but by the nature and species of the affection from which the infection is obtained.

For my part, gentlemen, I must allow that I regard favourably those doctrines which tend to multiply the sources of the virus. I see in them, in fact, a brightening confirmation of the opinions which I was the first to advance upon the nature, independent existence, and different prognosis of the two varieties or of the two kinds of primary venereal ulcer.

The necessity of creating at the present day several sources of origin for chancres, shows how correctly I was guided when I endeavoured to point out the differences, and to seek at the bedside those conditions which should one day enable me to distinguish from their commencement these two forms of ulceration.

But, gentlemen, let us put aside theory, and return to our clinical domain.

I have just told you that there exist two forms of chancre; it remains for me to point out to you the characters peculiar to each of them.

I shall consider, in the first place, the simple, noninfecting chancre, that which Dr. Clerc has lately named "chancroid.”

H

1

น

mueled Dr.

a the mufestations

u cases and to a

, the

..

There no longer

TORCE IN THE soil to modify the grain; it

if the ran winch gives birth to different

Instead of keeping us in the preceding doctrine, the simque chunere and the infecting chancre distinct, Dr. Cler also one of my pupils, considers them only as t

of the same virus. According to him, the si

is only a modification of the infecting h result of the inoculation from an infect subject already affected by constitutiona these chancres transmits itself singly logical species, and the consequence determined, not by any peculiar indi

• Lettres sur la Syphilis, XXXII

but by the nature and species of the affection from T the infection is obtained.

For my part, gentlemen, I must allow a perm favourably those doctrines which tend

sources of the virus. I see in them, in fa a meste confirmation of the opinions which I was there. upon the nature, independent existenz prognosis of the two varieties or fitt primary venereal ulcer.

The necessity of creating at the sources of origin for chancres, showe w guided when I endeavoured to point vir to seek at the bedside those condrine T day enable me to distinguish from T these two forms of ulceration.

But, gentlemen, let us put asite tem clinical domain.

I have just told you that ther it remains for me to point out ay to each of them.

I shall consider, in the fr infecting chancre, that a "chancroi

PART II.

OF THE SIMPLE CHANCRE (CHANCRE MOU, CHANCRE

NON-INFECTANT).

I.

RELATIVE FREQUENCY OF THE SIMPLE CHANCRE AND OF THE INFECTING CHANCRE-DOES THERE EXIST ANY IMMUNITY AGAINST THE SIMPLE CHANCRE-SUBJECTS, PRETENDED REFRACTORY-THE TWO THOUSAND TWO HUNDRED CHANCRES OF DR. L-ON THE INOCULATION OF CHANCRE UPON THE LOWER ANIMALS.

Of the two varieties of chancre, the form most commonly met with is the non-infecting.* It is, then, correct to state, that, in the great majority of cases, the chancre does not induce syphilis.

This excess of relative frequency of the simple chancre may be explained as follows:

* Observe the statistics collected by me, for M. Ricord, during three months amongst the patients of the Midi ::

Number of chancres seen

Chancres, indurated or infecting

Chancres, simple, not infecting .

341

126

215

Allowing, also, for cases in which chancres heal suo sponte, and do not compel the recipient to present himself at the hospital, and also for cases of balanitis attended by inflammatory phymosis, in which the existence of chancre cannot be accurately determined, it may justly be concluded that of every three chancres contracted, two, at least, belong to the simple variety, one only to the infecting kind. That is to say, that only one chancre in three will induce constitutional syphilis.

M. Puche has found from observation that chancres existed in the proportion of four simple to one infecting. —A. FOURNIER.

Firstly. The simple chancre is the most abundant source of the chancrous virus; it is the form of ulceration which secretes pus endowed to the highest extent with the property of contagion, and which retains for a long period the faculty of inoculation.

Secondly. It creates no immunity against a renewed contagion of a chancre of the same kind; that is to say, against its reproduction upon the same individual. It is well known, on the contrary (and I shall soon have the opportunity of insisting upon this point), that, as a general rule, the indurated chancre is only produced once upon the same subject.

It is in vain, gentlemen, that you will seek in the peculiar disposition of the organism for prophylactic conditions against this variety of chancre. I do not know, I have never met with a subject refractory to this virus. Before a good lancet, charged with pus taken from a simple chancre, at the period of virulent specificity, there exists no immunity.

This proposition, which I advanced a long time ago, and which the foolish attempts of the believers in syphilisation have not weakened, I again bring forward to-day, strengthened by the experience of twenty-five years.

Neither age, nor sex, nor idiosyncrasies, nor previous pathological conditions, are opposed to the contagion of the soft chancre.

Syphilisators have contradicted me: they imagine that they have found individuals incapable of this contagion. You know, gentlemen, what becomes of this pretended immunity of these invulnerable subjects before a lancet charged with good chancrous pus. Where, then, to-day are the syphilised subjects? Is it the famous M. L-, for example, who, as he himself says, was refractory only in consequence of the impotency of the pus employed for inoculation? Is it that intrepid experimentalist, M. Lind