But what I contend is, that, in our selection, we should prefer those which produce most speedily and effectively the desired change, with the least detriment to the general health. And to this end, I invariably enjoin, where practicable, warm or vapor bathing. I have elsewhere considered this subject at length, to which I refer the reader; but I will fearlessly assert that no one, or any plan of treatment, will be found so effectual toward increasing physical power to repel disease, or so permanently preservative of health, as the modified employment of the warm or vapor bath; and, therefore, in all cases of doubt and apprehension, or independent of either, the use of the warm or tepid, plain, or salt-water bath, two or three times a week for a month, or the vapor bath about every fourth or fifth day for the same period, is the best preventive that can be adopted to avert secondary symptoms. Where bathing of every kind is impracticable, as is the case in some country places, and the same necessity exists, I advocate the administration of alterative medicines; nor do I object to the employment of mercury, where, under other circumstances, without reference to its imaginary efficacy in syphilis, it would be prescribed. But of this as we proceed. Where, at the expiration of a week, the chancre neither recedes nor advances, and is the only symptom present, it is to be presumed that the condition of the patient’s health has something to do with it, and that condition should be minutely inquired into. There may be diminished or increased appetite, with imperfect digestion; there may be fever, with restlessness at night; there may be torpor or irritation of the bowels; or the patient may consider his only ailment to be the chancre, the irritation of which may be found to arise from too active exertion. To whichever cause it may be ascribed, the treatment should be directed. In conjunction with local remedies, which may be varied, alteratives may be given—five grains of the blue pill twice a day; for instance, the Plummer’s pill in doses of five grains every night, the occasional application of an active aperient (see Forms 33, 34), the decoction of sarsaparilla (see Forms 49, 50, 51). This plan, carefully pursued, seldom fails in setting up a permanent cure. The patient should be apprized of the vast importance of quiet, rest, and abstemiousness; for, where they can be attended to, the duration of the disease will be diminished one half; whereas, he who is continually in the erect posture, and subject to much walking about, who is indifferent to his diet, and lives as free as formerly, incurs the risk of bubo, and all its alarming consequences. Now, in no case or description of chancre, do these remarks apply so aptly as to the phagedenic and sloughing ulcer; in fact, they are applicable to all, but more particularly the two latter, as they are the result of already increased action. Mercury, violent aperients, and other