Relation of the Physician to Diseases consequent upon the Use or Misuse
of the Genital Organs.
§ 38.
In the preceding Sections we have become acquainted with the various
influences capable of favouring or counteracting the rise of diseases
consequent upon the use or misuse of the genitals in Antiquity. At
the same time we have shown how a multitude of affections of the most
different kinds attacked, as a result of the unnatural gratification
of sexual desire, those parts which under these circumstances had
to undertake the rôle of the genital organs of the one or the other
sex. Thirdly we have brought forward in the course of the enquiry at
any rate some examples, proving beyond a doubt that the sexual parts
themselves too under favourable external conditions sometimes became
diseased as the consequence of indulgence in sexual intercourse.
Still these results were for the most part based on the evidence
of non-medical Writers, for of set purpose we abstained as much as
possible from calling the professional Writers into Court on these
points, so as to be able to treat in their proper mutual connexion
whatever statements these latter have left us as to the maladies in
question. This course appeared to us all the more necessary, as it is
precisely the medical evidence which the opponents of the existence of
Venereal disease in Antiquity believe themselves able to utilize in
justification of their opinions.
But before we proceed to the detailed examination of the actual
statements, it would seem expedient to get an answer to the following
question: _whether indeed the Physicians of Antiquity generally were in
a position to acquire an adequate knowledge of the bodily consequences
of vicious living?_ In fact on the correct answer to this question
obviously depends the correct appreciation of the medical Writings as
sources for the History of Venereal disease. Only under the condition
that this question may be answered in the affirmative, can the evidence
supplied by the Physicians be regarded as satisfactory for their own
period. That it cannot of course be so for all periods, has been
pointed out already in our examination of the authorities for Antiquity
generally. Indeed for long periods of time Physicians had no special
_locus standi_, inasmuch as each individual in the case of the most
usual maladies endeavoured to help himself, and if the family recipes
left him stranded, then betook himself with prayers for assistance to
the Gods and their intermediaries on earth, the Priests. This still
continued, even after the Physicians had won their recognition as
a special profession, and we find accordingly throughout Antiquity
popular, sacerdotal, and professional or _medical_ medicine, if we may
be allowed the expression, continuing to exist simultaneously side by
side, and not a trace anywhere of the ridiculous limitation according
to which no man has a right to be well without the help of a doctor.
Now having made it clear by what we have said, that in order to gain
knowledge of a disease in Antiquity it is by no means enough to go to
the Physicians only, even when such existed, that the latter should
never be regarded as sole possessors of whatever was known from the
point of view of pathology and therapeutics, we are bound to apply
the same rule in the case of diseases consequent upon vicious habits.
Of this the foregoing Sections contain amply sufficient proofs. It has
there been shown how the genital organs were under the protection of
special deities. Diseases affecting them were ascribed to the vengeance
of the said deities, as at Athens to Dionysus, at Lampsacus to Priapus.
To them sufferers had recourse to win by their prayers the removal of
the divine anger, as well as its consequences; and all this happened
not only in times when Physicians did not as yet exist, but no less
when they did and in defiance of them, as the poems of the Priapeia
sufficiently prove.[270] How long these ideas lived on is shown by the
pictures _Philo_ (p. 315) and _Palladius_ (p. 318) draw of their times,
while the XVth. and XVIth. Centuries reproduced the same scenes.
The most obvious reason for this no doubt was the _enigma presented
by the origin_ of diseases of the genitals, particularly for any one
unacquainted with the existence of contagions and their modes of
activity. The man who with a healthy penis had accomplished coition,
observed some days afterwards, though without resenting the fact, a
mucous discharge to have been set up, or an ulcer, pustule, or what
not, to have appeared. The cause of these affections he sought for in
vain, for of course the mere act of coition was the very last thing he
was likely to regard as such. Rather accustomed, wherever the cause of
any phænomenon was unknown to him, to ascribe it to the intervention
of the deity, he saw in his complaint likewise the Θεῖον (divine) as
eventual cause. Naturally therefore it was divine assistance, and
not human, that would avail to relieve him of his pain. Long after
this time moreover, when men had ceased to refer all diseases to the
vengeance of the gods, and now discovered natural causes for maladies
of the genitals, as for other diseases, anything rather than just
the act of coition was looked upon as cause of the observed effects,
as indeed is the case to this day among the Turks,[271] and as the
earliest Writers on Venereal disease abundantly show to have been so
in their time. That the Physicians were no exceptions to this rule, we
shall show on a later page.
