These apparent digressions are not made either to be tedious or to weary the reader, nor without an object. They are made to show that, whereas syphilis is looked upon as such a deadly disease, and it may be said to be the sole cause of fear to the assiduous worshiper at the shrine of Venus Porcina, there is another still more fatal danger awaiting him, ambushed in the folds of the vaginal mucous membrane, or coming along silently out of the cervical canal,--like the legions of Cyrus stealing along the dry bed of the Euphrates into ancient Babylon, to fall unawares on the feasting Nebuchadnezzar on that fatal night. So, in like manner, the virus of tuberculosis, either extruding from a granular os or from its neighborhood, gradually moves down on the unsuspecting, uncircumcised, and easily inoculable-surfaced glans penis, to infect the system with a tubercular poison that has no such exceptions as those above noted, as at times are the followers of syphilis. It is not alone the individual himself that may be the sufferer from this poison, but his progeny for several generations may have to suffer for the infection thus received, just as much as they would were that infection to have been syphilitic. As before remarked, this has heretofore not sufficiently occupied the consideration of the profession, and, as it cannot certainly be denied that such a source of tubercular infection is both possible and probable, the subject is entitled to more serious and deliberate consideration than that which has heretofore been paid to it.
Tuberculosis certainly has these two channels of entrance: either through direct infection or through an evolutionary process resulting from syphilis. The appearance and vital statistics offered by the French War Office in regard to the Algierine provinces, the report of the United States Census, the opinion of Dr. Billings deduced from the census reports, the opinions of Hutchinson, Richardson, Bernheim, and many other observers, as well as the personal but unrecorded observations of many practitioners, all tend to bear testimony to the remarkable difference that exists between circumcised and uncircumcised races in regard to the ravages of consumption. Is circumcision a factor in this difference, or is it not? If it is, then circumcision should receive more attention than it has; if it is not, then we should not be idle in hunting up the cause of difference, for an ounce of prevention is certainly worth in this regard a whole pound of Koch's lymph as a curative agent.