Surgery : its theory and practice / by William Johnson Walsham.

  • William Walsham
Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: Surgery : its theory and practice / by William Johnson Walsham. Source: Wellcome Collection.

    72/902 page 56
    body exposed to infectiou, uiid lioiicc is not iuiVequeiit on the lingers of accoiiciieur.s, the lijis, nipiile, &c. Uu the genitals its most frequent situation is on the preinice just behind the corona glandis in the male, and on the inner siirface of the labia in the female ; but it is (jfteu met with on the glans, the skin of the penis, and just within the urethra; more rarely on the vaginal walls and OS uteri. It is commonly produced by direct con- tact with another chancre, or a mucous tubercle or other secondary lesion; but it may also be contracted indirectly in many ways, as by drinking out of an infected, vessel, or by inoculation with infected lymph in vaccination. The exact natm-e of the virus is not known, but is believed by many to be a specific form of bacillus. It is probable that it is generally inoculated through a crack or abrasion, except, in situations where the skni or mucous membrane is very thin and delicate. The period of incubation varies from ten days to six or seven .weeks or even longer. When, however, the syphilitic virus is inoculated in the pure state it usually gives rise to no signs till three to five weeks, when a small papule will be noticed, which enlarges and becomes indurated at the base, and may either remain as an indurated nodule throughout or if irritated change into a small ulcer. Not infreiiuently, however, the virus may be conveyed in the pus of a non-infcctiug or soft chancre, under which circumstances a soft chancre will form m two or three days whilst the syphilitic poison is still circulating in the system, and after the mcubative ]X'nod is passed will manifest itself locally by ludm-ation about the base of the soft sore, or, if this is healed, by an indurated nodule at its former site. The characters of an infecting chancre vary. In the typical form {JIru>1rn>ni chancre), it is raised though slightly deiiressed at its centre, whilst its siu-face is either glazed or covered wi li epithelial debris or scantv secretion; there is scarcely any inlliimmatioii, but marked and shar])ly circmnscnbed induration about its base. Tlie induration, however, may be absent in chancres on the glans penis and on the female genitals, and is seldom well marked hi chancres on ]);irts of the body other than Ihe genitals. It must be borne in mind, moreover, (hat a non-mtecting sore when inllamed mav be attended wilh some inllam- matory induration, and hence may be mistaken for an infecting sore. This inllanimatory induration, however.
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