Syphilis in obstetrics / by William J. Gow.

  • Gow, William J.
Date:
1908
Catalogue details

Licence: In copyright

Credit: Syphilis in obstetrics / by William J. Gow. Source: Wellcome Collection.

    15/134 page 373
    fashion between the connective and muscular fibres. Still more abundant were they in the villi Ipng in the mucoid tissue or in contact with the capillary walls. Some few were found in the decidual tissue which had penetrated the placenta, but none were found in the decidua basalis. Nattan and Tarnier have been able to demonstrate spirochaetes in the protoplasm of some of the large superficial cells of the decidua. According to these authors the spirochaetes reach the decidua through the medium of the foetus. The Foetus. Syphilis may prove destructive to the foetus in the early months of pregnancy, but at this time no very character- . istic lesions are found. In the later months of pregnancy, how- ever, when foetal death is common, very definite and very charac- teristic lesions may be often found in the foetus. As with the placenta, so with the foetus, syphilis may leave no mark upon it, although it may destroy its life either before or shortly after its birth. The Liver. Hepatic lesions are relatively frequent. The liver becomes enlarged with a smooth surface and a rounded margin. In some cases, although this is rare, the liver and spleen become so enlarged as to cause distension of the abdomen. In consistence the liver is firm and elastic and feels like rubber. The surface of the liver shows numerous white dots which have been likened to grains of semolina. On section the surface has a yellowish-white appearance which may be universal or, on the other hand, limited only to certain parts, and more of the semolina-like bodies are often to be seen. To this form of liver the name ‘ flint liver ’, or ‘ flint liver with semolina grains ’, has been given by French I writers. It is from the black and flint-like colour of the surface of the cut section, and not from the hardness, that the name is derived. Under the microscope there is a remarkable similarity in all syphilitic lesions. Periarteritis and a round-celled infiltration produce in the foetal liver a condition of general hypertrophic cirrhosis, sometimes with perihepatitis. The walls of the portal vein and hepatic artery may exhibit a similar thickening. Blood- vessels and bile-ducts alike may thus become compressed. Spiro- chaetes have been found, especially in the perivascular tissue
    digitised image 1
    digitised image 2
    digitised image 3