THE CHANCRE. 749 



patient be brought under favorable hygienic influences, and if he be de- 

 fended from all noxious agencies throughout the course of the disease. 

 If the circumstances permit, it is well to confine him to his chamber, or, 

 at all events, to forbid all unnecessary walking. Moreover, since the 

 majority of this class of patients are young and vigorous, living more 

 or less freely, and drinking spirituous liquors, it is generally advisable 

 to place them upon a rigid diet (gruel morning and evening, with broth 

 and a little meat at mid-day), to forbid coffee^ beer, wine, or spirits, and 

 now and then to give small doses of some saline cathartic (one or two 

 glasses of Friedrichshaller, or Pullnaer bitter water), which may be 

 taken in the morning, fasting. Although a chancre usually heals much 

 more quickly under this treatment than when a strict regulation of the 

 diet is neglected, it is merely because of the luxurious mode of life led 

 by most patients who have exposed themselves to the infection of the 

 chancre. The above directions are not applicable, and indeed might 

 do great mischief, and retard the healing of the sore, if applied hi the 

 case of a badly-nourished, cachectic patient. In such a case, the diet 

 must be nutritious and rich ; the use of wine and beer is indicated, 

 and often exerts a favorable effect upon the healing of the ulcer. 



The local treatment of a chancre must be similar to that of any 

 other atonic ulcer, of which the chancre may be regarded as the proto- 

 type. Until after the fourth or . seventh day, it is advisable to de- 

 stroy the ulcer by caustics. For this purpose, it is best to make use 

 of the potassa fusa, the Vienna paste (quicklime, five parts ; caustic 

 potash, six parts), or the chloride of zinc, which makes a dry eschar 

 (rj& zinci chlor., butyr. antim., aa 3ij, f. c. pulv. alth. past, mollis). 

 After the seventh day it is not advisable to cauterize, as then the pro- 

 cess of healing is retarded rather than promoted thereby. As a rule, 

 ointments should not be used, and the sore should be dressed with 

 warm camomile-tea, or other mild, stimulating liquid. The most 

 common applications are the aromatic wine, the black-wash (calomel 

 3 ss ; aquae calcis ij), the yellow-wash (hyd. chlor. corrosiv. gr. j ; 

 aquae calcis ij). The blue-wash (cupri sulp. gr. j ; aquae j), which 

 is almost exclusively used by Von JZarensprungr, is also highly to be 

 recommended. When the chancre is very painful, and when its dis- 

 charge is very profuse, compresses, wet with lead-water and cold sitz- 

 baths, are of benefit. It is generally sufficient to dress the wound 

 twice a day, after previously washing it or bathing the part in camo- 

 mile-tea. Too frequent dressing does harm. If, in spite of this treat- 

 ment, the floor of the ulcer retains its lardaceous aspect, it is advisable 

 to sprinkle the surface now and then with a thin layer of red precipi- 

 tate. After the sore has lost its specific character, and nevertheless is 

 slow in healing, it may be touched lightly with lunar caustic, or dressed 



