The treatment of syphilis / by H.C. French.

  • French, Herbert Cumming, 1860-1913.
Date:
1908
Catalogue details

Licence: In copyright

Credit: The treatment of syphilis / by H.C. French. 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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    o amongst 200 consecutive in-patients with venereal sores. The cases on discharge from hospital were kept under prolonged observation. I here were l'orty-fivo cases of syphilis, that is, a relative frequency of 3-5 non-infecting chancres (soft chancres) to 1 of syphilis* Previous and present experience and carefully collected military statistics support this view. Naturally it is a hard point to estimate accurately, as soldiers, more especially in England, may resort to civil practitioners and chemists in order to avoid loss of pay by reason of admission to hospital. No doubt many cases are only sent to Mr. Hutchinson when there is a strong probability of syphilis. I think, therefore, on the evidence, that the probability of chances in a large number of cases is about three to one against syphilis. The relative frequency, however, is of slight value in arriving at a correct diagnosis, the nature of the chancre and the condition of the adjacent lymphatic glands being of the utmost importance as regards treatment. In the foregoing investigation at Cairo, which I have since verified at Woolwich in many hundreds of cases, induration in some degree was almost invariably present at some time in syphilitic chancres, although it need not necessarily be obvious on the occasion or occasions on which the medical man happens to see the case, since it may have disappeared, or may not have developed. The indura- tion should be felt with the fingers. It is rapidly dissipated by adequate treatment with mercury, and is much more marked in some cases, especially on the tense corona glandis. It is commonly less marked and frequently overlooked on the fraenum. In the soft substance of the glands or on the external skin of the penis it may be absent, or not appreciable (parchment induration). Induration was, with rare exceptions, also present in the proximal lymphatic glands in the primary stage, and these glands were usually bilaterally enlarged as the rash came fully out. There was either a discrete bullety enlargement or hyperplastic non-suppurating mass (bubo), which rarely ended in suppuration in the case of syphilis, and the amygdaloid or bullet nature of the individual glands could be later made out as the mass slowly subsided under mercurial inunctions. These hyperplastic mattings in the groin usually resulted from concealment, irritation, and active exercise in the chancre stage. In the case of non - infecting sore, sup- * Syphilis in the Army, 1907, Jolin Bale, Sons & Donielsson, Appendix I.