ON THE ETIOLOGY 
OF 
HEREDITARY SYPHILIS. 
BY 
FREDERICK R. STURGIS, M. D., 
CLINICAL AS8ISTANT MANHATTAN EYE AND EAR HOSPITAL, NEW YORK. 
[REPRINTED FROM THE NEW TORE MEDICAL JOURNAL, JULY, 1671, 
AND JULY, 1873.] 
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1873. PROSPECTUS FOR 1873. 
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D. APPLETON & 00., 549 & 551 Broadway, N. T. ON TIIE ETIOLOGY 
OF 
HEREDITARY SYPHILIS. 
BY 
FREDERICK R. STURGIS,D., 
CLINICAL ASSISTANT MANHATTAN EYE AND EAH HOSPITAL, NEW YORK. 
[.REPRINTED FROM TIIE NEW YORK MEDICAL JOURNAL, JULY, 1ST1, 
AND JULY, 1873.] 
N E AV YORK: 
D. APPLETON AND COMPANY, 
5 49 & 55 1 BROADWAY. 
1873. OX THE ETIOLOGY OF HEREDITARY SYPHILIS. 
PART I. 
The idea lias for a long time obtained in works on vene- 
real, that a father may procreate a child which shall show 
evidences of syphilis without the mother being infected at all; 
in other words, that so-called syphilitic semen has the power 
to transmit the disease to the ovum alone, and thence to the 
child, while the mother who furnishes the ovum, and of whom 
the foetus is a most intimate part, whose blood circulates 
through and nourishes this diseased product, escapes. Syphi- 
lis is essentially a poisoning of the blood in which the virus is 
supposed to be carried throughout the system, and by which 
it is transmissible. 
Now, how the blood of the foetus can be charged with this 
active transmissible poison, can circulate through the moth- 
er’s arterial system without producing the disease in her, ap- 
pears incomprehensible. Either our belief that the virus of 
syphilis is contained in the blood is incorrect, that Pellizaris’s 
experiments of transmission of the disease by the blood are 
false, or else we must consider that the reported cases of 
healthy mothers giving birth to syphilitic children are untrue. 
To look at it in another light: it is a pure assumption on 
our part to say that the semen of a person afflicted with syphi- 
lis must be diseased, and capable of transmitting the infection. 
The only ground upon which it rests is that syphilitic fathers 
have syphilitic children. If the semen is diseased, of course 
the urine, the sweat, the saliva, the tears, the milk, in a word, 4 
ETIOLOGY OF HEREDITARY SYPHILIS. 
all tlie secretions and excretions of a syphilitic person must 
likewise be syphilitic and capable of transmitting the disease. 
I scarcely think there is any medical man who would advance 
such a statement, or who would find any proof to support it. 
Since the day wdien Cardinal Wolsey was accused of attempt- 
ing to transmit syphilis to his royal master by whispering in 
his ear, such cases have been looked upon as idle fables, and 
have never commanded the serious attention of the profession. 
Any one looking over the reported cases, where, of the 
two parents, only the father is diseased, will be struck with the 
meagre details of the mother’s history; she is often barely 
noticed. Where she receives something more than a mere 
mention of her existence, it is usually in such language as, the 
mother is and has been perfectly healthy, or, the mother has 
never presented any symptoms of the disease; and sometimes 
she is examined, when the report is, the mother was examined 
and nothing suspicious wras found. 
Nor do I consider objections to such bare and unsatisfac- 
tory histories as these mere cavil. When it is considered how 
imprudent it often is to arouse the mother’s suspicions by any 
questions about herself; how reticent women are upon such 
matters, even when they know about them ; how far from 
uncommon it is for the earlier symptoms to be entirely over- 
looked, or, if noticed, to be ascribed to some other cause, the 
difficulty of obtaining a correct judgment in these instances 
can be better appreciated. For the most part the cases of in- 
fection by the father alone are derived from the older writers, 
and, becoming stock-cases, are copied ad infinitum, by every 
one who writes upon the subject, without the slightest question 
of their truth being raised. Diday, one of the advocates of 
this theory, when writing upon the subject in his work on In- 
fantile Syphilis (Sydenham Society Publications, p. 17), gives 
but one case of his own observing, and curiously enough, al- 
though the father had undoubted syphilitic symptoms both 
before and after his wife’s impregnation, and ought therefore 
to have had a syphilitic child, it was born and continued to 
be healthy. At the time of reporting the case the child was 
two years old. 
Besides the causes already mentioned, which sometimes ETIOLOGY OF HEREDITARY SYPHILIS. 
5 
render a correct solution of tlie problem impossible, there is 
one which has not been mentioned. It sometimes occurs that, 
in those cases where the mother is examined, she is found free 
from all symptoms. Is it therefore proper to conclude that 
she is to be exempted from having any share in the disease of 
the child ? No, and for this reason : Between the disappear- 
ance of one set of symptoms and the appearance of the next, 
there is an interval of freedom from all signs of the disease, 
the so-called period of incubation. During this period it is 
often impossible to tell by an examination whether the patient 
has had syphilis or not. It may be objected that the indura- 
tion left after the chancre, and of the inguinal glands, or the 
presence of cicatrices, would give a clew to the truth when all 
else fails. Undoubtedly glandular induration and that of the 
chancre, when present, are valuable diagnostic signs, but, un- 
luckily for this view of the case, the former is not indelible, 
on the contrary, is frequently evanescent, and the latter in 
women is proverbially hard to find; in fact, is sometimes im- 
possible to discover.1 
Then, again, all chancres do not have the ligneous hardness 
usually associated with them ; they may be “ parchemine,” and 
at the date of the examination, which is usually made some 
time after the inception of the disease, all signs of the indura- 
tion have disappeared. Cicatrices do not occur until during 
the later stages of the disease, and a person may have had the 
earlier secondary manifestations, which have disappeared with- 
out leaving a trace of their presence. Given a case under 
such circumstances, how is an examination alone to enable us 
to decide whether the patient has or has not syphilis ? Viewed 
in this manner, Bicord’s case, which he describes in the four- 
teenth chapter of his “ Lettres sur la Syphilis,” is capable of a 
different intei*pretation from that which this eminent surgeon 
gives it. It is copied here in extenso, because it is one so often 
cited in support of the theory of paternal transmission, and 
the clearness and accuracy with which it is related render it 
1 la this connection consult De l’lnduration chancreuse chez la Femine, 
par Alf. Fournier ; Annales de Dermatologie et de Syphiligraphie, t. 2i5me, 
p. 46. 6 
ETIOLOGY OF HEREDITARY SYPIIILI3. 
less liable to the objection of carelessness made to the majority 
of tlie cases reported : 
Case I.—A young woman, accompanied by her husband, older than 
herself, consulted me with regard to her child, which had been put out to 
nurse. The child was infected with constitutional syphilis, which the 
mother accused the nurse of having given it. The child was almost com- 
pletely covered with a moist squamous sypbilide; the pourtour of the anus 
and of the lips was the seat of ulcerating mucous patches. The child was 
six months old; the nurse’s statement was, that the first symptoms showed 
themselves at the age of six weeks. 
The mother and the husband both declared to me that they had never 
had the disease, and the most careful examination failed to show any thing 
either present or past. The nurse, also, examined with the greatest care, 
seemed to me to be perfectly healthy. Her child, which she was suckling 
at the same time as the diseased nursling, was perfectly well. 
I was exceedingly puzzled in my attempts to discover the origin of this 
child’s syphilis, when, the next day, I was consulted by a young cavalry- 
officer for a plantar and palmar psoriasis. He questioned me, with the 
most touching solicitude, with regard to the illness of the child which had 
been brought to me the day before, and he confided to me his share in the 
affair; but, being ignorant of the laws of inheritance, he was surprised at 
the child being diseased, especially as he said he thought himself cured, 
and had not a single symptom of the disease when he had connection with 
the mother, who entirely escaped infection. 
In this case there are four parties—father, mother, nurse, 
and cavalry-officer. Of these only one, the latter, shows 
symptoms of the disease. The father and nurse can he ex- 
cluded ; the former, because it makes no sort of difference 
whether he did or did not have syphilis, the latter because of 
her child’s good health ; had she been syphilitic, it would have 
been so also. Two are left, mother and cavalry-officer. lie 
undoubtedly is one source of the child’s disease, and the ques- 
tion is, was he the only one. Ilis symptoms are syphilitic 
psoriasis; how far back do his contagious symptoms date ? 
This eruption is generally a late form of the disease, but may 
occur chronologically anywhere from six or eight weeks to 
two years and more after the primary lesion.1 The child is 
1 Consult Cullerier, “Atlas of Venereal Diseases,” translation by Bum- 
stead, p. 284; Bassereau, “Trait<5 des Affections de la Peau symptoma- 
tiques de la Syphilis,” p. 498; Bumstead, “Pathology and Treatment of 
Venereal Diseases,” pp. 406, 408, 546; Eeder, “Pathologic und Therapie 
der venerisclien Krankheiten,” p. 246; Muller, “ Compendium der veneri- 
sehen Krankheiten,” p. 233. ETIOLOGY OF HEREDITARY SYPHILIS. 
