Quoted by Marion Sims, q. v. ; reference not given. 3) Over fifty cases in medical men, from professional infection. Paget, Stephen. London. Sen. Assist. Surg., Metropolitan Hosp., and West London Hosp. " Chancre of the lip," Lancet, London, April 16th, 1892, p. 856. Statistics collected from various sources and mention of two cases with- out details. Palfyn, J. Ghent. " Heelkondige ontleedning von menschen lichnam," Leyden, 1718., (Girtanner, No. 810). Cases of midwives professionally infected. Paliard. Lyons. Lyon med., 1872, IX., p. 36; X., p. 481. Case, chancre of forehead. Panas. Paris. Univ. Prof, of Ophthalmology. (Cases related by Delapersonne, q. v. 1 , 2 ). Two cases, chancre of eyelid. Pancritius, F. W. T. Berlin. Geheim. Sanitatsrath. " Ueber Lungen-Syphilis," Berlin, 1881. 1) Case, chancre of finger, in a physician, by vaginal exploration (Obs. I., p. 72). 2) Case, chancre of finger, cause not given. (Obs. 6S, p. 205). 3) Family epidemic from wet-nursing. (Obs. 4, p. 223). 4) Case, chancre of lip, source not given. (Obs. 10, p. 234). 34 2 SYPHILIS INSONTIUM 5) Case, chancre of lip, from kissing. (Obs. 18, p. 245). 6) Case, chancre of tonsil, in a woman from her affianced. (Obs. 2, p. 291). Pare, Ambrose. Paris. Surgeon to Henri II. , and III., Francis II., and Charles IX., of France. " Oeuvres completes," 1585, 4th Edit., p. 701. (Cited by Audoynaud, " Syph. commun. par allaitement," These de Paris, 1869, p. n). Family epidemic, introduced by an infected wet-nurse. Parinaud, H. Paris. Case, chancre of eyelid. (Reported by Brocq, q. v. 2 , (service of Besnier). Parker, Langston. Birmingham. Queen's Hospital, Surgeon. Lancet, London, 1858, I., pp. 526, 606. 1) Two cases, chancre of nipple, from breast-drawing. 2) Case, wet-nurse infected by nursling. ' Parola. " La dottrina vaccinica," 2d Edit. per mezzo d. vacc," Torino, 1862, p. 4). Partridge, E. L. New York. New York Med. Journ., 1880, p. 303. Case, chancre of lip from kissing. Passani. Gazetta medicale di Milano, Oct. 14, 1843. (Cited by Leppmann, Archiv f. Derm. u. Syph., 1883, p. 543). Cases of vaccinal syphilis. Paul, C. Paris. (Reported by Letulle, q. v.). Case, chancre of lip in boy of 6 years, from mother. Paulini, C. F. Obs. med. phys., in Append. Eph. Nat. Cur., Ann. 5 (Girtanner, p. 278). Alleged infection from pulverized bone of syphilitic subject (?). Pauly, R. Lyons. Annales de Derm, et de Syph., Vol. III., June, 1892, p. 690. ' 1) Case, chancre lower lip, in man of 38 years, in whom 14 years later two chancres appeared on left cheek. (Service of Cordier): Soc. de sciences med. de Lyon, Nov., 1891. (Journ. des mal. cut. et syph., 1892, p. 342). 2) Case chancre of forehead in man of 48, wound inoculation ; 6 weeks later a chancre appeared on right cheek. (Service of Cordier). Pavlov, P. S. Moscow. Medits. Obozrenaie, 1890, No. 1, p. 12. (Archiv f. Derm. u. Syph., 1891, P- 327); 1) Statistics: 45 cases of extra-genital chancre. 2) Among 1236 syphilitic men, 10 cases (0.8 per cent.) were extra-genital; tonsils, 2 ; nose, 2 ; upper lip, 3 ; lower lip, 1 ; tongue, 1 ; back of hand, 1. 3) Among 165 syphilitic women, 12 cases (7.27 per cent.) were extra- genital; breast, 6; lower lip, 2 ; tonsil, 1 ; soft palate, 1 ; upper gum, 1. 4) Among 43 children, 23 cases extra-genital chancre. Payne, R. L. Lexington, N. C, U. S. A. North Carolina Med. Journ., 1879, IV., p. 119. 1) Case, syphilis in infant, from' syphilitic cousin, by kissing. 2) Case, chancre of breast, in mother of preceding, fron nursing. P6an. Paris. Hop. St. Louis, Surgeon. Case, chancre of right tonsil (reported by Hue, q. v.). Pease, W. A. Cincinnati med, and dental Journ., 1S86-87, II. ANALYTICAL BIBLIOGRAPHY 343 i) Case, chancre of nipple, nurse-mother from nursling (?) (p. 294). 2) Two cases, infection after tooth extraction (p. 297). Peatson. Manchester. British med. Journ., 1S60, II., p. 594. Case, infection of child of 4 years by parents ; it had slept with its mother. Pellizzari, C. Pisa. Univ. Clin, of Dermatology and Syphilis. Gioin. ital. d. mal. ven., etc., 1879. 1) Statistics: wet-nurses, 69; infants, 54(30 buccal chancres); adults, extra-genital, 70 cases (chancre of lip, 30). 2) Case, infection nursling from nurse (p. 32S). 3) Case, chancre of tonsil, mother from nursling (p. 324). " Delia transmissione accidentale della syphilis," Milan, 18S2 (also Giorn. ital. d. mal. ven., etc., 18S2, pp. 193, 257, 323). 3 a ) Case, chancre of anus in an infant, from a piece of cloth (Brochure, p. 33)- 4) Five cases, infection, nurses from nurslings, infect their own and other children (p. 209). 4a) Case, chancre right cheek, in girl of 16, from carrying a syphilitic infant (Brocure, p. 52). 5) Five cases, infection, nurses from nurslings (p. 209). 6) Case, infection, nurse from nursling, infects its mother (p. 209). 7) Case, infection, nursling from nurse, infecting his four-year-old brother (chancre on left angle of mouth) (p. 214). 8) Cases, lactation epidemic ; nurse infected by infant, infects her own and three other children, these infect three mothers and aunt (p. 200). 9) Case, chancre of hairy scalp, from a comb, infant (case of P. Pelliz- zari) (p. 219). 10) Case, infection, nursling, from mother (p. 221). 11) Nine cases, chancre of the lip, from common use of utensils. 12) Case, infection of a child, from kissing, infects its mother (p. 215). 13) Case, chancre of lip, workman using his comrade's glass (p. 260). 14) Case, chancre of lip, pregnant woman, drinking at public fountain (p. 261). 15) Case, chancre of lip, in student, from a pipe held only a moment (p. 263). 16) Cases, infection of four persons by eight-year-old. girl, infected by coitus (p. 219). 17) Case, chancre, right arm, in child of 4 years, from vaccination (p. 223). 18) Case, chancre of chin, in man of 48, infecting his wife, chancres on cheek and sub-clavian region, by means of plaster fallen from sore (P- 273)- 19) Case, chancre, right submaxillary region, from contact with chancre of chin (p. 274). 20) Case, chancre of leg, in child w T ith infantile paralysis, transmission by the brush electrode (case of Del Greco) (p. 271). 21) Case, chancre of breast, nurse from nursling, infecting 22) Husband, and 9-year-old boy, chancres on the eyelids (p. 276). 23) Case, chancre, right hand, in Prof. P. Pellizzari himself, while per- forming version (p. 279). 24) Case, infection of a medical man, from professional exposure (p. 279). 25) Case, chancre, righc index finger, from assisting at operation on syphilitic man (p. 2S1). 26) Cases, chancre of tonsil, 4; neck, 1 ; cheek, 1 ; arm, 1 ; chin, 1 ; chest, 1; mouth, 1 ; anus, 2 (from contact). La Nuova Clin. Dermosifil. di Siena, 1884. 27) Case, chancre, lower lip, in woman of 27 years (p. S3). 28) Case, chancre of nipple (p. S2). 344 SYPHILIS INSONTIUM Giorn. ital. d. mal. ven., etc., 1884, p. 173. 29) Case, chancre, right inguino-scrotal fold in 16-months-old child, sleeping with parents (p. 9). Pellizzari, P. Florence. Univ. Prof, of Dermatology and Syphilis. Lo Sperimentale, Florence, 1862, No. 4 (British med. Journ., May 10, 1862, P- 4i5)- 1) Case, chancre left arm, Dr. Bargioni, from inoculation of blood from syphilitic woman (experiment failed on Drs. Rosi and Passagli). " Can Syphilis be transmitted by the milk?" Giorn. ital. d. mal. ven., etc., Vol. II., 1866. 2) Case, chancre of eyelid in child, from sleeping with syphilitic mother; contact with her saliva (p. 219). Report of Clinic, 1873-74 (Giorn. ital. d. mal. ven., etc., 1875). 3) Five cases chancre of tonsil (p. 316). 4) Three cases, chancre of lip (p. 316). 5) Case, chancre of finger (p. 316). 6) Case, chancre of nipple, nurse from nursling (p. 317). Penny, W. J. Bristol, England. Bristol Med.-Chir. Journ., 1888, p. 46. 1) Case, chancre of lip, from shaving; probable re-infection. 2) Case, chancre of gum, sailor aged 32; thought to be from tooth- brush. Peola. " Relazione al Consiglio Sanitario Provinciale di Alessandria," 1874. Epidemic of vaccino-syphilis at Alexandria, 1873 ; sixteen directly inocu- lated. (See Epidemics). Percival. Aiken, S. C, United States. (Reported by Jones, q. v.). Epidemic of vaccino-syphilis, during American Civil War ; about one hundred and fifty victims. (See Epidemics). Pernhoffer, Gustav von. ' ' Untersuchungen u.. Erfahrungen iiber das Krankheitsiibel Skerljevo, etc.," Wien, 1868, p. 156. Complete treatise on Scherlievo, with many references. Perrin, L. Marseilles. Annales de Derm, et de Syph., 1884, pp. 332, 380. 1) Twenty-seven cases of extra-genital chancre. (See Lavergne). Annales de Derm, et de Syph., 1890, p. 654. 2) Case of vaccinal syphilis ; infant of 3 months, infected 3) Its mother , chancre of right breast. Perroud, L. Lyons, France. Lyon Medical, 1869, III., p. 417. 1) Three cases, chancre of lip, two in glass-blowers. 2) Four cases, chancre of nipple in wet-nurses. 3) Case, chancre of lip in wet-nurse. Peter. Berlin. Dermatolog. Soc. of Berlin, Dec. 1, 1S92. (Medical Press, Dec, 1S92). 1) Had observed in Lassar's wards, during the past year, 20 cases extra- genital syphilis: upper lip, 8; lower lip, 4; mouth, 2 (from coitus per os); 1 each on neck, finger, lumbar region, thigh, and labium major in infant of 8 months, from its father, by using child's diaper as a towel. Dermatolog. Soc. of Berlin, Dec. 6, 1S92. (Le Mercredi Medical, Dec. 28, 1892). 2) Case, chancre left index finger in young man, auto-inoculated from a chancre on his penis. Petersen, O. V. St. Petersburg. Royal Alex. Hosp., Venereal Division. St. Petersb. Wochenschr. , 18S0, No. 47. 1) Case, 2-year-old child, infected by dry-nurse. ANALYTICAL BIBLIOGRAPHY 345 Vratsch., 1886, Nos. 23, 24. (Also in Monatsh. f. prakt. Derm., 1888, p. 307). 2) Statement: in inland villages of Russia, 75 per cent, of infections are extra-genital. 3) Eleven cases, chancre of lip, in young apprentices, 9 to 14 years of age, living in common. 4) Case, chancre of cheek, from tooth inoculation. 5) Case, chancre of tonsil, man, who infected 6) His wife, chancre of. gum. 7) Case, nurse, infected by nursling of above. Vratsch., No. 44, 18S9, p. 980. 8) Case, chancre of left forefinger, man from bite. Vratsch., No. iS, 1890. (Monatsh. f. prakt. Derm., 1890, Vol. XI., p. 69). 9) Case, chancre, mucous surface middle of upper lip. Vratsch., No. 49, 1891, p. 11 14. 10) Case, chancre lower lip, man from a napkin. Petreni, M. Lo Speriment, Feb., 1871 (Giorn. ital. d. mal. ven.,etc, 1871, I., p. 238). Case, female, syphilis acquired by nursing. Petrini. Turin. II raccogl. med. Forli, 1850. (Gaz. des Hop., Paris, 1852, No. 5). 1) Two cases, chancre, of nipple, nurses from nurslings, infecting 2) Their two children and husbands. Petronius, A. Trajan. "De morbo Gallico," c. 22. (Cited by Loew, 1682, q. v.). Case, infection of a respectable matron, source unknown. Petry. Gratz. Ailgem. Wiener med. Zeit'g, 1859, V., No. 14. Epidemic from tattooing; nine soldiers victims, though only four were seen, inoculated from tattooer. (See Epidemics). Pettmann, P. B. Frankfort. Nov. Act Physico-Med. Act. Nat. Cur., 1767, III., Obs. 96, p. 497. (Gir- TANNER, No. 1323). Case, chancre of finger in a midwife. Pfluger. . Bern. Klin, monatsbl. f. Augenh., 1876. (Archiv f. Derm. u. Syph., 1876, p. 63S). 1) Case, chancre both eyelids, left eye, man aged 72 years. Augenklinik in Bern, Bericht, 1877. (Archiv f. Derm. u. Syph., 1889, p. 248). 2) Case, chancre both eyelids, right eye, woman aged 59 years. Pick, F. J. Prague. Allg. Wiener med. Zeitung, 1880, XXV., p. 79. 1) Case, chancre of ring finger, in a midwife. Allg. Wiener med. Zeitung, 1883. XXVIII., p. 18. 2) Case, chancre of lower lip, in girl aged 22 years. (See also Balm, Lazansky, and Plumert). Piogey, Gerard. Paris. Soc. med. du 2me arrondissement de Paris, Seance May nth, 1854 (Clerc, " Traite prat, des mal. ven.," Paris, i860 p. 12S). Case reported by Arnal (q. v.). Pirandran. " De la syphilis des amygdales," These de Paris, 18S4. (Archiv f. Derm. u. Syph., 1889, p. 248). Case, chancre of tonsil. Pitha, F. von. Vienna. Wiener med. Presse, 1867, No. 14 (Cited by Jaffe, q. v.). Epidemic from circumcision; thirty boys infected by one operator. (See Epidemics). 34 6 SYPHILIS INSONTIUM Pitton. Journ. des connais. med. chir., Dec, 1844 (Amer. Journ. of Syph. and Derm., Vol. I., p. 194). Two cases of supposed vaccino-syphilis. Plenck, J. J. " Doctrina de morbis venereis," Viennse, 1779, Vol. I., p. 154 (Roussel, " De la syph. tertiare,"i88i, p. 204). Case, 13-year-old girl, infected by nurse. Plinatus, I. St. Petersburg. Medizinskij Wjestnik, 1873, No. 19 (Monatsh. f. prakt. Derm., 1888 p. 310). Thirteen cases chancre of breast, from nurslings, in foundling asylum, from 1870 to 1873. Plouquet, W. G. Tubingen. Univ. Prof, of Medicine. " Literatura Medica Digesta," 1809, Vol. III., M-Z. Cites numerous references in literature, to syphilis insontium; under headings, obstetrix, nutrix infecta, propagata, per salivam infectam, oscula, pocula, vulnera, scarification em, etc. Plumert, A. Prague. Univ. Clin, for Skin dis. and Syph. (Prof. Pick). Allgem. Wiener med. Zeitung, 1879, Nos. 49, 50, 51. 1) Four cases, chancre of breast, from lactation. (Obs. I -IV.). 2) Case, chancre, upper lip, in woman ; her sister syphilitic ; infected by eating or drinking-ware. (Obs. V.). 3) Case, chancre, upper lip, in man, abnormal exposure. (Obs. VI.). 4) Case, chancre, lower lip, source unknown. (Obs. VII.). 5) Case, chancre, right angle of mouth, in woman of 40 years, from pap- bag of an infant ; this infant infected about same time, chancre of chin, source unknown. (Obs. VIII. , IX.). 6) Case, chancre of thumb, in midwife, professional exposure. (Obs. X.). 7) Case, chancre, male breast, from scratch by older brother. (Obs. XI.). (All the above during year 1 8 78-79). Allgem. Wiener med. Zeitung, 1880, No. 4. 8) Case, chancre of breast, from nursing strange infant. Poggio, R. H. Gazeta med. (?) (Lancet, London, April, 1850). Case, chancre of nipple, nurse from nursling. Poilroux, J. Journ. de med. et de chir. prat., Paris, 1841, XII., Art. 2337. Tatooing inoculation; operator the medium only, victim inoculated from another tattooed subject, through needle. Poincy, F. A. R. de. "Etude prat, sur la syph., infant, hered. et acquise." These de Paris, 1877.* Poisson. Paris. r Hop. du Midi. (Service of Ricord). (Fournier "Etude sur la chancre ceph.," 1858). 1) Four cases, chancre of lip. 2) Case, chancre of foot. Polaillon. Paris. Hop. de la Pitie. La France med., 1881, I., p. 445. Case, chancre sole of foot, girl aged 15 years, in site of a wound made by a peg in a second-hand shoe. Polak, J. E. Vienna. Foundling Asylum. Wiener Rundschau, Nov., 1870, (Archiv f. Derm. u. Syph., 1S71, p. 446). Case, nurse infected by nursling. Poliataieff, P. St. Petersburg. Vratsch., iS89 ; No. 40. (Archiv f. Derm. u. Syph,, 1S91, p. 327). ANALYTICAL BLBLLOGRAPHY 347 Epidemic of syphilis from cupping; eleven victims, chancre on the back from wet-cupping by a peasant woman. (See Epidemics). Polin, H. " Contrib. a 1' etude du role de la syph. dans la vaccinat.," Gaz. hebdom. de med. et de chir., Paris, 1882, XIX., p. 308). Of 471 vaccinated, 61 with success; among the latter 48 children were infected, presenting marks of syphilis, either in themselves or in their parents from their infection. Pollaesik, S. Buda-Pesth. Clinic of Dr. S. Rona. Orvosi Hetilap, 1890, No. 15 (Monatsh. f. prakt. Derm., Vol. X., 1890, p. 520). Multiple chancres after scabies. Pollis. Omodei's Annali universali di med., Apr., 1842.* Description of " Spirocolon." Pollock. Lancet, London, 1866, I., p. 424. Case, syphilis in child %*4 years old, possibly from vaccination. Polotebnoff, A. G. St. Petersburg. Trans, first St. Pet. Gov. sanit. meeting, 1875, Feb. 6, pp. 3-9. 1) " Foundling home " prolific source of syphilis of peasantry, who take infants to nurse. 2) Group of cases, chancre of nipple, infected in " foundling home." 3) Great numbers of peasant women, infected by nursing or by taking "sucking horn" into mouth (Drs. Kanin, Roshtchinin, Stromberg, Rosoff, Thatkovsky). 4) Eight cases, chancre of nipple, contracted in " foundling home;" on return home they syphilized upwards of 60 relatives and neighbors (Dr. Stein of Gdov. , q. v.). 5) Case, chancre of nipple, wet-nurse, on return home infected own infant and husband (Dr. Sotchara, q. v.). 6) Syphilis insontium spread by female servants (Drs. Sotchara, Ber- tei.s, and Alablskeff). Protoc. d. russ. syph. u. derm. Gesell., 1885, p. 27 (Archiv f. Derm. u. Syph., 1SS9, p. 249). 7) Case, boy, infected probably from drinking-cup in school. 8) Case, chancre, right tonsil, adult female. Poncelet. Bruxelles. Presse med. Beiges, 1884, No. 31. (Virch.-Hirsch Jahrb., 1884). Case, chancre, new-born infant, from mother's parts. Poncet. Lyons. Surgeon to Hotel-Dieu. Soc. de sci. med. de Lyon, Annales de Derm, et de Syph., 1881, p. 115. 1) Case, chancre of nasal septum in a young girl. 2) Case, chancre of gum, above a large molar tooth. Pontet, A. Paris. "De la syphilis infantile acquise." These de Paris, 1878. 1) Case of Fournier's, Hotel-Dieu, 1866, chancre of vulva in a 7 weeks infant, from an infected sponge. (Obs. I., p. 10). , 2) Case of Gueniot's, Hop. des Enfants-Assistes, infection per os of a 6-year-old boy, from kissing another child (p. 14). 3) Case of Fournier's, chancre of tongue, in an infant, who infected itself from its nurse, by its fingers. (Obs. II., 2 p. 15). 4) Case of Archambault's, Hop. des Enfants-Malades, 1878, nurse in- fected at breast by nursling, own infant acquires chancre of lip. (Obs. III., p. 16). 5) Case of C. Pail's, notes by Letulle, chancre of lip, in boy of 6 years; his mother was syphilitic. (Obs. VIII., p. 32). PERCENTAGE Males Females Total 35-40 44. 6.49 7.51 0.024 0.024 5.27 2.62 78.50 14.00 0.048 7.89. 34S SYPHILIS INSONTIUM Pontoppidan. Copenhagen. Archiv f. Derm. u. Syph., 1882, p. 201. Upon the subject of " Yaws." Poore. London. Brompton Hospital. Lancet, London, Jan. 10, 1880. Case, chancre beneath right eye. Popoff, K. D. Kursk, South Russia. Proceed, of Kursk Med. Council for 1884. 1) Of 338 syphilitic peasants in Kursk township, only 54 were infected by coitus, 44 inherited and 240 (85 per cent.) from family infection. Trans. 2d gen. meeting of med. men at Moscow, 1887, Vol. II. , Sec. vi., pp. 106-117. (See also Monatsh. f. prakt. Derm., 1887, p. 856). 2) During 1884-5, medical men in Kursk registered 11,749 syphilitics, (5038 males, 671 1 females; of these 2231 children under 5 years). Mode of infection ascertained in about one-third of cases as follows : NUMBERS. Males Females Total Innocent contact, 1400 1808 3208 Hereditary, 267 309 576 Vaccination, 11 2 Coitus, 217 108 325 3) Infection, from members of patients' own family, 1229; from neigh- bors, 103; from suckling infants, 50; in military service, 21; from domestic servants, 19; from dry-nurses, 15; from using a stranger's utensils, 11 ; from lodgers, 4; from kissing, 3 ; from a beggar woman, 1 ; at school, 1 ; from a cigarette, 1 ; from a publican, 1 ; at a public bath, 1. " Erster Vers, einer Erfors. ii. d. Verbreit. d. Syph. in Kursk'schen Kreise nach d. Kartensystem f. d. J. 188S" (Archiv f. Derm. u. Syph., 18S9, p. 249)- 4) In government Kursk, 85 per cent, extra-genital infection. 5) In government Wladimir, 91.3 per cent, extra-genital; of these, infec- tion per os, 63.9; hereditary, 7.7 ; and nursing, 2.4 per cent. Poray-Koschitz, W. Charkow, Russia. Univ. Clinic for Syphilis. Sitzungsb. der med. Gesellsch. zu Charkow, 1875, Moscow, Med. Gaz., 1875, No. 8. (Archiv f. Derm, und Syph., 1876, p. 660). 1) Three cases, chancre of lip, from syphilitic fellow-workman, by pass- ing the same thread through the lips of each of them. Zdorowje, 1881, Vol. VII. (Archiv f. Derm. u. Syph. 1889, p. 249). 2) Domestic epidemic of syphilis ; eight victims. Russkaja Medicyna, 1SS5, No. 48. 3) Case, chancre by tooth inoculation. 4) Case, chancre of the fauces. Monograph on Topography of Syphilitic Chancre, 1890, p. 149. Also in Wiestnik sud. med. y hyg. , Oct. 9, 1SS9. (Archiv f. Derm. u. Syph., 1890, p. 929). 5) Forty-eight cases extra-genital chancre during 1870-1S90 (lip, 3; fore- head, 1 ; tongue, 3; pharynx, 4; buccal cavity, 16; breast, 7; trunk, 1 ; arm, 2 ; finger, 1). 6) Case, chancre of foreskin, in Jewish boy of 15 months, from circum- cision. 7) Case, chancre right tonsil, in 6-year-old sister of above. 