I
Primary Syphilis. Simple Chancroid.
Often not venereal. Generally venereal.
Produced by mediate or Produced by immediate contagion
immediate contagion from from the secretion of another
the secretion of a syphilitic chancrous lesion.
lesion.
II. Incubation.
Usually from 17 to 30 days. Reaction within 24 hours.
III. First Appearance.
A papule or slightly eroded A pustule or ulcer spots.
IV Number of Lesions.
One usually. Generally multiple.
V Seat.
Not uncommonly extra genital. Almost without fail up on the
genitals.
VI Induration
Ulcer or lesion, firm, elastic Compressible, soft non-elastic
and with sharply defined edges. ill-defined, soft to touch.
VII. Surface.
Sometimes dry and scaly, red or Always moist, with pus-like
grayish, slightly moist at times. secretion, generally copious.
discharge.
VIII. Form
Generally round, with well First round, soon becoming
defined margins. angular in outline, with
irregular borders.
IX. Ulceration.
Ulceration often absent, edges Ulcer deep, with perpendicular
smooth, sloping ulcer, usually Jagged edges.
shallow.
X. Secretion
Secretion scanty, of a Secretion copious and
serous nature. purulent.
XI. Sensation.
Slightly sensitive. Sensitive.
XII. Innoculability.
Not innoculable upon a syphilitic Always innoculable upon
persons. others even upon the
infected one.
XIII. Adenopathy.
Polyadenitis; indolent; scarcely Monoadenitis; acute;
suppurates. supporting and virulent.
Mixed chancre. In mixed infection, it is difficult for even the experienced physician to make an early diagnosis. It therefore becomes extremely necessary to acquaint ourselves well with this initial lesion of which so much has been said. In the majority of cases of mixed infection, the inflammatory effects due to the mixed infection obliterates the fine distinguishing points of the initial or primary sore. Usually this mixed infection involves the chancroid as well as the true syphilitic virus. We then have both the sycotic as well as the syphilitic elements to deal with, as chancroid is but an ulcerative form of sycosis, while the true gonorrhoea is the catarrhal from.
Time, however, the revealer of all things, will soon show clearly, as the disease advances, its true nature, whether syphilis is present or not. In the meantime, care should be taken not only to guard yourself in a diagnosis as well as to protect others from infection. A carcinomatous papule may be mistaken for the initial lesion of syphilis in the mouth or on the genitals, but his is so rare that it is of slight consideration. The rapid evolution of syphilis, of course, distinguishes at once the nature of syphilis. A tubercular ulcer in the mouth or tip of the tongue cannot be taken for syphilis, even by those unfamiliar with the syphilitic lesion, if they put to the test the soft character of the tubercular lesion. Secondary eruptions, I can readily see, might confuse the unexperienced, but never in the first stage of syphilis.
The pathological anatomy of syphilis. The microscope reveals, in all stages, a dense cellular tissue and an infiltration of masses of large round cells. They seem to be a constant element in this disease. They pile up at the edges of all lesions and are also seen, to a marked degree, in the chancre and throughout all syphilitic processes.
The papillae at the periphery of all eroded surfaces are found to be enlarged and infiltrated; the connective meshes are loose and oedematous. The hardness of the peripheral edges and borders of all syphilitic lesions must therefore be due to this massing together of these round syphilitic cells that crowd themselves together at the periphery of all lesions. This is, perhaps, the cause of the unstableness of all syphilitic lesions. One quite prominent physiologist explains this instability in the following manner:
“The vital processes of the life forces are so profoundly disturbed, especially in the bloods vitalizing centers, that these cells are not perfectly vitalized, therefore making non- constructive, and therefore the tissues likewise are unstable. How often we notice the poor attempt nature or the life forces make in their feeble efforts to heal an old syphilitic ulcer or other lesion. We notice the false granulation, the exaggeration piling up of unhealthy granulation in many attempts to bridge over some breach in the tissues made by gummae or other destructive processes. This granulation or cells efforts fails because of the lack of true cell vitality”.
All cell effort at healing in this disease is neoplasmic. It has no durability, no constructive character; it is all histologically the counter part of disease. Hahnemanns definition of disease becomes paramount as we study the action of syphilis upon the life forces. “Disease” he says, “is the disturbance of the life force”. These three vital and far- reaching words, disease, disturbance, life force, cover all physiology all anatomical and histological discovery. No man yet has viewed so deeply into the mystery of life, disease and death The life process he fully comprehends, and his disease and death process is in harmony with the principles as laid down by God himself. His principles are in harmony with all the universal laws and also in perfect harmony with true healing.
How clearly we see this imperfect process of vitalization of white cells in a gummy tumor and gummy formation which represent the true counter- part of the formation and product of disease. Robin, Marchal, von Barenspinnd, Wien, Virchow, recognized all these things, but could not explain them because of their chemical conception of disease, while Hahnemanns masterly eye makes all these things clear and simple, although he lived in a day when he had no competitors nor great thinkers in this field of science. Of these greater men of the school of materialists of modern medicine, we feel we must place Virchow at the head, yet he testifies to the fact that the morphology of syphilitic lesion and growth held no vital significance.
Some authors attribute the scirrhous condition of the true chancre to the fibrous exudate and others to an hypertrophy of the epidermis. In the chancre, the epidermis is not destroyed, while in the chancroid ulcer it is destroyed.
J.H. Allen was a student of H.C. Allen. He was the president of the IHA in 1900. Dr. Allen taught at the Hering Medical College in Chicago. Dr. Allen died August 1, 1925
Books by John Henry Allen:
Diseases and Therapeutics of the Skin 1902
The Chronic Miasms: Psora and Pseudo Psora 1908
The Chronic Miasms: Sycosis 1908