7 
six months old, which, added to the nine months it was in 
utero, makes fifteen months. Fifteen months back the officer 
confesses to have had syphilis, and is it so improbable to sup- 
pose that, notwithstanding his belief that he was well when 
he had connection, he was mistaken, and really did have con- 
tagious symptoms at the time he had his intercourse with the 
mother? Is it so improbable that the mother was diseased, 
and may have known nothing about it ? I believe not, and in 
proof of my assertion I refer the reader to two cases mentioned 
in Bumstead’s work (pp. 478, 479), wdiere the patients had in- 
contestable signs of syphilis, and were yet totally ignorant of 
the fact. At the time she was examined by Ricord she was 
either well, or, what is not unlikely, in the period of transition, 
when she would not probably have had any symptoms in- 
dicative of the disease, but which she might have shown had 
Ricord had an opportunity of examining more than once. I 
am well aware how readily this explanation might be looked 
upon as more ingenious than correct, hut, when viewed by the 
results of other cases which I shall quote, it will not, I trust, 
appear so far fetched. Since I wrote the foregoing paragraph, 
I chanced, while looking over Zeissl’s work, “ Lehrbuch der 
constitutionellen Syphilis,” p. 317, to find the following state- 
ment, which to a certain extent is confirmatory of my view: 
“ I have noticed as a rule that women, -whose husbands are suf- 
fering from so-called latent syphilis, not only quickly fade and 
lose their former blooming appearance, even if they have never 
been pregnant, nor had any miscarriages, but that sooner or 
later in such leucsemic women glandular tumors and ostrosco- 
pic pains make their appearance together with nodes upon the 
sternum, cranium, tibia, etc., and that these symptoms disap- 
pear under anti-syphilitic treatment only. I recall to mind a 
case where the man affected with psoriasis palmaris was the 
father of two syphilitic children who died soon after birth. 
The mother remained apparently healthy until after the second 
confinement, when an undoubted psoriasis palmaris showed 
itself in her? 
Cullerier, in 1854, in a paper read before the Societe de 
Chirurgie de Paris, advanced the statement that the influence 
of the father was nil in the contamination of the foetus by 8 
ETIOLOGY OF HEREDITARY SYPHILIS. 
hereditary syphilis; that it depended upon the mother; so long 
as she remained free from disease, the child was safe. In the 
introduction to his work, “ Precis iconographique des Maladies 
veneriennes,” he says: “ I have since met with new facts which 
corroborate those I have already observed. I have under my 
care seven children affected with hereditary syphilis. In six, 
I have verified the disease in the mother. In the other, the 
father and mother both denied any previous disease, so that 
one cannot be accused of it more than the other. I have 
known eight men suffering from secondary syphilis impregnate 
their wives, and their children are exempt.” lie gives two 
cases in full, which occurred in his practice, and which first 
induced him to differ from the generally-received opinions of 
the day : 
Case II.—An officer in the French Army contracted an indurated 
chancre, followed by a squamous sypliilide, mucous patches of the anus, 
ulcerations of the mouth, impetigo of the scalp, alopecia, and induration 
of the cervical ganglia. After following treatment for fifteen days, he was 
salivated. In spite of all this, he married, and shortly after impregnated 
his wife. She escaped infection, and the child also. At the time the case 
was reported, the son was eighteen years of age, and had never shown the 
slightest symptom of the disease (op. cit., p. 87). 
Case III.—Indurated chancre six months before marriage; subsequent 
symptoms: roseola, cervical adenitis, and trouble in the throat. During 
this condition of the husband the wife became pregnant. She escaped in- 
fection. The child was born healthy, and has remained so for fifteen years 
(op. cit., p. 88). 
These cases of Cullerier were followed by observations 
bearing upon this subject published by M. !Notta in 1860, and 
by M. Charrier in 1862. The conclusions these gentlemen 
arrived at were similar to those of Cullerier, viz., that, pro- 
vided the mother escaped infection, the children were safe. 
I append their cases ill a tabular form : ETIOLOGY OF HEREDITARY SYPHILIS. 
9 
SYNOPSIS OF M. NOTTA’s OASES OF INHERITED SYPHILIS.—ARCHIVES GEN. 
DE m£decine, march, 1860. 
Cases. 
Condition of Father. 
Condition of Mother. No. of Children 
Condition & Ages. 
or Pregnancies 
Case 1. 
Indurated chancre, etc. 
Healthy. 
2. 
Healthy. 
At time of marriage, he 
had an exostosis of the 
ulna, and a syphilide on 
the outer surface of the 
1)4 and years. 
forearm. Followed four 
Case 2. 
years afterward by orchi- 
tis of both testes; his 
syphilide on the arm still 
continuing. 
Indurated chancre, mu- 
Healthy. 
1. 
Healthy. 
cous patches, alopecia, 
etc. One year after, all 
the symptoms having 
disappeared, he married. 
22 months. 
Two months after mar- 
riage. mucous patches re- 
turned on the tongue, 
which lasted one and a 
half year. Free from 
symptoms he impregnat- 
ed his wife,when a month 
after he presented him- 
self with palmar psoria- 
Case 3. 
sis. 
Indurated chancre, etc. 
Healthy. 
2. 
Healthy. 
Three months after mar- 
riage, he presented mu- 
cous patches of the scro- 
tum, in the throat, and 
round the anus. At this 
time his wife became 
3 and 2 years. 
pregnant. The mucous 
patches continued thro’ 
this and at the time of 
his wife’s second preg- 
Case 4. 
nancy. 
Indurated chancre, mu- 
Healthy. 
1. 
Healthy. 
cous patches about the 
scrotum and anus, and 
articular pains. Attime 
7 months. 
of marriage, free from 
symptoms. Two months 
after marriage, squamous 
eruption on scrotum, 
which continued during 
his wife’s pregnancy. 
Case 5. 
Indurated chancre, etc. 
Healthy. 
6. 
Healthy. 
Three years after mar- 
Ages of first two 
riage ulcerating gum- 
only given, 12 and 
mata of the arm. 
11 years. 
Case 6. 
Phagedenic chancre, 
followed two years later 
by orchitis and papular 
eruption. Between the 
chancre and his subse- 
quent symptoms had no- 
ticed nothing suspicious. 
Healthy. 
1. 
Healthy. 
15)4 years. 
The orchitis and erup- 
tion came on at the time 
of his wife's confinement 
Case 7. 
Indurated chancre, fol- 
Healthy. 
1. 
nealthy. 
lowed by mucous patches 
in the throat, papular 
eruption of the scalp, 
cervical adenitis. Two 
15 months. 
years later, cerebral 
symptoms indicative of 
tumor of brain, incom- 
plete hemiplegia, head- 10 
ETIOLOGY OF HEREDITARY SYPHILIS. 
SYNOPSIS OF M. NOTTA’s CASES CONTINUED, 
Cases. 
Condition of Father. 
Condition of Mother. 
No. of Children Condition & Ages. 
or Pregnancies. 
aches, and nocturnal 
pains. Recovery under 
use of iodide of potassi- 
um. He then married. 
Case 8. 
Indurated chancre, mu- 
nealthy. 
1. 
Healthy. 
cous patches about the 
anus, nocturnal pains, 
alopecia, and engorge- 
ment of cervical glands. 
2 years. 
Three years after recov- 
Case 9. 
ery he married. 
Father had syphilitic 
At time of concep- 
2. 
The first child, 
manifestations anterior 
tion had mucous 
when six months 
to the birth of the child. 
patches of the throat, 
old,mucous tuber- 
At time of the report a 
alopecia, nocturnal 
cles about the 
syphilitic eruption. 
pains, and headache. 
anus and an erup- 
Three years elapsed 
tion over bodv. 
between the two preg- 
The second child, 
nancies, during which 
eruption on body 
time neither showed 
& mucous patches 
any signs of syphilis. 
about scrotum. 
Case 10. 
Mucous patches in the 
Four months after 
1. 
Two months af- 
mouth, alopecia, and a 
marriage, mucous 
ter birth cachexia, 
syphilide of the scalp. 
After recoveryfrom these 
patches of the vulva, 
alopecia, and head- 
ache. 
blotches, and ul- 
cers over the 
body. 
Three months after, he 
had a syphilide which 
covered his penis and 
testicles. Three years 
later cerebral symptoms. 
Case 11. 
Indurated chancre three 
Indurated chancres 
1. 
Died at the sixth 
weeks before marriage. 
on the labia minora, 
month of intra- 
seen five months later, 
with mucous patches 
about the anus and 
uterine life. 
vulva. 
Here, again, are found precisely the same results as in M. 
Cullerier’s two cases, viz., the child inherits the disease only 
when the mother has syphilis; provided she has escaped infec- 
tion, it makes no difference whether the father has had it or 
not. In this series are four sets of cases: 
1. Where the father at the time of conception has syphi- 
litic symptoms, or where the diathesis is present, hut the 
mother is free from disease. 
2. Where the father shows no symptoms, nor is the diath- 
esis apparently present, although he has had an anterior syphi- 
lis. The mother does not suffer from the disease. 
3. Where the father has had syphilis, hut shows nothing 
of the disease. The mother has had an anterior syphilis; and, 
4. Where both are syphilitic at the time of conception. 
Among these four sets of cases, eighteen children are horn, 
fourteen for the first, and four for the last two sets. Of the 
first two sets, not one child is diseased; of the last two, all. ETIOLOGY OF HEREDITARY SYPHILIS. 
11 
In other words, when the mother escapes infection, the chil- 
dren are healthy, but, where she is syphilitic, the children are 
so also. 
SYNOPSIS OF M. CHARRIER’s OASES.—ARCHIVES GEN. DE MEDECIXE, 
SEPTEMBER, 1862. 
Cases. 
Condition of Father. 
Condition of Mother. 
No. of Children 
or Pregnancies 
Condition of Chil* 
dren and Ages. 
Case 1. 
Primary lesion one 
month before marriage, 
followed by roseola. Wife 
became pregnant daring 
his treatment. 
Healthy. 
3. 
Healthy. 
6, 4, 2% years. 
Case 2. 
Palmar syphilide. 
Mucous patches dur- 
ing pregnancy. 
3. 
One child died 
one month after 
birth with syphili- 
ticsymptoms.Two 
miscarriages, one 
at four months, 
the other at seven. 
The latter was 
born with mucous 
patches about the 
anus. 
Case 3. 