A much more weighty reason however why the patient attacked by some
affection of the genitals turned not to men (Physicians) for help, but
to the Gods, and the Priests who represented them, was the feeling of
_shame_. Since first Adam and Eve had recourse to the fig-leaf, it has
ever been a habit among all peoples of the ancient as of the modern
world to withdraw the procreative parts from the view of others by
covering them. But above all did the Ancients regard the exposure of
these parts[272] one of the severest trials to which modesty could be
exposed; and rightly enough therefore designate them by the name of
_pudenda_, αἰδοῖα, _the parts of shame_. Neither the wide extension of
Phallic worship, nor yet the compulsory exposure of the Ephebi[273] and
the naked exercises of maidens and youths at Sparta[274], can fairly
be cited in this connexion as proofs to the contrary.
In our own day the most accomplished voluptuaries are in no wise
shocked at undertaking in secret the most shameful doings, but yet
when it comes to showing the Physician the diseased instruments of
their bestial lusts, often put this off so long as to run great risks
of entirely losing the signs of their manhood; and without a doubt it
was the same at the period when habitual depravity had reached its
culminating point of enormity. Even Priapus himself asks (Carm. 3):
Nec mihi sit crimen, quod mentula semper operta est.
(Nor let it be laid as a crime against me, that my member is ever
covered up.) If with this is compared the poem from the Priapeia
quoted on p. 74 of Vol. I., no one can fail to agree with us when we
say that the field of observation open to Physicians in Antiquity
with regard to diseases of the genitals can never have been at all
extended. Even the Priests, at any rate in later times, were only
resorted to in the more serious instances; but even so their journals
of cases, supposing them ever to have kept such, would have been a far
better source of information than those of the Physicians. We find a
confirmation of this in the Mosaic Books of the Law, which contain the
earliest and clearest delineations we possess of affections of the
genital organs both in men and women.
But if men were so reluctant, how much more so must women have
been, who were universally held to have committed a crime if they
had given any part of their body to the eyes of a stranger. Just as
the assistance of the Physician was disdained in childbirth, and to
account for the fact the fable of Agnodicé invented, in the same way
in complaints of the genitals women hesitated to submit themselves to
the inquisition of the Physician. But seeing the female sexual organs
are pre-eminently the home and breeding place of Venereal disease,
this closed what was precisely the most direct way to a correct
understanding of maladies of the genitals. The ancient Physicians,
like our own forefathers, could at best make leucorrhœa the universal
scape-goat; and accordingly even _Galen_, as we shall find presently,
laid no stress on the circumstance, and drew no inference from it, that
wherever men were attacked by gonorrhœa, the women with whom they had
had coition likewise suffered from the complaint.
Further, to this general sense of shame was added a certain timidity
before the professional status of real Physicians as a class, as well
as the pretty universally prevalent idea of the _ignominiousness of a
sickness brought on by a person’s own fault_, at any rate among the
educated part of the population. This comes out in the following
passage of _Plato_,[275] where he says: “Does it appear to you
disgraceful to stand in need of medical help, when it is not wounds at
all or such sicknesses as depend on the seasons that have befallen, but
when a man through indolence and a way of life such as we have noted
(i. e. a very luxurious one), is filled full of fluxes and accumulations
of wind like a sea, giving occasion to the noble sons of Asclepius
to designate these complaints by the names of superfetations and
catarrhs?” This was more than a mere expression of individual opinion;
there is no doubt affections of the genital organs, more especially if
their relation to sexual intercourse was known, belonged to the class
of diseases held to be most disgraceful,[276] and the Poet is justified
in saying:
_Diis me legitimis nimisque magnis_
Ut Phoebo puta, filioque Phoebi
_Curatum dare mentulam verebar_.
(To the lawful gods, deities too exalted for me, such for instance as
Phoebus, and Phoebus’ son, I feared to entrust my member for cure.)
