The surgical diseases of the genito-urinary organs including syphilis / by E.L. Keyes ; a revision of Van Buren and Keyes's text-book upon the same subjects.

  • Keyes, E. L. (Edward Lawrence), 1843-1924.
Date:
1889, ©1888
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Licence: Public Domain Mark

Credit: The surgical diseases of the genito-urinary organs including syphilis / by E.L. Keyes ; a revision of Van Buren and Keyes's text-book upon the same subjects. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    tion for the bacillus of tubercle, and especially by the commencement of the ulcer, which in the case of tubercle always starts superticially without antecedent thickening. Eicord, Portal, Tr^lat, Fer6ol, Good- lee, and others have called attention to tubercular disease of the tongue and noted its special features. The tubercular ulcer of the tongue is very iincommon. I have seen it once on the inside of the check, once on the gum, but never upon the tongue. It is likely to coincide with tubercular disease elsewhere. Treatment of gummy tumors of the tongue is usually rapidly effect- ive if undertaken before they have ulcerated. After the ulcerations have become chronic they are very slow in yielding, but persevering effort will master them unless the patient be irremediably depressed by cachexia, and can uut digest the iodides. Syphilis of the (Esophagus.—Syphilitic ulceration occasionally attacks the oesophagus, either by extension from the pharynx or as a local gummy deposit. West* first called attention to these lesions. Virchow has found cicatrices and stricture of the oesophagus in autop- sies of syphilitic jjatients. Maury,f of Philadelphia, details a case uj)on which he was forced to the performance of gastrotomy. Symptoms of stricture with difficult deglutition usually first call attention to the affection under consideration. The stricture is the result of cicatrization of previous ulceration, and is therefore but little benefited by treatment. Some relief has, however, been noticed in cases which have been diagnosticated. A cure is reported in one case by Follin,J but the treatment is mainly that of stricture of the oesoph- agus by dilatation, etc. Syphilis of the Stomach and lNTESTi]<rE.—Functional derange- ments of the stomach and intestines are common early in secondary syphilis and in the cachectic stage. Loss of appetite is common, early and late in the disease. Excess of appetite, bulimia, is more rare. Fournier describes it fully, and found it often combined with head- ache, nausea, pain, high temperature, great thirst, polydipsia. Some- times the extra amount of food is kindly digested, at others it causes in its turn the customary stomach derangements. Chronic vomiting is another of the functional disorders which has been noted. All these derangements occur in the first half-year after chancre, and get well spontaneously in a time varying from a few days to several months. Antisyphilitic treatment does not appear to benefit them. I have seen one case of well-marked bulimia and one of pronounced polydip- sia in the tertiary stage. Both got well after some weeks during treatment, but, whether because of treatment or independently of it, I can not say. * Dublin Quarterly, February, 1860. t American Journal of Medical Sciences, April, 1870. X Traite 61em. de Path, cxt., tome i, p. 696, 1861.