Indurated chancre, ro- 
seola. Ecthyma at time 
of wife’s pregnancy. 
Healthy. 
1. 
Healthy. 
4 years. 
Case 4. 
Itupia and osteoscopic 
pains. At time of wife’s 
pregnancy, node on clav- 
icle and nocturnal cepha- 
lalgia. 
Healthy. 
1. 
nealthy. 
8 months. 
Case 5. 
Healthy. 
Roseola and mucous 
patches four months 
before marriage. At 
time of marriage, im- 
petigo of the scalp. 
Pregnancy one month 
after marriage. 
2. 
Abortion at 
third month. Chil- 
dren covered with 
copper - colored, 
spots. 
Case 6. 
Mucous patches about 
the anus, three months 
before marriage. At time 
of marriage, specific ul- 
cerations on the tonsils. 
Healthy. 
1. 
Healthy. Age 
not given. 
Case 7. 
Before gettiug syphilis, 
he had two healthy chil- 
dren. Chancre (indu- 
rated), followed by im- 
petigo of the scalp and 
cervical adenitis. One 
year later, ecthyma, and 
one year later still he had 
exostoses. 
Healthy. 
3. 
Healthy. 
4, 3, and 2 years. 
In the second case on the list is a singular fact, which could 
not well he expressed in the tabular form, but which is none 
the less worthy of mention. Here the man’s wife contracted 
the disease, but his mistress (for he had one) did not. Within 
a fortnight of the time that the wdfe was delivered of the 
seven-months’ foetus with the anal mucous patches, the mis- 
tress had a child, which up to the age of three years had never 
shown any symptom. Objection may be made to this child 
being by some other man, but M. Charrier answers that in 12 
ETIOLOGY OF HEREDITARY SYPHILIS. 
this maimer: “ Cet enfant ressemble en tout point a son pere, 
et qu’il a comme lui une conformation toute particuliere des 
pouces, que les enfants legitimes avaient egalement presentes.” 
Here are eiglit observations, in seven of which the father 
is syphilitic. In six of these eight, the mothers do not contract 
the disease; in two they have syphilis. What do we find? 
Wherever the mother is healthy, the children are so also; 
wherever the mother is diseased, the children are likewise dis- 
eased. And, in one case, this is strikingly exemplified: the 
husband communicates the disease to his wife, and all the 
children are syphilitic ; but his mistress, who escapes infection, 
presents him with a perfectly healthy boy. 
To close this paper, I quote one more case, which is particu- 
larly interesting and instructive. It is reported by Dr. Van 
Buren, of Hew York, in the first volume of the American 
Journal of Syphilography and Dermatology, and clearly 
demonstrates the fact which this paper seeks to show. The 
early part of the history, so far as syphilis is concerned, is not 
given, inasmuch as the patient declined an examination, but 
there is every probability that he had the disease at the time 
he married. Three years after his marriage (1861), he had 
“ retinitis syphilitica,” complicated by “ amblyopia pota- 
torum.” Eight years after his last symptoms (in 1869), and 
eleven after his marriage, he came under Dr. Van Buren’s 
care, with the following symptoms: “Irregularly nodulated 
and tender shins, superficial ulcers at the angles of the mouth, 
a yellowish patch on one tonsil, and a circular scaly spot as 
large as a sixpence on one of his palms.” The mother was at 
the time of her marriage perfectly healthy, and had never 
been married before. In 1860, two years after her marriage, 
she also came under Dr. Van Buren’s care, and the following 
is her record: “ From the enjoyment of brilliant health at the 
time of her marriage, she had become gradually pale, weak, 
and emaciated, without obvious cause. She had nursed both 
of her children. I was unable to make out any symptoms of 
secondary syphilis, save a characteristic ulcer upon the side 
of the tongue, of at least six months’ duration (query, was the 
ulcer or the syphilis of six months’ duration ?). She had also 
a gummy tumor the size of a hickory-nut, in the left labium ETIOLOGY OF IIEKEDITAKY SYPHILIS. 
13 
majus.” She ultimately seems to have recovered, under 
treatment, from the syphilis, to die in 1867 of peritonitis due 
to an ovarian enlargement. 
This couple have four children, first one horn May, 1859, 
healthy at birth, and remained so when last seen, seven years 
after. Second child born June, 1860, with defective develop- 
ment of brain and spinal cord. This child, as far as I can learn, 
never manifested any of the ordinary evidences of congenital 
syphilis. It showed a great deal of tenacity of life, although 
idiotic and paraplegic, and died at the age of five, from the 
consequence of whooping-cough. The third child was born 
January, 1862. Dr. Van Buren received from the family 
physician, April 9, 1862, a letter as follows: “ The child ap- 
peared quite healthy at birth and continued so until three 
weeks ago (i. e., two months after birth), when an eruption 
made its appearance (complicated with excoriations around the 
mouth and nose), which gradually invaded the whole body, 
and was in the writer’s opinion ‘ decidedly syphilitic.’ There 
are at present no marks of morbid action in the mother, but she 
has resumed the use of the corrosive sublimate, and is nursing 
the child.” The boy had subsequently periostitis of the tibia 
and ulna, and in 1868, at the period of his second dentition, 
lie had “ unmistakable evidences of the disease upon his inci- 
sor teeth, the development of the enamel quite imperfect—in 
fact, what I call syphilitic teeth.” 
The fourth and last child was born October, 1869. The 
child is in “ excellent health, having shown no evidences what- 
ever of disease.” 
Here is the case of a healthy woman, free from disease, mar- 
ried to a man who, if he does not present evidences of syphilis, 
is under the influence of the diathesis at the time of his mar- 
riage. They have four children ; are they all diseased ? Ac- 
cording to the generally-received opinion, they should have 
been. Throwing aside all preconceived ideas, what are the facts 
of the case ? The first two children are free from syphilis, for, 
in the case of the second, idiocy and paraplegia, in the ab- 
sence of other symptoms, are not sufficient to establish a diag- 
nosis due to hereditary syphilis, merely because the father 
is syphilitic. The third child is beyond doubt diseased, and 14 
ETIOLOGY OF HEREDITARY SYPHILIS. 
what is the condition of the parents? Two years before this 
child was born the mother had a gummy tumor and an ulcer 
on the tongue. One year before the child’s birth the father 
had “ retinitis syphilitica and amblyopia potatorum.” Both 
diseased; when did the mother’s trouble begin ? Dr. Yan Bu- 
ren thinks during the first pregnancy and lactation. But if 
so, unless acquired at a late stage of the pregnancy, how is the 
first child so healthy, and why does not the second one show 
syphilitic symptoms ? They do not, however. It is the third 
one only which shows evidences of hereditary taint. The in- 
fection probably occurred somewhere between the second and 
third pregnancies. Four months after the birth of the second 
child the mother shows the symptoms detailed above, and 
“ which were at least of six months’ duration.” From that it 
would seem that the mother became diseased at the very last 
part of the second pregnancy. If this view of the case be the 
correct one, we see these two facts : 1. That a mother begets 
non-syphilitic children so long as she is not infected, even 
though the father is syphilitic; and, 2. The moment she is 
diseased, the children are inevitably so. One other and still 
stronger fact: when the mother recovered, the next child was 
healthy, although the father was still under the influence of 
the diathesis; for two years after the child’s birth he came 
under observation with marked symptoms of syphilis. 
In the next paper I shall examine cases where the paternal 
influence is admitted; not all, for that would occupy too 
much time and space with no good result, but the most promi- 
nent ones, and show wherein the defects lie, so far as their 
scientific value is concerned. My object in writing these 
articles is to call attention to the fact of how little is known 
of the etiology of hereditary syphilis, and how needful it is, 
with our advanced knowledge upon the subject, to revise our 
former beliefs. To do this effectually, we must give up our 
blind reliance upon old authorities when they clash with new- 
ly-observed facts, and examine the question for ourselves, for 
in medicine, as in the other sciences, skepticism is the first step 
toward sound knowledge. PART II. 
In my previous paper on tliis subject, published in the 
Xew York Medical Journal for July, 1871, I attempted to 
show by a series of cases, gathered from various sources, that, 
for a child to become syphilitic by inheritance, the mother 
must be diseased; but, were she to escape infection, it made 
no difference whether the father had syphilis, so far as 
the child itself was concerned. To put it in a few words: 
the semen is per se incapable of transmitting syphilis, I 
pointed out where the error lay in pronouncing the woman 
sound because nothing could be found upon her person, or 
because she denied having had the disease. I also noticed 
that in very many of the detailed cases the reporter seems 
to have been satisfied with the mother’s statement of her 
health, or with the husband’s avowal that she was quite well; 
in others, the woman was not seen at all ; and in nearly, it 
not quite all, no mention is made of the woman having been 
examined, from which we are left to infer that she was not. 
Such defective proofs as these should hardly be brought for- 
ward or accepted in support of the paternal influence in hered- 
itary syphilis, when there are such strong and well-authen- 
ticated cases for the contrary belief. There is sufficient evi- 
dence to throw doubt upon the truth of the old doctrine, and 
my object in writing these articles is to show that, although 16 
ETIOLOGY OF IIEEEDITAEY SYPHILIS. 
the theory of the paternal influence may, perhaps, be correct, 
the proofs upon which it rests are defective, and that the be- 
lief which is so general upon the subject is based upon facts 
which are open to severe criticism. In selecting the cases for 
criticism I have copied from those whom I believe to be the 
best and most trustworthy defenders of this doctrine, from 
such men as Hutchinson of London, Langston Parker, of Bir- 
mingham, Diday, of Lyons, and others of equal weight. I 
shall report their cases in full, and then show in what respects 
they are defective as proofs of the point in question. 
