The old school of medicine distinguished four separate diseases which are now combined into the picture of venereal lymphogranuloma: 1. The so-called strumous or scrofulous bubo, known especially to the European venereologists and related particularly to tuberculosis or chancroid. 2. The so-called climatic bubo, known to tropical and naval physicians and associated by most of them to theclimate of the tropical countries. These physicians did not know the existence of the strumous bubo, and the venereologists in turn were not aware of the climatic bubo. 3. The so-called esthiomene, a kind of chronic ulcer and elephantiasis of the vulva related by most of the earlier venereologists and gynecologists to cancer, tuberculosis or syphilis. 4. The so-called inflammatory rectal stricture related by surgeons to gonorrhea, syphilis or other diseases. Esthiomene and rectal stricture frequently appeared in the same patients, but the gynecologists usually noticed only the esthiomene and the surgeons only
FREI W. VENEREAL LYMPHOGRANULOMA. JAMA. 1938;110(20):1653–1656. doi:10.1001/jama.1938.02790200021007
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