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CASE FOR DIAGNOSIS. Presented by Dr. Fernandez de la Portilla.
Nine months ago this boy had a hard chancre, which left a typical scar in the internal side of the foreskin. He had been given a complete course of silver arsphenamin, two courses of mercuric benzoate and one and one-half courses of neo-arsphenamin; one month after the last course of treatment, a lesion appeared on the penis next to the site of the first chancre; in the lesion Dr. Arcaute found spirochetes. Clinically the sore presented specific features, but it is doubtful whether it was a chancre or an ulcerative syphilid. The patient had not had sexual intercourse since acquiring syphilis; therefore the second infection must have been caused by spirochetes, which had become saprophytes and which had remained near the site of the first infection. They had evidently increased virulence and had caused a new chancre to develop. This