Venereal and urinary diseases / by Temple S. Hoyne.

  • Hoyne, Temple S. (Temple Stroughton), 1841-1899.
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: Venereal and urinary diseases / by Temple S. Hoyne. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    while one part of the ulcer is perhaps cicatrizing another portion is steadily advancing in an opposite direction. Sometimes the sore seems to be arrested and nearly well when rapid ulceration again sets in. We find this variety, as a rule, in scrofulous persons, such as are predisposed to phthisis, scurvy and chronic eruptions; such as have thin, delicate skins, which ulcerate from the slightest injury. This ulcer, though usually of a superficial character, sometimes penetrates deeply into the tissues, and, as it is essentially of a chronic nature, destroys a great amount of tissue before it can be checked. Its surface is uneven, covered with a dirty, grayish lymph, with more or less ichorous fluid, and its edges are thin, livid, ragged, steep and somewhat everted; often are so extensively undermined that they can be turned back like a flap. It sometimes extends under the skin of the penis as far as the abdomen, leaving as it heals an indelible white scar. The French authors describe a diphtheritic chancre to be one which is very sensitive to the touch, accompanied by a sharp, continuous pain, and which is covered with a thick layer of glistening gray or yellowish white lymph, resembling leather. It is very rare, occurs only in persons of debilitated constitution, appears at any period of the ulceration and always denotes an irritable and inflamed condition of the parts. Nature is unable to convert this lymph into healthy granulations, and hence it is thrown off as of no further use. The edges of the ulcer bleed on the slightest touch, and sometimes very profusely, almost amounting to a hemorrhage. Any attempt to detach this diphtheritic layer is also atten- ded by hemorrhage. The diagnosis of chancre is in the majority of cases comparatively easy, when we consider the period of incubation and the condition of the base, and it is only occasionally that one is in doubt whether the ulcer on the genitals or elsewhere is or is not a chancre; but the physician may require considerable time to determine whether he has the hard or soft variety to deal with. The table given a few pages back will aid greatly if the sore is regular and uncomplicated. The physician should be very cautious about pronouncing a positive opinion concerning the ulcer upon the genitals, following a suspicious connection. Let him take time enough to fully observe its true character, and if necessary examine the person from whom it was derived. If all other means of diagnosis fail, a small por- tion of the suspected matter may be innoculated, which, if specific, will soon show itself. Chancre is liable to be confounded with simple abrasions, eczema, herpes, or balanitis. Herpes is an eruption of groups of vesicles, preceded by fever and slight digestive trouble. The vesicles are of a whitish color, about the size of a pin's head, and are seated on a red base and attended by considerable itching, heat and pain. They occur on the head of the penis and prepuce a day or two after exposure. When they occur on the lips the diagnosis is more difficult and more time is required.