Mr. Hutchinson, in the second volume of the “ London 
Hospital Reports,” 1865, reports three cases where the children 
receive the taint from the father alone, the mother escaping 
infection. He gives in all eight cases; of these, five, or about 
sixty per cent., are born of parents who are both diseased. 
In the other three it remains to be seen how real the mother’s 
good health was. 
I. (page 182.)—“ A Child born Six Years after his Father 
contracted Syphilis, where the Latter had for long been 
free from Symptoms. Severe Disease in the Child. Pro- 
gressive Improvement in the Younger Children. 
“Mr. D., a big, powerful Scotchman, presenting every 
appearance of the most robust health, brought me his eldest 
son, a thin, dwarfed starveling boy of fourteen, the utmost 
contrast to his father. The boy’s tibiae were covered with 
nodes, and he had nodes also on the bones of both forearms ; 
his face was typically syphilitic, his cornese were opaque, and 
his test teeth were deeply notched. On a subsequent occasion 
Mr. D. admitted that before marriage he had suffered from 
syphilis, but said he had soon got well and had remained so 
ever since. lie has still some iritic adhesions in one eye. At 
a later period Mrs. D. was also my patient, on account of a 
troublesome ozsena. She displayed no positive symptoms of 
syphilis, nor did she appear to have suffered from such. From 
her I obtained the following facts as to herself and her chil- 
dren : All the latter were brought for my inspection. We 
appear to have a good instance of the younger part of the 
family escaping the taint. Mrs. D. has nursed all her cliil- ETIOLOGY OE IIEEEDITAKY SYPHILIS. 
17 
dren, and, excepting 4 debility,’ has considered herself in good 
health. 
“ During her early pregnancies she repeatedly had aching 
pains in the left eye (eighteen years ago). Gradually she 
found that the sight with this eye was much impaired. She 
thinks it has been as bad as it is now for six years at least. She 
describes distressing pain in the brow and temple, occurring at 
times, and lasting a day or two, always in the left side. For 
many years she has been quite free from this frontal head- 
ache. Her eye was never visibly inflamed. 
44 The pupil of the defective eye (left) is smaller than the 
other, not half the size and decidedly smaller than natural, 
but quite round. With this eye she can only just make out 
JSTo. 19, holding the book to one side and very near to her 
eye. There is nothing abnormal in the front parts of the eye. 
44 Mrs. D.’s family : 
44 1. A girl, stillborn. 
44 2. A girl, died at two years old, of scarlet fever. 
44 3. A boy, died, aged five weeks, of 4 yellow jaundice.’ 
44 4. Is our patient. The very type of syphilitic diathesis ; 
keratitis, notched teeth, earthy complexion, and numerous 
nodes (now aged fourteen). 
44 5. A girl, aged twelve, well grown, but of slightly-marked 
syphilitic physiognomy. Upper central incisors notched, but 
not so deeply as her brother’s. She has had keratitis, and 
in both eyes are extensive synecliise. It is about a year since 
her eyes inflamed. 
44 G. A boy, aged ten, has perfect teeth of large size, good 
complexion. Has not suffered in his eyes. 
44 7. A girl, died, aged four, of whooping-cough. 
44 8. A boy, aged five, quite healthy. 
44 9. A boy, aged two, quite healthy.” 
Thus, out of nine children, only two show any thing 
which can be proved to be syphilitic (the fourth and fifth). 
Can the mother be looked upon as entirely healthy ? True, 
neither the 44 ozcena ” nor “pain in the eye ” taken alone, is 
necessarily syphilitic, but considered together, with the fact 
that there has been extensive disease in the eye, renders it a 
question of doubt. Is it not likely the father infected the 18 
ETIOLOGY OF HEREDITARY SYPHILIS. 
mother ? Let us retrace our steps and inquire into the history. 
The child was born six years after the father contracted the 
disease. 
(Page 182.) The boy is fourteen years old. It is twenty 
years, therefore, at the time the case was reported, since the 
father was infected. Eighteen years back, the mother, during 
her earlier pregnancies, had repeatedly “ aching pains in the 
left eye, distressing pain in the brow and temple,” etc. Were 
these symptoms due to iritis? Supposing it to have been 
that, the probability is in favor of it being syphilitic, because 
the husband had syphilis about the time of, and probably 
during marriage, and sixty per cent, of all cases of iritis occur 
in syphilitic persons.1 lie has had the disease twenty-five 
years, and has been married certainly eighteen, perhaps longer, 
for the wife’s “ earlier pregnancies ” took place eighteen years 
ago. Whether the first or second we are not told, but, grant- 
ing it to have been the first, we must allow one year for the 
woman to become pregnant in. They would have been mar- 
ried then nineteen years, and the husband would have con- 
tracted his disease only one year before marriage, perhaps 
not even as long. When did his iritis appear ? before or dur- 
ing his marriage ? Upon that point we have no positive evi- 
dence, but we can approximate to the time. Syphilitic iritis 
is one of the so-called transition symptoms between the sec- 
ondary and tertiary stages, appearing as a tertiary as well as a 
secondary manifestation, and occurs from four months to two 
years and more after contagion.2 Persons having iritis are 
not likely to have that and nothing more ; they usually have 
mucous patches, eruptions, etc., in conjunction with it.3 Is it 
so improbable to believe, then, that the husband had his iritis 
during his married life, together with other symptoms capa- 
1 Bumstead, “Pathology and Treatment of Venereal Diseases,” third 
edition, p. 660, 1870. “VYecker, “Etudes Ophthal.,” tome i., p. 394. 
2 Of. Bazin, “Lemons Tkeoriques et Cliniques sur la Syphilis, et les 
Syphilides,” p. 69, 1866. Bumstead, “ Pathology and Treatment of Ve- 
nereal Diseases,” p. 666, 1870. Lancereaux, “ Trait6 Historique et Pra- 
tique sur la Syphilis,” p. 190, 1866. Geigel, “ Geschiehte, Pathologie u. 
Therapie d. Syphilis,” p.283, 1867. 
3 Cf. Ricord, “Iconographie des Maladies VCuSriennes,” pp. 109, 117, 
1862. Bumstead, op. cit., p. 666. ETIOLOGY OF HEREDITARY SYPHILIS. 
19 
ble of infecting his wife ? At any rate, although the evidence 
may not be strong enough to prove that the mother had syphi- 
lis, it is sufficiently so to cause doubt about her sound health, 
and whether the father was the only one of the parents who 
was diseased. 
II. (page 187.)—“ Case in Proof that Syphilis may be trans- 
mitted by a Father many Years after its Occurrence in 
Himself ’ and after his Apparent Restoration to Perfect 
Health. 
“ Tlie following case illustrates some very important laws 
in respect to the transmission of syphilis: 1. That the taint 
may be transmitted by the father only. 2. That it may be 
transmitted by a father who not only has no symptoms at the 
time, but who has been for seven years in good health. 3. 
That with the lapse of time such a taint dies out, and that 
the later offspring may escape any severe degree of contami- 
nation. 
“ Thomas J., a boy, aged thirteen, was brought to me at 
Moorfields, on March 19, 1863: he had syphilitic keratitis, 
characteristic physiognomy, and dwarfed teeth. I asked Mr. 
Dixon to see him, in order to verify my conclusions, and he 
quite agreed with me respecting them. The father of the lad 
came with him. lie was a very robust-looking man ; on in- 
quiry, he gave me, with perfect candor, the following his- 
tory: He had been married eighteen years, and was now 
forty-seven years of age ; two years before he married he had 
a venereal sore, which was followed by a rash on the skin. 
£ It was hanging about him for a long time, five or six months 
at least.’ When he married he was in perfect health, and has 
never since had a single symptom he could suspect of being- 
venereal. I examined his tongue, the palms of his hands, 
etc., and could not find the slightest evidence of the diathesis. 
Ilis wife was in good health at the time he married her, 
and remained so afterward, except that she was weakened by 
bearing a large family very quickly. Her first was born a 
year after marriage, and died a few hours after birth. Thomas 
J., our patient, was the sixth born, and the eldest living. lie 
suffered in infancy very severely from snuffles, rash, sores at 20 
ETIOLOGY OF HEREDITARY SYPHILIS. 
the corners of his mouth, etc.; his parents did not expect to 
rear him. There are five younger ones living, two girls and 
three boys, all (excepting one) healthy, and none have suffered 
from infantile symptoms. The one exception is delicate, but 
nothing special ails him. The wife died two years ago from 
an abscess in the back. 
“We must add that the boy was not an example of ex- 
treme cachexia. His teeth were not so deformed as we often 
see them. His growth was good, and he had a fair degree of 
coloration. After the outbreak in infancy, until incipient 
puberty, he had been quite free from symptoms, and had en- 
joyed good health. The attack of keratitis was, however, a 
sharp one, and exceedingly well characterized; his hearing was 
not affected at all. In proof that the ‘taint was slowly di- 
minishing in his parent, we have the fact that the younger 
children have all lived and have escaped symptoms in infancy. 
Of course, the fallacy remains that his mother may have con- 
tracted syphilis as well as his father, either before or after 
marriage. Such a conjecture is, however, wholly unsupported, 
while the health of the younger children makes it highly im- 
probable. 
“ The truthfulness*of the father’s statement is confirmed 
by the fact that the elder children all died, and, after careful 
consideration of the whole history, I am also of opinion that 
there is little doubt that this boy was born some years after his 
father contracted the disease, and that he has inherited the 
taint from his father only. 
“ I will now mention another case in which the probability 
seems very great that the taint has persisted for two years in 
the parent’s system with sufficient virulence to infect the off- 
spring even at the end of that period, 
III. (page 189.)—“Rash, Condylomata, and the usual Symp- 
toms, in an Infant horn Two Years after the Disease in 
its Parent, and after other Children had shown it. 