8) Case, chancre of lower lip, man 23, from kissing a gentleman friend. 9) Case, chancre lower lip, boy of 3 years, source unknown. 10) Case, chancre lower lip, in Jewish virgin of 15, from brother. 11) Case, chancre lower lip in married woman of 28, source obscure. 12) Case, chancre lower lip, in boy of 2, source obscure; infected 13) His sister of 6 years through the mouth. . 14) Case, chancre upper lip, in boy of 10, source unknown. ANALYTICAL BIBLIOGRAPHY 349 15) Case, chancre both tonsils, boy of 3, from maid-servant with labial ulcers. 16) Case, chancre both tonsils in priest of 40, source obscure. 17) Case, chancre hard palate, in girl of 7 years from mother. 18) Case, chancre forehead, in sculptor of 25, source unknown. 19) Case, chancre of areola of breast, external to nipple, in Jewess of 23, from nursing syphilitic infant of her cook, having too much milk for her own infant. 20) Case, chancre left nipple, from suckling her own child, which was occasionally fed from mouth to mouth by a syphilitic maid-servant. 21) Case, chancre left nipple, in lady of 29, from suckling own child, which was vaccinated when 9 months old, and contracted chancre at site of vaccination. 22) Case, chancre both nipples, from suckling own child which was vaccinated when 4 months old and contracted chancres at sites of vaccination. 23) Case, chancre left areola, in young wet-nurse from nursling. 24) Case, chancre both areolae, in married woman of 19, wet-nurse from nursling. 25) Case, chancre right thumb, about nail, in physician of 30, while reducing apara-phymosis in which there was chancre within prepucial sac. 26) Case, chancre back of hand, in medical student, from handling syphilitic patients. Medycyna, 1890, Nos. 53, 55, 56 (Journ. of Laryng. and Rhinol., London, Nov., 1890, p. 463, and London Med. Rec, 1890, p. 396). 27) Case, chancre upper lip, man aged 29 years. 28) Case, chancre lower lip, lad aged 16 years, who infected 29) His brother, aged 9, chancre buccal cavity. 30) Case, chancre, inner surface right cheek, man aged 28 years. 31) Case, chancre of fauces, man aged 35 years. 32) Case, chancre of fauces, boy aged 3, son of above, from playmate. 33) Case, chancre of fauces, little sister of above, from him. 34) Case, chancre of fauces, mother of above children. 35) Case, chancre, left tonsil, from spoon of syphilitic comrade. Portal, A. Paris. " Obs. sur 1. nat. et traitem. d. 1. phthisie pulm.," 1792. A prince inoculated when 19 months old, by a nurse. Porter, R. British med. Journ., 1887, II., p. 1277. Case, two chancres on forearm from tattooing; infection from operator, by use of saliva. Porter, W. H. Dublin. Prof, of Surgery, Royal College of Surgeons of Ireland. Dublin Quart. Journ. of Med. Sci. 1857, XXIII. , pp. 88, 257; XXIV., pp. 75, 287. Case, chancre of tonsil, in woman from husband (reported by Mr. Pratt 111 Dublin Med. Press, Oct. 5, 1853). Pospelow. A. Moscow. Univ. Prof, and Chief of Mjassnitzky Hospital. Protoc. (1. conf. d. Aerzte d. Mjass. Krankenh. in Moskau/ 18 78. 1) Case, chancre of thumb, man 54 years old. Protoc. d. phys. mod. (resells, an d. Univ. Moskau, 1881, I. 2 Case, chancre of tongue, shoemaker, aged 28 years. Protoc. d. GeseDsch. russ. Aerzte in Moskau., Apr. 4, 1881. 3) Case, chancre of chin, girl aged 18 years, from kiss. Archiv f. Derm. u. Syph., 1889, pp. 59, 217. 4) Statistics: from 1878 to 1887, extra-genital chancre. 198 cases; breast, 69 ; lip, 49; fauces, 46; finger, 5 ; eyelids, 3 ; tongue, 3 ; gums, 1 ; nose, 1 ; chin, 1 ; arm, 1 ; buttocks, 10; anus, 5; lower extremities, 4. 35° SYPHILIS INSONTIUM 5) Of the 69 breast cases, 56 were from hereditarily syphilitic infants and 13 from own nurslings previously infected. 6) Case, chancre of gum, clarionet player, from common use of instru- ment (p. 76). 7) Case, chancre of tongue, shoemaker, from shoepegs (p. 77). 8) Case, chancre of tongue, in 34-year-old female, nurse from nursling (P- 78). 9) Case, chancre of fauces, female from another with chancre on lip (p. 88). to) Case, chancre of fauces, virgo intacta, iS years, from ner mother, infected with a chancre of the tonsil (p. 88). 11) Case, chancre of fauces, girl 10 years of age, from kissing (p. 89). 12) Two cases, chancre of fauces, nurses from nurslings (pp. 89, 90). 13) Case, chancre of fauces, from common use of wooden spoon (p. 89). 14) Four cases, chancre of fauces, girls 14 and 15 years of age (p. 89). 15) Case, chancre right upper eyelid, coal dealer, aged 33 years (p. 228). ib) Case, chancre inner angle of eyelid, rubbing with a soiled apron (p. 229). 17) Case, chancre upper right eyelid, from application of tongue by a syphilitic (p. 229). 18) Case, chancre of nose, from a towel, in man of 26 years (p. 229). 19) Case, chancre of chin, female, sleeping with a syphilitic (p. 230). 20) Case, chancre of finger, musician, aged 45 years (p. 230). 21) Two cases, chancre of ringer, midwives (p. 231). Posselt, C. Munich. Univ. Docent in Syphil. Two cases, chancre of lip. (See Walter). Post, Abner. Boston. Boston Med. and Surg. Journ., Feb. 4, 1892, p. 118. Saw six cases of non-venereal contagion in two weeks. Pottcher, J. F. Konigsberg. " Bemerk. iiber med. Verf. Hosp. und Kurarten," Konigsberg, 1800. (Dieterich, "Die Krankheitsfamilie Syphilis," Miinchen, 1842, Bd., I., P- re- statements (with or without cases) as to the contagion of secondary syphilis, and the not infrequent infection of families (pp. 86, 91). Poumeau-Delille, A. "De la transmission de la syph. par la vaccination." These de Paris, 1869, 48, p. 42. (No original cases, only review of Cerioli, Wegeler, Hubner, epidemic in Lupara, Lecocq Viennois, epidemic in Rivalta, Trousseau, Devergie, Herard, Sebastian, Depaul, Millard, epidemic in Lot, Closmadeuc and Denis, Schule (Depaul), Guerin, q. v.). Pratt. Dublin Med. Press, Oct. 5, 1853. (Cited by Porter, q. v.). Case, chancre of tonsil, woman from husband. Prehn. Pfaff's Mittheilungen aus d. Gebiete d. Med. Chir. u. Pharm., Kiel, 1833, P- 47i- Epidemic from a wayfarer, in 1832, who put up at six places, en route, sleeping and eating in company; a number were infected. (See Epidemics). Prettyman, J. S. Jr. Med. Record, New York, 1886, XXX., p. 516. Case of supposed vaccino- syphilis. Prewitt, T. F. St. Louis, U. S. A. St. Louis Courier of Med., 1881, VI., p. 308. Case, chancre of the nose in a pregnant woman. ANALYTICAL BIBLIOGRAPHY 35 1 Price, D. Margate, England. Lancet, London, Aug. 1S46, p. 197. Two cases, chancre of nipple, nurse from nursling; one of them infects her own nursing child and her husband. Price, J. H. New York Med. Monthly, 1886-S7, I., pp. 97-101. 1) Infection of father, mother and three little children, source unknown. 2) Statement: has seen several cases, chancre of lip, among smokers. 3) Case, chancre of lip, young woman, from kissing. (Gross). 4) Fifteen women, 9 children, 10 men, infected through a midwife (Gross). 5) Two cases, chancre of finger, cook and chambermaid. (Marion-Sims). 6) Four children infected by their mother, towels and wash bowls (?) Profeta, G. Palermo. Univ. Prof, of Skin Diseases. " Sulla sifilide par allattamento," Firenze, 1869 (work not accessible). " Trattato pratico delle malattie veneree," Palermo, 1S88. 1) Case, infection by tooth-inoculation (p. 413). 2) Case, five chancres of cheek, from a bite (p. 413). 3) Infection of fourteen persons in one family from common utensils (p. 417). 4) Cases of Fallopius, and Marc, q. v. (p. 417). 5) Mention of cases, from common use of tobacco-pipes (p. 418). 6) Mention of syphilis transmitted to children by means of bread, etc. 7) Case, chancre between fingers, youth with scabies, through itch-mites (p. 4iS). 8) Case, chancre .of nipple in a male (p. 424). 9) Case, chancre of scalp from a comb (p. 425). 10) Case, chancre, dorsum of foot, through shoe (p. 425). Proksch, J. K. Vienna. "Die Litteratur iiber die venerischen Krankheiten." 3 volumes, Bonn, 1889, 1890, 1891. A complete bibliography of syphilis to the end of 1S89. Protopopoff, P. S. Vratsch., 1880, I., p. 139 (Archiv f. Derm. u. Syph., 1889, p. 250). Case, chancre upper lip, in 24-year-old man, excised by Protopopoff for microscopial study. Protzek, E. V. " Ueber extragen. primaraffecte,'' etc. Dissert., Breslau, 1891 (Archiv f. Derm. u. Syph., 1891, p. 788). Extra-genital chancres, Breslau Derm. Clinic, 1879-90; largest number on lip, finger, 5 (2 in midwives) ; cheek, 3; eyelid, 2; tongue, 1 ; tonsil, 1 ; ear, 1 ; several on the breast. Puche, P. Paris. Hop. du Midi. Surgeon. (Cited by Fournier, " Leeons sur la chancre," 1858, p. 240). 1) Cases, chancres, upper lip, 13; lower lip, 5; tongue, 5; tongue and upper lip, 1 ; lower lip and index finger, 1 ; labial, 1 ; naso-labiai furrow, 1 ; face, 1. 2) Case, chancre, Irom prison cot vacated by prostitute (see Acton). L'Union med., Paris, 1853, No. 10. 3) Case, chancre, left shoulder. Pujol. Paris. "De l'influence des malad. du nez, et de la gorge, sur la production des mal. de l'oreille," Paris, 1881. Two cases, Eustachian infection in a youth, and old lady, aged 63 (p. 131). Purdon, H. S. Belfast. Physician to Skin Hospital. Med. Press and Circular, Jan. 29, 1873. Case of vaccino-syphilis (see Scott). 35 2 SYPHILIS INSONTIUM Putegnat. Luneville. "Hist, et therap. de la syph. des Nouv.-nes," Paris, 1854. 1) Case, nurse infected by nursling. 2) Case, nursling infected by own mother (p. 126). 3) Two nurses infected by same nursling (p. 130). Quain, R. London, Univ. College Hospital. Med. Times and Gaz., 1859 — Mason, q. v. (also Brit. Med. Journ., i860, I., P- 145). Three cases, chancre of lip, mistaken for epithelioma. Quarenghi. Torre de Busi. (Cited by Viennois from Adelasio "Syph. vaccin. com. a l'Acad.," Paris, 1865, p. 303). Epidemic from vaccination, near Bergamo (see Adelasio). Quinquaud, Ch. E. Model in Musee de l'Hop. St. Louis (Annales de Derm, et de Syph., Vol. III., Aug., 1892, p. 944). 1) Case, chancre of breast. Model in Musee de l'Hop. St. Louis (Annales de Derm, et de Syph., Vol. III., Aug., 1892, p. 945). 2) Case, double chancre of the tongue. Quinquaud, Ch. E. and Nicolle. Annales de Derm, et de Syph., Vol. III., 1892, pp. 1228-1243. 1) Fourteen cases, chancre of lip (11 lower, 3 upper); cause given in only one case, that of a man of 25 years, chancre lower lip from smoking brother's pipe. 2) Case, chancre left breast in female of 18, no cause given. 3) Case', chancre right tonsil in female of 21, no cause given. 4) Case, chancre over Scarpa's triangle in female of 21, cause unknown. 5) Case, chancre right naso-labial furrow and right temple in man of 22, cause unknown. 6) Case, chancre tip of tongue in female of 20, no cause stated. 7) Case, chancre of chin in man of 26, cause unknown. 8) Case, chancre right forearm in woman of 36, cause unknown. Quitzmann. " Deutsche Briefe iiber den Orient/' Lancereaux, " Traite," etc., p. 42. Notice of " Spirocolon." Rabinovitch, M. F. Provincial Med. Journ., April, 1892, p. 211. Case, chancre, upper lip. Rabitsch, J. Cairo. Gazz. d. ospit., Milano, 18S3, p. 218 (Berlin, klin. Wochenschr., 1887, No. 17, p. 306). Case, chancre, left tonsil, in man aged 42 years. Rabl, J. Vienna. Semaine med. , 1S89, p. 23. Case, nurse infected by nursling. Rafinesque, G. " Contribution a l'etude de la syphilis infantile,'' Archiv. de toxicologie, 1874, P- 333- Twenty-seven cases of syphilis in infants, after birth ; mother, father, or both syphilitic. Randall, B. A. Philadelphia. (Personal communication to De Beck, and by him to author). Case, chancre of eyelid. Ranke. Groningen. Med.-chirurg. Centralblatt, Wien, 1S79, XIV., p. 374. ANALYTICAL BIBLLOGRAPHY 353 Case, nurse-mother, chancre of nipple, from own nursling (exception to Colles' law). Rasori, E. Rome. Clin, for Derm, and Syph. (Prof. Manassei). Gaz. d. Osp. d. Milano, 1883, IV., p. 653. 1) Case, chancre of external ear. Deutsche medicin. Zeit'g, 1885, I., p. 137 (Archiv f. Derm. u. Syph., 1888, p. 17). 2) Case, chancre of nostril. (See also Ravogli and Rasori). Rassler, A. Kiel. Beitrag zur Aetiologie des Morbus Gallicus, Inaug. Dissert., Kiel, 1S91 (Archiv f. Derm. u. Syph., 1892, p. 155). 1) Statistics of 12 years: among 630 cases of syphilis, there were 34 cases (5.3 per cent.), of extra-genital chancre. 2) Chancie of lip, 23: breast, 3; tongue, 2; genitals (without coitus) 3. Raulin, J. Paris. Physician to the King. " Observ. de med " Paris, 1754 (p. 250) (Rollet, " Traite des mal. ven.," 1866, p. 455. Epidemic of syphilis at Nerac, 1751, known as Pian de Nerac, beginning from lactation ; more than forty nurses and nurslings affected, and later members of their families. (See Epidemics). Ravel. (Cited by Bouchut, "Traite des mal. d. nouv.-nes," 5th Edit., 1867, p. 1057). Case, nurse infected by nursling; 5,000 fr. for damages. Ravogli, A. Cincinnati, U. S. A. Phila. med. News, Vol. LXL, 1892, p. 80. 1) Case, chancre beneath nail of right 3d finger, cause unknown. 2) Case, chancre of right thumb in a man, cause not stated. Ravogli, A. and Rasori, E. Rome. Univ. Clin, for Derm, and Syph. (Prof. Manassei). Giorn. ital. d. mal. ven., etc., iSSo, p. 384. 1) Two cases, chancre of lip. 2) Case, chancre of breast, nurse from nursling. 3) Two cases, infection of glass-blowers. Raye, Alph. "Schanker an mehreren Stellen des Korpers," etc. Presse med. Beiges Bruxelles, 1S58, No. 28.* Rayer. Paris. Court-Physician. Gaz. med., 1850. (Reported by Bouchut, q. v.). 1) Two cases, nurses from nurslings. 2) Case, young virgin, syphilitic from room-mate. (See Lancereaux). Raynaud, M. (Personal communication to Lancereaux, q. v. 1 )* Case, Eustachian-sound inoculation, 1863. Razumoff, V. J. Moscow. Trans. 2d gen. meeting of Russ. med. men at Moscow, 1887, Vol. II., Sec. vi., pp. 59, 62. 1) Statistics: among R95 wet-nurses examined, 179(20 per cent.) were syphilitic; among them, 2) Case, chancre of tonsil. 3) Three cases, chancre of breast, nurses from nurslings. Redner. Verhand. der deutsch. derm. Gesell., Sept. 17-19, 1891 (Monatsh. f. prakt. Derm., Vol. XV., 1892, p. 135). Case, chancre lower lip. 24 354 SYPHILIS INSONTIUM Regoby, P. Paris. " De la syphilis chez les personnes agies," These de Paris, 1887. (Annales de Derm, et de Syph., Paris, 1889, Vol. X., p. 168). 1) Case, chancre of chin, in man 66 years old (service of Tillaux) ' (P- 21). 2) Case, chancre lower lip, in woman 61 years old (service of Martineau) (P- 5i). Reiche. (Cited by Oesterlen, q. v., "Ven. Contagien," 1836, p. too). Domestic infection ; family of man, wife, nursling and two-year-old child, with recent syphilis ; wife had sores on nipples. Reichebach. Gottingen. Mittheil. aus d. syph. Abtheil. d. Ernst- Aug. Hosp. z. Gottingen, 1889, p. 14. 1) Nine cases, chancre of lip. 2) Case, chancre of breast, from lactation. Reid. (See Plouquet "Liter. Med. Digest," 1809). Diseases of the army and Navy. Renard, L. Nevers, France. L'Union Med., 1862, XVI., p. 578. Case, chancre of tonsil in newly married woman; husband mucous patches in mouth. Renault, Alex. * Annales de Derm, et de Syph., Vol. III., 1892, p. 1275. Case, chancre right side neck, in girl of 16, from a kiss. Reshetnikoff, I. P. St. Petersburg. Vratsch., No. 5, 1892, p. 118 (St. Louis Med. and Surg. Journ., June, 1892). Case, chancre back of neck in man from wet-cupping by a Finnish, woman with " whitish crust on her lips.'' Reumont, A. Aachen. "Syphilis und Tabes," 1SS1, p. 63, Obs. XL Case, chancre of lip from husband. Reynier. Paris. Hop. St. Louis. (Reported by Sardon, q. v.). Case, probable chancre (Fournier) right tonsil. Reynolds, H. J. Chicago. Philadelphia, Med. Times, 1888, XVIII., p. 321. Case, chancre left tonsil, in man of 45 years from unnatural practices.. Rhodius, J. Padua. " Observ. med. cent, tres.," Patavia, 1657 (Girtanner, p. 234). Infection by lactation (Plouquet). Richerand. Paris. (Cited by Clerc, " Traite prat, des mal. ven.," Paris, 1S66, p. 15). Case, infection per os from a pen held in the mouth. Richet. Paris. (Cited by Ricord, q. v., L'Union Med., Paris, 1S51, p. 201). Case, an infant infected by supporting it in the hand. Richon. Hop. Militaire de Belfort. Gaz. des Hop., 1881, No. 78, p. 620. Case, chancre lower eyelid from kissing, in man of 22 years. Ricord, P. Paris. Traite pratique des maladies veneriennes," Paris, 1S38. 1) Statistics: among 588 chancres, 24 extra-genital; lips, 7; fauces, 3; various locations, 14 (pp. 525, 526). 2) Case, chancre of fauces, from drinking-glass (p. 500). ANALYTICAL BIBLIOGRAPHY ^55 (Cited by Acton, q. v., "A complete treatise on ven. dis.," London, 1841, p. 227). 3) Case, chancre after venesection. Annal. d'oculistique, Vol. XXIV., 1S50, p. 233. 4) Case, chancre lower eyelid, lawyer, from rubbing eye with his soiled finger. " Clinique iconographique," Paris, 1863. Amer. Edit., Philadelphia, 1852. 5) Case, chancre of right thumb (plate 15, fig. 3). " Lettres sur la syphilis,'' Paris, 1S63 (also in L'Union Med., 1850, No. io, p. 145; 1851, No. ii, p. 131). 6) Case, chancre of finger in physician (p. 65). 7) Case, chancre of left cheek in medical student (p. 88). 8) Case, chancre upon the sinciput (p. 88). 9) Case, chancre of eyelid (p. 88). 10) Three cases, chancre of lip (pp. 89, 1S3, 199). 11) Two cases, chancre of nipple, one in a man from contact with lips of woman ; second from husband, breast-drawing. 12) Case, infection, child from contact with diseased parts (p. 201) (Richet). " De la syphilisation et de la contag. des accid. second, de la syph.," communication a l'Acad. nationale de med., Paris, 1853. 13) Two cases, chancre upper eyelid (p. 335). 14) Case, infection of a child, source unknown (p. 337). Bull, de l'Acad. de med., 1S53. 15) Case, chancre of eyelid (Gubler) (p. 284). 16) Case, chancre of back (p. 303). " Du chancre de la bouche et son diagnostic difT.," Gaz. des Hop., Paris, 1858, XXXI. 17) Nine cases, chancre of lip (pp. 503, 504). 18) Case, chancre of lip, female from pen used by syphilitic son (p. 503). " Legons sur la transm. de la syph. par la vaccin.," Gaz. des Hop., Paris, 1862. 19) Case, chancre left arm, female (Trousseau), Xo. 7, p. 25. 20) Case, chancre lower eyelid, Xo. 12, p. 46. 21) Case, chancre of forearm from vaccination, Xo. 11, p. 41. 22) Case, chancre of lip from kissing, Xo. 11, p. 42. 23) Infection of nine children after circumcision, Xo. 11, p. 42. Ricordi, A. Milan. Osped, Magg. and Instit. di S. Corona. "Sifilide da allattamento," Milano, 1865. 1) Infection of 4 or 5 nurses, from breast-drawing, they infecting own nurslings (p. 33). 2) Case, chancre of nipple, from applying dressing from a syphilitic woman (p. 34). 3) Case, infection from vaccination (p. 37). 4) Epidemic at Casorezzo: 23 infected, starting from a hereditarily syph- ilitic child; nurslings, 10; nurses, S; spoon-feeding, 3 (p. 49). 5) Epidemic at Ubolclo: i5 infected; nurses, 9; nurslings, 9 (p. 65). 6) Epidemic at Marcallo, 16 infected (p. 78). 71 Epidemic at Rovello, 14 infected (p. 78). 8) Case, chancre of nipple, nurse from nursling, infecting 9) Infant, chancre of mouth, infecting 10) Nurse-mother, chancre of nipple, from nursling (p. S6). 11) Case, infection, source unknown, infecting 12) Mother, chancre of nipple, from nursing (p. S7). 13) Case, chancre of lip, nursling from above nurse (p. 87). 14) Case, chancre of nipple, nurse from rfbove nursling (p. S7). 15) Case, chancre of nipple, nurse from nursling (p. 88). 16) Case, chancre of tongue, nursling from nurse (p. 88). 35 6 SYPHILIS INSONTIUM Ridley, H. London. 11 Observ. med. pract.," 1703. (Cited by Plouquet under "per mammas, lactationem, vice versa.") Infection by lactation. Riedlin, V. Ulm. " Linearum med. per singul. mens, contin. duct.,'' 1695-1702 (Girtanner, p. 297). ... "Lues venerea a pariente infecta in obstetricem translata" (III., Feb., Obs. 12). Righter, W. H. Topeka, Kansas. Prof. Gen. Urin. dis. and Derm., Kan. Med. Coll. Kansas Medical Journal, 1890, Vol. II., p. 648. Case, chancre, external ear, from application of court-plaster to a burn. Rigler. 11 Die Turkei und deren Bewohner," Wien, 1852. Syphilis, "Aleppo Evil," etc. Rinecker, F. von. Wiirzburg. Verhandl. d. phys.-med. Gesellsch. in Wiirzburg, 1852, 1., p. 117; III., 375. 1) Case, dry-nurse, aged 20, infected by infant. Wiener med. Presse, 1877, No. 42, p. 1359 (also Archiv f. Derm. u. Syph., 1878, p. 265). 