The most common kind of sore is the _simple ulcer_, at first excavated,
in consequence of the process of ulceration continuing; afterwards
the ulceration stops, and granulations, somewhat fungous, supply its
place, so that the surface is raised above the level of the surrounding
parts, and has a smooth, soft appearance; there is no hardness of the
edges, and there is no tendency to slough or extend by ulceration.
Sometimes it commences in the form of a pustule, which soon gives way,
discharging its contents, and leaving an exposed surface, in which
the process of ulceration quickly proceeds; but often it arises from
simple abrasion of the surface. Different forms of sores may exist on
the glans and prepuce at the same time; and it is maintained, that
one sore may produce another of a different kind, and the same is
asserted with regard to eruptions. The simple ulcer, as well as other
sores, is produced by the contact of secretions, generally morbid,
but often apparently healthy, with a susceptible surface. Sores, with
eruption and sore throat, sometimes appear in one or both individuals
immediately after marriage, and probably arise from the acrimony of
the female secretions causing tenderness and ulceration of the parts.
The application of gonorrhœal matter readily produces the simple
ulcer on the glans or prepuce, particularly if an abrasion or rawness
existed; and if the matter be allowed to remain on an unbroken surface,
a pustule will form, and ulceration follow. From this latter cause
numerous sores are produced, separated from each other by sound parts,
and not extending into one continuous ulcer; and this condition may
have been preceded, on the glans, by a rawness of the surface and a
profuse discharge, or by a herpetic eruption on the mucous lining of
the prepuce. One man may be affected with gonorrhœa, and another with
ulcer, from connection with the same female, the same day or hour; and
it is doubtful whether the effect is not similar, in both cases, viz.,
ulceration; for it is supposed, that in gonorrhœa, the discharge, in
some rare cases, proceeds from patchy ulceration of the mucous lining
of the urethra, similar to the ulceration usually met with on the
glans. In examining women who have communicated infection, very often
no sores are found, and but little unhealthy discharge. In short, the
simple elevated sore may arise from the application of secretions from
an unbroken surface, from inoculation of matter from a similar sore,
or spontaneously, from inattention to cleanliness. Sores with elevated
surface, more extensive than those of the glans and prepuce, occur
on the skin of the penis and scrotum, or in the folds of the thigh;
and in women they are often met with in the perineum, or the cleft of
the nates. Sores of different kinds arises at various periods after
the application of their cause, from a day or two to some weeks, or
longer, but the usual time may be said to be from four to eight days.
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