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| Syphillitic ulcers on other than sexual organs |
In the case of chancres that break out on other parts than the sexual organs, it seems scarcely possible to confound them-unless we except those the diagnostic characteristics of which we have recited in previous paragraphs (§ § 40 to 43)-with any other form of ulcer, with the exception of mercurial ulcers. We deem it so much the more incumbent upon us to offer a few remarks on this subject, since it is from this source that the most pernicious consequences frequently arise in a twofold manner. For, while on the one hand there are practitioners who falsely look upon every chancre that proves somewhat obstinate and cannot be influenced by Mercury, as a mercurial ulcer, and owing to this mistake, allow the chancre to cause the most horrid destruction; on the other hand there are practitioners, not only among the allopaths, but likewise among the homoeopaths, who smile contemptuosly at the aggravations supposed to result from large doses of Mercury, and, whatever course the ulcer may take, deem it necessary to pile on the Mercury in increased quantities, fancying that the organism had not been sufficiently saturated with this metal; and yet, the phenomena which they desire to combat, are most generally nothing else than the effects of large doses of Mercury, Mercurial ulcers being, therefore, an established fact, we will offer the following advice, by means of which they may be correctly known and distinguished from chancre. As a general rule, the mercurial ulcer is never as painless as chancre; on the contrary, it is very sensitive and painful to the touch, but is never accompanied by the nightly stinging and boring pains that sometimes attend the Hunterian chancre when very much inflamed. The ulcer spreads very rapidly, almost like a phagedænic chancre, but never like a serpiginous sore; its base is of a milky-white, gray or livid, very frequently with bluish-white, edges, sometimes superficial like simple excoriations, secreting a purulent serum, or else covered with a cheesy layer; sometimes the ulcer dips to the subjacent textures, with a dirty-looking, even lardaceous base, but always of an irregular indistinctly-circumscribed shape, with unequal circumference, and always healing from one side of its border, whereas a chancre first becomes cleansed on its base and afterwards cicatrizes from its circumference in concentric circles. These ulcers most frequently break out in the mouth, or on the inside of the lips, on the edges of the tongue, or on the sexual organs and in their neighborhood. Very frequently they break out in existing wounds, in cicatrices or on ulcerated surfaces, which, in such a case, spread rapidly and become painful, phagedænic, ichorous, and bleeding. Sometimes this kind of ulcer shows itself on hairy parts (especially on the hairy scalp) under the form of a superficial ulcer, with a rough, uneven surface and lardaceous, fungous growths without any malignant character, and dissolving into a purulent liquid, after which the ulcer disappears, without leaving a scar, but reappears again sooner or later on other parts.