Quotation from: Manual of Surgery

Written by: Alexander Miles and Alexis Thomson


_Diagnosis of Primary Syphilis._--In cases in which there is a history
of an incubation period of from three to five weeks, when the sore is
indurated, persistent, and indolent, and attended with bullet-buboes in
the groin, the diagnosis of primary syphilis is not difficult. Owing,
however, to the great importance of instituting treatment at the
earliest possible stage of the infection, an effort should be made to
establish the diagnosis without delay by demonstrating the spirochaete.
Before any antiseptic is applied, the margin of the suspected sore is
rubbed with gauze, and the serum that exudes on pressure is collected
in a capillary tube and sent to a pathologist for microscopical
examination. A better specimen can sometimes be obtained by puncturing
an enlarged lymph gland with a hypodermic needle, injecting a few minims
of sterile saline solution and then aspirating the blood-stained fluid.

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