A lecture on syphilis : delivered at Guy's Hospital, January 11, 1867 / by Samuel Wilks.

  • Samuel Wilks
Date:
1868
Catalogue details

Licence: Public Domain Mark

Credit: A lecture on syphilis : delivered at Guy's Hospital, January 11, 1867 / by Samuel Wilks. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

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    either in a concentrated or circumscribed form, whereby dis- tinct round masses are produced, and which are technically styled gummata; or in a more diffused manner through the organs or tissues, and which may be styled interstitial. The former constitute the alterations which are the more marked or characteristic, although the latter form is equally impor- tant. Ordinary inflammatory changes do not result in dis- tinct deposits of the kind mentioned, whilst they do present, as one of their phenomena, the simple fibroid diffusion. It is probable, therefore, from the latter form of syphilitic change being not so characteristic, it may often be con- founded with other morbid conditions; for instance, a syphi- litic lung, when disorganized, may be simply regarded as a case of phthisis, a syphilitic liver as one of alcoholic cirrhosis, or a syphilitic brain as one. of ordinary tumour or ramollisse- ment. In referring to some of the organs affected I shall not enter into minute details, nor shall I follow any anatomical arrangement, but ask your attention to some of the most striking and more important changes in the body. In considering the syphilitic constitution, the liver must retain its pre-eminence, both as the organ most commonly affected and the one in which an alteration was first dis- covered in connexion with the disease. It may be remarked, too, that hepatic disturbance and jaundice have been noticed in the course of syphilis by many of the more ancient writers; There are three varieties of the syphilitic liver; the first, that in which the whole organ has become infiltrated by a new fibre-tissue, producing a uniform and general hardening ; the second, in which the presence of the new material in the course of the portal vessels has produced a contraction like that of cirrhosis ; and the third and most striking form, where the organ is pervaded by distinct nodules of the new formation. The first variety has mostly been observed in children who have died of hereditary syphilis, the organ being large and intensely hard, all natural structure having disappeared to the naked eye, and the microscope showing the organ pervaded throughout by the adventitious material. The second form is constantly seen in those bodies which are tainted by syphilis, aud is often found associated with the lardaceous degeneration. Inasmuch as the patient may have been intemperate in drink, the change may have been wrongly attributable to alcohol. In many cases, however, judging from the history of the case, and the morbid appearances
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