“ On January 18, 1805, Mrs. J. brought me her baby, a 
year old, with a large forehead, and condylomata around its 
anus. She said that when born it was healthy, but that at 
six weeks old it became covered with rash and had snuffles ETIOLOGY OF HEREDITARY SYPHILIS. 
21 
in the nose. This rash lasted three months, and was at length 
cured by taking powders. The condylomata had now existed 
for six months. Mrs. J. had been married two years, and her 
husband had been throughout in excellent health; excepting 
once for ague, he has never been under medical care since his 
marriage. 
“ The first child was dead-horn, at full time (boy). 
“ The second died at a month old, ‘ covered with rash, and 
with its nose stopped up.’ 
“ The third, a girl, never had any symptoms whatever. I 
saw her, now a healthy, clear-complexioned girl of six years. 
“ The fourth, still-born, a seven months’ child. 
“ The fifth, a hoy, now aged three, quite liealthy-looking, 
and never had any special symptoms. 
“ The sixth, the bahy above alluded to. 
“ The mother has had no special symptoms. She is ailing 
■when pregnant. She now has a doubtful-looking sore in the 
lower lip, hut it is not positively characteristic.” 
In these two cases several points occur at once for criti- 
cism, but in the first place let us examine case No. 2. This 
loses much of its value as proof, from the mother not having 
been seen at all; she has died. Mr. Hutchinson assumes, on 
the husband’s word, that she had never had syphilis. That 
can hardly be adduced as evidence for these reasons. The 
disease frequently goes unsuspected and unnoticed; the hus- 
band could not and probably did not examine his wife to see 
if she showed symptoms, and, had he, he would perhaps have 
been none the wiser. Mr. Hutchinson himself says, “ the fal- 
lacy remains that his mother may have contracted syphilis as 
well as his father, either before or after marriage,” but he then 
goes on to say, “ Such a conjecture is, however, wholly unsup- 
ported, while the good health of the younger children makes 
it highly improbable.” Grant that the conjecture is wholly 
unsupported in the mother’s case, yet the statement of her 
freedom is also wholly conjectural, and as for the good health 
of the younger children making it highly improbable, I beg 
leave to differ. A syphilitic woman may entirely recover 
from her disease and bear healthy children; in support of 
this view, I refer the reader to Dr. W. H. Van Buren’s case 22 
ETIOLOGY OF HEREDITARY SYPHILIS. 
in the first volume of the American Journal of Syjphilogra- 
jphy and Dermatology, and quoted in my former paper in this 
Journal, July, 1871. That argument, therefore, loses a great 
deal of its force. 
The opinion expressed that there is little doubt that “ this 
boy was born seven years after his father contracted the dis- 
ease, and he has inherited the taint from the father onl}T,” is 
somewhat startling. Here we have the extraordinary belief 
that a man may convey a disease from which he has seemingly 
entirely recovered for seven years, of which he has had no 
symptoms for that length of time, and to make it still more 
remarkable, the woman, although incapable of bearing other 
than diseased children, herself escapes harm. 
In summing up case No. 3, Mr. Hutchinson states : “ It is 
highly probable, in this case, that the infant inherits a syphi- 
litic taint from its father, he having had the primary disease at 
least two years before its birth, and having, during most of 
that time, been free from symptoms.” 
In the history of the case, nothing is said about the man’s 
disease; on the contrary, it is stated that he had enjoyed “ ex- 
cellent health.” 
Why, then, accuse him more than the woman of syphilis ? 
He is to all appearances as innocent of disease as she. In tact, 
more so, for what is this “ doubtful-looking sore in the lower 
lip, but which is not positively characteristic,” which she car- 
ries? Accusing him of syphilis would seem to be an arriere- 
pensee to account for the child’s condition. 
In reviewing these three cases, I claim that the details 
given are not such as to prove the entire innocence from dis. 
ease of the woman, and, until clearer and stronger evidence is 
adduced, belief in the doctrine of the paternal transmission 
alone of the disease must be suspended. Let us see if any 
other cases will support this belief. • 
Martinez y Sanciiez. These de Paris, 1855, p. 30. The 
only one given of his own Observation. 
“ M. X., a medical man, had, near the close of his studies, 
contracted an indurated chancre in the balano-preputial fold ; 
this chancre was followed by a confluent roseola and rheu- ETIOLOGY OF HEREDITARY SYPHILIS. 
23 
matoid pains, symptoms which were dissipated at the end of 
some weeks by means of an energetic mercurial treatment 
(pills of protoiodide of mercury, mercurial fumigations, etc.). 
M. X. returned to his country, and, believing himself radically 
cured, did not hesitate to marry. At that time nothing could 
make him believe the possibility of having a diseased child, 
inasmuch as he had not had the slightest sio;n of constitutional 
syphilis. Eighteen months had passed by since the disappear- 
ance of the roseola and his marriage. Ilis young wife became 
enceinte/ the pregnancy went on to full term, and the ac- 
couchement showing nothing special. But the child, contrary 
to the father’s belief, showed, five days after birth, pustules 
which were decidedly syphilitic, together with an acute coryza. 
It died at the end of twelve days. The father, much alarmed 
at this accident, the true cause of which he suspected, recom- 
menced an anti-venereal treatment (liqueur de Yan Swieten 
every evening), and continued it for two months. His hopes 
were not disappointed; he had a second child, strong and 
healthy, which up to the present time has shown nothing 
doubtful or abnormal.” 
There are, unfortunately, no means of judging of the length 
of time which had elapsed between the birth of the second 
child and the reporting of the case. The man’s history is tol- 
erably full, but the wife’s is totally ignored; we are not even 
told if she is a healthy woman. Was he the only one treated, 
or, as frequently occurs in such cases, was she also included ? 
The silence on her condition is much to be regretted, inas- 
much as having the reports of cases where the disease of the 
mother is coincident with that of the children, and vice versa, 
it leads to the suspicion that the disease in the woman was 
ignored, or else overlooked. We are not told how soon, after 
the second treatment had been instituted, the second child 
was born. This is of some importance as regards the mother, 
for, if it were some while after, there was time, supposing the 
mother to have been infected, for her recovery, and hence the 
second child being born healthy. At all events, the case is 
lacking in such important details as to render it of compara- 
tively little value in proving the point M. Sanchez wishes to. 24 
ETIOLOGY OF HEREDITARY SYPHILIS. 
Yon Barensprung’s Cases. Die Hereditare Syphilis, p. 87. 
Oat of ninety-nine cases reported by Lira, only two occur 
where the father was under the influence of the disease at the 
time of marriage, and during the wife’s conception, where the 
children were not carried to full time, or were syphilitic at 
birth, and where the mother was apparently free from the dis- 
ease. I say apparently, because, in reviewing the cases, we 
shall see if such was really the fact. 
Case I.—Six months before marriage, the man contracted 
an indurated chancre on the penis, for which he was treated 
by pills of protoiodide of mercury. Fourteen days before 
marriage, the following symptoms made their appearance: 
mucous patches on the tonsils, alopecia, and a papular erup- 
tion over the body. At his marriage, he still had these symp- 
toms. He was treated by Zittman’s decoction, and got well. 
Ilis wife became pregnant soon after marriage, and was de- 
livered of a six months’ child, which lived only a few hours. 
It showed no marks of syphilis. Her health all this time was 
excellent, only that, a short time before the child was born, 
she had a slight scaly eruption on the scalp, and lost, not the 
hair of her head alone, but her eyebrows and eyelashes. She 
w~as examined, and, with the exception of the symptoms noted 
above, she had no signs of syphilis. The ernption was re- 
garded as eczematous, and she was put upon decoc. sarsapa- 
rillae c. senna internally, and unguent, hydrarg. prrec. alb. ex- 
ternally, with simple diet. Under this course she recovered. 
A year and a half after her first confinement, she became preg- 
nant again, and during the second half of her pregnancy the 
eruption and alopecia returned. She was delivered of an 
eight months’ child, still-born, but well formed and free from 
syphilitic symptoms. lie then goes on to say: “ After a very 
careful examination of the whole body, I found nothing more 
than I found before, little spots covered with scales between 
the roots of the hair on the head; not a trace of glandular 
swelling nor any other symptom of syphilis. The embonpoint 
was good, complexion fresh; the growth of the hair was strong, 
although the patient had herself noticed a falling out of the 
hair of the head, the eyelashes, and eyebrows. I advised the 
use of salt-water baths for husband and wife. On the 2d of ETIOLOGY OF HEREDITARY SYPHILIS. 
25 
October, 18G2 (i. e., seven months afterward), I was again 
consulted, the salt-water baths had not been attended with 
much success; the squamous eruption on the scalp was more 
pronounced, and some aphthous erosions were present upon the 
sides of the tongue; her general appearance was as good as 
ever. The husband was free from all symptoms.” 
Was this eruption really nothing but eczema, and what 
were the aphthous patches on the side of the tongue? Were 
they also eczematous? The first time she had these symp- 
toms they disappeared more rapidly than subsequently, but 
at that time she was using a preparation of mercury, which 
was not continued afterward, and it must be remembered 
that the earlier syphilitic eruptions disappear more rapidly 
than the later ones. Suppose these symptoms were nothing 
else than eczema, what evidence is there that-the children 
were syphilitic? Nothing, beyond the fact that they were 
prematurely born. That alone is not a sufficient evidence 
of hereditary syphilis, for non-syphilitic women also give birth 
to children prematurely. Thus, one of two things from the 
history—either the mother was really free from the disease, 
and the premature birth of the children was not due to syphi- 
lis, or else both were syphilitic. 
Case II.—In this case, the father was not seen at all; it is 
stated that he was subject to ulcers on the legs and feet; 
whether due to syphilis or not is not known. No traces of 
syphilis found on the mother. The child was still-born and 
syphilitic. 