Thus it was not to the “noble sons of Asclepius”, in other words the
Physicians, who treated freemen only, that patients resorted for help,
but to the gods, or else to the medical underlings (ὑπηρέται τῶν
ἰατρῶν,—subordinate assistants of the physicians), to the slave-doctors
and quacks, who plied their trade in the doctor’s shops,—establishments
where, as we have seen above, paederasts and pathics foregathered.
Exactly the same state of things prevailed down to the middle of the
last Century; and to this day a majority of such sufferers rarely as a
matter of fact come under any other hands.
The knowledge and observations of these Cullers of simples and
Compounders of balsams, if indeed as a rule they really possessed the
former, or knew how to make the latter, necessarily perished on their
decease, or at best were passed on by tradition to their successors in
the doctor’s shops, without professional Physicians or medical Science
being one whit advantaged. To such men it was a matter of perfect
indifference what was the origin of the disease for which they sold
their powders and decoctions, for as _Plato_ (De legg. IV. 720) says,
they paid no attention to the existing conditions of disease, and did
not care to give a thought to any such thing. But at any rate,—and this
was the chief point,—the patient was spared a humiliating confession,
and was glad enough to buy the privilege even at the cost of possible
ruin to his health. We must further remember that the “filles de joie”
in Greece and at Rome were mostly slave-women, who from the very
fact of their status could make no claim to treatment by free-born
physicians, and that during the flourishing period of Greek medicine
under the Hippocratic school it was chiefly persons of the lowest
station or else sailors and foreign traders and the like who sought
enjoyment in the arms of prostitutes. Such men by their constant
change of abode made all continued observation a simple impossibility,
so that the very imperfect knowledge possessed by the scientifically
trained Physicians with regard to diseases of the genitals and their
consequences need occasion little surprise.
It is true of course that at the period of universal degradation
of morals Physicians must have found no lack of opportunities for
observation; but the great majority of them were incapable of utilizing
these, actually blocked the way of set purpose, as we shall see
presently, that led in the direction of more accurate investigation,
or else troubled their heads little about the cultivation of Science
or the systematic record of observations. The latter, if they had
published them, whether in writing or orally, could only have been
detrimental, particularly in the case of physicians of the character
of Charidemus’ medical attendant,[277] to their own interests. In
fact they were bound to call all their subtlety into play for the
express purpose of concealing the true cause of diseases of this type,
a circumstance which no doubt we have to thank for a large number of
the extravagant and often more than ludicrous statements regarding the
origin of Venereal disease in the XVth. and XVIth. Centuries.
But as a matter of fact the public itself was no less careful to
guard the secret, as we gather from _Martial_,[278] as well as from
the fact that _Galen_ felt himself constrained even in his day to
compose a special Treatise on dissimulated diseases. This sort of
intentional deception on the part of patients was so much the easier,
as Physicians in those times, as said above, in virtue of their
pathological views,—some of which indeed may very well have originated
in this way,—were little accessible to the truth. For these reasons
they deserved, at any rate to some degree, the satiric lash of Martial;
and were very generally ridiculed by the more discerning of the laity.
This comes out in the important words of _Appuleius_ (Metamorph.
X. 211.) as follows: “Crederes et illam fluctuare tantum vaporibus
febrium: nisi quod et flebat: _Heu medicorum ignavae mentes!_ Quid
venae pulsus, quid caloris intemperantia, quid fatigatus anhelitus
et utrimque secus iactatae crebriter laterum mutuae vicissitudines?
_Dii boni! Quam facilis, licet non artifici medico, cuivis tamen docto
venereae cupidinis comprehensio_, cum videas aliquem sine corporis
calore flagrantem.” (Could you imagine her so tempest-tossed by the
vapours of mere fever,—not to mention that she kept forever crying:
“_Oh! the sorry wits of doctors!_” What means the throbbing vein,
the excessive temperature, the labouring breath, and the hurried
interchange of heaving flank, panting now on one side now on the other?
_Great heavens! how easy the diagnosis, not of course for a medical
expert, but for any one learned in the symptoms of love_, when you see
a person burning, yet without bodily fever-heat).
