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Updated: June 25, 2025
It is but seventy years ago since Ricord, the great French syphilologist, following Bassereau, first taught the complete independence of syphilis both from gonorrhoea and soft chancre, at the same time expounding clearly the three stages, primary, secondary and tertiary, through which syphilitic manifestations tend to pass, while the full extent of tertiary syphilitic symptoms is scarcely yet grasped, and it is only to-day beginning to be generally realized that two of the most prevalent and serious diseases of the brain and nervous system general paralysis and tabes dorsalis or locomotor ataxia have their predominant though not sole and exclusive cause in the invasion of the syphilitic poison many years before.
Some persons with syphilis may have almost no recognizable lesions after the chancre has disappeared. Others under the same conditions may have crop after crop of them.
No layman shall go to the Sacrament without confession and absolution; and no one shall receive it under two forms. No chancre shall be made in the ceremonies, which, derived from the Word of God, have come down to us from the Holy Fathers and our worthy ancestors.
The hard chancre is usually solitary, but sometimes there are two or more; when there are several, they are individually smaller than the solitary chancre. It is the exception for a hard chancre to leave a visible scar, hence, in examining patients with a doubtful history of syphilis, little reliance can be placed on the presence or absence of a scar on the genitals.
The man who calculates that he will have had his fling in the ten or twenty years before tertiary troubles appear may be astonished to find that he can develop tertiary complications in his brain almost before he is well rid of his chancre. "Late accidents," as we call them, are the serious complications of syphilis.
It is oval in shape, perhaps somewhat irregular, with a raw surface and red colored base devoid of pus. Immediately following the appearance of the chancre, the glands in direct connection with it become enlarged, hard and rarely painful, but they have no tendency to suppurate like the enlarged glands of chancroid.
The impossibility of securing even the simplest coöperation from such patients is scarcely realized by any one who is not called upon to deal with them face to face. Even with an interpreter, they display the wilfulness of irresponsibility. One Italian woman wiped her chancre, which was on her lip, with her fingers at every other shake of the head.
This is peculiarly so in syphilis. In the earliest days of the disease, while the infection is still local and the blood test negative, the prospects of radical cure are practically 100 per cent. This is the so-called abortive cure, the greatest gift which salvarsan has made to our power to fight syphilis. It depends on immediate recognition of the chancre and immediate and strenuous treatment.
The chancre disappears in a few weeks and then there is a period when the individual has no outward manifestations of the disease. In about six weeks after the chancre the so-called secondary symptoms make their appearance.
If the induration is well marked, the chancre can be palpated through the prepuce, and is tender on pressure. As under these conditions it is impossible for the patient to keep the parts clean, septic infection becomes a prominent feature, the prepuce is œdematous and inflamed, and there is an abundant discharge of pus from its orifice.
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