As, in this case, one parent cannot be accused more than 
the other, it can scarcely be accepted as proving either side of 
the argument. 
Campbell’s Case.—London and Edinburgh Monthly Journal, 
for 1844, p. 514. 
“ A young medical man, six months before marriage, con- 
tracted a chancre. No subsequent symptoms. The wife pre- 
sented no symptoms of syphilis, but had three miscarriages. 
(The condition of the children is not stated.) Both were put 
upon mercurial treatment, when the wife for the fourth time 
became pregnant, and was delivered at full term, of a child 26 
ETIOLOGY OF HEREDITARY SYPHILIS. 
who lived without having syphilis. The length of time it 
lived is not given. Aside from the scanty details of the his- 
tory, these points occur at once for criticism: Was the hus- 
band’s chancre a simple one (chancroid) or was it a primary 
lesion (indurated chancre) ? Probably it was the former, for 
syphilis does not remain latent for six months, or longer, as 
seems probable in this case, without showing itself in some way. 
Miscarriages alone are not enough evidence that syphilis is 
the determining cause. It may be objected that after the use 
of mercury the miscarriages ceased. True ; but what does 
that prove ? It is no evidence that they were due to syphilis, 
for it is very possible that the same result might have been 
attained without its use. One more point: in 1823, when this 
case occurred, the distinction between the simple and specific 
ulcers was not recognized, and both were called indiscrimi- 
nately syphilis. I should not have quoted this case at all, but 
for the fact that Yidal, in his “ These pour l’Agregation,” 
brought it forward to support the theory of the paternal trans- 
mission. It seems to me erroneous to consider it a case of 
syphilis at all in either parent, for the history of the disease 
is wanting in father, mother, and children, and the only points 
on which the idea is based are the father’s sore, the mother’s 
miscarriages, and their cessation after the use of mercurials, 
neither of which alone or together is sufficient to establish 
the diagnosis. 
Langston Parker’s Cases.—Modern Treatment of Syphilitic 
Diseases, p. 297. 
This gentleman records two cases, and I shall copy them 
in full, that they may speak for themselves: 
Case I.—“ In August, 1852, I treated a patient for a well- 
marked attack of syphilitic lepra. The symptoms disappeared 
under the treatment, which was not very protracted nor was 
it regularly followed. In 1854, this patient married a liealthy- 
looking young woman, who in 1855 was prematurely deliv- 
ered of a dead child. In 1856 she was delivered, at her full 
time, of an infant, which, appeared well and hearty for three 
weeks. It then began to ‘ snuffle,’ then had puckering of and 
a dry eruption about the mouth, and two large vesicles re- ETIOLOGY OF HEREDITARY SYPHILIS. 
27 
sembling pemphigus on the thigh and on the side. The child 
was treated by mercurial inunction on flannel bandages round 
the knees, and cured.” 
Mr. Parker then goes on to say: “ In this case, the father 
remains without symptoms of syphilis for more than three 
years, yet the disease breaks out in the offspring. Mark what 
takes place on the part of the mother in the mean time : the 
premature birth of a dead infant, and a diseased living child 
cured by mercurials. 
“ The father during this interval lias had no symptom of 
syphilis; the mother never had any in her life; the ova 
suffer, and doubtless by impregnation with diseased semen.” 
From the history we have learned nothing about the mother’s 
condition, and we are glad to be told in the summing up of 
the case that she had never had syphilis. Whether this was 
known by examination, or merely by what the husband and 
wife said, is left for us to guess at. The husband, we are told, 
has had “ no symptoms for more than three years, and yet 
the disease breaks out in his offspring.” But at the time of 
his marriage he had not been well so long as three years; it 
was only two. At that time he had “ a well-marked attack 
of syphilitic lepra.” What was this lepra ? was it psoriasis? 
and was this the only symptom he had ? The treatment was 
irregularly followed out and not protracted; is it not, there- 
fore, probable that he had symptoms subsequent to his 
“ lepra ? ” He was not seen at the time of his marriage ; 
how are we to know that he did not at that time have symp- 
toms capable of conveying the disease ? 
Case II.—“ A. B. was treated by me in the Queen’s Hos- 
pital for a pustular syphilitic disease of the skin, of a very 
formidable character. The symptoms disappeared under the 
treatment employed. While he was in the hospital, his wife 
brought her infant to me, covered with scaly blotches. The 
child was plump and apparently healthy when born, but a 
few weeks afterward the patches broke out and the health be- 
gan to decline. The mother had no symptom of disease ; her 
breasts, as well as the infant’s mouth, were free from ulcera- 
tion. She was extremely anxious to be examined, fearing she 
might be laboring under some disease of the parts themselves. 28 
ETIOLOGY OF TIEREDITAEY SYPHILIS. 
I instituted the most careful examination with the speculum, 
not‘only once, but four or five times, and could never discover 
the least local disease. The child in this instance was alone 
treated and cured. I purposely abstained from treating the 
mother, whom I watched for nearly two years. She has 
never suffered from syphilis in any form.” 
What a very bald history of syphilis in the child; scaly 
blotches on the body and a decline of the health ! Not a word 
about coryza or mucous patches. The mouth, however, was 
found free from ulceration. Is that of common occurrence 
in syphilitic children \ Are scaly blotches on the body, with- 
out other symptoms, sufficient to establish the diagnosis of 
hereditary syphilis ? Does not eczema attack infants, and is 
not the disease one which in its course becomes scaly ? All 
these facts would go strongly against the supposition of the 
child’s eruption being due to syphilis. 
Langston Parker.—The Mercurial Vapor-Bath, p. 43. 
“ A young gentleman and lady married, with, all the pros- 
pects of future happiness that fortune and apparent health 
could give. In due course the lady became pregnant, hut mis- 
carried. The same things happened in her second and third 
pregnancies ; a good deal of mental uneasiness was produced, 
and some suspicions arose. The fourth child was horn alive, 
hut at six weeks old had snuffling and the eyes became bad ; 
condylomata also appeared about the anus. A neighboring 
physician of great local eminence was consulted, who said 
rather abruptly, ‘ The child is diseased.’ The parents, as may 
naturally be supposed, were shocked and horrified beyond 
measure, the father having at a remote period before his mar- 
riage been affected with syphilis; but the mother had never 
exhibited the least symptom of the disease. lie was put upon 
a course of blue pill and iodide of potassium ; the mother at 
first was not treated. A fifth child was born, who at the end 
of the first month had symptoms of syphilis. The father was 
again only treated, and a sixth child was again born diseased. 
The mother was again examined, but no trace of the disease 
could be found in the throat, vagina, uterus, or elsewhere. 
The patients were now placed under my care; I recommended ETIOLOGY OF HEKEDITAKY SYPHILIS. 
29 
that both should bo treated by a full course of mercurial 
vapor, and that no intercourse should take place during that 
period. 
“ The seventh child was born healthy, and has remained 
so, and neither father nor mother has as yet exhibited any 
further symptoms of disease. 
“ This case illustrates one or two very important points in 
the treatment of syphilis : 1. It establishes the law, which 
should always be acted on, that, in the event of two married 
persons, apparently healthy, having a diseased child born to 
them, both should be treated, although the mother has 
never shown the least trace of the disease. 2. It shows the 
efficacy of the mercurial-vapor treatment after the failure of 
several of the ordinary methods. It is true, an exception 
might be taken to this, since the mother was never treated till 
the mercurial vapor-bath was used; but, on the other hand, it 
is hardly probable that the father could have been cured by 
the previous treatment, or he would not have continued to 
procreate diseased children.” 
And is it not also singular that, despite the treatment the 
father goes through when he alone is treated, the children 
continue diseased, but, the moment the mother is included, 
the next child is born healthy, if the blame rest upon him 
alone ? 
Mr. Parker wras undoubtedly right in putting the mother 
under treatment also, inasmuch as she probably was as much 
at fault as the father for the unhealthy condition of the chil- 
dren. But, if she was, as he believes her to have been, blame- 
less, of what use putting her upon treatment at all ? It was 
not until after the birth of the fourth child, that the parents 
were examined, and it is not such a matter of wonder that 
after four years, at the least, nothing was found upon the moth- 
er indicative of syphilis. I am assuming that she was exam- 
ined at that time (although it is not so stated), from it being 
said that, after the sixth child was born diseased, “ the mother 
was again examined.” The father’s history is very loose, “ hav- 
ing at a remote period before his marriage been affected with 
syphilis.” IIow remote; and did he have no symptoms dur- 
ing his married life ? The repeated births of so many syphi- 30 
ETIOLOGY OF HEREDITARY SYPHILIS. 
litic children, their continuance after the father has been sub- 
jected to two successive courses of treatment, and their final 
cessation only after the mother has been treated also, should 
tend to awaken doubt as to whether the father was alone the 
cause. Hay, more, there is strong presumptive proof that the 
fault lay with the mother. These cases are like too many of 
their kind, very loose and careless in their details—too much 
so to admit of a scientific value. And, as if for the express 
purpose of contradicting himself in the belief that “ syphilitic 
semen ” can disease the ovum and its product, and leave the 
mother free, Mr. Parker reports two cases on the next page, 
where the fathers were infected with syphilis, in the one case 
apparent, in the other latent, and yet the mothers, and the 
children born to them, show no signs of the disease. IIow 
are these statements to be reconciled ? Mr. Parker does not 
seem to attempt to do so; he merely states the fact. 
