Selected essays and monographs : translations and reprints from various sources.

Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: Selected essays and monographs : translations and reprints from various sources. Source: Wellcome Collection.

    331/476 (page 295)
    If, on the other hand, the crust be allowed to remain from the first appearance of the tubercle up to the time of its absorption, it will be larger, because its development takes place from the periphery, and it eventually assumes the form of a rupial crust of conical shape ; but even then it is not unfrequently depressed in the centre. The crusts have a honey colour and often during the initial period exhibit red spots, which are nothing more than specks of dry blood included in the crust and derived from the papillae which, at this stage, bleed on the slightest provoca- tion. At a later period the papillae of the tubercle acquire a connective tissue . covering, and offer successful resistance to external influences. Framboesia may affect an individual for a long time, and ultimately undergo spontaneous involution. Its course is greatly curtailed by appropriate treatment, and should not exceed a few months. One may speak of the course of framboesia as extending over years, in the sense that whilst one tubeicle heals fresh ones are developed in other situations. Although such occurrences are exceptional it is usually noticed that the various lesions do not progress equally. All parts of the body are liable to the disease, including the hairy scalp, the face, the nose, mouth and back, the skin around the anus, the glccns 'penis, the skin of extremities and joints, of the palms and soles, and that between the toes and fingers. In connection with the tubercles on the hairy scalp we must allude to the relation between the hair and the tubeicles. Throughout the process the hair is firmly fixed upon the tubercle, much more firmly as a rule than in the healthy skin. On traction the hairs come away completely, and their entire root-sheaths are brought away with them. The following observations serve to prove that the hair remains normal throughout the whole process : 1. The hairs are not shed where the tubercle is developed. 2. The hair is more firmly fixed in the tubercle than m the healthy skin, and when the lesion follows an excentnc ser- piginous course, we find in the pigmented aiea the same healthy hairs as were present at the commencement at the process. . . „ Tubercles developed where the hairy scalp joins the lace show no deviation from the normal type. The lesions may