But does all this justify us in casting a stone at our medical
colleagues of Ancient times? For the last three hundred years we
imagine ourselves clearly acquainted with Venereal disease and all its
forms; yet how many a bubo has been mistaken for a strangulated hernia,
anal callosity, or the like, how many a case of vaginal gonorrhœa
for simple _fluor albus_ (white discharge, leucorrhœa), how many a
condyloma on the posteriors for hæmorrhoidal swellings, and accordingly
not treated as the physician in _Juvenal_, _medico ridente_ (the
physician grinning the while), treated them,—that is duly cut away or
ligatured?
Lastly to all these reasons was added further the _mildness and
absence of danger characterizing the disease_ itself, at any rate in
the majority of instances,—as proved in our earlier investigations.
To our own day genuine amateurs of Love, thanks to those who supply
“advice, direction and information” on these subjects, endeavour as a
rule, at any rate in the earlier stages, to cure without assistance the
wounds received in the fight. This was equally so in Antiquity, as the
following significant passage of _Galen_[279] shows: “This is pretty
well all I have to say at present as to ephemeral fevers. For _patients
who have contracted fever consequent upon a bubo, do not consult
physicians as to what they must do; but after first treating the ulcer
which occasioned the bubo and then the bubo itself_, bathe after the
abatement of the severity of the attack. After that if any one says a
word as to the “diatriton” (fast till the third day), all laugh and
declare him a precisian: I suppose because they are of the opinion that
nothing must be resigned to nature that is not invariably there.”
We know quite well that the Ancients called all glandular swellings
buboes, and that they were perfectly well acquainted[280] with those
glandular swellings in the arm-pits and the groin which follow upon
ulcers of the fingers and toes; but this in no way justifies us in
referring the above passage, which is certainly written in a general
sense, _solely_ to suchlike buboes and not equally to those in the
soft tissues; more particularly as _Galen_, in the place where he is
dealing expressly with the treatment of buboes and the phlegmonous
affections preceding them and occasioning ulcers (loco citato p. 881),
explicitly mentions phlegmonous symptoms as κατὰ αἰδοῖον (affecting the
privates) and γυναικὶ κατὰ μήτραν ἢ αἰδοῖον (in women affecting womb
and privates),—loco citato p. 893. Hence we think ourselves justified
in drawing attention to the passage as containing an indication of
the reason why ulcers of the genital organs pursued a milder course
and admitted of an easier cure in Antiquity, because the _ephemera_
evidently facilitated the assimilation and elimination of the
contagion, this taking place either at the point primarily attacked,
or else occurring because it (the ephemeral fever) led to an enhanced
activity of the cutaneous glands by provoking an exanthematous eruption.
§ 39.
But for no small part of this reluctance on the part of patients the
Physicians were themselves to blame. We have no wish in this place
to enlarge upon the possibility of professional indiscretion in
their case, though long ago the Hippocratic masters saw themselves
constrained to guard their scholars against it.[281] Of far greater
weight was the nature of the _treatment_, especially that applied to
ulcers of all kinds, which was excellently adapted to fill sufferers
with fear and trembling. Already _Hippocrates_[282] taught that
ulcers with callous margins must be cauterized or else cut away with
the knife. _Galen_[283] declares himself even more plainly in the
same sense: “But if the margins of the ulcer merely are discoloured
and callous, they must be removed right to where the healthy flesh
begins. Supposing this condition to have extended more widely, then the
question arises,—whether we ought to cut away all the diseased tissue,
or prefer a more tedious method of cure. It is natural and necessary
in this case to consult the inclination of the patient; for whereas
some prefer to avoid the knife and submit to a more tedious treatment,
others on the contrary are ready for anything, so long as they get
cured.” The same procedure was adopted with ulcers of the genitals,
especially gangrenous ulcers, as is proved at once by the passage
already quoted on p. 176 of Vol. II above.
The Asiatic, for whom the genital organs were an object of veneration,
was no doubt horrified, as the Turk is to this day,[284] at the idea
of any such operation on himself; while the licentious Roman, who
must have dreaded its very probable result in the entire loss of the
further use and enjoyment of the parts in question,[285] sought any
other means for choice, preferred to have recourse to Priapus or even
resorted to suicide, like the _Municeps_ of Pliny mentioned on p. 257,
before he trusted himself to the physicians who ever since the Carnifex
(Butcher) Archagathus had appeared at Rome, strove to rival one another
in infatuation for cautery and amputation. In any case it was only the
direst necessity[286] that drove the sufferer under such circumstances
to the physician; while the latter had really and truly no reason for
enquiring into the origin of the evil, as very often absolutely no
alternative was left him but to grasp the knife or cauterizing iron. In
this way medical procedure could not but have fallen into disrepute,
while physicians were in most instances necessarily deprived of all
opportunity of systematic observation.