2) Case, vaccino-syphilis, chancre, left upper arm, in a child born with hereditary syphilis. Ring, H. W. New Haven, Conn. New York Med. Record, Vol. XLII., 1892, p. 535. Case, chancre, right upper eyelid, in 17-year-old girl, cause not stated. Ritter, Paul. (Dentist). Deutsch. Monataschr. f. Zahnheilk., X., Jahrg., Feb. (Monatsh. f. prakt. Derm., Vol. XV., 1892, p. 316). Syphilitic affections of the mouth and the transmission of syphilis by operations upon the mouth and upon the teeth. Riverius, L. Montpellier. ''Observ. med. et curat, insignes," Paris, 1646 (Cent. L, 91 ; II. 95 ; IV., 91). (Plouquet). Nurse infected by nursling, etc. ; three observations. Rizat, A. Paris. " Manuel pratique des maladies veneriennes," Paris, 1SS1. 1) Case, chancre of lip, infection through cigar-guillotine, used just pre- viously to cut cigar, moistened in another's mouth (p. 68). 2) Three cases, chancre of lip (lower 2, upper 1) (pp. 66, 68, 69). 3) Case, chancre of chin (p. 73). 4) Case, chancre of nucha, from carrying woman on shoulders (p. 77). 5) Three cases, chancre of fingers (p. 78). 6) Case, chancre of abdomen, from contact (service of Mauriac) (p. Si). 7) Case, infection, nurse from nursling (p. 248). Annales de Derm, et de Syph., 1SS5, p. 115. 8) Case, chancre of both tonsils. Rizzi, M. Gazz. med. di Milano, April, 1S46, No. 14. Case of lactation syphilis. Robbins, H. A. Washington, U. S. A. Medical News, Phiia., March 5, 1S92, pp. 263, 264. 1) Case, chancre of hand, in girl of 7 years, from sucking wound by uncle with mucous patches. 2) Case of circumcision syphilis ; mucous patches in mouth of rabbi. 3) Several cases, infection from razors in shaving. 4) Case, infection from bite of a man. ANALYTICAL BIBLIOGRAPHY 357 Robert. Annates de Derm, et de Syph.. 1879, p. 417. Tattooing inoculation ; three soldiers from same operator. Robert, A. Paris. Hop. Beanjon. Two women, grand-mother, aged 70, and aunt of an infant, infected by the latter. (See Castelnau). Robert, Melchoir. Marseilles. (Ex-Interne Hop. du Midi, Paris). Traite des malad. verier., Paris, 1S53, p. 192. 1) Statistics: among 202 chancres in service of Ricord, 25 extra-genital; lip, 7; chin, 6; tongue, 1; gum, 1; eyelid, 1; cheek, 1; forehead, 1; finger, 1; anus, 4; region of trochanters, 3. Xouveau Traite des mal. ven., Paris, 1S61, p. 321. 2) Case, chancre external angle of eye. L'L nion med., Paris, 1S62, Xo. 47, p. 150. 3) Review of vaccino-syphilis ; statistics of 219 collected cases. Robert, P. Montrejeau. Archiv. de Tocologie, 1S74, I., p. 756. Case, syphilis acquired through vaccination, chancres at points of insertion. Robinson, Edmund. Birmingham, England. Public Vaccinator. "Vaccino-syphilis," Lancet, London, 1S73, !•> P- 3 21 - Cases of supposed chancre at site of vaccination, but patients previously syphilitic. Robinson, F. British Med. Journ., 1S82, II., p. 632. Case of infection from tattooing. Robinson, T. London. St. John's Hospital. " Diagnosis and Treatment of Syphilis," London, 1S86, p. 29. 1) Case, chancre "penis, from use of a foul scalpel in phymosis operation 6-year-old boy. 2) Case, chancre lower lip, cashier of a shop, through coin held in mouth. Roche (fils). Strasbourg. Journ. des connais. med. chir., Feb. 16, 1S51 (Ann. d. mal. d. la peau, 1850-51, p- 194)- 1) Three cases, chancre of nipple, nurses from nurslings (pp. 95-96). 2) Case, chancre nipple, nurse from nursling, infecting her three daughters, 15 months, 4 years and 15 years of age (p. 96). 3) Case, chancre nipple, nurse from nursling, infecting her child of 18 months, and her sister, of iy 2 years (p. 96). 4) Case, infection, nurse from nursling. Roddick, T. G. Montreal. Prof. Clin. Surgery, McGill University. Canada med. and Surg. Journ., 1880, VIII. 1) Case, chancre lower lip, A. B., 27 years, from smoking pipe of syphilitic (p. 4-6). 2) Case, chancre left nipple, woman of 27 years (p. 487). 3) Case, chancre of neck, from a bite (p. 4S8). 4) Case, chancre upper lip, from kissing, female of 30 (p. 4S9). 5) Case, chancre right tonsil, from common use of spoon, woman of 42 (p. 490). Montreal med. Journ.. [888, XVII., Xo. 2, p. 93. 6) Case, chancre of gum, in married lady of 30, by forceps in extraction of a tooth. 7) Case, chancre forehead, from scratch, during altercation with a man having syphilis. S) Case, chancre lower lip, glass-blower, fellow-workman syphilitic. 9) Case, chancre palmar surface of wrist, washerwoman's daughter. 35 8 SYPHILIS INSONTIUM 10) Case, chancre dorsum of penis, midway between glans and root in a young boy, probably from watercloset. Rodet. Lyons. Surgeon-in-Chief, Hosp. de l'Antiquaille. Gaz. med. d. Lyon, May 5, 1862. 1) Case, re-infection, chancre of lip (reported also by Diday). Gaz. med. d. Lyon, Jan. 16, 1865, p. 35. 2) Case, infection from vaccination. 3) Case, infection, nurse from same nursling, vaccinifer. Roger, H. Paris. Hop. des Enfants. " De la syphilis chez des enfants,'' L'Union med., Paris, 1863 (and Gaz. des Hop., 1863, Nos. 118, 119). 1) Case, infection of a child by its mother (p. 5, No. 118). 2) Case, chancre upper lip in child of 2 years, from kissing its syphilitic mother who had a chancre of the lower lip (p. 7, No. 118). 3) Case, infection of a child of 11 months, from contact, dry-nurse (p. 23, No. 119). " Etude clin. d. 1. syph. infant.," Paris, 1864. 4) Case, infection, nurse from nursling, producing 5) Case, infection, nursling from nurse (p. 91). With Depaul, q. v., Bull, de l'Acad. de med. de Paris, XXXI., p. 888. 6) Epidemic, of vaccino-syphilis at Morbihan ; 44 infected. (See Epi- demics). Rognetta. Paris. Hotel-Dieu. (Service of Dupuytren). Revue med., 1833 (1832 ?), II., p. 383 (Cited by Yvaren, "Metamorph. de ia syph.," Paris, 1854, p. 138). Case, chancre of breast and eyelid, from nursling. (See Dupuytren). Rone, G. H. Baltimore, United States. Archives of Dermatology, New York, 1S78, p. 217. 1) Case, chancre of nose, man 22, from bite. (See Brinton). Chicago Med. Journ. and Exam., July, 1878. 2) Case, chancre, tip of tongue, from lead pencil. Rollet, J. Lyons. Hosp. de l'Antiquaille. " Recherches cliniques et experim. sur la syphilis,'' Paris, 1861 (also,, Archiv. gen. de med., Pans, 1859, 5th Ser., XIII., pp. 129-417, and Gaz. hebdom, 1861, p. 589. 1) Ten cases, chancre of nipple, nurses from nurslings (pp. 251-258 , 261). 2) Case, chancre of nipple, from suction by a syphilitic woman, in- fecting 3) Case, chancre of lip, nursling from above nurse-mother (p. 270). 4) Case, chancre upper lip, from a bite (p. 273). 5) Two cases, chancre of lip, glass-blowers; one of them had two chancres on upper lip and one on the lower (p. 276). 6) Four cases, chancre of lip, from kissing (pp. 279, 280, 284, 285). 7) Case, chancre lip, from using a spoon of a female cook (p. 282). 8) Four cases, chancre of tonsil, in one family (grand-mother, two sisters, one brother) (p. 2S6). 9) Two cases, chancre lip, in same family (child 15 months, and brother 18 years ; child infected by kissing (286). "Traite des maladies veneriennes," Paris, 1866. ga) A very full description of Radesyge (p. 471). 10) Cases, chancres of lip and tongue, from bites (p. 606). 10a) Case of Waller (q. v. G ) (p. 613). n) Case, chancre both tonsils, nurse from nursling, using common spoon (p. 617). 12) Mention of fifteen cases, infection of glass-blowers, from 1 858-1864; also of a large number seen after that date (p. 619). 13) Two cases, chancre of eyelid (p. 693). 14) Four cases, chancre of nose (p. 693). ANALYTICAL BIBLIOGRAPHY 359 15) Two cases, chancre of chin, medical men, from scratching with in- fected fingers (p. 693). 16) Case, chancre right cheek, house-keeper (p. 693). 17) " Sibbens d'Ecosse." Diet, encycl. d. Sc. med., Paris, 1881, 3, s., IX., 522-526.* Romanoff. Viatka. Sbornik. Meditz. Departamenta, 1876, Vol. I., Part II. 1) Case, infant of 2 months, infected by a nurse of 12 years, by kissing. 2) Same* infant infects its two sisters, 3 and T4 years old, a brother of 8, and their mother. Rona, S. Buda-Pesth. Orvosi Hetilap. , No. iS, 18S9. (Monatsh. f. prakt. Derm., 18S9, p. 192). 1) Case, chancre of right tonsil, five-year-old child. "Extra-genital Syphihsinfection mit Riicksicht auf die heimischen (un- garischen) Verhaltnisse." Gyogaszat, 1890, No. 50, a. c. t. (Monatsh. f. prakt. Derm., Vol. XII., 1891, p. 459). 2) Statistics: forty-six cases extra-genital chancre; lip, 26; tonsil, 8; finger, 3 ; forehead, 1 ; eyelid, 1 ; conjunctiva, 1 ; face, 1 ; abdomen, 2; right groin, 1; anus, 1; multiple chancre, 1. 3) Case, chancre of forehead, in site of moist eczema ; patient in hospital and had assisted nurse dress a syphilitic. 4) Case, chancre right lower eyelid, probably from a towel. 5) Case, chancre left ocular conjunctiva, boy aged 4 years. 6) Case, multiple chancres (four) from cupping-glasses in public bath- house. Soc. royale des med. du Budapest, Seance, Oct. 31, 1S91. AVeiner med. Presse, 1891-, pp. 1716, 1753. (Annales de Derm, et de Syph., Vol. III., Mar. 1892, p. 315). 7) Case, chancre beneath crest of ilium, in a man of 35 years. Rosen von Rosenstein, N. Stockholm. " Underratelse om bjarnssjukdom," Stockholm, 1764. (German Edit., "Anweis. zur Kenntn. u. Kurd. Kinderk.,'' Gottingen, 6th Edit., 1798; with notes by Loder and Buchholz). 1) Family epidemic in Stockholm, introduced by a nurse, eight persons infected (p. 728). 2) Case, 2-year-old child, infected by servant's chewing her food (p. 737). 3) Cases, two children, sisters, infected by nurse (p. 738). (Also under proper heads, cases of the editors, Loder and Buchholz, and two cases cited by Bierchen). Rosenthal, O. Verhand. der Berliner dermatol. Verein, Sitz., Jan. s, 1S91. (Archiv f. Derm. u. Syph., Vol. XXIV., 1892, p. 513). 1) Case, chancre of hand in a physician; one of three which he has observed (cases of Lewin). Berliner med. Gesell., Sitz, Feb. 3, 1S92 (Monatsh. f. prakt. Derm., Vol. XIV., 1S92, p. 332). 2) Case of vaccino-syphilis in a girl of 12 years. Roster, G. Florence. Hosp. S. Maria Nuova (Clinic of Prof. Pellizzari). Giorn. ital. d. mal. ven., etc., 186S, II., pp. 65, 136. 1) Statistics: of 156 chancres during 1S67, 13 extra-genital ; lip, 3; eyelid j ; tonsil, 1 ; fauces, 1 ; female breast, 6. 2) Twenty-six cases, nurse from nursling (pp. 160, 163). 3) Two cases, nursling from nurse (p. 150). Roussel, A. Paris. " De la syphilis tertiaire dans la seconde enfancc et chez les adultes," Paris, 1 881. 1) Statistics: infantile acquired syphilis, Lyons civil hospitals; 1S76, 7 cases; 1S77, 10; 1878, 7; total, 24. 3 6 ° SYPHILIS INSONTIUM 2) Family epidemic, nurse infected by nursling, infects another nursling, the infant infects mother, and she her husband (p. 59). 2d) Case, chancre of right tonsil, in child of 7 years, from using a spoon after mother (p. 70). 2b) Case of Trousseau (p. 71). 3) Case, chancre lip, child 2 years of age, source unknown, infects 4) Two other children (chancre of throat) and grand-mother, who infects her husband (service of Dron) (p. 78). 5) Case, infection, boy 9 years, from mouth-piece of cornet, used by some unknown person (service of Aubert) (p. 89). 6) Case, infection, child 2^ years, source unknown (service of Dron) (p. 102). 7) Case, chancre penis, child 15 months, source unknown (service of Dron) (p. 102). 8) Case, chancre, inner surface of cheek, child 9 years, source unknown (service of Aubert) (p. 103). 9) Case, girl 18, infected by mother in infancy, she from strange child (service of Aubert) (p. 196). 10) Case, infection, child 12 years, from mother in infancy (service of Aubert) (p. 19S). (Other cases claimed as syphilis acquise, are not here quoted, as data in regard to infection are wanting). Roux. • Gaz. med. de Paris, 1852, p. 64 (also Mem. de l'Acad. med., 1853, p. 331). Case, chancre of tonsil, woman aged 50, from kissing her son. Ruggiere. Epidemic of syphilis at Capistrello. (See Demarchi and Tanturri). Rumpf, Th. Bonn. " Die syphilitischen Erkrankungen des Nervensystem," Wiesbaden, 1887. 1) Case, chancre of lip, man 44; syphilis of brain (p. 264). 2) Case, chancre of hand, medical man 26 years; tabes dorsalis (Pierson) (p. 387). Vogel, Archiv f. klin. Med., Bd., XX., p. 32. 3) Case, infection at an autopsy (p. 183). Charcot and Gombaut, Archiv. de physiol, norm, et path., 1873, p. 143. 4) Case, chancre of lip in female of 19 years (p. 316).) Rupp, J. " Syphil. Ansteckung ohneBeischlaf," Zeitschr. d. Nord-deut. chir. Verein f. Med. etc., Magdeburg, 1848, II., 6. 1) Case, infection, nursling from dry-nurse. 2) Case, infection, nurse-mother from preceding. 3) Case, chancre fauces, husband of preceding, by breast-drawing through pipe-bowl. Russell, Alexander. " Nat. hist, of Aleppo evil particularly of the plague, with methods used by the Europeans for their preservation," London, 1856.* Russell, C. P. Journ. Cutan. and Ven. Dis.. 18S4, II., p. 240. Case, chancre of right index finger. Rust, J. N. Berlin. Charite Hospital, Surgeon-in-Chief, etc. Rust's Magazin, Berlin, 1823, XIII , p. 542. 1) Family epidemic of syphilis, starting from 4-year-old infant. Jahresber. Charite Krankenh., 1834. (Cited in Bolschwing " Syph. und Aussatz," p. 34). 2) Statistics: of 820 venereal cases, 6 infected, sine coitu. " Helkologie, etc.," Berlin, 1842, p. 246. ANALYTICAL BIBLIOGRAPHY 361 2d) Buccal propagation by tobacco-pipes. (See HuFELAND'sMakrobiotik, 444)- 2b) Buccal propagation by kissing. (See Alberti). 3) Epidemic of circumcision syphilis in Cracow, 1805; first recorded instance, p. 247. (See Epidemics). 4) Similar epidemic in Rhine provinces, official investigation, p. 247 (See Epidemics). Ruthenberg, A. Bonn. " De syphilis ab aliis atque apartibus genitalibus exeunte ; observationes quasdam," Inaug. Dissert., Bonn, 1830. Eleven observations: of Wolf; Nasse (two); Klein; Kilian (two); Velten ; Kopp; Haase; Anonymous (two). (All of which see) Ryan, C. S. Melbourne. Australian Med. Journ., July, 15th, 1886, p. 305. 1) Case, chancre of nose. (See Bird and Snowball). 2) Case, chancre of lip, in an old lady from preparing the feeding-bottle of her syphilitic grand-child. Ryan, James P. Melbourne. Surgeon Skin Dept., Melbourne Hosp. Trans. Intercolonial Med. Congress of Australia, Second Session in Mel- bourne, Victoria, 18S9, p. 994. Case, chancre of forehead, in 3-year-old girl, probably infected by kisses of mother who had mucous patches in the mouth. Sabinin, A. Kh. (See Ssabinin). Voronej, Russia. Trans, of the 4th meeting of Zemsky Med. men of Voronej Gov. 1882, p. 40, et seq. Statistics: among 3098 consecutive cases of syphilis ; 121 children infected per os by their mothers; 54 children infected per os by other persons; 15 nurses infected by nurslings; 243 infected by family life; 4 infected by contact with neighbors. Sabolotsky, A. Medicinskoe Obozrenaie, 1S84, p. 466. (Archiv f. Derm. u. Syph., 1S89, P- 251). Case, two chancres on right eyelid. Sadoul, L. Strasbourg. " De la transmiss. de la syph. du nourrisson a la nourrice," These de Strasbourg, 1848. Case, nursling infects nurse. St. Martin. Pans. Hop. d. Quinze-vingt. Bull, de la ciinique nationale Ophthal. d. Quinze-vingts, 1S84, II., p. 33. Two cases, chancre of left upper eyelid. Salleneuve. Paris. '• Sur la valeur semieotique des affect, ganglionnaires," These de Paris, 1S52. Case, chancre of tongue, from prostitute. Salomon (father). Hamburg. Jewish Rabbi. Proc. deutsch. Rabbin. Versaml., Breslau, 1S46. (Cited by Jaffk). Epidemic of circumcision syphilis, from buccal lesions of psylle. Salsotto, G. Turin. "Sifilomi extra-genitali ed epidemic di sifilide," Torino, 1892. 1) Statistics: private and public practice from Jan. 1st, 1SS4 to July 31, 1892, 201 cases extra-genital infection, as follows; breast, 108; lip, 61; arm, 12; chin, 3; finger, 3; anus, 2; groin, 2; upper eyelid, 2; cheek, 2; tongue, 2; thigh, forehead, back and gum, each r. The 108 cases with chancre of the breast communicated the disease to 109 children and 66 adults, included in these were: 2) 12 cases, vaccinal syphilis, one infected by saliva of operator (p. 4). 362 SYPHILIS INSONTIUM * 3) Lactation, 105 nurses infected by nurslings; all of these but 31 pro- pagated the disease further to 226 persons (p. 10). 4) Among accidental cases; a) 2 of eyelids from kissing, p. 14-15, b) cheek, from bite, p. 15); c) cheek in girl from contact with pillow; p. 15 ; d) upper gum in a barber, p. 16, etc. San Juan, M. Madrid. Revista esp. d. oftalm., etc., Madrid, 1883, VII., p. 145, andBolet. demed. naval., San Fernando, 1883, VI., p. 198. Case of lactation syphilis. Sarda. Montpellier. Health-Officer. (Cited by Legrand, "De Tor et de mercure . . . . " 18S4, p. 439). Case, chancre of lip. Sardon, G. Paris. Hop. St. Louis. (Interne, service of Reynier). " Gommes du couturier," Annales de Derm, et de Syph., 1887, 2d Ser., VIII. , p. 406. Case, Fournier, probable chancre of right tonsil. (See Reynier). Sartorius, P. Strasbourg. Hospital for Venereal Diseases, Surgeon. " Frantzosenarzt " 1645. (Girtanner, p. 215). Cases of lactation syphilis. Sattler, R. Cincinnati. (Personal communication to De Beck, q. v.). Case, chancre of conjunctiva from kissing. Saulsay, Nicolais du. Fourgeies. Journ. d. med. chir. pharm. etc., Mar. 1759, p. 232 (Girtanner, No. 1184). Case, chancre right middle finger in obstetrician ; professional exposure Sauvages, F. B. de. Montpellier. Univ. Prof, of Medicine. "Nosologia methodica," etc., Venet., 1764, p. 781 (Rosen von Rosenstein, " Kinderk.," p. 727). Case, infection of medical man from resting head on pillow of patient; probably infected through saliva. Savy, ^Claude. Lyons. "Eruptions de la conjunctive,'' etc., These de Paris, 1876, p. 63. Case, chancre of eyelid in medical man, infected by patient coughing in face. (See Fournier). Sbordone, G. Naples. II Movimento med.-chir., 1882, Nos. 3 and 4, pp. 155-160. (Giorn. ital. d. mal. ven., etc., 1882, p. 361). Case, chancre of eyelid in a physician. (See Del-Monte 2 ). Scarenzio, A. Pavia. Univ. Prof, of Skin Diseases and Syphilis. Giorn. ital. d. mal. ven.,. etc., 1866, II., p. 12. 1) Case, nurse infected by nursling. 2) Case, infection of an 8-year-old, per os, by mother. 3) Case, infection of a nursling, per os, source unknown. 4) Case, infection of a 15-year-old, per os, from famiky. Giorn. ital. d. mal. ven., etc., 1880, p. 16. 5) Case, infection of mother by own nursling (exception to Colles' Law). (Reported by Jullien. Also Annales de Derm, et de Syph., 2d. Ser., V., 1884, p. 77). 6) Inoculation of Scarenzio, himself, source not stated. (See Soffiantini). Schirajew, P. Moskow. Mjasnitzki Hosp. (Service of Posfelow). St. Petersburg med. Woch., iSSo, No. 39, p. 323. (Archiv f. Derm. u. Syph., 1881, p. 127). 1) Case, chancre left tonsil, girl aged 28, from felknv-cook. 2) Case, nursling infected by wet-nurse. 3) Case, chancre, left tonsil, mother from above nursling. ANALYTICAL BIBLIOGRAPHY 3 6 3 Schlegel, J. H. G. Jena. " Material f. d. Staatsarzneiwissensch. u. prakt. Heilkunde,'' Jena, 1S04, IV. Syphilis insontmm by buccal secretions, " oscula pocula" (Plouquet). Schmalz, C. L. Leipzig. " Seltene chirurg. u. med. Vorfalle," Leipzig, 1784, S°, pp. 162-164. 1) Case, nursling infected by nurse. 2) Case, mother of above from own nursling. Schneider. " De catarrhis," p. 415. (Plouquet, " per salivam, osculum "). Schnitzler, J. Vienna. Univ. Prof. Dis. of Respiratory Organs. " Lungensyphilis und .... Lungenschwindsucht," Wien, 1SS0 (Wiener med. Presse, 1S79, XX.). Two cases, chancre of finger, in medical men. (Obs. V. and p. 20). Schnur. " Ueber die Lustseuche in Litthauen u. ihre Behandlung,'' Med. Zeitsch. d. Verein f. Heilk. in Preussland, 1S37, Nos. 50, 51. 1) Syphiloid of Lithuania. "Med. Zeitsch. d. Verein f. Heilk. in Preussland, 1S39, Nos. 17, 18; 1841, Nos. 2, 3. 2) Petty epidemics of family syphilis. Schubert, P. Xiirnberg. Eye and Ear Clinic of H. Cohn, Breslau. ''Syphil. Augenkrankheiten," Berlin, 1881. 1) Statistics, of 35 histories; 2 extra-genital (?). 2) Case, midwife professionally inoculated (p. 82, obs. 20). 3) Case, possible infection per os, fauces (p. 112, obs. 35). Schiiller, M. Vienna. Wiener med. Wochenschr., 1S61, No. S, (Jahrb. f. Kinderheilkunde, 1S61, No. 4). 1) Case, chancre of finger, in 6-year-old attendant, from nursling. 