On looking over the reported cases, one thing will, I think, 
strike every one, viz., the vague and unsatisfactory manner in 
which they are reported. Compare them with those given in 
the first paper on this subject, where it was argued that syph- 
ilitic transmission depended upon the mother, not upon the 
father, and, where the former was healthy, the children would 
not be infected. The difference in the way in which they are 
detailed is apparent; the one set being clear and logical, the 
other careless and unsatisfactory. Then, again, even the ad- 
vocates of the theory of transmission by the father give cases 
where the father is diseased at the time of impregnation, but 
the mother is not contaminated. Yet the children grow up 
sound and well, whereas, were the doctrine of paternal trans- 
mission true, they should have been syphilitic. IIow is this 
discrepancy explained; why should such opposite results en- 
sue from similar causes? Diday {op. cit.) says, and I quote 
him as he is one of the principal exponents of this theory: 
“ The father, in fact, is very rarely affected with the disease 
without communicating it to the mother before or during preg- 
nancy. . . . However, despite these inherent difficulties in es- 
tablishing the paternal influence, there are few specialists who 
have not been able to do so ” (p. 15). He then adduces cases 
from various authors, none of which are convincing, and pro- ETIOLOGY OF IIEKEDITAEY SYPHILIS. 
31 
ceeds to give a case of his own. A man lias syphilitic symp- 
toms both before and after his wife’s impregnation ; she es- 
capes ; the child is born at full term—syphilitic ? The con- 
trary ; for the two years it was under observation it showed 
no symptoms of syphilis (p. 17). And this is the way in 
which he explains it: “ It seems natural to admit that a di- 
athesis which does not yet manifest itself, or no longer mani- 
fests itself by sensible effects, should be less marked, and con- 
sequently less capable of transmission than one of which the 
symptoms are actually present.” 
Yery good, M. Diday, and now, for “ less capable of trans- 
mission,” etc., read “ incapable of transmission” and there 
stop. Have we not already proof of the fact in the cases col- 
lated in the first paper; do we not know that contact beneath 
the skin with diseased secretions is all that is necessary to pro- 
duce the disease, and, if the doctrine be true that semen is a 
diseased secretion, how do some mothers and children escape ? 
Would they be so fortunate if the secretion of a primary lesion 
or a mucous patch were substituted for the seminal fluid ? 
Before concluding this article, I cannot refrain from quot- 
ing Mr. Berkeley Hill,-of London. This gentleman says: 
“ The transmission of syphilis from -father to child is an acci- 
dent of frequent occurrence, when the mother also participates 
in the infection before or during pregnancy. In such cases it 
is impossible to say the virus does not reach the child directly 
through the mother, and only indirectly through the father. 
It is also believed that the child can inherit the disease direct 
from the father, while the mother remains intact. The evi- 
dence in support of this view is at present imperfect, because 
syphilis in women often causes so little inconvenience, that its 
presence passes unnoticed. . . Diday (“ Infantile Syphilis,” p. 
15, et seq.) and Lancereaux (“Traite de la Syphilis,” p. 653) 
have collected the authorities whose observations support this 
theory, but they do not decide the question. In all, the es- 
cape of the mother is inferred from the absence of symptoms 
of syphilis sufficiently prominent to attract her attention. 
“ For an example of the kind of cases brought to prove 
this theory, Trousseau (V Union Medicate, 1857), in a clinical 
lecture on syphilis in young children, relates that a patient 32 
ETIOLOGY OF HEREDITARY SYPHILIS. 
with syphilitic laryngitis told him that his wife, though always 
in excellent health, had been pregnant six times, but her chil- 
dren were all born prematurely, some of them being marked 
witli blotches on the skin. Trousseau had no opportunity of 
examining the mother himself, and the health of both parents, 
excepting the laryngitis of the father, is not stated. It is not 
clear that the mother escaped disease; on the contrary, the 
continued abortions are strong presumptive reasons that she 
had syphilitic disease of the womb, which prevented matura- 
tion of the ovum. . . . 
<£ Even if syphilis be not in active progress in the father, it 
is held by many that the ovum may receive syphilis with the 
semen. This is an extremely uncertain point, and must await 
further investigation.” (“ Syphilis and Local Contagious Dis- 
orders,” p. 89, et seq.) 
ADDENDA. 
Since the first of these two papers was written, my friend 
Dr. E. S. Dunster, of this city, has kindly sent me the record 
of two cases occurring in his own practice, hut which arrived 
too late for insertion where they properly belong. They show 
proof in favor of the doctrine of the paternal non-transmissi- 
bility of syphilis, and are here recorded as Dr. Dunster gave 
them: 
Case I.—“ A. B., forty-seven years of age, contracted syph- 
ilis in 1854. Was treated pretty largely, but disease passed 
into constitutional form, well marked. Married in 1859. 
Wife perfectly healthy, and has remained so to date. Five 
children have been born. First (boy), in 1860; second (boy), 
in 1862; third (boy), in 1865; fourth (girl), in 1867; fifth 
(girl), in 1869. All these children are living and are perfectly 
healthy, well developed, and robust. Xo symptoms either of 
syphilis or scrofula. Two years I have been physician to the 
family, and know them all very well. The father, for about 
four years past, lias been a frequent sufferer from nodes and 
neuralgia. Was very heavily and repeatedly mercurialized 
before he came into my hands. lie is compelled almost con- 
stantly to take iodide of potassium in large doses, which keeps 
his pains in abeyance. Ilis general health otherwise is good. ETIOLOGY OF IIEEEDITAKY SYPHILIS. 
33 
Has had no mucous patches since he has been under my care. 
Uses tobacco by chewing only.” 
Case II.—“ C. D., thirty-six years of age, contracted syph- 
ilis in the spring of 1862. Had but slight treatment. Mar- 
ried in 1863. Wife perfectly healthy. Ilad three children. 
First born in 1865 ; second born in 1867; third born in 1870. 
Ho miscarriages. Second child died in 1868 of cholera infan- 
tum. The other two are perfectly healthy. Ho traces either in 
teeth, skin, mucous membranes, osseous or lymphatic system, 
of the disease. The father has had roseola, mucous patches, 
nodes on one tibia, one clavicle, one ulna, and slight engorge- 
ment of one epididymis of one testicle. Is a great smoker, 
and has occasional mucous patches which yield readily to the 
iodide. This is the only symptom now for several years. 
This case was under my observation at the time of the origi- 
nal lesion, and during most of the time since then the treat- 
ment has been directed by myself.” 
These two cases are well and fully reported, including the 
history of father, mother, and children, and certainly seem 
conclusive. The other case in favor of the paternal transmis- 
sion is one occurring in the practice of Dr. Kennard, of St. 
Louis, Mo., and is copied from the sixth volume of the “ Medi- 
cal Archives: ” 
“ April 12, 1870.—I was called to see an infant aged four 
weeks, in the southern portion of St. Louis, which three days 
after birth began to manifest symptoms of hereditary syphilis, 
such as cutaneous eruptions, superficial ulcerations of the mu- 
cous membranes, and that general appearance of exhaustion 
peculiar to those cases, where venereal disease has been trans- 
mitted from the parent to the foetus, in the act of impregnation. 
Different from most cases of the kind, which, if born free 
from external symptoms of infection, generally remain so for 
three or four weeks, the child during that time appearing 
plump, with a smooth skin, this child, on the third day after 
birth, began to be covered with an eruption so rapidly that 
the mother and all the neighbors became alarmed, and con- 
cluded that the child had the small-pox, and a so-called M. D., 
who was summoned to the case, confirmed their suspicions by 
stating that it was an awful case of hereditary small-pox, and 34 
ETIOLOGY OF HEREDITARY SYPHILIS. 
most undoubtedly originated from the poison of variola, still 
lurking in the mother’s system. He treated the case for small- 
pox for more than three weeks, when, no improvement occur- 
ring, but a gradual change for the worse alarming the mother, 
I was requested to see it. As incomprehensible as it may 
seem, this child, which had for more than three weeks been 
treated for hereditary variola, was born of a mother whom I 
had treated for small-pox two years previously, and whose 
face was badly pitted ; so that, if such a thing were possible 
as hereditary small-pox, her history alone would have pre- 
cluded all possibility of such a thing. It presented one of 
the most typical cases of infantile syphilis that I ever saw. 
The child had that characteristic look of a little debilitated 
old woman ; the skin was wrinkled and loose, hanging in little 
folds to its emaciated form, and of a muddy, dirty, dead-leaf 
color, especially on the chin, forehead, and buttocks. There 
were chaps and cracks around the mouth, nares, and eyes, and 
a great portion of the body was covered with scabs, resulting 
from the bullae of pemphigus ; the nostrils were nearly closed, 
and consequently snuffling was very troublesome. There were 
great fretfulness and marked insomnia; the voice was weak, 
hoarse, and characteristic, and that indescribable odor pecul- 
iar to this disease was very marked ; vomiting and diarrhoea 
were both very troublesome. 
“ The peculiar cough which accompanies bronchitis in these 
cases was very harassing, and in fact the child looked as 
though the ordinary termination of such severe cases, death, 
would soon and inevitably bring its sufferings to a close. It 
was not only in an extreme state of debility from the influence 
of the poison in its blood, but the plugging of the nares was 
so complete as to seriously inconvenience the child in nursing, 
and thus prevent its proper nutrition. It had three diseased 
nails on one hand and two on the other, and also three on each 
foot. They were abnormally thickened, yellow, dried up, and 
soon became detached. 
“ The sanio-purulent discharge from the nose, after the 
scabs obstructing the nares had been removed, was profuse 
and offensive, and there were troublesome follicular ulcera- 
tions and cracks on the inner portion of the aloe nasi, which ETIOLOGY OF HEREDITARY SYPHILIS. 
35 
easily gave rise to slight haemorrhage. The characteristic 
stridulous, squeaking, scarcely-audible cry, showed that the 
larynx was implicated, while the obstinate cough and impeded 
respiration proved that there was trouble in the lungs. The 
symptoms of bronchitis were indeed alarming. 
