Selected essays and monographs : translations and reprints from various sources.

Date:
1897
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Licence: Public Domain Mark

Credit: Selected essays and monographs : translations and reprints from various sources. Source: Wellcome Collection.

    163/476 (page 147)
    mistaken for soft chancres,* than for a primary syphilitic sore; that on the cervix uteri for mucous patches (syphilides). Similar diagnostic mistakes frequently happen with chronic recurring herpes of the oral cavity, as well as in the rarer herpetic affec- tions of the hard and soft palate and pharynx, especially where the eruption alternates with a similar one on the genitals.! Again, it is frequently mistaken when herpes zoster, which usually occurs but once, affects the genital region. In 1873 I showed a case of herpes zoster sacro genitalisJ limited to the distribution of the Nerv. pudendus et N. cutaneus major posticus femoris on the left side. The eruption implicated the posterior aspect of the left half of the scrotum, of the penis, and of the glans. In the latter site the vesicles had broken, and a diagnosis of soft chancre was the result. Herpes zoster of the mouth, especially when the fauces § are involved, ought not to be readily mistaken, as it generally implicates the area of distribution of the second and third branches of the trifacial on the same side. The neuralgia affecting the teeth of both jaws, the parassthesia of the mucosa and the groups of vesicles covered in places with sloughs, are characteristic. Those rarer cases of herpes occurring vicariously in different regions belong to the same category. An acute outbreak of numerous vesicles appears alternately on the tongue or penis and scootum, often in the latter case preceded by pruritus.|| I have 1 may iere men'ti°n a case of herpes vulvse et vestibuli in a pregnant woman where it was mistaken for soft chancres. It was only after repeated failure with auto-moculation that I was able to convince her medical attendant of its nature and so stay proceedings in the Divorce Court on the part of the wife. T For similar cases vide Sabrazes, Recurring Herpes of the Mouth and Penis (9 years) (Annal. de la Policlin. de Bordeaux, 1890, p. 188); S. Flatau’s case of 16 years duration (Dent. Med. Wochenschr , 1891, No. 22); cf. also Monographs by P. Diday and A. Doyon, “ Recurring Herpes of the Genitals.” 7 Annual Report of the Schles. Gesellsch. f. vaterland. Cultur. fur 1873 Breslau 1874. I may here again urge the necessity of thoroughly examining the’whole of a;pr r:°1;: fwlbU?10n f th0 PUdendal nerve in herPes fetalis, especially as Beibh states that vulvar herpes is so frequently unilateral only. The same holds good m herpes ins of the genitals, for in a case in 1877,1 shall mention further on, the eruption repeatedly appeared at first on one side only, but on further examination attacked the greater part of the cutaneous are! supplied by tH pudendal nerve on the same side. a dot MalfdencutFetrRnie^ °n Z°na 0CCUrrin^ in n™c°us membranes (Journ. clef Maiad. cut. et syph., III. year, August, 1891). J a Uf V0 °aSeS °f my °wn where thG etiology was unknown, but recommend (cf. ii^bnn^^^^S16 °f °rmedicinet]ie Patient maybe taking