Whether there were other factors as well to induce the old Physicians
to apply the ordinary treatment of ulcers in general to those of the
genital organs, we cannot indeed as yet for the time being determine.
Certainly the conjecture is an obvious one that they may well have
had an inkling of the specific nature of such ulcers, and that it
was not merely the local mischief they sought to put a stop to by
early application of cautery and knife. However it is only further
and more careful investigations that must be allowed to decide the
point,—the more so, as the general _views as to the formation of
ulcers_ held by the Ancients seem in many respects to tell against it.
Thus _Galen_[287] says: “The mode in which these (ulcers involving
destruction of substance) are set up however is twofold; they arise
either by removal of surrounding tissue (ἐκ περιαιρέσεως) or by eating
away (ἐξ ἀναβρώσεως). How the former acts is well known. As to the
eating away, if it proceed from the inward parts of the organism, it
is an outcome of the evil humours; but if it arise from outside, then
it is a result of the physician’s remedial measures or of fire.” From
this we gather that all ulcers of the genitals, as well as others,
which did not result from the action either of remedial measures or of
fire, were held as being necessarily an outcome of the evil humours
of the body. Further, that this view was not in any way peculiar
to the time of Galen, but was a direct and necessary consequence
of the further development of the pathology of “humours,” follows
from the circumstance that we find the same opinion expressed by
_Hippocrates_.[288] Again _Plato_ shared the latter author’s general
doctrine of _apostasis_ (suppurative inflammation taking off evil
humours) in his “Timaeus”, where he derives from the white phlegm,
striking outwards to the skin, cutaneous eruptions, rashes and the like
maladies, from the acrid, salty phlegm on the other hand the fluxes of
all types, bearing different names according to the different parts of
the body affected.
If we do not choose to infer from this the proof of a then occurring,
genuine and consistent genesis of the affections peculiar to the
genitals, we are bound at any rate to admit that such a view must
necessarily have debarred all thought of any _specific_ character as
belonging to ulcers of these organs,—the more so as to this very day
we look in vain for any clear conception of really characteristic
symptoms marking out Venereal ulcers in particular. Further, the
knowledge that ulcers of the genitals were contracted through sexual
intercourse, lacked entirely, so far as the ancient Physicians were
concerned, the necessary confirmation and authority to induce them to
make a special and distinctive class of morbid process to include them,
because as a rule they paid no sort of attention to the occasioning
cause, unless in virtue of its being still present and active, or else
by the necessity for its elimination, it could afford some indication
for therapeutic purposes. _Galen_ brings this out best and most
clearly in the following passage:[289] “Moreover it will be a fitting
occasion now to make it clear that not one of the causes directly
occasioning the diathesis, or particular condition of body, will give
any indication as to treatment; guiding signs for the purpose must
rather be gathered from the complaint itself. What is to be done in
any individual case depends on the immediate purpose and the nature of
the part attacked, on the predominant temperament and the like facts.
For to put it shortly, _in no case can an indication as to what is
beneficial be taken from any one of the factors that are no longer
existent_,—i. e. in actual operation. But as it often happens that in
order to diagnose some affection that cannot be recognized either by
help of ratiocination or by the senses, we are obliged to inquire into
the cause that occasioned it, laymen conclude the guiding signs for
remedial treatment to be taken from the same source. But this is by
no means so. This may be plainly seen in those instances where the
diathesis is quite well known in all its details; for whether it be
_ecchymosis or ulceration or erysipelas or putrescent ulcer_ (σηπεδὼν)
_or phlegmonous affection in any organ, it is perfectly useless to
trace out the cause that occasioned it_ (αἴτιον ποίησαν), _if this
latter is now no longer active_. On the other hand for any affection,
a clear insight into which is lacking, a knowledge of the occasioning
cause is useful.”
