§ 9. Venereal Diseases

Three principal venereal diseases are numbered, which are propagated by contagion from an infected person.

47. - I. Blennorrhagia (gonorrée; chaude-pisse, "hot piss"; and, if it has become chronic, goutte militaire, "military drop") is due to the microbe called the gonococcus, by which the urethra is inflamed in a purulent manner. Neighboring organs in both sexes are easily infected, so that the disease becomes general. This disease can indeed be cured in a sufficiently short time, but not without pain, for example by the electrolytic method of Dr. Virghi; and, although it is not hereditary in the strict sense, it is easily transmitted to the infant during birth itself. It can bring very grave harms upon the body.

For the wife to whom it is communicated, it is a frequent cause of perpetual sterility. Infected offspring is born wretched, often blind.

48. - II. Syphilis, which, because it raged among the forces of the French while Charles VIII was besieging Naples in 1490, is also called the French disease - in Italian, celtico - is most properly called a venereal disease; and because it easily invades the whole body and corrupts it in manifold ways, it is regarded as a universal wasting disease.

Recently, after the studies of Schaudinn in 1905 and Metchnikoff in 1906, a proper name was given to the microbe to which this pest is due: treponema pallidum (spirocheta pallida).

Moreover, a sort of threefold stage is observed in the course of this disease, so that primary, secondary, and tertiary syphilis are distinguished.

A certain period of incubation precedes for two, three, or four weeks, during which the virus lies hidden. Then a hard ulcer (chancre dur) appears, concerning which Antonelli has this ¹: "At the place of infection there appears a small vesicle, which is easily ruptured by friction and gradually extends. This ulcer is the first sign of syphilis, and can arise on the prepuce, at the mouth of the urethra, and at whatever place the virus was received. A little later, the lymphatic vessels of the member harden and the glands of the groin swell."

¹ Medicina pastoralis, vol. 2, no. 780.

After a new preparation or incubation and a struggle between the treponema pallidum and the leukocytes, which lasts ten to eleven weeks, there follows another stage in which syphilis becomes general from being local: it breaks out through the whole body; besides various interior disturbances, the skin is infected with small red spots. In this stage syphilis is most contagious. And thus it remains contagious for three or four years.

Finally, in the third stage the phenomena are less universal, but more grave for the victim. Let us note tabes dorsalis, or locomotor ataxia. In that period the danger of contagion is much less, unless phenomena of the secondary phase recur. Moreover, tertiary syphilis is cured with the greatest difficulty, and perhaps is to be called incurable.

This disease brings every kind of harm, sometimes horrible, and can lie hidden under almost every species or appearance of disease ².

² "It can be said that there is no disease or stage of a disease which syphilitic infection cannot at least temporarily simulate." Dr. Pontano, Sul valore clinico della reazione di Wassermann, Il Policlinico, practical section, 1915, p. 42.

He who, not having been perfectly cured, at least before tertiary syphilis, contracts marriage exposes his innocent spouse to the greatest danger of contagion, and consequently the fetus also ³, which will either be aborted, or brought forth dead, or will be born an idiot, blind, deaf-mute, or affected by other infirmities of this sort.

³ For the offspring is infected through the mother, not through the father. Compare Dr. Carle, cited by Dr. Piccardi, La profilassi della sifilide con gli arseno-benzoli, Il Policlinico, practical section, 1917, p. 454.

Since the infant is already infected, nothing prevents its taking milk from an infected mother; but it cannot be entrusted to a healthy nurse, any more than an infected nurse is to be permitted to suckle a healthy infant.

Would that this pest were rare! But, if The Times is to be believed, in January 1919, throughout England, two persons out of a hundred were infected; every year several thousand infants die from hereditary wasting disease before completing their first year of life; of the blind and insane in England, more than half were deprived of sight or the use of reason because of syphilis. In Paris, in 1912, fifteen men out of a hundred were estimated to be infected, and several thousand succumbed to death each year. In Italy, as the Reverend Dr. Gemelli reports, almost 16,000 persons infected with this disease are received into hospitals each year; in 1900 there were more than 82,000 who sought remedies at the places of distribution, the syphilitic dispensaries ⁴. And how many others bear the evil in secret!

⁴ Non moechaberis, p. 90.

Nevertheless, we are not permitted wholly to ignore recent studies and the progress of the medical art.

Accordingly:

1. For detecting syphilis, the so-called Wassermann test ⁵, abbreviated Wr., is very helpful.

⁵ Épreuve de Wassermann, Reazione di Wr. The method was invented by Drs. Wassermann, Neisser, and Bruek.

2. For treating the disease itself, more effective remedies than those sought from mercury, which was formerly employed, have been sought from arsenic in the "arsenobenzols," although nothing prevents both kinds of remedies from being employed together. Let us mention Salvarsan, or 606, which Ehrlich discovered in 1909 and afterwards perfected under the name Neo-Salvarsan, or 914; and Galyl, or 1116 ⁶, which appeared in 1915.

⁶ These numbers indicate the sum of experiments which were necessary for the invention.

From these remedies, according to Dr. Piccardi ⁷, there is a greater probability of a perfect cure, of a more prompt cure, and of a more general and stable efficacy, so that the contagious period becomes much shorter, treatment is useful in every stage of the disease, and the further progress or evolution of the wasting disease is cut off.

⁷ Il Policlinico, practical section, 1917, pp. 448-455, La profilassi della sifilide con gli arseno-benzoli.

Hence, although physicians still deny that marriage can safely be contracted before four or five years have elapsed since the disease was observed, account must be taken of the progress of the medical art. The moral theologian will more prudently abstain from copying assessments which can vary from day to day; rather, he will counsel that an upright and experienced physician who is diligent in medical studies be approached for consultation.

3. For preventing the contagion of the disease, ointments have been discovered ⁸, with which one who anoints the member immediately before intercourse or immediately afterwards is rendered immune from contagion. They assert that immunity is certain if the use precedes intercourse, but less certain if it follows within the space of one or two hours after infection.

⁸ Drs. Metchnikoff and Roux of the Pasteur Institute prescribed this formula: "Calomel: 33 percent; lanolin: 57 percent; vaseline: 10 percent."

49. - III. Soft carcinoma (chancre mou, "soft chancre") is more confined to the place, namely, the sexual parts, and is more benign; but it occurs more rarely.