2) Case, chancre back of hand, in wet-nurse, from nursling. Schurig, M. Dresden. "Sialogia histor. med.," Dresdeae, 1723. (Monatsh. f. prakt. Derm., 1SS8, p. 190). Case, child infected on an abraded surface, by kiss of nurse. Scott, J. M. J. Belfast. Med. Press and Circular, Jan. 29, 1873, L, p. 84. Case of vaccino-syphilis (in practice of Purdon, q. v.). Sebastian. Beziers. Maternite, Physician. Gaz. des Hop., Oct. 22, 1863. Case vaccino-syphilis (reported by Blot, q. v.). Secheyron, L. Paris. Annales de Derm, et de Syph., 1SS6, VII., p. 75. 1) Case, weanling, from foster-mother. 2) Infection of child under 5 years from foster-mother, or possibly Eustachian infection. Se>. Gaz, hcbdom. de med. et de chir., Mar. 9, 1S55. Epidemic of vaccino-syphilis. (See Lancereaux % and HObner). I Seeley, W. W. Cincinnati. Med. Coll. of Ohio, Proi. Ophthalmology. Case, chancre of eyelid. (See De Beck). Segel. Pitha-Bilroth, ITandb. d. Chirurgic. (Cited by Jaff£, q. v.). Case of circumcision syphilis. Selenew, J. Th. Verhand. des Kiewschen Militarhosp., Mar. 1891, Vratsch., 1891, No. 15 (Monatsh. f. prakt. Demi., Vol. XIII.. 1891, p. 32). 364 SYPHILIS INSONTIUM 1) Case, chancre right tonsil, in 21-year-old married man, infection probably from neighboring syphilitic family. 2) Case, probable chancre of tonsil, in a 22-year-old man. . Selli. One of the investigators of the endo-epidemic at Capistrello. (See Demarchi, Tanturri, Durante, Ruggiere). Serduckov, A. S. St. Petersburg. Voyenno-Meditsinsky Journal, June, 1S90, p. 119 (St. Louis Med. and Surg. Journal, Sept., 1890, p. 235). 1) Case, chancre upper eyelid in a wet-nurse. Vratsch., No. 14, 1892 (St. Louis Med. and Surg. Journ,, June, 1892). 2) Case, chancre right tonsil, in man of 23 years, from smoking cigarettes in common. 3) Case, chancre right side soft palate, in man of 25 years from cigarette smoking. Vratsch., 1892, No. 18, p. 462. 4) Case, chancre middle of upper lip, in a boy of 15 years, source unknown. Settegast. Coblenz. Rust's Magazin, Berlin, 1823, XV., p. 146 (Hacker, "Lit. der Syph." Leipzig, 1830, p. 144). Epidemic of lactation syphilis, in two communes near Coblenz. (See Epidemics). Seutin. (See Joly). Seweke, W. Prof. Tarnowsky's Clinic (assistant). Russkaja Medicina 1886, No. 42. (Archiv f . Derm. u. Syph., 1889, p. 251). Two cases, chancre of tonsil from Eustachian catheterization. Shand, J. C. Phys. for Dis. of Women and Children, Glasgow Public Dis- pensary. Med. Press and Circular, London, 1S82, N. S., 33, p. 135. 1) Case, nursling infected by nurse. 2) Case, chancre of mouth in the mother. Sheild, A. M. London. British Med. Journ., 1887, I., p. 274. (MonaKh. f. prakt. Derm., Vol. VIII., 1889, p. 208). 1) Case, chancre at angle of mouth, in 32-year-old woman. British Med. Journ., Jan. 30, 1892, p. 228. 2) Case, chancre left cheek in widow of 34 years, source unknown. Sherwell, S. Brooklyn, N. Y. Proceed. N. Y. Derm at. Soc, Journ. Cutan. andVen. Dis., 1886, p. 84. 1) Case, chancre lower lip, in girl of 20 years. Proceed. N. Y. Dermat. Soc, Journ. Cutan. and Genito-Urin. Dis., 1887, p. 311. 2) Case, chancre both nipples, from nursing 6-months-old hereditarily syphilitic infant. Shoemaker, J. V. Philadelphia. '• Diseases of the Skin," 1888. Case, chancre of lip, from kissing. (Plate, p. 153). Sick. Muskan. " Seltene Arten von syphilitischer Ansteckung." Med. Zeit'g, herausg. v. Vereine f. Heilkunde in Preussen, Berlin, 1837, No. 13.* Unusual methods of syphilitic infection. Sigmund, Carl von. Vienna. " Ueber die syph. Ansteck. durch Cigarren-Rauchen," Wiener med. Woch- enschr., 1853, III., No. 10, p. 145. 1) Case, chancre, lower lip, \\\ a man. 2) Case, chancre, both lips, in a woman. ANALYTICAL BIBLIOGRAPHY 365 Wiener med. Wochenschr., 1854, Xo. 9, p. 132. 3) Case, chancre of nipple, nurse from nursling. Wiener med. Wochenschr., 1S54, Xo. 16, p. 241. 4) Eleven cases, chancre of ringer, from professional exposure. 5) Case, chancre of nipple, nurse from nursling. 6) Case, chancre of finger, from contact. 7) Case, chancre of the vulva, from washing with a sponge. 8) Case, chancre on the neck, and shoulder, from bandaging. 8a) Zeitschr. der Wiener Aerzte, 1855, p. S7.* (Cited by Rollet, "Traite," etc., 1S66, p. 465). A personal study of Scherlievo, Facaldina, etc. 8b) Zeitschr. der Wiener Aerzte, 1S55, p. 33.* (Cited by L.a^cereaux, "Traite," etc., p. 42). Personal account of " Mai di Breno," and " Fienga." Wiener med. Wochenschr., 1863, Xos. iS, 19, 21, p. 290, 291. 9) Case, chancre of finger, midwife, infecting 10) Child, chancre at right angle of mouth. 11) Four cases, chancre of upper lip, in glass-blowers. 11a) Three cases, chancre of lip, from blow-pipe. 12) Case, chancre at angle of lip, nursling from nurse. Wiener med. Wochenschr., 1S65, p. 1430. 13) Mention of 29 cases* chancre of finger. 14) Mention of 5 cases, chancre of nipple. 15) Statistics: 75 cases extra-genital chancre ; lip, 40; tonsil, 5; tongue, 2; nose, 1 ; finger, 27 (p. 1445). Wiener med. Wochenschr., 186S, p. 137. 16) Four cases, chancre of lip. 17) Statistics: 73 cases, chancre of lip, from 1S61-67. Wiener med. Wochenschr., 1S7S, p. 562. 18) Statistics of chancre acquired late in life: finger, 9; mouth, 7; nipple, 1; by sucking, 8; total, 25. Signorini, Mario. Florence. Univ. Clinic for Syphilis. Lo Sperimentale, iSSS, p. 249. (Giorn. ital. d. mal. ven., etc., 1S88, p.220). Seven cases of vaccinal syphilis: 15 children vaccinated from same infant ; first 6, from clear vesicles, not infected. Simon, F. A. Hamburg. " Antwortschreiben auf Ricord's Briefe." Hamburg, 1S51, I., p. 9. 1) Case, obstetrician, professionally infected; life-long invalid therefrom. "Kritische Geschichte der Syphilis." Hamburg, 1858, II., 1, p. 133, note. 2) Family epidemic of syphilis in Hamburg ; physician sued for damages. " Kritische' Geschichte d'er Syphilis," Hamburg, 1S60, II., Theil, II., abstract, p. 103. 3) Five cases of Lebe.nwald, from bleeding with a lancet. (Lebex- wald, q. v.). Simoneau. Florensac. (Legkand, " De Tor et du mercure," 1846, 2d Edit. Obs., 377). Case, chancre of tongue from kissing. Simonet. Paris. Surgeon to Hop. du Midi. 1) Case, chancre of cheek, from bite. (See Hortei.oup and Leprovost). 2) Case, chancre of nucha, direct contact. (See Ciiiher and Rizat). 3) Case, chancre of nipple, wet-nurse. (See Audoynaud). Sims, J. Marion. New York. Surgeon to the Woman's Hospital. Transact. Amer. Med. Ass'n, Vol. XXIV., 1-76, p. 104. 1) Two cases, chancre of finger, in medical men, professionally infected. 2) Family epidemic, husband infects wife and four children; towels, basins, etc. 3) Case, mother infected in the eye, from towels of son. (See also Price, J. H.). 366 SYPHILIS INSONTIUM Siredey. Paris. Hop. Lariboisiere. (See Audoynaud and Morel-Lav allee). Sirski, K. L. Moscow. Clinic of Polotebnoff. British Journ. of Derm., Oct., 1889, p. 424. Case, chancre of finger, in a man. Sistach. Gaz. med. de Paris, 1863, p. 1. Case, chancre left arm, female 18 years from vaccination. (Service of Trousseau). Skae, D. " Condyloma, a primary form of venereal disease identical with Sib-bens." North. Journ. Med., Edinb., 1844, I., pp. 89-104.* Skinner, T. Liverpool, England. British Med. Journ., 1864, I., p. 595; 1865. I., p. in. Case, chancre of breast, from a syphilitic nursling. Smith, J. L. New York. New York Medical Journal, 1857, p. 341. Case, nursling infects nurse. Smith, T. London. Trans. Clin. Soc, London, 1871, p. 53. Case of vaccino-syphilis. Smith, W. P. San Francisco. Western Lancet, San Francisco, 1872, I., pp. 33-38. Case, chancre of eyelid. Snell, S. Sheffield. Lancet, London, 1882, I., p. 522. 1) Epidemic from lactation. British Med. Journ., 1882, II., p. 1252 (also Trans. Ophthal. Soc. of Great Britain and Ireland, 1883, p. 4). 2) Case, chancre inner canthus of eye in young woman, from manifold exposure to a five-months-old infant. Snitzer, S. Bamberg. Archiatrus (Physician -in-Chief). Describes the epidemic from cupping at Bamberg, 1603, in a letter to Libavius, published both by Hornung and Horst (q. v.). Snowball, W. Melbourne, Australia. Austral. Med. Journ., July 15, 1886, p. 305. Case, chancre ala of nose in a dry-nurse, from a tooth wound by a nursling. (See Ryan, C. S. 1 and Bird). Soffiantini, G. Pavia. Clinic of Scarenzio. Giorn. ital. d. mal. ven., etc., 1885, pp. 12, 142. Thirteen cases, nurses infected by nurslings. Sokoloff. Archiv f . gerichtliche Medizin. St. Petersburg, 1867, No. 2. An article on the Berreshof Disease, a " Syphiloid" of Siberia. Solari, B. T. Circulo Medico Argentino (St. Louis Med. and Surg. Journ., 1890, LIX., No. 4, p. 225). Case, chancre of right Eustachian tube in a prostitute, aged 32 years, acquired probably through unnatural practices. Soler-y-Buscala, Juan. Spam. Revista de las Ciencias Medicas. (Provincial Med. Journ., i8go, IX., p. 43). Also " Varios casos de sifilis," Barcelone, 1S90). 1) Case, chancre of lip in a man, mode of infection not given. 2) Case, chancre of lip, laborer, from wife, who had contracted the dis- ease in wet-nursing. ANALYTICAL BIBLIOGRAPHY 3 6 7 3) Case, chancre of cheek, infection from a bite (Practice of Dr. Homs, of Mogas). 4) Case, chancre of tongue in an infant, suckled by another woman after mother's milk failed. 5) Case, chancre of nipple, in mother of above infant; he slept with her and used to suck her empty breasts at night. 6) Case, chancre of arm in the grand-mother of this infant ; from carry- ing it. Solis-Cohen, J. Philadelphia. "Diseases of the Throat and Nose," Philadelphia, 1S79 (2d Edit.). Case of Eustachian-sound inoculation (p. 119). Solomon, J. Vose. Birmingham. Queen's College, Prof, of Ophthalmology. British Med. Journ., 1S63, p. 236. 1) Case, chancre of eyelid, in 8-months-old child, from saliva "sputtered" into its face, by its aunt who had buccal lesions. 2) Case, chancre of nipple in mother of above child, developed after buccal lesions were present in child's mouth. British Med. Journ., 1S69, II., p. 645. 3) Two cases of probable vaccination syphilis. Solovioff. London Medical Recorder, July 1890, p. 266. Case, chancre of little finger. Sommerbrodt, J. Wiener med. Pr'esse, 1870, p. 413 (Archiv f . Derm. u. Syph., 1882, p. 500). Case, chancre of lip, in a girl. Sommering. " De morbis vasorum absorbentmm.'' (Clossius). Case, or cases of infection of anatomists from syphilitic cadavers. Sonsino, Prosper. Imparziale di Firenze, 1S70, Apr., and May. (Annales de Derm, et de Syph., Vol. II., 1870, p. 449). Discussion on circumcision syphilis. Sotchara. Trans, of the 1st St. Petersburg Gov. sanit. meeting; Feb. 6, 1875, PP. 3-9- Case, chancre ot nipple, nurse from nursling ; she in turn, infected her own infant and husband. (See Polotebnoff). Souchier. (Cited by Legraxd " De l'or et du mercure,'' 2d Edit. Paris, 1842, p. 174). Case, multiple chancres of breast, nurse from nursling. Spaack. Brussels. Prof. Thiry's Clinic. Presse med. Beiges, 1862, No. 48.* Article on cephalic chancre. Sparks, E. J. London. Charing Cross Hospital. Lancet, London, 1874, II., p. 869. Case of acquired syphilis in a child 12 years old, of healthy parentage. Speransky, N. S. Moscow. Russkaja Medicina, 1SS8, No. 39, p. 624 (Archiv f. Derm. u. Syph., 1889, P- 251). t) Case, chancre of nose, from a bite during a quarrel. Meditzina, 18S9, No. 52, p. 1. 2) Case, chancre, lower lip, in girl of 15. 3) Case, chancre, both fauces, in girl of 14. 4) Case, chancre of fauces, in girl of 15. (All seamstresses in same house, from common use of utensils). Vratsch., 1891, No. 7, p. 207 (Annales de Derm, et de Syph., 1891, p. 419). 5) Statistics: 80 to 90 per cent, syphilis in country districts, extra-genital; 368 SYPHILIS INSONTIUM in Miasnitskaja hospital, Moscow, in 1888, males, 4.78, females, 8.86 per cent.; in 1889, males, 6.87, females, 12.15 per cent; in 1890, males, 6.88, females, 18.15 per cent. ; total, 313 cases of extra-genital infection, among 3258 cases. Meditzinskoe Obozrenaie, 1892, No. i,p. 90. 6) Five cases, chancre of nipple, nurses from nurslings, in Oct. and Nov., 1 891. (All nurses from nurse bureaus, of which there are over 50 in Moscow ; syphilis is thus daily increasing and infection of nurses or nurslings is an "every day occurrence"). Sperck. (Cited by Petersen, Monatsh. f. prakt. Derm., 1888, p. 309). In Kalinkin hospital in St. Petersburg, 24.3 per cent, extra-genital infection in syphilitic women. Sperino, C. Turin. " La sifilizzazione studiata qual mezzo Curat " Torino, 1853. 1) Case, nurse infected by nursling (p. 25). 2) Three chancres produced by puncture with unclean lancet, used seven months previously for syphilization inoculations (p. 97). Spillman, P. Nancy. Rev. med. de l'Est., 1878, p. 292 (Annales de Derm, et de Syph., 1879, P- 79)- 1) Case, chancre, right tonsil, woman aged 59, from foster-child, through nursing-bottle. 2) Case, chancre lip, upholsterer's apprentice, from fellow-workman; saliva on tacks held- in mouth. Spoof, B. Abo, Finnland. Hospital of Abo. Upsalalak., For., 1873, VIII. , p. 352. Epidemic from cupping ; 1 7 received at hospital, claiming this source for their disease. (See Epidemics). Sprakel, H. " De morbo qui dicitur Radesyge," Hales Saxonum, 1864. Ssabinin. (See Sabinin). (Cited by Herzenstein, "Syph. in Russl." Bd., I., p. 492, and Beloussow, Arbeit des II., Congr. russ. Aerzte, 1887; Archiv f . Derm. u. Syph., 1889, p. 252). Statistics: in Gov. Woronesch, of 865 syphilitics; 201 by coitus; 219 hered- itary ; and 445 from family life. Stahl, G. E. and Holl, J. S. Halle. " Dissertatio de requisitis bonae nutricis." Halae, 1698. Case, girl seven years old, syphilitic, probably from lactation. Stanch, F. A. St. Petersburg. Vratsch., No. 14, 1892 (St. Louis Med. and Surg. Journ., June, 1892). Case, chancre of lower lip, in man of 37 years, cause not stated. Stanley, E. London. St. Bartholomew's Hospital, Surgeon. British Med. Journ., June 20, 1857. (See also Mason). Case, chancre of lip, in a nurse attendant on syphilitics; probably through digital auto-infection or through a towel. Stark, J. Edinburgh. Edinburgh Med. and Surg. Journ., 1851, p. 366. Case, probable chancre of tonsil, elderly dry-nurse from nursling. Startin, J. (Senior). London. Hospital for Skin diseases, Blackfriars. Discussion, Royal Med.-Chir. Soc, 1871. 1) Statement: had seen 30 cases of vaccinal syphilis in as many years. British Ass'nMed. Journ., 1870, 1S71 (Nayler, "Dis. of the Skin," London, 1874, p. 355). 2) Two cases of vaccinal syphilis (seen witn Mr. Nayler, q. v.). ANALYTICAL BIBLIOGRAPHY 3 6 9 Steele, F. London. Resident Medical Officer, Bloomsbiiry Dispensary. Medical Press, 1S91, LI., p. 270. Case, chancre, upper lip, woman 31 years, in site of crack in lip, attri- buted to having held tacks in the mouth. Steffens. Christiania. Norsk. Mag. f. Laegevidensk., 1S41, p. 1. Epidemic of family syphilis. Steffens, M. M. H. Christiania. One of three appointed to investigate Radesyge in Norway; results reported April 30, 1774, as regards the disease in Christiansand. (Cited by Boeck, "Traite d. 1. Radesyge," etc., 1S60, p. 6). Stein. Gdov, Russia. Trans, of the 1st St. Petersburg Gov. sanit. meeting, Feb. 6, 1875, pp. 3-9. Eight cases, chancre of, or about nipple, nurses from nurslings; these infected upwards of 60 relatives and neighbors (see Polotebnoff). Steinbach. Internat. klin. Rundschau, 1SS7, p. 366. (Archiv f. Derm. u. Syph., Vol. XXL, 1SS9, p. 2S4). Case, chancre of temple in physician, following application of leeches ; source of infection unknown. Steinberger. Busch's neue Zeitsch. f. Geburtsh., 1S34, II., p. io3. (Cited by Dieterich, "Die Krank. Fam.," etc.). Five cases, nurslings infected by nurses. (Author supposes this to occur through the milk). Stellwag von Carion, Carl. Vienna. Die Ophthalm. vom naturwissensch. Standpunkt, 1S58, Bd. , II., p. 954. Case, chancre of eyelids, from contamination with fingers. Stepanoff, A. D. St. Petersburg. Vratsch., 1890, No. 40, p. 625; No. 44, p. 1012. (Monatsh. f. prakt. Derm., Vol. XL, 1890, p. 549). 1) Case, chancre both breasts, in wet-nurse aged 32, in foundling hospital. Vratsch., 1S91, No. 1, p. 21. 2) Case, chancre left nipple, nurse from nursling. Stevens, J. G. B. London. British Med. Journ., 1S90, II., p. 1477; Lancet, London, 1S90, II., p. 1334. Case, chancre ulnar side of last phalanx, middle finger, married man aged 50; mode of infection not discovered; disease communicated by him to a second person. Stirling, R. A. Melbourne, Australia, Austral. Med. Journ., Apr. 15, 18S5, p. 15S. 1) Two cases, chancre of lip, in young ladies from kissing. 2) Case, chancre of lip, in a man Trans Intercolonial Med. Congr. of Australia, Second session, Melbourne, Victoria, Jan. 18S9, p. 991. 3) Case, chancre lower lip, in child 6 months old, possibly from recur- rence of old syphilis in mouth of the father. Austral. Med. Journ., 1890, XIL, No. 3, p. 127. 4) Case, syphilis acquired through tattooing ; operator at the time was free from ulcerative lesions in the mouth, though with annular syphilide on the body. Stoll, M. Vienna. Univ. Prof, of Medicine. " Ratis medendi," etc. Vienna, 1777-90, III., p. 392. 1) Two children aged 9 and 10 years, from father (possibly late hered- itary syphilis). " Praelectiones in diversos morb. chron.," 1787, pp. 101-2. 25 37° SYPHILIS INSONTIUM 2) Nursling from another nursling, through the nurse. 3) Family epidemic: nursling infected by nurse; mother and rest of family from nursling through kissing. Stourme, A. Lyons. " Essai sur la progn. du chan. cephal. indur.," These de Lyon, 1889. One hundred and three cases, cephalic chancre- from service of Aubert, 17; AUDRY, 2; AUGAGNEUR, I J CENAS, 4; CORDIER, 12; DlDAY, 6; Farre, i; Gailleton, 44; Guillaud, 7; Poncet, 4; Rollet, 5 ; q. v. Stratton. Edinb. Med. and Surg. Journ., Vol. LXXI., p. 276 (cited by Lancereaux, "Treatise on Syphilis," 1868, Vol. I., p. 40). St. Paul's Bay Disease. Strauss, Arthur. Dr. Unna's Clinic in Hamburg. Monatsh. f. prakt. Derm., Vol. XV., No. 10, p. 509. Case, chancre lower lip, cause not stated. Streatfield, J. F. London. Surgeon to Ophth. Hospital, Moorfields. Brit. Med. Journ., 1882, II., p. 634. 1) Case, chancre, inner canthus left eye. (Reported by De Beck, q. v.). 2) Several cases, chancre of eyelid, but no particulars given. Strieker, W. Virchow's Archiv, Berlin, 1861, XXIL, p. 285. Review of vaccinal syphilis, giving large number of references, but no- original cases. Struve, L. A. " Ueber die aussatzartige Krankeit Holsteins, allgemein daselbst die Marschkrankheit genannt. Ein Beytrag zur Kenntniss der Pseudo- syphilitischen Uebel," Altona, 1820. An original and full account of Morbus Dithmarensis. Stukowenkow, M. J. Kiew, Russia. Protoc. d. Sitz. Kiew'schen Aerzte, 1885, p. 54; 1886, p. 45. (Archiv f* Derm. u. Syph., 1889, p. 252). 1) Case, chancre of tonsil, probably through kissing child. 2) Case, chancre, right cheek, married woman, aged 24. Sturge, A. London. Med. Times and Gaz., 1877, H., p. 116. 1) Three cases, nurses infected by nurslings. 2) Family epidemic: infant infected by nurse, communicated chancres of lips or tongue to mother, father, grand-mother, and others, by- means of its fingers put into their mouths. Sturgis, F. R. New York. University, Prof, of Venereal Diseases. New York Med. Record, 1868, p. 530. 1) Case, chancre right cheek, man aged 38, from a bite (case of Bumstead's). Amer. Journ. Med. Sci., Vol. LXV., 1873, p. 102. 2) Case, chancre, right lower eyelid, infant aged 22 months. 3) Case, chancre of left cheek, sister of preceding, aged 6 (cases of Loring). American Specialist, 1881, II., p. 65. 4) Case, chancre of lip, in young woman. 5) Case, chancre of tonsil, source unknown. Suchanck. Prague. General Hospital, service of Waller. Prag. Viertelj., 1849, XXIII., pp. 48, 49. 1) Among 472 cases of chancre in women ; right nates, 1 ; right groin, 2' r finger, 1. 2) Among 234 cases of chancre in men; upper lip (auto-inoculation) 1. ANALYTICAL BIBLIOGRAPHY 37* Prag. Viertelj., 1853, XL., p. 93. 3) Case, nurse infected by nursling. Prag. Viertelj., 1854, XLL, p. 55. 4) Case, nursing mother, infected by foundling. 5) Case, chancre right index finger, in a midwife, in 1845. Suche, S. L'Union med. , Paris, 1853, VII., p. 37. Case, chancre of left shoulder, m man 19 years old. Sutton. R. S. Pittsburg, U. S. A. Journ. Amer. Med. Ass'n, 1886, p. 642. Two cases, infection by kissing. Swediaur, F. " Traite complet . . . des mal. syphilitiques," Paris, 1S01. 1) Two children, sisters, infected from sleeping with syphilitic servant (p. 89). 