This principle was equally applied to affections of the genitals, the
antecedent act of coition being regarded as affording absolutely no
help in diagnosis, as we see from the passage of _Galen_ to be next
discussed. In this passage the declaration of a gonorrhœal patient to
the effect that the women with whom he had connection suffered no less
than himself from the malady, was entirely without influence on our
author in the way of inducing him to assume and lay down a _specific_
type of gonorrhœa. Under these circumstances it is really a matter
for no surprise[290] that the old Physicians in discussing affections
of the genitals never allege sexual intercourse as an occasioning
factor amongst others; and the conclusion drawn that such affections
in Antiquity were not contracted by coition, _because_ the ancient
Writers do not definitely and in every single instance assign this as
a cause, evidences really and truly merely the absence of any accurate
study of their works and the knowledge of their views that is acquired
as a result of such study. It is abundantly clear however that the
neglect of the etiological factors referred to led eventually to their
being completely overlooked; and it is no less obvious that this must
needs have been a source of manifold mistakes, which degraded the
physician in the eyes of the non-professional laity, very often made
him ridiculous by reason of this ignorance, and brought down, as we
have seen, many a cut of the satirist’s whip on his devoted shoulders.
But how many of our colleagues are there not at the present day whom
Venereal disease involves in the same doubts and difficulties?
However it may perhaps be suggested that, although the ancient
Physicians did not feel themselves obliged to make any mention of
sexual intercourse as cause of affections of the genitals, they cannot
for all that have failed to notice the phænomena of infection. To say
nothing of the fact that in no small proportion of instances affections
of the genitals under the favouring conditions previously described
did not as a matter of fact arise through infection, but actually in
a sense spontaneously,[291] and further that to this day we possess
absolutely no criterion to distinguish such diseases arising in this
way,—for it is only superficial and indolent observers that deny the
possibility of such origination altogether,—apart from all this,
the view which the Ancients took as a whole of the general question
of infection was one in the highest degree inadequate. For this
state of things, as _Heyne_[292] long ago pointed out, the τὸ θεῖον
(the divine element), or in other words the prevalent opinion that
infectious diseases were an infliction of the offended deity, is mainly
responsible. In these very diseases of the genitals, we have in fact
seen how they were ascribed to the wrath of Dionysus and Priapus; and
how long such ideas lasted, and how intimately they were interwoven
with the life of the people, may be gauged by the circumstance that
even the Christian Fathers themselves took every pains and used every
effort to maintain them.
Now is it really in any way reasonable to expect the physicians of
those times to have so completely extricated themselves from the
predominant range of ideas? and have we any right to abuse them for
their beliefs at the present moment, when in our own day there are to
be found not a few physicians who deny absolutely the contagiousness of
Venereal disease under its different forms? All the old practitioners
could do was to draw attention to the fact that underlying the τὸ θεῖον
there lurked some natural cause, and this view Hippocrates did actually
maintain in his writings. As to the indicative signs of this cause
perceptible by the senses, as to the material substance, whatever it
may be, that communicates infection, into all this they could hardly
be expected to initiate investigations,[293] deficient as they were in
every sort of aid and assistance for the task. For I ask, have we, in
spite of all our researches, thus far attained to any satisfactory and
certain results? Could the Anti-Contagionists ever have come forward
at all, if we had been successful in demonstrating the contagion to be
perceptible to the senses?
Besides all this, we actually find to the present day that in the
countries in question the contagion exhibits but a low degree of
virulence, and only under epidemic influence, as at the epoch of the
Athenian Plague, did it assume a virulent character at all,—a fact
that will be made yet clearer in our Continuation of the History of
Venereal Disease. But wherever the contagion did exhibit this virulence
of character, the ulcers that were set up passed over as a rule into
gangrenous mortification, or else the physicians either exterminated
it altogether by the actual cautery or removed it along with the part
in which it had established itself. Thus any further spread of the
contagion in its original form was not to be expected, as in patients
of the sort there can be no doubt all desire for coition must have been
destroyed.
If we now bring together the results of our discussion so far, we
shall find reason to believe that, speaking generally, the ancient
physicians,—that is physicians properly so called,—possessed but scanty
opportunities, especially in the case of women,[294] of observing
with any precision the origin and course of affections of the genital
organs, for it was mostly only the malignant forms of these that came
under their notice, and these were of their very nature, except when
epidemic conditions were at work, necessarily of infrequent occurrence.
