Identifier: syphilis00coop (find matches)
Title: Syphilis
Year: 1895 (1890s)
Authors: Cooper, Alfred, Sir, 1846-1908 Cotterell, Edward, 1857-1898
Subjects: Syphilis Syphilis
Publisher: Philadelphia : P. Blakiston
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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urated base—the surface on sectionwill be found to be pale red in colour, not containingmuch blood, uniformly compact, smooth, prominent,and of a firm elastic consistence. Perpendicularsections under the microscope show small cell infil-tration of the papillae and throughout the corium,uniform in character and closely distributed. Thisinfiltration has a somewhat abrupt margin at thesides and below; the cells are embedded in a reticu-lum formed by the original fibres of the cutis. Onthe surface of the ulcer, the network and the cellulardeposit are irregularly exposed. I^umerous isolatednuclei, small shrivelled cells, and other similarstructures are also found. At several points on thesurface of the ulcer, there are isolated patches ofepidermis and rete lying on the surface of the infil-trated corium. At other points there are remains of EXPLANATION OF PLATE IV. Section of hard sore, showing loss of epithehum, destruction ofpapillae, and small cell infiltration of the corium. Plate 4.
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THE HARD OR INDURATED CHANCRE. 99 the rete, and signs of the papillae, the limits of eachbeing more or less obliterated. The part infiltratedwith cells is but scantily supplied with vessels, thewalls of the latter are considerably thickened andtheir calibre is much reduced. Auspitz and Unna attribute the induration prin-cipally to the connective tissue growth about theblood-vessels; and in addition, they describe a largeincrease in thickness of the rete^ with prolongationsdownwards from the under surface of this, forminglong processes, or becoming detached, forming isolatedblocks of epidermic cells, surrounded by the smallcell infiltration. As this cell infiltration increases,the epidermic layer is gradually invaded, and passingthrough the stratum lucidum and corneous layer itappears upon the free surface. Diagnosis of the Hard Chancre.—The symptomsto be relied upon are the induration of the base andmargins of the sore, and the induration of thelymphatic glands in the vicinity, this

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