2) Statement: has seen many examples of midwives and surgeons infected ; one midwife infected over one hundred women (p. 96). 3) Statement: many examples, infection by lancets and surgical instru- ments. 4) An account of the Disease of St. Paul's Bay (p. 371). Sydow. Gefneberg's Hala. Lakar. For., 1879, No. 6. Two cases, chancre of nipple, nursing-women, from a male breast drawer. Symonds, C. J. London. Brit. Med. Journal, 1890, II., p. 1477. In discussing a case cf chancre of finger, stated that he had seen many similar cases, five in medical men. Szadek, K. Kiew, Russia. " Primitive syphilitic sclerose of throat" (Russian), Kiew, 1884 (Medicinsk. Westnik., 1884. Nos. 2S-30, 36-40). 1) Case, chancre left tonsil, soldier aged 21 (p. 16 of reprint). 2) Case, chancre right tonsil, soldier aged 23 (p. 19). 3) Case, chancre tonsil, child aged 3, from kissing nurse (p. 22). (Reference to 65 cases from literature). Provincial Medical Journal, Sept., 1S87, p. 422. 4) Review of Russian cases of extra-genital chancre. St. Louis Med. and Surg. Journ., 1S91, LX., I., p. 9. 5) Case, chancre right tonsil, in a married man 32 years old. 6) Case, chancre right tonsil, in an unmarried man 40 years old. 7) Case, chancre right tonsil, in a laboring man 40 years old. 8) Case, chancre right tonsil, man 25 years old. (Xo cause given for the above four cases). Szokalski. Warsaw. Pamietnik Zowarzys. Lekar., 1880, p. 917. Case, chancre, conjunctiva of eyelid, from removal of eyelash by the tongue. Tait, L. Birmingham England. " Syphilitic Hemiplegia," etc., Med. Times and Gaz., Feb. 27, 1869. Case, chancre of finger, in medical man, professional exposure. Tanturri, V. Naples. II Morgagni, 1869, XL, p. 100. (Giorn. ital. d. mal. vcn etc., 1S69, I., P- 243)- 1) Epidemics at Capistrello, and Castellafiume, previously reported by Dema&CHI, q. v. (See Epidemics). 2) Epidemic at Roccavivi ; disease had existed 20 years under the nameol sc/u'avino (or vajnolo oviiw). (Cited by Profeta " Tratt. prat, delle mal. ven.," Palermo, 188S, p. 419). 37 2 SYPHILIS INSONTIUM 3) Case, chancre of nipple, mother infects own infant. (See also Camp ana and De Amicis). Tardieu, A. Paris. Prof. Legal Medicine, Faculty of Medicine. " Etude siir les mal. provoq. ou communiq.," etc. Paris, 1864. ^(Cases reproduced in the following work) : "Etude medico-leg. sur les mal. prod, accident, ou involontaire.," Paris, 1879. 1) Case, chancre left breast, nurse from nursling (p. 160). 2) Two nurses infected by same nursling (p. 166). (Seen with Adelon, and Devergie). 3) Inoculation of patient with unclean vaginal speculum (p. 272). 4) Inoculation of young man in operation for phymosis by serre-fmes (Service of Fournier). (p. 272.) 5) Eight cases of Ricord's from Eustachian-sounds (p. 272). 6) Case, nurse infected by nursling; 5,000 francs damages (p. 175). 7) Case, chancre left breast, nurse from nursling ; culpable reticence of Dr. B. (p. 191). 8) Case, nurse infected by nursling; defendants sustained (p. 195). 9). Case, nurse infected by nursling, infects husband; 400 francs damages (p. 198). 10) Case, nurse infected by nursling, infects husband; 3,000 francs from child's father (p. 199). 11) Case, nurse infected by nursling (p. 203). (Reported by Dr. de Castelnau). 12) Case, nurse infected by nursling (p. 214). 13) Boy, aged 10 years, inoculated experimentally, right arm, from secretion of mucous patches ; visiting physician fined 50 francs, and interne 100 francs (p. 274). Tarnowsky, B. St. Petersburg. Univ. Clinic for Syphilis. Wojenko-Medicinski Journ., Feb., 1881, pp. 95-96. 1) Two cases, chancre of chin, soldiers from razor cuts. 2) Five cases, chancre of lip, in pupils of military school. Traite histor. et pratiq. de la syphilis, by Lancereaux ; translated by Tar- nowsky (p. 620). 3) Case, chancre, upper third, inner side of right forearm, from a chancre on the left hip, which in turn was caused by a bite. Proc. of the Russian Dermat. Soc, 1886-87, p. 135. 4) Two cases, chancre of eyelid, in women, from contact with amniotic fluid during labor. (All cited in Archiv f. Derm. u. Syph., 1889, p. 252; see also cases reported by Tschistiakow, and Zewecke). 5) Personal communication, 1892: chancre of lip, 45 ; mouth (cavity), 24; finger, 15; tongue, 3; pharynx, 3; eyelid, 2; chin, 2; abdomen, 2; anus, 2; nose, 1; neck, 1. Tassani. Cremona, Italy. Gaz. med. di Milano, 1843, II., No. 4 (Cited by Bouvier, " Syph. Vacc," Acad, de med. de Paris, 1865, p. 162). Epidemic of vaccino-syphilis at Grumello: 56 vaccinated, 35 infected, and from these, 29 mothers and nurses, total, 64; 8 children and 2 women died. Cerioli, q. v., described same epidemic, later stage. (See Epidemics). Tay, W. London. London Hospital, Surgeon. See Hutchinson's second series of cases of vaccino-syphilis Taylor, R. W. New York. New York Med. Journ., Vol. XVIII., 1873, p. 563. 1) Four cases, infection after circumcision, operator healthy, source unknown. ANALYTICAL BIBLIOGRAPHY 373 " Syphilitic lesions of the osseous system in infants and young children," New York, 1875, p. 27. 2) Case, chancre lower lip, girl, from her sister's child, congenitally syphilitic. Archives of Dermatology, New York, Vol. II., 1S76. (Also Amer. Journ. of Obstetrics, N. Y., 1875, VIII. , p. 436). 3) C?„se, chancre right nipple, nurse 38 years, from nursling (p. 32). 4) Case, chancre left nipple, nurse 19 years, from nursling (p. 34). 5) Case, chancre left nipple, nurse McNally, 19 years, from nursling (P- 33). 6) Case, infection after vaccination from unclean scarifier (p. 205). 7) Case, chancre of mouth, child from kissing, infecting its nurse- mother with a chancre of nipple (p. 230). Archives of Dermatology, New York, Vol. V., 1879, P- 374- 8) Case, chancre of mouth, sailor, from drinking-cup. 9) Case, infection, young man, from a towel. " The Pathology and Treatment of Venereal diseases.'' Bumstead and Taylor, Phila., 1883. 10) Case, chancre of nipple, from suction by husband (p. 464). 11) Mention of infection of dentists, known personally (p. 464). 12) Case, chancre, lower lip, female cigar-maker, from drinking-cup (p. 467). 13) Case, chancre of chin, from shaving (467). 14) Case, chancre left nipple, male, from bite (p. 468). 15) Mention of two cases, chancre of tonsils (516). New York Med.- Journ., May 24th, 1884. 16) Three cases, chancre of tonsil. " Atlas of Venereal and Skin Diseases,'' Phila. 18SS, p. 10S. 17) Two cases, chancre of chin, female and male. 18) Two cases, chancre of male breast, infected by woman. Journ. Cutan. and Yen. Dis., 18S9, p. 66. 19) Case, chancre of tonsil, in a man. Journ. Cutan. and Genito-Urin. Dis., New York, 1890, p. 201. 20) Fifteen cases of non-sexual chancres: probable modes of contagion; chewing gum, necropsy, caustic holder, handkerchief, bathing suit, syringe, pair of drawers, adhesive plaster, water closet seat, con- ductor's whistle, tongue scraper, towel, pillow, and razor. Medical News, Philadelphia, 1891, p. 214. 21) Case, chancre upper lip, man 23 years old, from a bite. New York Med. Record, 1S91, XXXIX., p. 69. 22) Case, chancre right index finger, in man 22 years old, source not stated. 23) Case, chancre left index finger, in medical student, source not stated. 24) Case, chancre right index finger, in woman, from dressing chancre of penis in her lover. 25) Family epidemic, starting from chancre on finger of midwife ; mother, father and four children infected. Trans. New York Dermatolog. Soc., 2iSth meeting (Journ. Cutan. and Genito-Urin. Dis., Vol. XI., Jan. 1893, p. 2S). 26) Case, chancre forehead near hairy border, in young man, inoculated by scratching mosquito bites with infected finger. Tchagin, A. A. St. Petersburg. Protoc. Russ. Syph. Derm. Soc, iSSS, Vol. II., p. 133 (Brit. Journ. of Derm., 18S9, p. 347). 1) Case, chancre left eye (canthus), woman, from washing brother's linen; he had chancre of lower lip. Vratsch., No. iS, 1890, p. 496. 2) Case, chancre upper lip, just beneath left nostril, man aged 20 years. Russ. Syph. Derm. Soe., Dec. 22, 1890 (Vratsch., Xo. 1, 1891, p. 21).' 374 SYPHILIS INSONTIUM 3) Case, chancre left cheek, man aged 24, from bite. Leicester Provincial Med. Journ., Mar. 1891, p. 174. 4) Five cases of extra-genital chancres. Tchistiakow, M. A. St. Petersburg. (Clinic of Tarnowsky). Protoc. Sect. f. Syph. I. Congr. russ. Aerzte in St. Petersburg, 1885, p. 41 (Archiv f. Derm. u. Syph., 1889, p. 254). 1) Statistics : percentage of extra-genital chancre ; lower lip, 30 ; upper lip, 15; tongue, 3; throat, 3; buccal cavity, 24; lower eyelid, 2; chin, 2 ; neck, 3 ; nose, 1 ; finger, 14 ; finger and lower lip, 1 ; abdomen, 2 ; anus, 2. 2) Case, chancre of throat, nurse from nursling. Protoc. russ. Gesellsch. f. Derm. u. Syph., 1887, p. 9 (Archiv f. Derm. u. Syph., 1889, p. 254). 3) Case, chancre right tonsil, man aged 28. Vratsch., 1889, No. 5, p. 133 (Virch.-Hirsch, Jaresber., 1889, p. 634). 4) Case, chancre of forehead, child 8 months, from nurse. Bolnitchnaya Gazetta Botkina, 1890, Nos. 7, 8. (Leicester Prov. Med. Journ., 1890, p. 306). 5) Case, chancre inside of cheek, woman from cigarette. 6) Case, chancre inside of cheek, lady from spoon used by syphilitic cook. Vratsch., 1S90, No. iS, p. 426 (Monatsh. f. prakt. Derm., 1890, Vol. XI., p. 69). 7) Four cases, nurses infected by nursling, the latter infected by pre- vious wet-nurse. Vratsch., 1890, No. 40 (Monatsh. f. prakt. Derm., 1890, Vol. XL, p. 549). 8) Case, chancre both tonsils, child two years old. 9) Case, chancre left tonsil, girl of 15 years (case of Lewy). 10) Case, chancre lower lip, man 38 years old. 11) Case, chancre upper lip, girl 23 years old. 12) Case, chancre nipple, nurse from nursling, from foundling asylum. Vratsch., 1891, pp. 21, 159 (Annales de Derm, et de Syph., 1891, p. 238). 13) Case, chancre lower lip, prostitute of 17 years. Vratsch., 1891, No. 11, p. 300. 14) Case, chancre left side of head, in site of contusion; student, aged 21, infection by barber (?). Vratsch., 1891, No. 18 (Monatsh. f. prakt. Derm., Vol. XIII., 1891, p. 4S). 15) Case, chancre dorsum of tongue, in woman aged 21 years. 16) Case, chancre at junction of hard and soft palate, managed 34; being subject to throat affections, he had used atomizers of syphilitic patients. Vratsch., 1892, No. 18, p. 462. 17) Case, chancre lower lip, in married man of 38, source unknown. 18) Case, chancre abdomen left of median line, four fingers' breadth above pubes, in married man of 34 years, source unknown. Vratsch., 1892, No. 14. (St. Louis Med. and Surg. Journ., June, 1892). 19) Case, chancre upper lip in student of 20 years, origin not stated. Tchudnowsky. Proceed. Caucas. Med. Soc, 1886, p. 161 (Archiv f. Derm. u. Syph., 1889, p. 254). Case, chancre of chin in site of razor cut. Tedenat. Lyons. Faculty Prof, of Clinical Surgery. (Cited by Roussel, " De la syph. tert. d. 1. sec. enf." . . . 1881, p. 90). Case, chancre of upper lip, in 2-year-old boy, from father, by mouth- piece of cornet. Temple, W. F. Boston. Boston Med. and Surg. Journal, July 2, 1S91. Case, chancre upper lip, in a young girl from kissing. ANALYTICAL BIBLIOGRAPHY 375 Tenneson. Paris. Hop. St. Louis. Annales de Derm, et de Syph., Vol. X., 1889, p. 791. Case, two chancres on cheek of young girl, from kissing. Tepliaschin, A. P. Wjatka Gouv., Russia. District-Physician. Vratsch., 18S7, No. 17 (Monatsh. f. prakt. Derm., 18S7, p. 770). Epidemic of syphilis, from applying tongue to the eye ; 34 persons directly infected, and 34 others from them ; total, 68. (See Epidemics). (La France med., Feb. 7, 1S88, mentions epidemic of same character at Glastikow, Roumania, ascribed to Tepliachnis ; evidently the same episode). Theobald, S. Baltimore, U. S. A. Amer. Journ. Med. Sci., 1S73, Vol. LXVI., p. 423. 1) Case, chancre of lip, infant from servant. 2) Case, mother of above infant, infected by nursing. Thiry, A. Brussels. Prof, and Surgeon to Hop. St. Pierre. Presse med. Beiges, Bruxelles, 1S62, No. 48. 1) Cases of cephalic chancre, reported by Spaack. Presse med. Beiges, Aug. 4, 1878 (Archivf. Derm. u. Syph., 1879, ^p. 472. Virch.-Hirsch. Jaresber. , 1878, Bd. II., p. 535). 2) Two cases, chancre of eyelids. Presse med. Beiges, 1SS1, XXXIII., p. 193. 3) Case, nurse infected by nursling. Presse med. Beiges, 1885, p. 409; i836, p. 9. 4) Case, chancre of the tongue. 5) Case, chancre of left tonsil. 6) " Contam. chanc. d'un enfant pendant l'accouch.," etc. Presse med. Beiges, 1S84, XXXVI., pp. 241-246.* Thomas. Pittsburgh. Soc. Proceed. Allegheny County med. Soc, Dec. 15, 1S91 (Journ. Amer. Med. Ass'n, Vol. XVIII. , 1892, pp. 165-166). 1) Case, chancre of lip, in a man, from kissing, infecting 2) Case, chancre of forehead, his 2-year-old son, by kissing. Thomaschewsky, S. P. Kiew. Russia. Military Hospital. Russkaja med. voskresensk., 1885, pp. 346, 367, and Wiener med. Presse, 1S86, 27, p. 969; 30, 36. 1) Case, chancre left tonsil, virgin of 15^ years, attendant on infected child. 2) Case, chancre right tonsil, soldier of 26 years, source unknown. 3) Case, chancre left tonsil, in an attendant, 25 years old, in syphilitic ward of hospital. London Med. Recorder, Oct. 1S90, p. 396. 4) Case, chancre of finger. (Unpublished cases, personal communication, 1S92). 5) Statistics: chancre of pharynx, 7; lip, 6; eyelid, 4; buccal cavity, 4; forehead, 1 ; temple, 1; cheek, 1; finger, 5; breast, 4; arm, 1. — Total, 34. Tiling, R. " Ueber Syphilis und Syphiloid," Mitau, 1S33.* Tillaux. Paris. Hop. Lariboisiere. (Cited by Rizat, "Man. pratique des mat vener.," Paris, 1SS1, p. 71). Case, chancre dorsal surface of tongue. Todd, R. H. Dublin. Surgeon to Dublin Hospitals. Dublin Hospital Reports, 1819, II., p. 182. Case, infection of woman aged 70, from spoon of syphilitic grand-child; probable throat chancre. Tommasi-Crudeli. Turin. Instituz. di Anat. Patol., 1SS2. (Cited by Merz q. v.). Case, mother infected by nursing own child (exception to Colles' Law). 37 6 SYPHILIS INSONTIUM Torella, G. Rome. Physician to Pope Alexander VI. "Tractatus de pudenagra cum consiliis," 1497. (Cited by Audoyna^jd, "Syph. comm. par l'allaitement," Paris, 1869, p. 8). Statement: had often seen an infant infect many nurses. Touchaleaume, A. " Etude sur le chancre syphilitique de la conjunctive.'' These de Paris, 1889. Case, chancre conjunctiva, right upper eyelid, youth of 19 years from a kiss. (Service of Prof. Dianoux). Toujan. Toulouse. Annales de Gynec. etd'obstet., July, 1892 (Brit. Med. Journ., Sept. 3d, 1892, p. 39; epitome of current literature). 1) Case, chancre lower lip in married man, infecting 2) Case, probable chancre of lip in the wife. Tourner, G. R. Lancet, London, 1887, Vol, I., p. 218. Case, chancre of lower lip. Townsend, W. E. Boston. Boston Med. and Surg. Journ., Vol. LIX., 1859, p. 456. Case, chancre of breast, acquired from a syphilitic nursling. Trelat. Paris. Hop. de la Charite, Surgeon. (Cited by Jullien " Traite des mal. vener.," Paris, 1886, p. 552). Case, double chancre of chin. Trevisanello, G. Florence. Clinic of Prof. P. Pellizzari. Giorn. ital. d. mal. ven., etc., 1875, p. 307. 1) Five cases chancre of tonsil ; one in a girl of 1 5 years, from infant nephew, child of a syphilitic soldier. 2) Three cases, chancre of lip. 3) Case, chancre of finger. 4) Case, chancre nipple, nurse from nursling, infecting another nursling. 5) Case, infection, nursling from nurse. Triboulet. Paris. Hop. St. Eugenie, Surgeon. (Cited by Audoynaud " Syph. comm. par l'allaitement. " These de Paris > 1869, p. 28). Case, chancre of breas., nurse from nursling. Trivet. Paris. (Service of Fournier). These de Paris, 1887. (British Journ. of Dermatology, 1889, p. 426). Case, chancre of forehead. Trotter, Spencer. Philadelphia Med. Times, 1885-86, XVI., p. 125. Case of inoculation by tattooing, saliva on needle. Trousseau, A. Paris. Hop. Necker and Hotel-Dieu, Physician. Gaz. des Hopit., 1854, p. 358; 1855, p. 497. 1) Case, chancre buttocks in baby, from contact with mother in bed. L' Union med , 1857, p. 207. 2) Two nurses infected by same nursling. Gaz. des Hopit., 1862, p. 25 (also " Syph. vacc," Acad, demed., Paris, 1865, p. 69). 3) Case, infection from vaccination, woman aged 18 years. (See Sistach). (Roussel " De la syph. tertiaire," Paris, 1881, pp. 142-143). 4) Case, infection of girl of 7 years by a nurse. Tuholske. (Cited in the Archives of Gynecology, 1891, No 6, p. 347). Case, chancre of nipple, young married woman, from her infant with chancre of lip, acquired by kiss of a young man with syphilis. ANALYTICAL BIBLIOGRAPHY 377 Tuilier. Limoges. Limoges Hospital. Physician-in-Chief. Some of the cases of lactation syphilis reported by Bardinet (q. v.), were in the hospital under the charge of Tuilier. Tur, M. Russkaja Medycyna, 1885, No. 39 (Monatsh. f. prakt. Derm., 1887, p. 41). Case, chancre right tonsil, followed by scorbutus-like syphilis. Turati, A. F. Milan. Institute d. St. Corona. Division for Syphilis. Annali universali di med. , 1S75 (Profeta "Trattato pratico'd. mal. ven.," etc., 1888, p. 414). Cited as reporting cases of lactation syphilis. Turner, G. R. London. Guy's Hospital. British Medical Journal, 1887, I., p. 212. Case, chancre of lip. Tzitrin. Voyenno-Sanitarnoie Dielo, St. Petersburg, 1887. Observed several cases of soldiers, contracting syphilis from the com- mon use of razors, combs, and cigarette stumps. Ussas, M. S. St. Petersburg. Proceed. Russ. Syph. Derm. Soc, 1888, Vol. II., p. 29 (British Journ. of Derm., Vol. I., No. 4, p. 133). 1) Case, chancre left palm, on site of burn; from attending a syphilitic child, who had been infected by a wet-nurse. Vratsch., No. 18, 1890 (Monatsh. f. prakt. Derm., Vol. II, 1S90, p. 69). 2) Case, infection of girl of 16, probably in mouth. 3) Case, infection of an engineer, in same manner. 4) Case, nurse infected by nursling. London Med. Recorder, Aug. 1890, p. 304. 5) Case, chancre upper eyelid. Vratsch. No. 10, 1892 (St. Louis Med. and Surg. Journ., June, 1892). 6) Case, chancre right tonsil, in married woman of 41 years; origin not stated, but husband syphilitic. Vadja, L. Vienna. Assistant, Clinic of Sigmund. Archiv f. Derm. u. Syph., 1875, p. 180. 1) Case, chancre lower lip, man aged 20. Bericht der Klinik f. Syph., von Sigmund (Archiv f. Derm. u. Syph., 1876, p. 124). 2) Case Eustachian infection, girl aged 27. Valcourt. Paris. Gaz. des Hop., Paris, 1865, p. 445. Case, chancre of tonsil, from a lozenge. (Case of Prof. Hardy, reported by several observers). Valentine, E. Revista espec. de oftalmolog., derm., etc., Madrid, 18S6, 9, pp. 353-363. (Bibliog. Syph., Szadek, 1888, p. 20). Case, chancre of eyelid. Valenzasca. Annali universali di medicina, No. 93, fasc, I., Venet., 1840.* (Cited by LANCEREAUX, "Treatise on Syphilis," 1S68, p. 41). A description Facaldina. Valery, Chas. " De la transm. des accid. second, du nourrisson a la nourriee, et de celle-ei a son nourrice." These de Pari 1 ... Vallauri, G. Piedmont. Rep. med. chir. del Piemonte, 1836. (Cited by DlETERICH, "Krank. Fam. Syph.," 1S42, p. 147). Case, chancre in site of a razor wound. Van Buren, W. H. New York. (See Keyes). 37 8 SYPHILIS INSONTIUM Van Deurs. Journ. de med. et de chir., June, 1835.* (Boeck, "Traitede la Radesyge," P- 47)- Description of syphiloid of Jutland. Van Dugteren and Van Walsem. Amsterdam. Clinic of Prof. D. Van Haren-Noman. Mitth. aus der Klinik, etc., Bericht ii. d. in d. J. 18S6-7, etc., Haarlem, 1889. 1) Statistics: chancre of lip, 35; breast, 3; nose, 1; tonsil, 1; of 372 syphilitic women and children, 131 or 35 per cent, were innocent. 2) Case, chancre of tonsil, child, from syphilitic father. 3) Two cases, chancre of lip,' brother and sister, from mother. Van Harlingen, A. Philadelphia, U. S. A. Philadelphia Med. Times, 1884-5, xv -> P- 8o - 1) Case, chancre lower lip, in woman of 52, from a bite. 2) Chancres of upper and lower lip, in girl of 14, said to be from a bite; this girl infected her infant sister, who then infected her mother and brother. 3) Case, chancre, angle of mouth, man 30 years old. 4) Case, chancre lower lip, woman 23 years old, probably from kissing. 5) Case, chancre upper lip, in woman of 24, source unknown. 6) Case, chancre, angle of mouth, man of 43, from a bite by a prostitute. 7) Case, chancre of tongue, probably from kissing. 8) Case, chancre of face, in man of 53, contracted in shaving. 9) Case, chancre nipple, young woman, from bite by young man with sore mouth. 