THE CHANCRE. 743 



would remain local ; if the attempt failed, then a series of affections of 

 remote parts of the body, resulting from constitutional implication, fol- 

 lowed the local ulcer, the secondary and tertiary syphilitic diseases. 

 The formation of an induration upon the base or edges of the primary 

 sore was considered an ominous sign, proving the almost certain infec- 

 tion of the system. Hence the attempt was usually made to destroy 

 recent non-indurated ulcers with strong caustics, while older and in- 

 durated sores were nearly always treated constitutionally, especially 

 with mercury, which was almost universally regarded as the antidote 

 for syphilis. Finally, the majority of syphilologists, following the teach- 

 ing of Ricord, supposed that syphilis could only be propagated by the 

 primary sore, or chancre, or, in other words, that the secretion of the 

 chancre was the only vehicle of contagion ; and that it was not con- 

 tained in the discharge of secondary affections, nor in the blood, or 

 secretions of syphilitic persons, a theory which was never fully credited 

 by practising physicians. It would take too long to relate in detail 

 how each of these propositions in turn first was doubted, then was re- 

 futed, until at last the whole theory was abandoned as false, or, at all 

 events, as based upon erroneous observation. We shall touch upon 

 some of these errors in laying down the tenets of the modern doctrine. 

 In the present chapter we shall treat first of the chancre, and of 

 the glandular chancre or acute bubo; after which we shall describe 

 constitutional syphilis, the first manifestation of which consists in 

 syphilitic induration and the primary syphilitic ulcer. To the latter 

 we shall not apply the term chancre, according to the usage of most 

 modern authors. 



A. THE CHANCEE. 



As the chancre is not a constitutional disease, it might, perhaps, 

 have been entirely separated from the subject of syphilis, and classified 

 with gonorrhoea, and other affections of the genitals ; but, although 

 such an arrangement would be more systematic, yet, considering the 

 extremely frequent coexistence of the chancre with syphilitic indura- 

 tion, it does not seem so practical. 



The chancre often is called the " soft chancre," in contradistinction 

 to the sore of primary syphilis, the " hard chancre." Other authors 

 call it the " chancroid," reserving the term chancre for the primary 

 syphilitic ulcer. Other syphilologues apply the epithet " virulent " to 

 the chancre, and call the ulcer of primary syphilis the " infectious ' 

 ulcer. It is very desirable that authors should agree as to the names 

 of the two diseases, in order to allay the confusion arising from a diver- 

 sity of nomenclature. 



ETIOLOGY. We shall not discuss the question as to the origin of 

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