Secondary ulcers on the female parts :

-JAHR Georg Heinrich Gottlieb

Most of these ulcers which present themselves for treatment are, most likely, consecutive symptoms of the transition stage from the primary into the secondary period, although I have met them in company with unmistakably secondary phenomena. They are most frequently seen near the inferior commissure, at the entrance of the vagina and on the perineum. The pratings of old-school physicians concerning the difficulty of curing ulcers located near the inferior commissure must, however, not be referred to the nature of these ulcers, but should be understood of the peculiar manner in which these gentlemen treat such ulcers, exclusively by external means, and thus securing their cicatrization. If treated with appropriate specific remedies internally, they yield to such treatment neitheir sooner nor later than any other ulcers of the same class, no matter where located; only those which are seated at the entrance of the vagina (if of a phagedænic character, and after having lasted a long time, may perforate the walls of the vagina, and may penetrate into the rectum; and those that are seated anteriorly, may find a passage into the urethra, and give rise to incurable fistulæ of this canal. Even on the neck of the womb, these secondary chancres have made their appearance;

Secondary syphillitic ulcers

and it is here that-on account of the accompanying stinging pains; of the badly-colored ichorous discharge from the vagina, and of a peculiar feeling of weight in the rectum; as well as on account of the swelling, of the increased warmth, and of the ulcerations of the neck of the womb, which are readily discovered by exploring the parts with the finger-these ulcerations have frequently been mistaken for cancer, until their true nature was ascertained. But even in such cases, where the physician should never lose sight of the possibility of confounding syphilitic with cancerous ulcerations, the previous history, and the initial symptoms of the case, in addition to other syphilitic symptoms that may likewise be present, may excite suspicion, which an examination with the speculum may soon clear up. It is true that such an examination is not always easy, for there are cases where the physician-even if he should suspect a syphilitic infection-cannot, and dare not give utterance to such a thought. If we consider how many pure-minded, virtuous, and sensitively-modest women, whose husbands fancied themselves cured, and radically freed from all syphilitic taint, have been infected by them with this horrid disease, without the poor patients having the least suspicion regarding the true nature of their ailments, it is not difficult to understand that so many syphilitic ulcerations have been mistaken for cancerous disease, and have been treated accordingly. I have had women come to me, who had been treated by allopathic physicians for cancerous ulcerations, and who, being unwilling to submit to another examination, were treated by me, for a long time, without any abatement of the pains or the discharge (although with our present means relief can be afforded, even if patients are suffering with cancer), until, suspecting a syphilitic taint, I finally had recourse to Merc. sol. and Nitri. ac., by which means I not only effected a rapid improvement, but a complete cure; in no case did the treatment last beyond three months.