Their pathological views stood in the way of unprejudiced observation,
_conspicuous_ characteristic symptoms were as little to be found
then as they are nowadays, any adequate knowledge of the material
_substrata_ of contagions was lacking to them in these as in other
forms of disease, and thus they felt no direct inducement to class the
_primary_ affections of the genitals as forming a special category of
disease.
Then again with regard to the _secondary_ symptoms, the ancient
practitioners in the cases treated by them made the occurrence of such
all but impossible, for scalpel and cauterizing iron either entirely
eradicated the contagion along with its material _substratum_, or
else removed it with all speed before it could be reabsorbed into the
system. Even when these did nevertheless appear, in some instances too
great an interval of time intervened, in others the parts attacked
were too remote from the spot primarily affected for it to have been
possible for them to be referred to any direct inter-communication.
Indeed this was made an actual impossibility in most cases, as it
was just those very spots that are the usual seat of the secondary
affections which were attacked primarily in consequence of the
different modes of _Venus illegitima_ (abnormal love) with such extreme
frequency as to make it barely practicable for the keenest eye at a
diagnosis to discover any actual distinction between the two,—and
this without taking into account the circumstance that in view of the
pronounced tendency conditioned by climatic causes for the morbid
process to strike outwards to the external skin, mischief in the mucous
membranes and bones must necessarily have fallen to a considerable
extent into the background.
If circumstances put it out of the power of the ancient Physicians to
unite under one whole the separate forms of Venereal disease, to look
at the morbid process in its entirety, it is no less self-evident that
for the same reasons they could have found no occasion to invent a
_special name_ for a thing that was simply invisible to them. Hence
the conclusion drawn that, because no such special name is found,
_therefore_ Venereal disease cannot have existed, strictly speaking
requires no further consideration. Still, granting for the sake of
argument that they had recognized at any rate the generic difference
of the primary affections, were they therefore bound to introduce
a special name for them? _Galen_ shall supply the answer. He says,
mentioning[295] that the old Physicians possessed no special name for
depression of the skull in conjunction with fissure of the bone: “It
is better to give a clear description than to fall back miserably on
barbarous names, which the younger physicians have invented in great
plenty.” In another place[296] he finds fault with the different
designations given to ulcers, and then proceeds: “If I consented to
enumerate all the names, I should be running the risk of deliberately
teaching what I recommend others to avoid, when I say that the true
searcher after truth must needs withdraw his attention from the
nomenclature that has grown up, and fix his eyes on the actual fact.”
While these expressions of opinion demonstrate the uselessness of the
names, they show at the same time that no inconsiderable number of
such names must no doubt have been in existence. So far as affections
of the genitals are concerned, not only is this indicated by the Greek
φθινὰς,—wasting disease and the Latin _robigo_,—ulcerous sore, not
to mention the ambiguous ἄνθραξ,—carbuncle, malignant pustule, but
_Celsus_ expressly declares the fact, saying (Bk. VI ch. 18) at the
beginning of his description of Diseases of the sexual parts: “Proxima
sunt ea, quae ad partes obscoenas pertinent, quarum apud Graecos
vocabula et tolerabilius se habent et accepta iam usu sunt, cum omni
fere medicorum volumine atque sermone iactentur, apud nos foediora
verba, ne consuetudine quidem aliqua verecundius loquentium commendata
sunt.” (Next come such words as apply to the parts of shame, the Greek
names for which are at once less offensive and are now sanctioned by
usage, as they are constantly occurring in every medical book and
medical discussion, whereas our native (Latin) names are coarser and
are not even recommended by any custom on the part of those who speak
with some regard to modesty). Celsus himself communicates but few
of these words, for he wrote _simul et pudorem et artis praecepta
servans_, (observing at once the laws of modesty and the rules of his
art); while between him and the writers of the Hippocratic school
medical Literature is all but a blank to us. The same is the case
between _Celsus_ and _Galen_; and of a period so important for our
purpose as that of the licentious Emperors, likewise not a single
independent medical Writer has come down to us. In fact even the
Fragments of the Compiler Oribasius, lately made known to the world by
Mai, contain, alas! nothing more than the headings of the Chapters most
interesting to us.
