A practical treatise on the diseases of children / by Alfred Vogel ; translated and edited by H. Raphael.

Date:
1886
Catalogue details

Licence: Public Domain Mark

Credit: A practical treatise on the diseases of children / by Alfred Vogel ; translated and edited by H. Raphael. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    do not live long enough for that purpose, but collapse rapidly, and per- ish, without any additional sickness, under weakness and exhaustion. The prognosis, in this bullous exanthema, may be put down as fatal with the utmost certainty. Children who bring the develo]Ded pustules with them into the world die in the first few days after de- livery ; but, when they acquire them a little later, between the third and eighth day of life, they may live for a few weeks, but ultimate- ly die almost unexceptionally. That form of congenital syphilis, which, according to ZeissVs extensive experience, almost entirely manifests itself in the form of pemphigus, is invariably fatal. It is a remarkable fact that syphilis, in the great majority of these cases, descends from the father, and that the most careful examina- tion of the mother leads to no positive results, so that the connection between these exanthemata and syphilis has often been doubted. The doubts have mainly arisen in lying-in-houses, where the affected fathers very naturally could seldom be seen, while, in private practice, the previous and present state of health of the father can readily be ascertained. In the latter case it becomes apparent that the father invariably suffers, or at least had suffered, fi'om secondary syphilis. It has often been observed that, after the father had subjected himself to a thorough antisyphilitic treatment, the children then generated come into the world normal, without any sign of syphilis whatever, and subsequently also remained well. Besides these pathognomonic pemphigus pustules, there is yet a pustular eruption which occurs at a later period in syphilitic chil- dren, but these pustules are situated upon a red, hard base, and, after they burst, leave behind deep lardaceous ulcers (ecthyma pus- tules). The cutaneous ulcers and rhagades, which only break out after birth, are the most characteristic lesions of syphilis; they occur by special preference at the angles of the mouth, on the margins of the lips, and around the anus and genitals. The ulcers on the lips are flat, have a yellow, but slightly-indurated base, and are strictly con- fined at first to the red margin which hems the lip. Not till after some time do they grow beyond their original limits, and involve the adjacent integument, particularly the lower lip, where the epidermis is softened, by the food and sugar-teat. By rhagades^ cracks, fissures of the lips in the direction of the nat- ural cutaneous folds, are understood. Tliey sometimes originate in perfectly-healthy lips, generally, however, the ulcers just described are present, from the crusts of which the lips become brittle, and, when they are much stretched, as they necessarily must be every time the