The Edinburgh regulations of September 1497 are evidently framed upon the idea that “the contagious plage callit the grandgore,” as they term it, was propagated by simple contact, and personal intercourse, or probably even by the air. Hence their strict injunctions for the removal and detention of the “infectit, or that hes bene infectit and incurit,” to their secluded position upon the island of Inchkeith, for “the eschewing” (to cite again the words of the edict) “of the greit apperand danger of the infectioune of the lieges.” Indeed, it seems to have been believed that the disease might be communicated through medical attendants, or intermediate individuals who were themselves unaffected. This is at least the natural, or, indeed, the only interpretation of that part of the edict which enjoined that all persons who take upon them “to hale the said contagious infirmitie,” go with their infected patients to Inchkeith; and if they attended and treated such cases within the city, they did so at the peril of being themselves cauterised on the cheek with the “marking iron,” and banished without favour (banisht but favouris) out of the town. The anxiety of the authors of the Edinburgh regulations to prevent this supposed medium of communication through a third person is further displayed in the severity of the punishment—(the application, namely, of the actual cautery to the face)—denounced against the medical attendants who should infringe the above edict by not passing to, and remaining on, Inchkeith. “Lykwayis the saidis personis that takis the said cure of sanitie vpoun thame, sal be byrnt on the cheike with the marking irne that thai may be kennit in tyme to cum.” For some time after the first outburst of the disease, sexual intercourse with the infected does not seem to have been suspected as the source and means by which the syphilitic contagion was propagated. Nor was the local primary affection of the sexual organs generally noticed by the authors of these times as either a constant or marked symptom. They were acquainted with, and described, only the secondary symptoms of the malady—the hideous eruptions on the skin—the ulcers of the throat—the nocturnal pains in, and lesions of, the bones—while they mostly all pass over the genital organs, as if they remained unaffected. So much so was this the case, that we find Montagnana, in 1498, advising not as a means of infection, but rather as a means of cure, moderate coition; for, in laying down various rules of treatment to a sick bishop under his care for syphilis, he inculcates, among other items “coitus vero sit temperatus.”[620]