Clinical notes on chancre of the tonsil, with analysis of fifteen cases / by L. Duncan Bulkley.

  • Bulkley, Lucius Duncan, 1845-1928.
Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: Clinical notes on chancre of the tonsil, with analysis of fifteen cases / by L. Duncan Bulkley. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    In my own cases there were three in young men where the lesion confessedly came from vile practices with their own sex, and one of these patients told me of a friend who had chancre of the lip from the same horrible source. In two of the cases, in young ladies, the contagion came presumably from kissing the gentlemen to whom they were engaged; one of these latter came later under my care with syphilis, he having also infected another lady with chancre on the lip, who was also my patient, and whom he married. In an- other estimable lady the tonsillar chancre came also from kissing frequently a cousin who had abundant mucous patches in the mouth, she also helping him to wash out the mouth. Of course, the poison may have found access otherwise than by kissing, for an instance is on record by Hardy, of Paris, where a troche passed from mouth to mouth communicated syphilis. In two other cases, married women, the disease seemed to come from their husbands, through the mouth; and in another case, a girl, aged nineteen, singing in the opera, it was probably from kissing. In three male patients the infection seemed to come from a drinking-cup in one, and from either drinking or smoking a pipe in the other two. In the boy aged eleven, the poison probably came from his father, who had chancre of the lip and mucous patches in the mouth; but a female servant, from whom the father contracted the lip chancre, had also syphilis, and also came to me for treatment. In two instances no probable hypothesis could be made; one was the man aged forty-six, with chancre of each tonsil, and the other in a lovely lady, aged thirty-three, whose husband was free from syphihs, and the only possible supposition was that the infection came from a public drinking-cup. The treatment of chancre of the tonsil does not differ essentially from that of syphilis in general. It is well to remember, however, the probable severity of the disease from this mode of infection, both to warn the patient against neglect of the case, and to carry out efficient treatment long enough to overcome the disease. Very great care should also be exercised by the patient against infecting others, for not only is there much virulent secretion from the local lesion on the tousil, but mucous patches in the mouth are apt to be very abundant and severe in these cases. Mercury should be given with a free hand from the first, and the full course of anti-syphilitic treatment carried out for two years, at least, according to modern rules of therapeutics.