SOFT SORE III 



SOFT SORE 



Soft sore is now known to be due to the bacillus described by 

 Unna and by Ducrey. It is apparently invariably present in 

 these lesions, and it can be cultivated, though with difficulty, and 

 when inoculated will reproduce the disease. It, or an organism 

 morphologically indistinguishable from it, occurs sometimes in 

 ulcers following herpes preputialis, though of unusual severity ; 

 possibly in these cases the bacilli are less virulent than in the 

 ordinary soft sore. It is scarcely necessary to say that syphilis 

 and soft sore (or gonorrhoea and soft sore) may be inoculated at 

 the same time, and the lesions appropriate to both diseases may 

 be present simultaneously. 



The bacillus in question is a short straight rod, less than a 

 quarter the length of the tubercle bacillus, and not much longer 

 than the bacillus of influenza, and is frequently arranged in 

 chains. It is rather thick in proportion to its length, its length 

 being only about three times its breadth, and it has rounded ends, 

 which often stain more deeply than the centre of the bacillus. It 

 does not stain by Gram's method ; it stains, indeed, with some 

 difficulty, and powerful stains (such as dilute carbol fuchsin or 

 Loffler's blue) should be used. It is best demonstrated in films 

 made from the deeper parts of a typical soft sore, for the super- 

 ficial parts contain bacteria of all sorts, and the recognition of 

 Unna's bacillus is not easy unless it is obtained in large numbers. 

 The bacteriological examination for this bacillus has most often 

 to be made in cases of urethral sore, or of a sore concealed 

 beneath a phimosis. The method of obtaining the specimen is 

 the same in both cases. A fairly stiff platinum loop is inserted 

 beneath the prepuce, or into the urethra, and moved gently about 

 until the most tender spot is found. This should be scraped as 

 forcibly as the patient will allow, and the loop withdrawn, care 

 being taken that the mass of secretion is not wiped off in so doing. 

 Several films should then be made, the secretion being rubbed up 

 on the slide with a drop of water. They should be stained with 

 either of the stains mentioned above for five minutes or more : 

 it is an advantage to warm them gently. They are then rinsed 

 in water, dried and mounted, and examined thoroughly with an 

 oil-immersion lens. 



When buboes occur in the course of soft sore, the pus they 