10) Case, chancre lower eyelid, in a man, site of a blow; tumefaction punctured by a penknife and sucked by a friend with mucous patches in the mouth. Vanier. (Cited, without reference, by Jaffe, " Die rituelle circumcision," Leipzig, 1886). Case of circumcision syphilis. Vanmerris, H. C. " De la transm. de la syphilis par 1' operation de la vaccine." These de Strasbourg, 1863, (pp. 41.)* Van Swieten, G. Vienna. " Abhandlung von der Liebesseuche," ixankturt, 1727, p. 20. Case, infection of a nursling by a diseased wet-nurse. Vassal, P. A. Paris. Hop. des Veneriens. " Mem. s. 1. transm. d. virus vener. d. 1. mere a 1' enfant." These de Paris, 1807. 1) Case, the second child of syphilitic parents infects nurse (Legrand, Obs. IV.). 2) Case, similar, second child infects nurse (Obs. VIII., IX). 3) Case, prematurely born child lives long enough to infect nurse (Case of Gilbert's; Obs. VII.). Vaughan, B. E. New York. Trans. N. Y. Dermatolog. Soc, 218th meeting (Journ. Cutan. and Genito- Urin. Dis., Vol. XL, 1893, p. 28). Case, chancre front part of scalp, in married man of 35, inoculated pre- sumably by finger-nail wound, in a fight. Velpeau, A. Paris. Memoir of the Academ. of Medicine on Syphilization. Discussion, 1852, p. 302, et seq. ANALYTICAL BLBLLOGRAPHY 379 1) In debate Velpeau recapitulates certain of Ricord's cases (p. 321), and cases of Bardinet, soon afterwards published. 2) Case of Henri-de-Saint-Arnould (p. 363, q. v). Velschius, G. H. (See Welsch). Observ. med. episag. cent., etc., Ulmae, 1667. (Cited by Plouquet). Lactation syphilis. Velten. (Cited by Ruthenburg "De syph. ab aliis atque a part, genital.," Diss., Bonnae, 1830). Domestic epidemic, spread among families ; introduced by a child who had been at a religious festival (Obs. VI.). Venot, J. Bordeaux. Hop. St. Jean. L'Union med. Paris, 1852, p. 472. Case, nursling infected by nurse. Vercelloni, J. Rome. " De pudend. morbis. . . ." Astae, 1716, p. 205 (Cited also by Van Swieten, " Abhandl. von d. Liebesseuche," Frankfurt, 1727, p. 21). 1) Epidemic involving an entire village, which began from two nurslings. (See Epidemics). 2) Case, chancre of hand, cited by Lancereaux (q. v.). Vere-Delisle. Paris. Acad. gen. de med., Paris, April, 1830, p. 566. Case, chancre of anus in infant, whose mother was infected three months after delivery. Verneuil, A. Paris. Hop. de la Pitie. Bull, de la soc. de chir., July 25, 1855. (Cited by Tardieu " Etude med.- leg.," etc. Paris, 1879, p. 216). 1) Case, chancre left breast, nurse from nursling. 2) Case, infant of above nurse, infected by nursing. Gaz. des Hopit., 1879, p. 106. 3) Case, acquired infantile syphilis. L'Union med., Paris, 1888, p. 297. 4) Case, nurse infected by nursling. 5) Case, nurse infected by nursling, infects her two children. Veslin, L. Paris. Hop. St. Louis. (Externe). Statistics of extra-genital chancre, 1888: 26 cases (15 males, 11 females); chancre of lip, 10 (lower, 9; upper, 1); tonsil, 4; tongue, 2; eyelid, 1 ; breast, 2; abdomen, 2; thigh, 1; anus, 4. Viani. Piedmont. Gaz. med. Lombard., 1849. (Journ. de med., Paris, 1849, IV. , p. 874). Family epidemic, nursling infects three nurses, and one of them in- fects another nursling; the first child then infects two uncles by vaccination. Vicherat. Nemours. (See Depaul 5 ). Victorius. Padua. Univ. Prof, of Medicine. " Liber de morbo gallico." Florentine, 1551. Case, chancre of lip, young man from kissing. Vidal, A. (de Cassis). Paris. Hop. du Midi. Traite des malad. veneriennes, Paris, 1S53, p. 522. Four children, in weaning house, infected through tin cup, by infant who had been infected by nurse. Vidal, Emfle. Paris. Hop. St. Louis, Surgeon. Annales de Derm, et de Syph., Paris, 1SS9, X. 1) Case, chancre on dorsum of tongue, man aged 27 (p. 213). 2) Case, chancre lower lip, girl 21 years, from speaking-tube (p. 337). (also in Journ. de med., June, 1SS9). 380 SYPHILIS INSONTIUM 3) Case, chancre right side, tip of tongue, man aged 26 (p. 455). 4) Case, chancre left tonsil, wife of the above (p. 454). Viennois, A. Lyons. Hosp. de l'Antiquaille. (Service of Rollet). " Recherches sur les chan. prim, et les accid consec. prod, par la contag. de la syph. second." These de Paris, i860. 1) Ten cases, nurses infected by nurslings ; one infected her husband by coitus, another her daughter, by breast-drawing. 2) Case, chancre lower lip, glass-blower (p. 65). 3) Case, chancre both lips, from kissing husband, infects 4) Child, 7 years, chancre tonsil, from using spoon, and 5) Another son; no particulars given (p. 66). 6) Mention of several infections from tattooing at Val-de-Grace (p. 29). Archives generales de med., Paris, June, i860 etseq., (Reprinted in " Syph. vaccinale," Acad, de med., Paris, 1865, pp. 220-358). 7) A very extensive study of vaccinal syphilis, with very many valuable quotations and references, but giving no orginal cases. "De la syph. contracted par les verriers dans 1* exercise de leur prof.," (Extrait du conapt-rendu, med.-chir. de Rouen, 1863). 8) Four cases, chancre of lip, in glass-blowers ; one excised for epithe- • lioma. 9) Three cases, chancre tonsil, in glass-blowers (one reported eight others infected) ; one infected his wife. 10) Case, chancre of fauces, glass-blower. 11) Three cases, infection of glass-blowers. 12) Epidemic at Rive-de-Gier, 1862, twenty victims. (See Epidemics). 13) Cases of Bazin, Hervier, Lagrange, Rollet, q. v. Vigla. L'Union med., Paris, 1864, No. 129, p. 217. Case, chancre from Eustachian infection. Viguier, E. Hop. du Midi. (Interne, service of Mauriac). 41 Etude sur les chancres infect, extra-genit.," These de Paris, 1888. 1) Case, chancre, free border of left upper eyelid, female, cause unknown. 2) Case, chancre inner angle of eye, from husband's kiss. (Service of Abadie, q. v.). 3) Case, chancre nose, upper and lower lip, male. 4) Case, two chancres of cheek, from bite in play. 5) Five cases, chancre of lips. 6) Three cases, chancre of tongue. 7) Case, chancre inside right cheek, from mouth-piece of cornet. 8) Two cases, chancre tonsil and throat ; one from a flute. 9) Case, chancre of chin, from razor-cut. 10) Case, chancre neck, level of thyroid, male aged 24. (Notes by J. Huguet). 11) Case, chancre over mastoid bone, male aged 20. (Notes by J. Huguet). 12) Chancre of anus, 3 ; thigh, 1 ; calf of leg, 1 ; finger, 2. Villard. Lyons, France. Lyon Medical, 1890, LXV., p. 196. Case, chancre lower lip, glass-blower; fellow-workman blowing tube immediately before patient, had mucous patches in mouth ; three other workmen also acquired syphilis from same man. Villeneuve. Marseilles. Marseille Medical, 1890, No. 6, p. 366. Case, chancre lower lip, man 25 years old, mode of infection unknown. Vincent. "Expose clinique des maladies des Kabyles," Paris, 1S62. (Lancereaux, " Traite," etc., p. 42). ANALYTICAL BIBLIOGRAPHY 381 Violet,J. " Etude pratique sur la syph. infantile," These de Paris, 1874. 1) Case, child of 6 years infected by father, contact in bed (p. 28). 2) Case, chancre of breast, infected by nursling (p. 35). Voege, F. H. Wiirzburg. Poliklinik, Children's Diseases. " Ueber S\-philis der Kinder." Inaug. Dissert., Wiirzburg, 1S69. Case, infant of 4 months, infected by woman, with whom it slept. Vvedensky, A. A. St. Petersburg. Proceed. Russ. Syph. Derm. Soc, 1SS5, p. 12. (Provin. Med. Journ., 1S87, p. 422.) i)Case, three chancres, left forefinger, man aged 35, from a bite. Yratsch., 1889, p. 980. 2) Case, chancre right temporal region, man, hospital infection. Vyshogrod, I. Vladikavkaz, Russia. Russkaja Meditzina, Dec. 17, 1SS9, p. 729. Case, chancre palmar surface right little finger, at meta-carpo-phalang. joint, in hospital waiter, aged 24. Walch, F. A. Jena. " Praktische Darstellung d. vener. Krank," Jena, 1S11 (Cited by Wendt, "Die Lustseuche in alien ihren Richt.," Breslau, 1825, p. n). Obstetrical epidemic, over 50 infected (See Epidemics). Wallace, Wm. Dublin. " Lectures on Yen. Dis," Lancet, London, 1835-6 (Behrend's Syphilidolo- gie, I., 1S39, p. 193). 1) Case, boy 8 years old, infected by mother. 2) Case, feeble minded boy of 17, infected by mother, probably in throat. 3) Case, chancre of lip, man, from pipe of comrade. 4) Description of " Morulus " or " button scurvy" of Ireland, (pp. 475, 485). Medico-Chirurgical Trans., Vol. XIII., 1S38, p. 469. 5) Three cases of Morula; one illustrated by a plate. Waller, A. Prague. General Hosp., Director. PragerVierteljahrreschrift, 1S51, t. I. (Annales des mal. de la peau et de la syph., t. III., 1S50-51). 1) Infection of two-year-old girl by nurse, (p. 177.) 2) Infection of three infants, 2 to 3 years of age, by their respective mothers (p. 178). 3) Three cases, infection by pederasty in boys ; one infects younger brother, by contact in bed (p. 178). 4) Case, nurse from nursling (foundling), infects 5) Her own infant (p. 180). 6) Mother of above nurse, aged 66, chancre left cheek and side of neck, from contact in carrying grand-child (p. 1S0). 7) Woman infected by foundling at breast; communicates the disease to her own four children (p. 180). (Reported by Suchanek q. v. service of Waller, 1S53). 8) Case, nurse infected by nursling. PragerVierteljahrreschrift, 1S59, p. 153. 9) Infection of servant-maid, from her employers (Obs. 16). 10) Case, chancre of lip, in a servant-maid. Walter, L. Wiirzburg. Julius Hospital. (Interne or pupil). "Ueber einige selt. Falle v. Syph.," etc. Inaug. Dissert., Munncheh, 1S80. 1) Case, chancre, lower lip in a girl, bitten by a stranger. <( )bs. I., ]>. 1 1 1. 2) Case, chancre lower lip, in student, from kissing. (Obs. 11., p. (Two following eases seen at Munich in Hospital). 3) Case, chancre lower lip, in servant girl, kissing. (Obs. III., p. 4) Case, chancre lower lip, in man, no history. (Obs. IV, p. 17'. 382 SYPHILIS INSONTIUM Watson. Stourport, England. Case, lactation syphilis, nurse infected at nipple. (See Abernethy). Watson, Spencer. London. Kings College Hospital. Lancet, London, 1S65, I., pp. 119, 519. 1) Case, chancre cheek, from husband with buccal lesions. 2) Case, chancre lower lip, female aged 19. (See Mason). Medical Times and Gaz., 1S81, I., p. 428. 3) Case, chancre nostril, nurse from nursling. British Med. Journ., 1881, I., p. 721. 4) Case, chancre lower eyelid, source of infection unknown. Watson, W. London. Trans. Coll. Physicians, III., 1785, p. 325. Also see "Lectureson Syph.," etc. Phila., 1875, p. 20. Case, inoculation of syphilis by transplanting a tooth. (Given also by Hunter, and Swediaur). Wecker, L. de. Paris. "Traite compl. d'Ophthal.," Paris, 1880, Vol. I.; de Wecker and Land- oldt. (Cited by De Beck, q. v.). 1) Case, chancre left lower eyelid (p. 69). 2) Case, chancre conjunctiva left eye, from kissing (p. 409). 3) Case, chancre conjunctiva left eye, from kissing. 4) Case, chancre conjunctiva right eye, from cleaning eyelids with spittle, by mother. Wedekind, Geo. " Fragmente iiber d. Erkentniss d. ven. Krank.," 1790. (Girtanner, No. 1855, and Clossius). Cases, infection of midwives (p. 21). Wegeler. Med. Zeit. d. Verein d. Heilk. in Preuss., 1850. (Fournier, " Syph. vacc," Paris, 1889, p. 197). Epidemic of vaccinal syphilis ; 19 infected at K., in 1849. (See Epidemics) # Weiger. Strasbourg. (See Wolff). Weil, A. Heidelberg. Univ. Prof. Dermatology and Syphilis. Wiener, med. Presse, 1877, P- 1483- (Archives of Dermatology, New York, Vol. V., 1879, p. 92). 1) Case, chancre root of nose, new-born child; claimed infection per partum. "Ueber. . . . Vererbung der Syph." Volkmann's Samml. klin. Vortr., No. 130, 1878, p. 892. 2) Case, chancre both breasts, nurse from nursling; infects own child and husband. Weinberg, J. Vienna. Siczungsber. d. K. K. Gesell. d. Aerzte zu Wien, Nov. 8, 1878. 1) Case, chancre, cheek, from room-mate, nail inoculation. 2) Case, chancre of tongue, woman, source unknown. Mittheil. d. Wiener med. Doct. Colleg., V., No. 1, 1879 (Wien. med. Presse, 1S79, p. 21). 3) Case, infection per os, father by son, common use of utensils. Welsch. (See Velschius). Wendt, J. Breslau. " Die Lustseuche in alien Richtungen," etc., 3d edit., Breslau, 1S25. 1) Epidemic of obstetrical syphilis, from chancre on finger of midwife ; many infected in one of provinces of Silesia, (p. 11). (See Epidemics). 2) Epidemics of circumcision syphilis in two towns in Silesia ; many in- fected (p. 11). (See Epidemics). 3) Case, chancre cheek, in attendant on a syphilitic, whom he had car- ried in arms, with his cheek resting on his own (p. 214), ANALYTICAL BIBLLOGRAPHY 383 Werfel, F. G. "Dissert. Inaug. med. inquirens qusestionem au morbi, qui dentium trans- locationem sequuntur verier, sint, nee ne ?" Halae 1792, (pp. 30).* Wherry, G. Cambridge, England. Univ. Prof, of Surgery. Trans. Ophth. Soc. United Kingdom, 1S92, p. S (Brit. Med. Journ., 18S2, I., p. 120). Case, chancre conjunctiva of lower eyelid. White, Jas. C. Boston. Prof. Dermatology, Harvard University. Boston Med. and Surg. Journ., February 4, 1S92, p. 107. 1) Statement: has notes of 15 cases of physicians inoculated in dis- charge of professional duties, and knows of other cases. 2) Once saw midwife, who had delivered 32 women, with an open primary lesion on ringer. White, J. Wm. Philadelphia. Surgeon Univ. Hospital. Univ. Med. Magazine, 1890, II., p. 263. Case, two chancres of left cheek shown by Mr. Frederick Treves, of London. Whitehead. Manchester, England. Third Report Clinical Hospitals of Manchester, 1859. Fourteen cases alleged vaccinal syphilis, between 1S56-1S59, Whitehead, H. R. England. Surgeon British Army. British Med. Journ., 1SS9, II., p. 601. Five cases, syphilitic infection from tattooing (out of a dozen operated upon) in Landour, India ; tattooer had mucous patches on tongue and gums, and used saliva to cleanse the surface from blood, when water was not accessible. Wibmer, C. Munich. "Das Spyrokolon ; eine neue Krankheit im nordlichen Griechenland." — Schmidt's Jahrbiicher, 1S41, XXX., p. 305. 1) Report of 20 cases of " Spirocolon." Schmidt's Jahrb., 1S41, XXX., p. 3o6(Hirsch, Handb. der hist.-geograph. Path., Stuttgart, 1SS3, p. 66. 2) A mention of " Frenga." Widmann, M. Isny, Suabia. (Letter published by Horst, q. v.). Epidemic from cupping, at Yvindsheim, 1624. (See Epidemics). Wiethe, Theodore. Vienna. First Asst. to Dr. Jaeger. Allg. Wien. med. Zeitung, 18S2, No. 23, p. 249. 1) Case, chancre right lower eyelid, girl aged iS, from blow during a dance (wood-cut illustration). 2) Case, chancre eyelid. (Service of Arlt, q. v.). Wigglesworth, Edw. Boston, U. S..A. Archives of Dermatology, New York, 1S79, p. 374 and New York Med. Journ., 1884. 1) Case, chancre tonsil, physician, from inflating lungs of new-born. Boston Med. and Surg. Journ., Feb. 4, 1892, p. 116. 2) Refers to a midwife who infected 17 women in Boston, and then went to Xova Scotia and infected several more there. Wilcox. CJ. S. Military Service, Surgeon. (Observation published by ARTHUR, q. v.). Epidemic of syphilis from tattooing; 26 soldiers infected. (See Epi- demics). Wildbore, F. Brighton, England. British Med. Journ., 1861, I., p. 464. Case, syphilis from secondary inoculation, " infection of wife and offspring." 3^4 SYPHILIS INSONTIUM Wildhagen, F. C. Drammen, Norway. City Physician. " Sypilisation udfort i Drammens Sygchuus," Norsk. Mag. for Laegevid., Christiania, i860, p. 938 (Behrend's " Syphilidologie," N. R., 1862, p. 325). 1) Case, chancre upper lip, female aged 19. 2) Case, chancre upper lip, female aged 30, room-mate of previous case. 3) Case, dry-nurse, aged 36, infected by infant. 4) Case, chancre left breast, nurse from nursling. Wilks. London. Guy's Hospital. Phila. Med. News, Vol. LX., 1892, p. 264. (Reported by Robbins). Case, infection of a surgeon who cut finger while operating upon a syphilitic. Willemin. Memoir sur le Bouton d'Alep., 1854.* Willemoes. " Af handling om den i Skotland herskende Sibbens v. Syphilis insontium med. Hensyn tildennorske Radesyge," Biblioth. f. Laeger., Kjpbenh., 1810, II., 25-42* (quoted by Boeck, " Traite d. 1. Radesyge," i860, p. 49). A comparison of Sibbens with Radesyge. Willi, J. V. Colmar. "De morbis castrensis internis," Hafnise, 1679 (Girtanner, No. 525). Case, syphilis acquired by kissing. Williams, A. St. Louis Med. and Surg. Journ., 1881, XL., p. 424. Case, chancre right middle finger, man aged 48, alleged to be from operation on fistula in a horse. Willams, R. Liverpool. Liverpool Medico-Chirurgical Journ., 1884,1V., p. 195. Case, chancre conjunctiva bulbi ; nurse infected by nursling, her niece. Wills, D. ' 4 Remarks on Sibbens.'' Month. Journ. Med. Sci., Edmb., 1844, IV., pp. 282-289, also > Dublin Quart. Journ. Med. Sci., 1844, XXV., pp. 346-354.* Wilson, Wm. Journal of Cutaneous Medicine, 1871, p. 259. 1) Case, infant infected by nurse, its aunt, and infects 2) Its mother, chancre of breast, and 3) Three cases, two sisters and brother, probable chancre of fauces, from spoon feeding. Wiltshire. London. Royal Infirmary for Sick Children. Report of British Admiralty Commission, 1867, p. 364. Nurses infected by nurslings. (No exact data supplied). Windheuser, E. Miinstermaifeld. "Ueber Initialsclerose am Kinn." Inaug. Dissert., Bonn, 1890. Case, chancre of chin, in man of 60, from razor-cut (p. 22). Winslow, R. Baltimore, U. S. A. Maryland Med. Journ., 1883-4, X., p. 731. Case, chancre of both breasts, from sucking by syphilitic husband. Winters, J. E. New York. New York Med. Record, Vol. XXX., 1886, p. 510. 1) Case, nursling infected by nurse. 2) Case of Donne (q. v.). Wirpscha, G. F. Ssamara, Russia. (Cited in Archiv f. Derm. u. Syph., 1889, p. 255). ANALYTICAL BIBLIOGRAPHY 3 8 5 Statistics: of 5396 cases of syphilis, 249 (4.61 per cent.), were extra- genital; of these, males, 50; females, 99; children, 100. Woillez. Paris. Hop. Lariboisiere. (Reported by Ory, q. v. " Contrib. . . . syph. malignes precoc," These de Paris, 1875). Case, chancre upper lip. Wolf. f (Reported by Ruthenberg q. v. " De syph. ab aliis atque a part, genit.,"' 1830). 1) Case, child infected by dry-nurse, from chewing its food. 2) Case, mother of above child, infected per os. Wolfe. Glasgow. Anderson College, Prof, of Ophthalmology. " Diseases and Injuries of the Eye," 1882 (2d edit). Two cases, chancre of the eyelid. Wolff, A. Strasbourg. "Syph. hered. tarda." Volkmann's Samml. klin. Vortr., 1886, No. 273. Case, chancre index finger, in midwife (service of Weiger) p. 2517. Wood, Wm. C. Gloversville, N. Y. New York Med. Journ., 1888, XLVII., p. 184. 1) Case, chancre of finger in a barber. 2) Case, chancre knuckle, from blow on mouth of a syphilitic (personal communication). Wright, W. "Syphilis in Canada, as denoted by Sibbens." Med. Chron., Montreal, 1855, II., pp. 299-303.* Yakimovitch, N. N. Russian Derm, and Syph. Soc. Meeting, Jan. 3, 1891 (Annales de Derm, et de Syph., 1891, p. 237). Case, chancre right tonsil, source unknown. Yvaren. (See Rognetta). Zabolotski. Moscow, Russia. Med. Obosrenaie, 1884, No. 5, p. 466 (Cited by De Beck, q. v.), also (Revue gener. d'Ophthalm., 1884, p. 325). Case, chancre of right upper eyelid, from kiss, male 33 years of age. Zakharevitch, V. M. Kharkov, Russia. Trans. Kharkov Med. Soc, 1887, Vol. II., 1888, p. 10 (St. Louis Med. and Surg. Journ., 1889, LVL, p. 106). Eighteen cases of syphilitic infection through promiscuous use of spoons, tumblers, etc. ; in most of the cases, the primary lesion was in the oral or faucial region. Zallonis, John A. Syra, Greece. Bull, de l'Acad. de med., Paris, 1867, P- 1017. (See Depaul). Two cases of vaccinal syphilis. Zarewiez. Krakau. Hosp. St. Lazarus. Eight cases, chancre female breast. (See Gluck). Zecchinelli. Annali universali di medicina, Nos. 39,335* (Cited by Rollet "Traite,'' etc., 1S66, p. 464). An original account of Facaldina. Zeisse. Allgem. Wiener mcd. Zeit'g, 1877 (WlNDHEUSER " Initialscl. am Kinn," Inaug. Dissert., Bonn, 1890, p. 19). Two cases, chancre of chin, one following a bite, the other from a kiss. Zeissl, Hermann. Vienna. Univ. Prof, of Syphilis. Wochenbl. der K. K. Gesells. d. Aerzte in Wien, 1S61, Nos. 48, 49. (Lchrb. der Syphilis, 3d Edit., Stuttgart, 1S75, p. 25). 26 386 SYPHILIS INSONTIUM i) Case, chancre of lip, in a soldier. 2) Case, chancre of arm, physician, inoculation from above case. 3) Case, Eustachian-sound infection, chancre of fauces, perforating velum palati, (Part II., p. 37). 4) Case, chancre chin, man aged 22. 