Chancroidal bubo and bubonic chancroid / by J. Macdonald Brown.

  • Brown, J. Macdonald (John Macdonald), 1857-1935.
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: Chancroidal bubo and bubonic chancroid / by J. Macdonald Brown. 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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    Such, then, are the leading features of this lesion. I shall now briefly refer to the two clinical cases mentioned previously. Alexander M., a strong, robust man of 35 years of age, was admitted to Ward IV. of the Royal Infirmary about the middle of April last. He had remains of soft sores on the prepuce, and a soft fluctuating swelling in the left groin. He complained of considerable pain in the part, which was exaggerated on movement. The bubo was opened, and a large quantity of thin puriform fluid evacuated. The resulting wound for two weeks was most assiduously treated with dry iodoform dressing, the patient at the same time being strictly confined to bed. In spite of this the ulcer gradually increased in size, and, in place of showing signs of healing, became more and more unhealthy-looking. A slight abrasion of the skin about an inch distant from it quickly assumed similar characteristics, auto-inoculation having evidently taken place. So rapidly did the destructive process proceed, that in a few days only a mere bridge of skin separated the two ulcers from each other. This was subsequently divided to relieve tension, and two days later one large ulcer resulted. On 5th May, the patient was chloroformed, and the margins of the ulcer brushed with pure carbolic acid, while solid chloride of zinc was thoroughly rubbed into the base. Simple water dressing was then employed, and five days subsequently an extensive slough separated, leaving a simple healing ulcer behind. This, under dry iodoform dress- ing, healed kindly in eight days’ time. James S., 21 years of age, was admitted into Ward IV., on 12th July, complaining of pain in both groins, increased by walking. On examina- tion, a soft fluctuating bubo was found in each groin. Two months previously he had chancroid, but the sores had healed three wTeeks before admission. Only a fortnight previous did he feel any pain in the groins, or observe any swelling there. The buboes were opened, and thin sanious pus evacuated. The sores had dry iodoform dressing applied. They increased somewhat in size during the following week, and presented all the features of bubonic chancroid, though in a somewhat mild degree. Subsequently, and with- out change of treatment, they gradually took on a healthy action, decreased steadily in size, and in fully three weeks’ time had completely healed. A chancroidal or virulent bubo is distinguished from a simple one by several marked differences. It occurs at a later period, rarely before the third week of the existence of the sores, and often at a much later date, sometimes, as in the second case described, after the sores are com- pletely healed. The simple bubo, on the other hand, usually appears during the first week of the existence of the chancroid. The two forms are indistinguishable before evacuation, although