Manual of Surgery eBook

This eBook from the Gutenberg Project consists of approximately 697 pages of information about Manual of Surgery.

Manual of Surgery eBook

This eBook from the Gutenberg Project consists of approximately 697 pages of information about Manual of Surgery.
small groups or in short chains.  Soft sores are always contracted by direct contact from another individual, and the incubation period is a short one of from two to five days.  They are usually situated in the vicinity of the fraenum, and, in women, about the labia minora or fourchette; they probably originate in abrasions in these situations.  They appear as pustules, which are rapidly converted into small, acutely inflamed ulcers with sharply cut, irregular margins, which bleed easily and yield an abundant yellow purulent discharge.  They are devoid of the induration of syphilis, are painful, and nearly always multiple, reproducing themselves in successive crops by auto-inoculation.  Soft sores are often complicated by phimosis and balanitis, and they frequently lead to infection of the glands in the groin.  The resulting bubo is ill-defined, painful, and tender, and suppuration occurs in about one-fourth of the cases.  The overlying skin becomes adherent and red, and suppuration takes place either in the form of separate foci in the interior of the individual glands, or around them; in the latter case, on incision, the glands are found lying bathed in pus.  Ducrey’s bacillus is found in pure culture in the pus.  Sometimes other pyogenic organisms are superadded.  After the bubo has been opened the wound may take on the characters of a soft sore.

Treatment.—­Soft sores heal rapidly when kept clean.  If concealed under a tight prepuce, an incision should be made along the dorsum to give access to the sores.  They should be washed with eusol, and dusted with a mixture of one part iodoform and two parts boracic or salicylic acid, or, when the odour of iodoform is objected to, of equal parts of boracic acid and carbonate of zinc.  Immersion of the penis in a bath of eusol for some hours daily is useful.  The sore is then covered with a piece of gauze kept in position by drawing the prepuce over it, or by a few turns of a narrow bandage.  Sublimed sulphur frequently rubbed into the sore is recommended by C. H. Mills.  If the sores spread in spite of this, they should be painted with cocaine and then cauterised.  When the glands in the groin are infected, the patient must be confined to bed, and a dressing impregnated with ichthyol and glycerin (10 per cent.) applied; the repeated use of a suction bell is of great service.  Harrison recommends aspiration of a bubonic abscess, followed by injection of 1 in 20 solution of tincture of iodine into the cavity; this is in turn aspirated, and then 1 or 2 c.c. of the solution injected and left in.  This is repeated as often as the cavity refills.  It is sometimes necessary to let the pus out by one or more small incisions and continue the use of the suction bell.

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Manual of Surgery from Project Gutenberg. Public domain.