. Syphilis : a treatise on etiology, pathology, diagnosis, prognosis, prophylaxis, and treatment . enlarge. Cancer must bedifferentiated, and this can be done by the rules laid down underchancre of the lip. Lesions in this site may arise from kissing,from perverted sexual habits or from the use of infected eatingutensils. Tonsil.—Chancres of the tonsil have recently been carefullystudied by Smith,^^ who finds that primary lesions in this loca-tion are certainly much commoner than has generally been be-lieved, inasmuch as many of them escape recognition because ofthe atypical forms assumed. Wil
. Syphilis : a treatise on etiology, pathology, diagnosis, prognosis, prophylaxis, and treatment . enlarge. Cancer must bedifferentiated, and this can be done by the rules laid down underchancre of the lip. Lesions in this site may arise from kissing,from perverted sexual habits or from the use of infected eatingutensils. Tonsil.—Chancres of the tonsil have recently been carefullystudied by Smith,^^ who finds that primary lesions in this loca-tion are certainly much commoner than has generally been be-lieved, inasmuch as many of them escape recognition because ofthe atypical forms assumed. Wilson,^^ in a review of 6000 cases of THE PRIMARY STAGE 81 extragenital chancre found that 600 were tonsillar. The righttonsil is more affected than is the left, and women suffer morefrequently than do men. It is claimed by some physicians, in-cluding as keen an observer as Osier, that these lesions usuallyresult from improper practices, but Smith disagrees with thisview, and believes that kissing is the most frequent cause, andthat the careless use of eating and drinking utensils ranks Fig. 11.—Chancres of the tongue are similar to those of other mucous membranes. (Col-lection of Drs. Fordyce and MacKee.) lie further states that pipes, mouthpieces of wind instruments,nursing bottle nipples, cigar stubs, tonsillotomes, eustachiancatheters, mouth to mouth insufflation, and a common blowpipein glass factories have all been reported as modes of conveyingthe infection. The first symptom noted by the patient is usually sore throat,Avith some stinging pain. Glandular enlargement is prompt. Thetonsil is always enlarged and of a deep red color, and the pil-lars are likewise red. The fact that both the tonsil and the neigh- 82 SYPHILIS boring parts are not infrequently covered by a membrane oftencauses the condition to be mistaken for a Vincents angina ordiphtheria. Fournier describes five clinical varieties, erosive,ulcerative, quinsy-like, diphtheroid and gangrenous. The cond
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectsyphilis, bookyear192
