IMPETIGINES. 64,5 



ticularly the various symptoms which so frequently attend it ; 

 but it does not seem necessary for me to attempt this after the 

 late publications of Dr. Foart Simmons, and of Dr. Schwedi- 

 auer, who have treated the subject so fully, and with so much 

 discernment and skill. 



MDCCLXXX. The other form of the local affection of 

 syphilis, is that of chancre. The ordinary appearance of this 

 I need not describe, it having been already so often done. Of 

 the few remarks I have to offer, the first is, that I believe chan- 

 cres never appear in any degree without immediately communi- 

 cating to the blood more or less of the venereal poison : for I 

 have constantly, whenever chancres had appeared, found, that 

 unless mercury was immediately given internally, some symp- 

 toms of a general syphilis did certainly come on afterwards, and 

 though the internal use of mercury should prevent any such 

 appearance, it is still to be presumed that the poison had been 

 communicated, because mercury could act upon it in no other 

 manner than as diffused in the fluids. 



MDCCLXXXI. It has been a question among practitioners, 

 upon the subject of chancres, Whether they may be immediate- 

 ly healed up by applications made to the chancres, or if they 

 should be left open for some time without any such application? 

 It has been supposed, that the sudden healing up of chancres 

 might immediately force into the blood a poison, which might 

 have been excluded by being discharged from the chancre. 

 This, however, is a supposition that is very doubtful ; and, up- 

 on the other hand, I am certain, that the longer a chancre is 

 kept open, the more poison it perhaps generates, and certainly 

 supplies it more copiously to the blood. And although the 

 above-mentioned supposition were true, it will be of little conse- 

 quence, if the internal use of mercury, which I judge necessary 

 in every case of chancre, be immediately employed. I have often 

 seen very troublesome consequences follow from allowing chan- 

 cres to remain unhealed ; and the symptoms of general syphilis 

 have always seemed to me to be more considerable and violent 

 in proportion as chancres had been suffered to remain longer 

 unhealed. They should always, therefore, be healed as soon as 

 possible ; and that by the only very effectual means, the appli- 

 cation of mercurials to the chancre itself. Those that are 