“ The eruption was composed of dark, purplisli-red patches, 
papular in appearance, slightly elevated above the natural 
surface, and the cuticle over them raised into blisters, tilled 
with a yellowish-green fluid, which soon escaped, mixed with 
blood and dried into scabs; under many of the scabs ulcera- 
tion occurred. Mucous patches around the anus, on the peri- 
nsemmand vulva, were very numerous, in the form of pinkish, 
elevated spots, moist, but soon began to dry and disappear un- 
der treatment. The eruption was a mixed, pustulo-papular 
one, with considerable amount of exudation, which formed 
into hard scabs, firmly adherent to the adjacent derma, and 
upon their detachment sluggish ulcers were found underly- 
ing them. Such are the details of the appearance of this 
case as first seen by me.” . . . 
The peculiarities and points of most interest in this case 
were: 
“ 1. The possibility of a father procreating a child so seri- 
ously diseased, when the only mode of communicating the 
syphilitic poison was through his semen, and at a time when, 
the poison in his system manifested no activity whatever, 
proving that the poison may be transmitted to the offspring 
at any period of the constitutional disease, and when it is la- 
tent in the parent. 
“ 2. The strange fact that a non-syphilized mother could 
nourish and bear to full term such a grievously-afflicted child, 
and yet escape contamination herself, both then and while 
continually nourishing it. . . . 
“ This case furnishes an undoubted instance of the indi- 
rect transmission of syphilis by a diseased father, while the 
non-syphilized mother remained uninfected, proving that the 
poison reached the child directly, and only through the im- 
pure semen of the father, and that neither the diseased child 
nor the father communicated it to the mother (a fact the pos- 
sibility of which is generally denied); and that tire ovum be- 36 
ETIOLOGY OF IIEEEDITAEY SYPHILIS. 
came contaminated from the semen of the father when syph- 
ilitic disease was at the time in abeyance in his system. The 
inherited disease, as a rule, is more or less severe in the child 
in proportion to the virulence of the disease in the parent 
communicating the same, and the time which has elapsed 
since syphilitic symptoms were manifested in him or her, or 
in both, but it may be communicated at any stage from six 
months to twenty years after the empoisonment, and some 
contend that it can be transmitted to the third generation.” 
Dr. Kennard’s case is one certainly difficult to question, 
from the care with which it is reported. In reply to a note of 
inquiry I wrote him, he says: “ I have purposely delayed an- 
swering your kind letter of inquiry, because I thought it 
would be much more satisfactory to you for me to examine 
the mother once more before doing so. She had been a patient 
of mine some years previous to the birth of the child, whose 
case was reported in the ‘ Medical Archives,’ and been thor- 
oughly examined by me on several occasions with the specu- 
lum, and otherwise, and never at any time did I detect any 
sign of venereal disease whatever. During the treatment of 
the child and since, she was repeatedly examined and most 
assuredly manifested no symptoms of syphilis at all. She is 
now in very robust health and most positively declares that 
she never had any venereal disease.” 
Only two things are needed to make Dr. Kennard’s paper 
perfect: a history of previous births, if any, or of miscar- 
riages ; and a history of the father’s disease. It is only by im- 
plication, and seemingly not from actual knowledge, that he 
is assigned as the cause of the child’s disease. 
Suppose, now, on questioning him, that he should deny ever 
having had the disease, to whom should we refer the child’s 
illness ? Perhaps the raising such objections may be regarded 
as quibbling; such is, by no means, my intention. 
The reason why I express these doubts is, that this doctrine 
of paternal transmission has been questioned and denied by 
many competent authorities and upon pretty good grounds; 
better by far than those adduced by the adherents and be- 
lievers in the old theory. To disprove their assertions we 
must have better arguments than we now possess. The cases ETIOLOGY OF HEREDITARY SYPHILIS. 
37 
on the side of the paternal non-transmissibility are fuller, 
clearer, and more convincing than they are on the other; and, 
although this case of Dr. Kennard’s, and the one of Ricord, 
are the best of any reported, they fail of being convincing. 
To be so, they should be exact in the details of both parents; 
if any thing is left doubtful or questionable, their value is 
lessened. For that reason I have left out those cases which 
I have seen, because I had unfortunately kept no record of 
them, and could not, therefore, speak positively about them. 
This much I remember was strongly impressed upon my 
mind: in all my cases I have been able to trace the disease, 
past or present, back to the mother, and m other cases, where, 
upon examination, the father was diseased, the mother healthy, 
and the child imported syphilitic, I have, on inspection of this 
latter, been able to diagnosticate some simple eruption, such 
as eczema or the like. 
Although I do not say absolutely that the paternal trans- 
mission is impossible, I do not hesitate to say that it is very 
improbable, and on these grounds: 
1. Because the reported cases are wanting in such details 
as to render them convincing. 
2. Because this theory is entirely opposed to our present 
knowledge of the contagious properties of syphilis and its mode 
of propagation ; and— 
3. Because our knowledge of infantile syphilis has not kept 
pace with our progress in the other branches of the disease. 
Here is really the way in which the proposition stands: 
Both sides grant the contagious properties of a primary lesion 
and of mucous patches; one side further argues that the 
semen of a person in whom the disease is either present or 
latent is also capable of conveying the poison ; the other side 
demurs, and offers as proof against this argument the fact that 
many cases exist where the syphilitic father has perfectly 
healthy children, and in this connection the mother is found 
free from disease. The first side say this is possible, and go 
further yet: notwithstanding that this poison is eminently 
virulent and dangerous for those previously free from its influ- 
ence, they insist that a perfectly healthy woman may and does 
receive this poisoned semen into her body, a diseased foetus 38 
ETIOLOGY OF HEREDITARY SYPHILIS. 
is carried by her for the nine months of intra-uterine life (the 
relations between the two being of the most intimate char- 
acter for that length of time), she nourishes this rotten product, 
which, when born, may become a centre of contagion to those 
about it, and yet escapes contagion. If this be true, then one 
of two things : either we are ignorant of the real condition of 
the mother, or else syphilis is not the contagious disease which 
wre have been accustomed to consider it. 
I myself believe it is, the former, and showed, in the first 
paper, the why and wherefore of my belief. 
What I now wish to urge is new and independent observa- 
tions. Both the parents and the children should be examined 
and watched for some time before we may conclude one way 
or the other, but above all things let us cease copying old and 
poorly-reported cases, and observe anew for ourselves. In this 
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D, APPLETON & 00., 549 & 551 Broadway, N. Y. APPLETONS’ JOURNAL FOR 1873. 
ENLARGEMENT. 
Appletons’ Journal will henceforth be enlarged to the extent of four more pages of 
reading. The Advertisements, which have hitherto occupied a few pages at the end, 
will be remanded to a cover, and the entire thirty-two pages of the sheet will be devoted 
to literature. The Journal has always contained a larger quantity of reading-matter 
than any other periodical of its class, and this addition renders it the cheapest literary 
periodical in the country. 
Appletons’ Journal gives, in a weekly form, all the features of a monthly magazine. 
Its weekly issue brings it a more frequent visitor to the family than is the case with a 
monthly periodical, while, in course of the year, a much greater aggregate and a larger 
variety of papers are furnished than are given in any of the regular monthlies. But, for 
those who prefer it, the Journal is put up in Monthly Parts, and in this form its scope 
and variety, as compared with other magazines, become conspicuously apparent. 
Appletons’ Journal will continue to present healthful, sound, instructive, and enter- 
taining literature. It will confine itself, as a rule, to one serial novel at a time; it will 
contain the best short stories attainable; it will give picturesque descriptions of places, 
and stirring narratives of travel and adventure; it will have entertaining papers upon 
various subjects that pertain to the pursuits and recreations of the people ; it will give 
portraits and sketches of persons distinguished in various walks of life; will present 
lively, social sketches, having in special view those things the knowledge of which will 
contribute to the welfare and happiness of the household ; it will describe phases of life 
in all quarters of the globe; it will discuss the important events of the time, and the 
advances made in art, literature, and' science; it will endeavor to reflect the ideas, 
movements, and development of society; and, while hoping to enlighten, will stren- 
uously aim to entertain, with large abundance of material, all who resort to its pages 
for intellectual pleasure. Illustration will be used sufficiently to give variety and ani- 
mation to its pages ; but the aim will be to make it rather a journal of popular high- 
class literature than merely a vehicle for pictures. In carrying out this programme, the 
editors will have the aid of the ablest writers procurable. 
Price, 10 Cents per Number ; or $1.00 per Annum, in advance. Subscriptions received for Twelve 
or Six Months. Subscription Price of Monthly Parts, $4.50. 
Any person procuring Five Yearly Subscriptions, for weekly numbers, and remitting $20, 
will be entitled to a copy for one year gratis; Fifteen Yearly Subscribers, for weekly numbers, 
and remitting $50, will entitle sender to a copy lor one year gratis. 
The postage within the United States is 20 cents a year, payable quarterly, in advance, at the 
office where received. Subscriptions from Canada must be accompanied with 20 cents ad- 
ditional, to prepay the United States postage. New York City Subscribers will be charged 20 
cents per annum additional, which will prepay for postage and delivery of their numbers. 
Ji remitting by mail, a post office order or draft, payable to the order of D. Appleton & Co., is 
preferable to bank-notes, as, if lost, the order or draft can be recovered without loss to the 
sender. 
Volumes begin with January and July of each year. 
Appletons’ Journal and either Harper's Weekly, Harper's Bazar, Harpers Magazine, 
Lippincott's Magazine, the Atlantic Monthly, Scribner's Monthly, or the Galaxy, for one year, on 
receipt of $7; Appletons’ Journal and Littell's Living Age, for $10; Appletons’ Journal and 
Oliver Optic's Magazine, for $5; the Journal and Popular Science Monthly, for $8. 
D. APPLETON & CO., Publishers, 
349 & SB1 Broadway, N. Y.