In such a condition of things it is really verging on the borders
of folly to hope to give a dogmatic and decisive judgement as to
the knowledge of Venereal disease possessed by the Physicians of
Antiquity,—the more so as the extant medical Works have never once
been adequately ransacked, as _Naumann_ only the other day proved in
the case of _Galen_. But of a surety it is easier to maintain the
Ancients knew nothing of Venereal disease, than to devote the best part
of a man’s life-time to the investigation, how much the Ancients did
actually know about it!
§ 40.
If we turn now from these discussions to the statements of the ancient
Physicians themselves, there are two different ways in which we may
regard them ourselves and present them to the reader’s eyes. _Either_
we put down consecutively everything that has been said by one and the
same Author and examine each single datum we owe to him by itself, _or_
we bring together the data given by different writers on one and the
same subject, and then compare these one with another. The first way,
the one generally followed by historians of Venereal disease hitherto,
gives us it is true the general results of the knowledge possessed by
the several writers on the different forms of Venereal disease; but,
seeing on the one hand we do not in most instances actually possess
all the works of our Author, while on the other even when we do, we
are not justified in looking upon his report as embodying a _résumé_
of all the knowledge of his time, the advantages of such a way of
dealing with the subject are on the whole but slight, while it has the
_dis_advantage of rendering considerably more difficult the general
survey of the information possessed by Antiquity as to Venereal
disease, which nevertheless is really our immediate and capital
concern, and cannot fail moreover to occasion a host of contradictions.
The second way not only relieves us from this disadvantage, but also
ensures us that general Survey which is peculiarly necessary, and to
the absence of which the circumstance is chiefly to be ascribed that it
has been possible hitherto to convince the opponents of the antiquity
of Venereal disease only in the most incomplete manner of its actual
existence in those times at all, as the exposition of the contrary
view, in itself incomplete, was bound in its fragmentary presentment
to seem even more incomplete still. Of course, in following the second
way of exposition, there is an unavoidable dislocation of the data
communicated by each individual writer, but this is a thing of but
little moment, more particularly as its inconvenience is minimised by
our giving the passages, when quoted for the first time, _in extenso_,
so as to have on subsequent occasions merely to refer back to them.
Again the want of a clear marking of dates, a point undoubtedly of
great importance in historical researches, is readily obviated by our
laying down the available fixed points of our chronology in the general
Survey that forms a necessary conclusion to our exposition.
No doubt _Hensler_ and _Alex. Simon_ had already struck out this second
way of exposition; but the latter writer merely examined the data of
the several Writers by themselves without making any effort to build
them up into one whole. To do this was, it is true, a proceeding
quite foreign to the method adopted by the Ancients, but for our own
time, accustomed as we now are to demand a systematic exposition of a
subject, it seems absolutely indispensible. _Hensler_ on the other hand
in his treatment of the question fixed his particular attention solely
on the Middle Ages, and made it his immediate aim merely to prove that
previously to the ninetieth year of the XVth Century local affections
of the genital organs were already well known, and had been subjected
to treatment.[297]
Now with regard to the actual exposition that follows, we shall refrain
in it as much as possible from going into particulars, such as the text
itself or the views of the Authors might seem to make obligatory, as
the needful space fails us, at any rate for the present. Moreover the
matter coming under review has been discussed already by many others,
while as for critical elucidations, let them be as pressingly required
as they may, we lack all the necessary _apparatus criticus_. In fact in
the case of several Writers, the translation, let alone the original
text, was with difficulty accessible, for which reason many a passage
of those already known may perhaps have been passed by unregarded.
A complete collection of all passages, including those still
unknown,—for the harvest as was mentioned above has by no means been
all reaped,—will certainly not be demanded by any reasonable reader
from a Student of thirty, for hardly even a greybeard Enquirer surely
could boast of having read all printed works of the ancient Physicians.
For the rest, our present object is not at all to give an exhaustive
exposition of all the ideas and observations of ancient Physicians as
to affections of the genital organs; it only concerns us here to bring
together what is true and directly available for our task. Under this
head would certainly seem to come the following seven points: