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Updated: June 25, 2025
It has first of all made possible the control of the contagious lesions of the disease. Secondly, as was said before, it has made possible the cure of the infection in the primary stage, before it has spread from the starting-point in the chancre to the rest of the body. To understand how it accomplishes these results it is important to understand its mode of action.
If the base of the knot widens and flattens so that it feels and looks like a button under the skin, and the top rubs off, leaving an exposed raw surface, we may have the typical hard chancre, easily recognized by the experienced physician, and perhaps even by the layman as well. On the other hand, no such typical lesion may develop.
Puschmann says: "The accounts given of intermittent fever, pneumonia, phthisis, psoriasis, lupus, which they called the malum mortuum, of ulcers on the sexual organs, among which it is easy to recognize chancre, and of the disturbances of the mental faculties, especially deserve mention." They seem to have been quite expert in their knowledge of phthisis.
The glands in nearest relation to the sore are those first affected, for example, the epitrochlear or axillary glands in chancre of the finger; the submaxillary glands in chancre of the lip or mouth; or the pre-auricular gland in chancre of the eyelid or forehead.
A patient who has gotten a fixed conception of a chancre into his head will argue insistently that he never had a hard sore, that his was soft, or painful instead of painless, or that it was only a pimple or a chafe. All these forms are easily within the ordinary limits of variation of the chancre from the typical form described in books, and an expert has them all in mind as possibilities.
The chancre may be small and hidden in some out-of-the-way fold or cleft, and because it is apt to be painless, escape recognition entirely. In women the opportunity for concealment of a primary sore itself is especially good, since it may occur inside the vagina or on the neck of the womb.
It is important to bear in mind the possibility of a patient having acquired a mixed infection with the virus of soft chancre, which will manifest itself a few days after infection, and the virus of syphilis, which shows itself after an interval of several weeks.
These sexual diseases are contagious that is, transmitted by contact. They are all germ diseases; one of them is practically local, one is capable of spreading the infection to contiguous organs and one is systemic. a. =Chancroid or Soft Chancre.= This is the least dangerous of the venereal diseases.
Even a cold-sore on the mouth or genitals may become the seat of a syphilitic infection which will be misunderstood or escape notice. Pronounced shan'-ker. +Syphilis and Gonorrhea may Coexist.+ It is a not uncommon thing for gonorrhea in men to hide the development of a chancre at the same time or later.
If it is covered with a dry crust, it is, of course, less so, but as soon as the crust is rubbed off, the germ-infested surface is exposed and the thin, watery discharge contains immense numbers of the organisms, especially in the first two or three weeks. This is just as true of a chancre on the lip or chin as on the genitals.
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