The fitness of the germ of syphilis for
long-continued life in the body, and the difficulty of marshaling a
sufficient defense against it, is what makes it impossible to cure the
disease by any short and easy method.

+The First Sore or Chancre.+--The primary lesion, first sore or
chancre,[6] is the earliest sign of reaction which the body makes to the
presence of the growing germs of syphilis. This always develops at the
point where the germs entered the body. The incubation period ends with
the appearance of a small hard knot or lump under the skin, which may
remain relatively insignificant in some cases and in others grow to a
considerable size. Primary lesions show the greatest variety in their
appearance and degree of development. If the base of the knot widens and
flattens so that it feels and looks like a button under the skin, and
the top rubs off, leaving an exposed raw surface, we may have the
typical hard chancre, easily recognized by the experienced physician,
and perhaps even by the layman as well. On the other hand, no such
typical lesion may develop. The chancre may be small and hidden in some
out-of-the-way fold or cleft, and because it is apt to be painless,
escape recognition entirely. In women the opportunity for concealment of
a primary sore itself is especially good, since it may occur inside the
vagina or on the neck of the womb. In men it may even occur inside the
canal through which the urine passes (urethra). The name "sore" is
deceptive and often misleads laymen, since there may be no actual
sore--merely a pinhead-sized pimple, a hard place, or a slight chafe.
The development of a syphilitic infection can also be completely
concealed by the occurrence of some other infection in the same place at
the same time, as in the case of a mixed infection with syphilis and
soft ulcers or chancroids. Even a cold-sore on the mouth or genitals may
become the seat of a syphilitic infection which will be misunderstood or
escape notice.

[6] Pronounced shan'-ker.

+Syphilis and Gonorrhea may Coexist.+--It is a not uncommon thing for
gonorrhea in men to hide the development of a chancre at the same time
or later. In fact, it was in an experimental inoculation from such a
case that the great John Hunter acquired the syphilis which cost him his
life, and which led him to declare that because he had inoculated
himself with pus from a gonorrhea and developed syphilis, the two
diseases were identical. Just ho