5) Case, chancre right cheek, from kiss. 6) Case, chancre right index finger, back of last phalanx, attendant aged 65, in Foundling Asylum (plates of last three). Allgem. Wien. med. Zeit'g, 1877, p. 309 (De Beck, q. v., p. 7). 7) Statistics: among 40,000 syphilitic patients, two cases chancre of eyelid. Allgem. Wien. med. Zeit'g, 1878, Nos. 2-7. 8) Case, chancre ball of left thumb, man aged 28, from bite. 9) Case, chancre left breast, from bite. (Reported by Finger q. v. Archiv f. Derm. u. Syph., 1881, p. 273). 10) Case, chancre upper lip, soldier aged 50. Allgem. Wien. med. Zeit'g, 1882. 11) Case, chancre of lip, (p. 54). 12) Case, chancre of tongue, (p. 314). Archiv f. Derm. u. Syph., 1884, p. 547. 13) Infection of Prof. Zeissl, May, 1870; chancre of finger from wound in opening bubo. Zeissl, Maximilian. Vienna. Allgem. Wien. med. Zeitung, 1882, p. 396. 1) Case, chancre of nipple in mother, from her own hereditarily syphi- litic child ; exception to Colles' Law (case of Luth q. v.). Archiv f. Derm. u. Syph., 1887, p. 298. 2) Personal account of "Skerljevo" mostly late syphilis, frequently with history of being acquired in early life.' Zeleneff. London Med. Recorder, Oct. 1890, p. 397. 1) Nine cases, extra-genital infection. Vratsch., 1891, p. 212 (Journ. of Laryngology, July, 1891, p. 277). 2) Case, chancre of lip, m a soldier. 3) Case, chancre of the tonsil in a man. Zewecke, V. A. St. Petersburg. Clinic of Prof. Tarnowsky, (q. v.). Russkaja Medizina, 1886. (Cited as Leweke, in Monatsh. f. prakt. Derm., 1888, p. 314). Two cases, chancre of tonsil, Eustachian-catheter infection. Zingalis. (Cited by Merz, Journ. des mal. cutan. et syph., Vol. II., 1890, p. 56). Case, infection of mother by child ; exception to Colles' Law. Zucker, J. Zeitschrift f. Ohrenheilkunde, 1884, p. 167. Case, chancre of external ear from tongue. Zuriaga, M. Valencia, Spain. La Cronica Medica, 1891, XIV., p. 321. A study of vaccinal syphilis, citing cases from Signorini, and Perrin. Zwetitch, M. " Sur la chancre syph. hypertroph.," These de Paris, 1S84. 1) Four cases, chancre of lip (Guibout, 3; Fournier, i). 2) Three cases, chancre of chin (Fournier). 3) Two cases, chancre of cheek (Barthelemy, and Mauriac). 4) Case, chancre of finger (Mauriac). INDEX Aalborg, epidemic from glassblowing at, 122. Abo, epidemic from cupping at, 122. Abortion, effect of syphilis in producing, 198. Abscess, infection by opening, 191. Abyssinia, syphilis in, 10. Acarus scabiei, its role in the communica- tion of syphilis, 112, 194. Accidental professional wounds, infection by, 190, 191. Accouchement, epidemics of syphilis from, 115-117, 119, 122, 123, 177, 178. Accoucheurs, infected with syphilis, 20, 28, 174, 175- syphilis conveyed by, 177, 178. Aerial transmission of syphilis, 19, 20, 169, 176. Afghanistan, syphilis in, 9. Africa, syphilis in, 9, 10, 122. Ages of patients with extra-genital chan- cres, personal cases, 38. Aikin, epidemic from vaccination at, 121. Alaska, syphilis in, 1 1. Aleppo Evil, 17, 136. Alexandria, epidemic from vaccinatien at, 122. syphilis in, 9, 10. Algiers, epidemic from vaccination at, 122. syphilis in, 9. Alsembourg, epidemic from breast-draw- ing at, 118. Altorf, epidemic from cupping and phleb- otomy at, 115. Amboyna Pustule, 17, 127, 128. American Dermatological Association, sUtistics of syphilis for 14 years, 200. Anal and peri-genital chancres, 25, 30, ^^. Andernach, epidemic from vaccination at, 117. Antilles, syphilis in the, 11. Antiquaille, hospital statistics from, 25. 14S. Antiquity of syphilis, 2. Anus, chancre of the, 20, 30, 147 Arabia, syphilis in, 9. Arkansas, epidemic from vaccination in, 120. Arm, fore, chancre of, 30, 37, 104, 151, 171. Armenia, syphilis in, 9. Army, United States, syphilis in the, 199. Artificial flower makers' syphilis, 18, 155.. teats, as a cause of syphilis, 19. Asia, syphilis in, 8. Minor, syphilis in. 9. Assayers' syphilis, 18, 154. Astragal and Calibera, epidemic lactation at, 121. Attendants, infection of, 19, 27, 166 176. Auray, epidemic from vaccination at, Australasia and Oceanica, syphilis in, Austria, epidemics of syphilis in, 115, 117 119, 121. Austro- Hungary, syphilis in, 7, 30. froi 172, 121. 12. Axilla, chancre of the, abscess, 191. from opening an Bamberg, epidemic from cupping at, 115. Bandages, infection by, 20, 14S. Hunk-notes, infection by, 156. Bardella and Bergona, epidemic from vac- cination at, 122. Bassoon, infection from, 154. bathing suit, infection from, 105, 106, 147. Bavaria, syphilis in, 7, 1 15, 118. Hed, infection by contact in, 153. J Bedding, infection from, iS, 1 |S. Beer-mug, infection from, [44. j Belgium, epidemic from breast-drawing in, 118. and Holland, syphilis in, 6. Beloochistan, syphilis in, 9. Ben eshoff disease, S. Biskra Bouton, 17, 136. * This index does not refer to material in tin- be consulted for complete information. Synopsis' or " Bibliography, which should also 3 88 INDEX Biting, infection from, 18, 23, 151, 152. Blood, infection by the, 23. Blood-letting, epidemic of syphilis from, "5- Blowpipe, infection from, 154. Blunt instruments, infection by, 192, 193. Boala lumeasca, or le mal qui court le monde, 6, 137. . Bones, evidence of syphilis, furnished by prehistoric, 3, 11. Boutons d'Amboine, 17, 127, 128. Brazil, syphilis in, 11. Breach of promise, syphilis a complete defence for, 207. Breast, chancre of the, 25, 30. countries where most common, 31. in young married women, 84-87. personal cases, 37, 84-87. relative frequency, 31. from breast-drawing, 180- 1 82. from kissing, 86. from nursing, 84-86, 159, 160. from scratch, in a male, 152. from soiled dressings, 148. drawing, epidemics of syphilis from, 1 1 6- 1 18, 120, 122, 180- 182, 202. infection from, 20, 176, 180-182. Brephotrophic syphilis, 19, III, 142, 158- 171. Brive, epidemic by accouchement at, 122. British America, syphilis in, 1 1. Brunn, epidemic from cupping and blood- letting at, 115. Brush, electric, infection from, 193. Buccal cavity, chancre in, 25, 30. countries where most common, 31. chancre from conductor's whistle, 155. from nursing, 86. contact, infection from, 150-152, 168, 176, 178-183. infection in industrial relations, 153-155. through an open wound, 178-180. without open wound, 180-183. Bugle, infection from, 154. Buttocks, chancre of from contact in sleep, 170. from incision of furuncle, 191, 192. Button Scurvy, or Morula of Ireland, 132. Cadaver, syphilis contracted from, 20, 173. Cane, infection from a, 18, 150. Caneotica, 17, 136. Capistrello, epidemic from lactation at, 6, 119, 138, 161. Cardeillac, epidemic from vaccination at, 121; Carrying or supporting, infection by con- tact in, 18, 19, 153, 170, 171. Cashiers' syphilis, 18, 155, 156. Castellafiume and Roccaviva, epidemic from lactation at, 121. Castellanza, epidemic from chewing pap at, 166. Causes of the spread of syphilis, 107, 108. Caustic-holders, infection from, 193. Cazorezzo and Ubaldo, epidemic from lactation at, 120. Central Africa, syphilis in, 10. Cephalic contact, infection from, 176. Chalice, infection from the, 146. . Chancre, appearance aDd characters of, 22. as a source of the virus, 23. Hu Sahara, 17, 136. Charles VIII., syphilis spread by the army of, 114. Chavanne-Lure, domestic epidemic at, 1 1 8. Cheek, chancre of the, 25, 30. personal cases, 37, 91-95. relative frequency, 33. from attendance, 176. from a bite, 151. from contact with a syphilitic infant, 171. from a pinch, 152, 153. from razor wounds, 92-95, 191. from a scratch, 152. from sucking a wound, 178, 179. from a towel, 148. Chewing food, infection from, 19, 166. Chin, chancre of the, 25, 30. personal cases, 37, 97-99. relative frequency, 33. from kissing, 97. from razor cut, 97, 98. China, syphilis in, 8. Chinese literature of syphilis, 2. Chirurgical manipulations, syphilis con- veyed in, 177. Cigars and cigarettes, infection from, 45, .5 2 » 54, 5 6 > 58-6o, 62, 146, 147. Circumcision, epidemics from, 1 1 7, 118, 121, 122. as a means of syphilitic infection, 19, 29, 30, 179, 180. syphilis, how first known, 201. relative frequency, 33. Clandestine prostitution, effect upon, by examination of the men, 206. Clarionette, infection from a, 154. Classification of the modes of infection of syphilis, 17-21. Clerks, syphilis in, 18. Cloth, infection from piece of, 167. Clothes dealers' syphilis, 18. Clothing, infection from cast off, 156. INDEX 3*9 Coblenz, epidemics from lactation and vac- cination at, 117, 118 Coccyx, chancre over, in man of 45 years, personal case, 105, 106. Coins, infection from, 155, 156. Coitus preternaturalis, infection from, 64-66. Colles' law, definition of, 159. exceptions to, 19, 23,159,160,221. Cologne, epidemic from breast-drawing at, 118 Columbus, syphilis imported by the fol- lowers of, 1 14. Combs, infection from, 19, 149, 167. Commodes, infection from, 18, 149. Communion cup, infection from, 146. Conceptional syphilis, case of, 75, 76. Conde, epidemic from breast-drawing and lactation at, 117. Conductors' syphilis, 18, 154, 155. Contact in arms, infection from, 171. in bed, infection from, 170. Contagious diseases prevention acts, of England, 8, 203, 204. Contagious diseases, syphilis placed in category of, 203-CO7.' Cooks, syphilis in or from, 18, 144. Cork, epidemic of syphilis from breast- drawing at, 1 16. Coughing in face, infection from, 20, 176. Countries where governments have exerted control over syphilis, 203. Courland, syphiloid of, 133. Cradle, infection from, 19, 167. Cremona, epidemic from vaccination at, Csomad, epidemic from vaccination at, 120. Cupping, communication of syphilis by. 20, 30, 184, 185. epidemics of syphilis from, 7, 115, 1 19, 121-123, 184, 185. and phlebotomy, relative fre- quency of chancre from, 33. Cups, infection by use of, 18, 19, 143,166. Cutting instruments, infection by means of, 189-192. Definition of syphilis, 2. brephotrophica, in. economica, III. endemica, 1 1 1. epidemica, 1 10. pandemica, HO. sporadica, 1 1 1. technica, III. Delhi Boil, 17, 136. Dellys, Mai Kabyle at, 132. Demography of syphilis, 107-113. Denmark, syphilis in, 7, 118, 122. Norway and Sweden, statistics of extra-genital chancres from, 30. Dental instruments, infection from, 19, 20, 90, 91, 190. Dentists innoculated with syphilis, 20, 175- Diapers, infection from, 19. Diffusion of syphilis, modes of, 3, 4. Digital contact, infection by, 152, 153, 168, 169, 174, 177, 178. infection in industrial relations, 156, 157- in professional relations, 177, 178. Disease of St. Paul's Bay, 17, 128. Distribution of syphilis, 5, 108. Divisions of non-venereal syphilis, 15, 17, no, in. Domestic and social relations, infection in, 18, 143-145. Domestic transmission of syphilis, 18, 27. epidemics from, 118, 123. Drawing instrument, infection from, 150. Dressings, infection from surgical, 148, 193. Drinking glasses, infection from, 18, 143- 145, 166. Druggists, syphilis in, 18. Dyke builders of Holland, syphilis among, 4. Ear, chancre of the, 30. personal case, 37, 101, 102. relative frequency, 33. from a bite, 101, 102, 151. Eastern Africa, syphilis in, 10. Eating and drinking, infection from, 18, 143-H6. Economic syphilis, definition of, ill. Eczema, virus gaining entrance at site of, 21, 194. Egypt, syphilis in, 9, 10, 122. Endemic syphilis, m, 124-142. England, epidemics of syphilis in, 116, 120, 122, 123. legal control of syphilis in, 203, 204. Epidemic syphilis, first record of, 113, 114. rapid spread of, no. and endemic syphilis, reason for diminution in severity, 138. Epidemics of syphilis, earlier descriptions confounded with other diseases, 1 12. their diminution with advancing knowledge, ill. r Europe, I 16-120. of Central Germany and Switzer- land, 115. in recent times, table of, I 15-123. total number of persons affected, 123. over the whole world, 1 19-123. 39° INDEX Epidemics from accouchement, 1 7, 115-117, 119, 122, 123, 177, 178. from application of tongue to eye, 17, 123, 182, 183. from breast-drawing, 17, Il6-Il8, 120, 122, 180-182, 202. from circumcision, 17, 33, 1 1 7, 118, 121, 122 from cupping, 7, 17, 33, 115, 119, 121-123. from eating and drinking, and domestic propagation, 17, 118, 123. from Eustachian catheterization, 17, 121-123. from glassblowing, 17, 1 20- 1 22. from handling cast-off clothing, 156. from handraising of infants, 17, 116, 120. from lactation, 6, 17, 116, 1 1 7, 119-121, 157-166. from phlebotomy, 33, 1 15. frorr sheltering wayfarers, 1 15, 118. from tattooing, 17, 119, 122, 123, 183, 184. from vaccination, 17, 33, 1 17- 122, 186 189. Esthonia, syphiloid of, 133. Europe, epidemics of syphilis over, 116-119. Europe, syphilis in, 5. Eustachian catheterization, epidemics of syphilis from, 1 21 -1 23. how its dangers were first known, 201. infection with syphilis by, 20, 27, 32, 192, 193. location of primary syphilitic lesion, 192, 193. Examination of the men instead of the women, 206, 207. Examinations, syphilis communicated in, 177, 178. Extra-genital chancres, clinical appear- ances of, 35. difficulty in recognition of, 108. relative frequency and statistics of, 24-29. frequency of occurrence in 2,000 personal cases of syphilis, 36. general considerations, 24. location of, 24, 25, 29-35, 37- true percentage of, 26. personal cases, clinical consider- ations, 35, 36. relative proportion in private and public practice, 36. Eye diseases, syphilis communicated in the treatment of, 182, 183. Eyelid, chancre of the, 25, 30. personal cases, 37, 95-97. removed for epithelioma, 96, 97. acquired during parturition, 170. from application of the tongue, 182, 183. from contact during sleep, in an infant, 170. from coughing in the face, 176. from a glove, 148. from handkerchief, 149. from incision of a stye, 192. from kissing, 151, 168. from mother's and also nurse's infected fingers, in an infant, 169. from opera glass, 149, 150. from a towel, 96, 148. from wash- water, 193. from washing clothes, 156. Eyelids and conjunctiva, chancre of the, methods of acquiring and relative frequency of chancre of, 31, 32. Facaldina, 6, 17, 129. Face, chancres of the, causes of infec- tion in. 33. Facial contact, infection by, 176. Farther India, syphilis in, 8. Faymoreau, epidemic from glass-blowing at ? 120. Feeding-bottles, infection from, 165. Females, relative frequency of genital and extra -genital chancres in, 26-28. Feu de volupte', 8. Finger, as medium of conveying the virus of syphilis, 168, 169. chancre of, personal cases, 37, 73-84. from assorting rags, 156. from a bite, 151. from craniotomy, 175. from drawing instrument, 1 50. from dressing a chancre, 152. from infected clothing, 81, 82. from manipulative procedure, 174. from operation upon piles, 194. from soiled linen, 156. from wound by bone of cadaver, 173. in adults, 168. in a barber, 152. in a dentist, 175. in midwives, 27, 168, 177, 178. in a nurse, 168. in physicians, 74-81, 109, 173. Fingers, chancre between, at site of scabies lesion, 194. and hand, chancres of the, 25, 30. INDEX 39 1 Fingers, chancre of, occupations favoring, and relative frequency of, 31. Finnland, epidemics of syphilis in, 119, 121, 122. prevalence of syphilis in, 140, 141. First epidemic of syphilis on record, 113, .114- Fmme, epidemic from vaccination at, 121. Flute, infection from a, 154 Foot, chancre of, from shoe peg, 148. Forearm, chancre of the, 30, 151, 171. personal cases, 37, 104, 105. Forehead, chancre of the, 25. from incison of a furuncle, 191. Forehead and tempie, chancre of the, 30. relative frequency of, 33. Forks, infection from use of, 18, 143, 144. Forms of syphilis, 13. endemica, 17, 124-137. Fort Smith, epidemic from vaccination at, 120. Fournier, non-venereal syphilis in females in private practice of, 27, 28. Frarnbcesia, 17, 134, 135. France, epidemics of syphilis in, 1 16-122. syphilis in, 3, 6. Belgium and colonies, statistics of extra-genital chancres, 30. Fredricksborg, epidemic from vaccination at, 118. Frenga, 6, 17, 131. Frequency of syphilis in the United States, 200. Frienlels, epidemic from vaccination at, 118. Furriers' syphilis, 18. Furuncle, infection from incision of, 191. General considerations in regard to syphilis, I. Germany, epidemics of syphilis in, 115. Switzerland and Holland, statis- tics of extra-genital chancres from, 30. Generation, effect of syphilis upon, 198. Glassblowers' syphilis, 18, 29, 154. Glassblowing, epidemics of syphilis from, 120-122, 154. Glasses, drinking, infection from use of, 18, 143-146, 166. Glove, infection from a, 148. Granos syphilis in Honduras, 11. Gratz, epidemic from tattooing at, 119. Great Britain and Ireland, syphilis in, 7, S. Great Britain, Ireland and colonies, sta- tistics of extra-genital chancres from, 30 Greece, syphilis in, 6. 'and, syphilis in. 1 1. Greenville, epidemic from vaccination at, I20. Groningen, epidemic from breast-drawing at, 117. Grosse Verole, 114. Grumello, epidemic from vaccination at, 118. Guillotine, infection by cutting cigar in, 147. Gum, chancre of the, 30, 190. Hakola, epidemic from cupping at, 119. Hand, chancre of the, personal cases, 37, 99- from handling cast-off clothing, 156. from a plaster, 148. from tooth wound, 99, 100, 151, 152. Hand feeding of infants, epidemics of syphilis from, 19, 116, 120. Handkerchiefs, infection from, 18, 149. Hat, infection from a, 148. » Hawaiian Islands, syphilis in the, 12, 199. Hereditary syphilis, cases, effects, evils, and mortality of, 15, 17, 22, 27, 197-199. Herpes, virus of syphilis gaining entrance at site of, 21. Hesse, syphiloid of, 133. Hindostan, syphilis in, 9. Hip, chancre of, from contact in bed, 153. Holland, epidemics of syphilis in, 116, 1 1 7. syphilis in, 4. Honduras, syphilis in ; Granos, II. Hong Kong, syphilis in, 8. Hotel proprietor, his duty toward con- tagious diseases, 206. Housemaids' syphilis, iS, 155- Hungary, epidemics of syphilis in, 116, 120. Hygiene, in the prophylaxis of syphilis, 200, 201. Iceland, syphilis in, 5. Implements and utensils, infection from, 143-146. India, syphilis in, 9. Indian tribes, effect of syphilis upon, 199. Indians, American, syphilis among the, 1 1. Individual prophylaxis, 200-202. Industrial transmission of syphilis, 18, 153- 158. Infancy, accidental infection in, 27. Infants with acquired syphilis, methods of infection of 160. Infection by attendance on syphilitic in- fants, 166-171. by cephalic (buccal or facial) COn- ta< t. 170. by direct contact, 167-169, 177- 183. by eating and drinking, 143-146. by hand feeding, 165, [66. 39 2 INDEX Infection by nutrition of infants, 158-165. by one woman, of 300 men, 204. auto-, by own act, 18. hetero-, by another's act, 18. immediate and mediate, definition, etc., of, 22, 23. Inflating lungs of new-born, syphilis caused by, 20, 76. Inguinal region, chancre of, from contact in bed, 169. Inherited syphilis, 15, 17. absence of initial lesion in, 22. from father alone, 23. Initial lesion, appearance and characters of, 22. Innocent syphilL 5, 195. relative frequency of and per- centages in males and females, 27-29. Innsbruck, statistics from Dr. Lang's clinic in, 25. Instrumental contact, infection by, 183- 185. Intentional professional wounds, infection by, 191, 192. Ireland, epidemic from breast-drawing in, 116. Italy, epidemics of syphilis in, 116-122. statistics of extra-genital chancres from, 30. syphilis in, 2, 6. spread by the invasion of by Charles VIII., 2, 114. Japan, syphilis in, 8. Japanese literature of syphilis, 3. Jaw, chancre of, personal case, 93, 94. Jugs, infection from, 18, 143. Jutish Peninsula, syphilis in the, 7. Jutland, syphiloid of, 133, 134. Kartoum, syphilis in, 10. Kasan, extra-genital syphilis in, 141. Kissing, as a cause of syphilis, 18, 19, 23, 150, 151, 168. chancre of the lip from, 41-44, 46, 49, 50, 52, 53, 62, 150, 151, 168. Klein-russland, syphiloid of, 133, 134. Knives, infection from, 18, 143, 144. Konigsberg, epidemic from Eustachian catheterization at, 122. Krakau, epidemics from circumcision at, 117, 118. L abrador, syphilis in, 11. Lactation, epidemics of syphilis from, 116, 117, 119-121, 161-165. syphilis communicated by, 19, 158-165. Laundresses, syphilis in, 18, 156. Law for controlling the spread of syphilis, 206, 207. Lebus, epidemic from vaccination at, 122. Leech-bites, a medium of syphilitic trans- mission, 20. Leeds, epidemic from breast-drawing at, 116. Leg, chancre of, from an electric brush, 193. from sucking a wound, 179. Leg and thigh, chancre of, 30. Legal control of syphilis, 202-207. responsibility in communicating syphilis, 207. Lepra Siberica, an endemic syphilis of Siberia, 137. Lepre Kabyle, 9, 10, 17, 132, 133. Leprosy, mistaken for syphilis, 112. relation to Radesyge, 127. Lips, chancres of, 25, 30, 37, 39-62. personal cases, 37, 39-62. relative frequency, 31, 39. sex of patients with, 39. from artificial flower making, 155. from assayer's blowpipe, 154. from a bassoon, 154. from a bite, 152. from a bugle, 154. from cigarette smoking, 55, 56. from cigars, 45, 54, 58-60, 146. from coins, 155, 156. from common use of cup, 45, 46. from dental instruments, 190. from drinking vessels, 144, 145. from feeding-bottle, 165. from infected finger, 168, 169. from furrier's thread, 155. from gum paste, 155. from kissing, 41-44, 46, 49, 50, 52, 53, 62, 150, 151, 168. from lead pencil, 57, 58. from paper cutter, used as tongue depressor, 174. from pen held in mouth, 174. from a spoon, 144. from upholsterers' tacks, 155. Liquid substances, the medium of syphilitic infection, 186-189. Lint, infection from, 148, 180, 193. Lithuania, syphiloid of, 133. syphilis in, 7. Location of extra-genital chancres, 24, 25, 29-35- personal cases, 37. Lombardy, epidemics from vaccination in, 117, 118, 120. London, epidemic from circumcision at, 1 22. from tattooing, 123. from vaccination, 120, 122. Lourcine Hopital, statistics from, 25. INDEX 393 LumDar region, chancre of, from contact in bed, 153. Lungs, syphilis from inflating, 20, 176. Lupara, epidemic from vaccination at, 1 19. Luxeuil, epidemic from vaccination near, , 118. Madagascar, syphilis in, 10. Mai Anglais, or disease of St. Paul's Bay, 11, 128. Francais, 114, 132. Kabyle, 9, 10, 17, 132, 133. Napolitain, identity with Mai Kabyle, Syphilis, and Mai Francais, 132. Portugias, 8. de Brunn, epidemic of, 7, 115, 184. de Chavanne-Lure, epidemic of, 118, 144, 145. de Chicot, 128. de Fiume, or Scherljevo, 129, 130. de Naples, 114, 132. de Saint Euphemie, epidemic of, 116. des Espagnols, 114. des Ottawas, 11. di Breno, 6, 17, 131. di Scarlievo, or Scherljevo, 129, 130. Maladie de Berreshof, an endemic disease in Siberia, 137. de Ditmarsh, description of, 128, I2 9- d'Egersund, identity with Rade- syge, 126. Malay Archipelago, syphilis in, 8, 9, 127. Manual contact, infection from, 174. Marcalle, epidemic from lactation at, 120. Marital syphilis, or syphilis e coitu legit- ima, 15-17. its relation to syphilis insontium, 196. 197. Marseilles, syphilis in, 6. Marsh disease, 7. Krankheit, or Morbus Dithmaren- sis, 128. Marsksygdom, or Morbus Dithmarensis, 128, 129. Mask, infection from a, 148. Medical attendants, infected in their calling, 20, 174, 175. Medico-legal aspect of venereal diseases, 203. considerations, in syphilis in- sontium, 196-198. Men, examination of, 206, 207. Mercantile Marine, syphilis in the, 199, 200. Methods of the spread of syphilis, 107-1 10. Mexico, syphilis in, II. Middle German States, syphilis in, 7. Middlebourg epidemic from breast-draw- ing at, 116. Midi, Hopital du, statistics from, 25. Midwives, infection of, 27, 174, 175. syphilis conveyed by, 177, 178. Milan, epidemic from breast-drawing near, 120. Milk, infection through the, 19, 23, 164. Minor surgery, infection by, 20, 191, 192. Modes of diffusion of syphilis, 113, 114. of infection of syphilis, classifica- tion. of the, 17-21. in syphilis brephotrophica, 19. economica, 18. epidemica, 17. insontium sine coitu, 21-23, ll1 ' technica, 20. Mohammedans, syphilis among the, 9. Molucca Islands, syphilis in the, 12. Money, infection by means of, 155, 156. Montecatini di val di Nievole, epidemic from lactation at, 121. Montlugon, epidemic from glass-blowing at, 121. Montmorenci, epidemic from lactation at, 116. Morbus Dithmarensis, contagiousness, modes of transmission, etc., 17, 128, 129. Gallicus, 114. Morocco, syphilis in, 9. Mortality in hereditary syphilis, 197, 198. Morula, description, nature, symptoms, treatment, etc., 17, 132. Mouth, chancre of, from dental work, 190. from handkerchief, 149. from lactation, 179. from raising uvula with finger, 177. from speaking-tube, 155. from tobacco pipe, 146. from tooth brush, 149. personal case, 43, 44. Mucous patches, most prolific source of syphilitic contagion, 23, 109. Musical instruments, infection from, 154. Musicians' syphilis, 18, 154, 155. Napkins, infection from, 167. Naples, epidemic from vaccination, at, I 19. Nates, chancre of, from anal examination, 177. Neck, chancre of the, 25, 30. from a bite, 151. from carrying a woman, 153. from COn tad W it li infant, 168, I 7 I - from court plaster, [03, [0 |, 1 im- personal case, simulating sarcoma, 37, 103, 104. 394 INDEX Netherlands, syphilis in the, 6. New Orleans, syphilitic bones exhumed in, II. New York City, accommodations for syph- ilitics in, 204. number of syphilitics treated in one year, 200. Nipple as conveyer of syphilitic virus, 19, 164, 165. chancre of, from kissing, 151. from lactation, 160, 161. personal cases, 84-87. Non-reciprocal kissing, infection from, 150, 151. Non-venereal syphilis, divisions of, 15, 17. in Founder's private practice, 27. personal cases, 35-107. North America, syphilis in, 11. Norway, epidemic of syphilis in, 118. and Sweden, syphilis in, 5. Nose, chancre of the, 25, 30. from infected ringer, 152. from tooth wound, 152. infected during parturition, 170. personal case, 37, 100, 101. relative frequency, 33. Nubia, syphilis in, 10. Nuremberg, epidemic from cupping at, 115- Nurses infected by lactation, 159-163. by syphilitic nurslings, 19, 23, 27, 161. Nursing, the chief mode of infection in Radesyge, 126. Nursing-bottles, infection from, 19, 165. Nurslings infected by nurses, 19, 23, 163, 164. Nutrition of infants, infection through, 158-165. Obstetrics, syphilis acquired in, 20, 174, 175, 177, 178. Occupation, influence of, in production of syphilis, 28. Opera glasses, infection from, 18, 149, 150. Operations, syphilis acquired in, 20, 173, 191, 192. Operator, infection of, 20, 1 72-176. by, 20, 176-196. Palate, chancre of, from blowpipe, 154. infection by lifting with finger, 20. Pandemic syphilis, definition, etc., of, no, in, 113. Pap, infection from, 165, 166. Parangi, 17, 136. Parasites, transmission of syphilis by, 194. Paris, epidemic from accouchement at, 116. from Eustachian catheterization at, 121. Paris, number of syphilitic beds in hos- pitals of, 204. police inspection in, 203. syphilis in, 6. Parturition, infection of infants during, 169, 170. Passive contact, infection by, 153. Paste or lip gum, infection from, 155. Pastille, infection from a, 147. Pencils, infection from, 57, 155. Pens, infection from, 155. Percentage of extra-genital chancres, ac- cording to location, 31-34. in 2000 personal cases, 36. of syphilis in the United States, 200. Peri-genital chancres, 30. Per partura, infection of infant, 19, 169, 170. Persia, syphilis in, 9. Personal cases of extra-genital chancres, 35-I07- Personal and household effects, infection from, 147-150. Philadelphia, epidemic from tattooing at, 122. Phlebotomy, transmission of syphilis by, 20, 30, 115, 191. Phymosis, infection by operation for, 191. Physicians and surgeons infected in manip- ulative procedures, 174, 175. Pian, 10, 17, 134-136. de Nerac, epidemic from lacta- tion, known as, 116, 161, 162. Piles, infection upon finger during opera- tion for, 194. Pillows, infection from, 148. Pinching, infection from, 18, 152, 153. Pins, infection from, 18, %%, 89, 150. Plan for the legal control of syphilis, 205- 207. Plaster, infection from, 103, 104, 148. Pocken amboyneuse, description of, 127. Poland, epidemics from circumcision in, 117, 118. Porte-caustiques, as conveyers of syphilitic virus, 20, 193. Portugal, the amount of syphilis in, 204. Premezzo and Castellanza, epidemic from hand-feeding at, 120, 166. Primary lesions, location of, 25, 29, 30. Professional infection, general considera- tions, etc., 172-174. Prophylaxis of syphilis, 196, 197, 200, 201. Prostitution as a cause of syphilis, 4, 198, 202. effect of examining the men upon clandestine, 206. its bearing upon the matter of legal protection against syphilis, 202. INDEX 395 Prussia, epidemics of syphilis in, 117, 118, 122 syphilis in, 7. Psylle, as a syphilifer, 20, 179. Purpura, mistaken for syphilis, 1 12. Radesyge, 5, 17, 126, 127. Ragpickers' syphilis, 18. Rags, infection from, 156. Rape, innocent, syphilis caused by, 27. Razor wounds, infection in, 20, 190, 191. Reciprocal kissing, infection by, 150, 151. Republican ideas in United States, effect upon sanitary police inspection, 204. Riga Hospital, statistics from the, 25. Rivalta, epidemic from vaccination at, 119. Rive tie Gier, epidemics from glass-blowing at, 120, 154. Rochechonart, epidemic from accouche- ment at, 119. Roumania, syphilis in, 6. Rovello, epidemic from lactation at, 120. Rufino, epidemic from vaccination at, 119. Russia, epidemics of syphilis in, 123. prevalence of syphilis in, 140, 141. spread of syphilis in, 204. syphilis in, 4, 5. Poland and Asia, statistics of ex- tra-genital chancre from, 30. Sacral region, chancre of the, personal case, 37. 147. Sahara, syphilis in, 10. Sailors, syphilis, spread by, 4, 199, 200. Saint Euphemie, epidemic from accouche- ment at, 1 16, 177. Saint Lazare Hopital, statistics from, 25, 203. Saint Maria Nuova, R. Arcesped. d., of Florence, statistics from, 25. Saliva, as a conveyer of syphilitic virus, 20, 23. Scabies, masking the lesions of syphilis, 1 12, 194. Scalp, chancre of, acquired during parturi- tion, 170. from comb, 149. Scherljevo, 6, 17, T29-131. Schleinitz and Saint Veit, epidemic from vaccination at, [21. Schleswick, epidemic from sheltering way- farers in, 1 [8. Schleswig Holstein, syphilis in, 7. Scinde Boil or Aleppo Evil, 17, 136. Scotland, syphilis in, 7. Scratching, infection from, t8, 152. Scrofula, its relation to syphilis, 140. Scrotum, chancre of, from scarification, 191. Seeland, syphilis in, 6. Semen, syphilis transmitted by, 23, 24. Senegal, syphilis in, 10. Serres-fines, a medium of syphilitic trans- mission, 20, 193. Servia, syphilis in, 6. Sex of patients with extra-genital chancres, 26, 28. 37. Shanghai, syphilis in, 8. Sheets, infection from, 148. Sheffield, epidemic from accouchement near, 122. Sheltering wayfarers, epidemics of syphilis from, 115, 118. Shoemakers' pegs, infection from, 155. syphilis, 18. Shoe peg, infection from, 148. Sibbens, 7, 17, 125, 126, 192. Siberia, syphilis in, 8. Sicily, epidemics of syphilis in, 118. Sick chairs, infection from, 18, 149. Sierra Leone, syphilis in, 10. Siewens or Sibbens, endemic syphilis of Scotland, 125. Silesia, epidemic from circumcision in, 117. syphilis in, 7. Singapore, syphilis at, 8. Sitka, syphilis at, 1 1. Sivvens or Sibbens, distribution of, 125. Skin-grafting, infection by, 20, 185, 186. Sleep, infection during, 18, 19, 152, 170. Society, the rights of, in the question of protection from syphilis, 207. Soldiers, syphilis spread by, 4, 199. Sommerach, epidemic from cupping at, 1 15. Sorrento, epidemic from hand-raising of a foundling at, 116. Soudan, syphilis in, 10. Sounds, infection by use of, 20, 193. South Africa, syphilis in, 10. America, syphilis in, 1 1. Carolina, epidemics from vaccina- tion in, 121. Spain and Portugal, syphilis in, 6. Portugal, Mexico, and Brazil, sta- tistics of extra-genital chancres from, 30. Speaking-tube, infection from, 155. Specula, syphilis transmitted by use of, 20, 193. Spedalskhed, relation to Radesyge, 127. Spirocolon, 6, 17, 131, 132. Sponges, infection from, i<), 149, 167. Spoons, infection by use of, iS, 19, 143, 144, 155, 165, 166. Sporadic Syphilis, definition and divisions of, in. Sprinklers, infection from, in weavers, 154. Spyrokolon or spirocolon, its identity with syphilis, 1 ; 1 . Statistics of American Dermatological As- sociation for 14 years, 200, 39^ INDEX Statistics of extra-genital chancres from different countries, 25-34. in author's practice, 28, 35. of syphilitic births, 197, 198. Sterility, effect of syphilis in causing, 198. Stockholm, epidemic from breast-drawing at, ri6. Stye, chancre from incision of, 192. Submaxillary chancre, from contact with chancre of chin, 153. Sucking of wounds, infection from, 178, 179. Sugar teat, infection from, 165. Surgeons infected with syphilis, 20, 28, 173. Surgical dressings, a means of transmis- sion, 20, 148. Surgical operations, infection in, 191, 192. Surgical sounds, infection from, 193. Sweden, epidemics of syphilis in, 116. Switzerland, epidemics of syphilis in, 115. syphilis in, 7. Syphilifer, operator the, 176-195. Syphilis, allusions to in the Bible, 2. among the Mohammedans, 9. among sailors and soldiers, 4, 199. antiquity of, 2. as a venereal and non-venereal disease, 13, in. brephotrophica, 19, ill, 142,158. carelessness of patients with, 199. contracted by operating upon syphilitics, 177, 178. conveyed by the semen, 23, 24. definition of, 2, 3. demography of, 107, 108. differs from other infectious dis- eases, 108. diffusion by railways, rivers and canals, 3, 4. distribution of, 5, 108. domestic transmission of, 18. from eating and drinking imple- ments, 18 e coitu legitima, or marital syph- ilis, 15-17, 197. economica, 8, III, 142. effects of race and climate upon, 137. endemica, 17, no, in. epidemica, 17, 113. forms of, 13. ground upon which safety from rests, 201, 202. industrial transmission of, 18. in Abyssinia, 10. in Afghanistan, 9. in Africa, 9. in Alaska, II. in Alexandria, 9, IO. in Algiers, 9. in Amboyna, 12. Syphilis in the Antilles, n. in Arabia, 9. in Armenia, 9. in Asia, 8. in Asia Minor, 9. in Australasia and Oceanica, 12. in Austro- Hungary, 7. in Bavaria, 7. in Belgium and Holland, 6. in Beloochistan, 9. in Brazil, n. in British America, n. in Central Africa, 10. in China, 2, 8. in Communities and Cities, 3, 4. in Denmark, 7. in Eastern Africa, 10. in Egypt, 9, 10. in Esthonia, 133. in Europe, 5. in Farther India, 8. in France, 3, 6, in Great Britain and Ireland, 7. in Greece, 6. in Greenland, 1 1, in the Hawaiian Islands, 12. in Hindostan, 9. in Holland, 4. in Honduras, II. in Hong Kong, 8. in Iceland, 5. in India, 9 in the Indian tribes, 1 1, in Italy, 2, 6. in Japan, 8. in Japanese literature, 3. in the Jutish Peninsula, 7. in Kartoum, 10. in Labrador, n. in Lithuania, 7, 133. in Madagascar, 10. in the Malay Archipelago, 8, 9. in Manufacturing centres, 4. in Marseilles, 6. in Mexico, 1 1 . in the Middle German States, 7. in the Molucca Islands, 12. in Morocco, 9. in the Netherlands, 6. in North America, 1 1. in Norway and Sweden, 5. in Nubia, 10. in Paris, 6. in Persia, 9. in Prussia, 7. in Roumania, 6. in Rural districts, 4. in Russia, 4, 5. in Sahara, 10. in Schleswig-Holstein, 7. INDEX 397 Syphilis in Scotland, 7. in Seeland, 6. in Senegal, 10. in Servia, 6. in Shanghai, 8. in Siberia, 8. in Sierra Leone, 10. in Silesia, 7. in Singapore, 8. in Sitka. 1 1. in Soudan, 10. in South Africa, 10. in South America, 11. in Spain and Portugal, 6. in Switzerland, 7. in Syria, 9. in Tien-tsin, 8. in Tunis, 9. in Turkey, 6. in the United States, 11. in Western Africa, 10. in Western Asia, 9. in the West Indies, 11. in Wurtemberg, 7. in Yokohama, 8. in Zanzibar, 10. ingenita, or inherited syphilis, 15, 17, 197- innocentium (or insontium), 13, 14, 17. insontium, general considera- tions, 5, 14, 15. insontium, modes by which it is spread, prophylaxis, etc., 140, 141. insontium sine coitu, modes of infection, 21-23. insontium, total personal cases, 37, Hi- later effects of. 198, 199. legal control of, 202, 207. modificata, identity with syph- iloid, 133, 134. pandemica, 17, 1 10, III, 1 13. pravorum, ore coitu illicita, 13, 17. prevalence of, in this country, 199, 200. relations to commercial inter- course, 4. relation to prostitution, 4. relation to scrofula, 140. sine coitu, 15-17, III. sporadica, 18-20, III, 142, 1 58, 172, 195. spread by wars, fairs, festivals, etc., 4. technica, definition, etc., of, 20, in, 142, 172. Syphilitic bones exhumed in France and New Orleans, 3, 1 1. Syphilization, so-called, syphilis commu- nicated by, 20, 189. Syphiloid, description, distribution, symp- toms, etc., of, 17, 133, 134. Syphiloids, their relation to syphilis, 192. Syria, syphilis in, 9. Syringes, infection from, 19, 20, 149, 167, 193- Table I., proportion of extra-genital to genital chancres, 25. II. , cases of non-sexual syphilis in females in private practice (Fournier), 27. III., localisation of extra-genital chancres, 30. IV., personal cases of extragen- ital syphilis, 37. V., ages of patients with extra- genital chancres (personal cases), 38. VI., epidemics of syphilis, 115- 123. Tacks, method of infection by, 155. Tattooing, epidemics of syphilis from, 119, 122, 123, 184. relative frequency of chancres caused by, 33, 34. syphilis communicated by, 20, 29, 30, 104, 183, 184. Tavastehus, epidemic from cupping at, 121. Tears, incapable of communicating syph- ilis, 23. Teeth, infection by transplantation of, 20, 185. by wounds of, 15 1, 152. Temple, chancre of, 30, 37, 102, 103. Tennessee, epidemics from vaccination in, 120. Thread, infection from, 155. Throat, deep, oral and nasal, chancres of, 3°' 32. lesions of, in Lustachian infection, 192. 193. Thumb, chancre of, from carrying infant, 171. by manipulative procedure, 174. in mid wives, 1 78. personal cases, 79, 99, IOO. Tien-tsin, syphilis in, S. Time, period of, iu which danger of infec- tion is greatest, 109. Tobacco and tobacco pipes, infection by use of, [8, 1 1". 147. Toilet articles, infection from, 1 X, 1 |.8, 1 I ». Tonga, an endemic syphilis of New Zea- land, 12, [37. Tongue, application of to eye, as cai syphilis, 20, 1 chancres of the, 25, 30. from dental instrument, I90. MAR 11 ou, 398 INDEX Tongue, from own infected finger in in- fancy, 169. from pins, 88, 150. from shoemakers' pegs, 155. from spoon, 144. from tobacco pipe, 146. personal cases, 37, 87-91. relative frequency, 32. Tongue spatula, as medium of trans- mission, 20. Tonsils, chancres of the, 30. from nursing-bottle, 165. ' from spoon, 144. modes of infection and relative frequency of, 32. personal cases, 37, 47, 62-73. Toothbrush, infection from, 149. Toothpick, infection from, 149. Tooth wounds, infection from, 15 1, 152. Topparla, epidemic from cupping at, 1 19. Torre del Buse, epidemic from vaccina- tion at, 120. Tourcoring, epidemic from breast-drawing at, 122. Towel, infection from a, 148. Transplantation of teeth, infection by, 20, 185. Troches, infection by, 18, 147. Trunk, chancres of the, 30. Tunis, syphilis in, 9. Turkey, syphilis in, 6. Udine, epidemic from vaccination at, 117. Uleaborger, epidemic from cupping at, 119. Umbilicus, infection of new-born at, 20, 178. Unclassified chancres, 25. Unclean instruments and substances, infec- ion from, 189 194. United States, epidemics of syphilis in, 120-122. hospitals for syphilitics in, 204. statistics of extra-genital chancres from the, 30. syphilis in the, 1 1. Upholsters' syphilis, 18, 155. Urinals, infection from, 18, 149. V accination, epidemics of syphilis from, 117-122, 186-188. infection from, 19, 20, 27, 30. relative frequency cf chancres by, 33- Vaccination syphilis, how it differs from ordinary syphilis, 188, 189. how first observed, 201. Vagina, infection by exploration of, 20. Variolation, transmission of syphilis by- process of, 20, 189. Venereal clinics, statistics from, 25, 26. syphilis, reason of its frequency, 109, no. Vienna, epidemic from circumcision at r 121. statistics frcm the Allgem. K. K. Krankenhaus in, 25. Virus of syphilis, nature, etc., of, 2, 107, 202, 203. Vulva, chancre of, from sponge, 149, 167. Washing, infection from, 156. Wash-water, infection from, 19, 20, 167, 193. Water closets, infection from, 18, 149. Wearing apparel, infection from, 18, 147, 148. Weavers, infection in, 18, 154. Western Africa, syphilis in, 10. Western Asia, syphilis in, 9. West Indies syphilis in the, 1 1. Wet-cupping, syphilis from, 184, 185. Wet-nurses, infection in, 27, 159. Whistle, infection from, 154, 155. Wilbedessen, epidemic from lactation at, 117. Windsheim, epidemic from cupping at, "5- Wjatka Government, epidemic from ap- plication of tongue to eye in, 123. World, diffusion of syphilis throughout, 5. epidemics of syphilis over the whole, 119-123. Wounds, professional, infection in, 190- 192. Wound sucking, infection from, 20, 176, 178-180. Wurtemberg, syphilis in, 7. Yang-mey-tchoang, 17, 133. Yaws or Frambcesia, 7, IO, II, 17, I34-I36- Yokohama, syphilis in, 8. Zanzibar, syphilis in, 10. Zurich, epidemic from cupping and sheltering wayfarers at, 115. ^M H" i<& m % t m tf ■ ■i fa: ■ .t>. v ■ ■ ■