The venereal diseases : including stricture of the male urethra / by E.L. Keyes.

  • Edward Lawrence Keyes
Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: The venereal diseases : including stricture of the male urethra / by E.L. Keyes. Source: Wellcome Collection.

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    hard. It remained an ulcer long after the others got well, and was at- tended by an outbreak of general syphilis. Robert inoculated a medical student with the secretion of a mixed sore. Auto-inoculable soft chancroid followed. When the first ulcer had nearly healed, it reulcerated, became hard at the base, and general syphilis followed. A mixed chancre, then, may result from the inoculation of either sore upon the other, and its characters will be correspondingly modified ac- cording to the period of development of either sore; either one may be nearly well before the other gets fairly under way. If the compound poison is inoculated, the chancroid would naturally be well along in its course before it assumed any syphilitic features. Inoculation of the secretion upon a healthy subject clinically may produce chancroid alone, or mixed sore, or, it is said [but this must be quite exceptional], chancre alone; just as vaccination from a syphilitic child may produce in the healthy one either vaccinia alone, or both vac- cinia and chancre, or chancre alone. Clinically the mixed chancre is very rare. Chancre of the general integument occurs as a flattened papule or elevated tubercle, or excoriated patch, or a moist, flat tubercle, or an indurated ulcer. All of these forms have been seen and studied in con- nection with experimental auto- and hetero-inoculations, and they may be encountered clinically. The lesions resemble the same varieties upon the penis. The excoriations are often in part or totally scabbed over; there may be nothing more than an insignificant, dry, scaling papule upon the skin to mark the point of entrance of syphilis. The flat, moist tubercle resembles exactly the condyloma—the flat, mucous tubercle of the skin. I have seen a number of them at a time upon the skin, as the initial lesion of syphilis—some dry, some moist, some scaling, all livid, raised, flat, and none of them markedly indurated. Finally, a superficial or a deep excavated ulcer may mark the starting-point of syphilis upon the skin, and in such case the induration of the ulcer is apt to be quite exten- sive. Chancre of the lip is generally a globular mass of induration as large as a marble, with an excoriated or exulcerated surface. I have seen two lesions of this sort, both upon young girls, both acquired innocently from a lover's kiss. The only other case I have seen was on the lip of an old Frenchman. The chancre in this case was a deep ulcer, acquired by smoking the pipe of a companion. It was large, oval, ragged, and much indurated. Chancre of the nipple, acquired by nursing a syphilitic child, may be a large, deep, indurated ulcer, a brawny excavation, an excoriated or ulcerated, indurated fissure, or a flat, mucous papule more or less livid, moist, or dry, scaly or scabbed, sometimes but little indurated. I have reported' a case where the last-named lesion occurred in a multiple form. Both nipples were involved, four chancres being on one side, eight on the other. Fournier' has published one case with seven on one nipple, and sixteen on the other, and another case of extensive phagedenic chancre of the nipple derived from contact with a mucous patch. The mother of a child with inherited syphilis, although she may never have shown any symptom of having had syphilis, cannot acquire chancre at ' Archives of Dermatology, April, 1878, p. 126. 2 Gaz. des hop., Dec. 1, 1877, p. 1109.