An American text-book of surgery : for practitioners and students / By Phineas S. Conner, M.D., Frederic S. Dennis, M.D., William W. Keen, M.D., Charles B. Nancrede, M.D., Roswell Park, M.D., Lewis S. Pilcher, M.D., Nicholas Senn, M.D., Francis J. Shepherd, M.D., Lewis A. Stimson, M.D., J. Collins Warren, M.D., and J. William White, M.D. Ed. by William W. Keen and J. William White.
- William Williams Keen
- Date:
- 1899
Licence: Public Domain Mark
Credit: An American text-book of surgery : for practitioners and students / By Phineas S. Conner, M.D., Frederic S. Dennis, M.D., William W. Keen, M.D., Charles B. Nancrede, M.D., Roswell Park, M.D., Lewis S. Pilcher, M.D., Nicholas Senn, M.D., Francis J. Shepherd, M.D., Lewis A. Stimson, M.D., J. Collins Warren, M.D., and J. William White, M.D. Ed. by William W. Keen and J. William White. 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.
![ISO AN AMEJUCAX TKXT-nnOh' OF SI'RC.'KJn'. c. There remains for consideration the influence upon the child of a syph- ilis acquired by tlie mother during some period of utcro-frestation. That under these circumstances the child can become infected has been and is still abso- lutely denied by some very respectable authorities. All that is necessary for proof of its occurrence is, however, (1) freedom of both parents from syj)hilis at the time of conception, or, in other ■words, syphilis must have been acc^uired by both—not alone by the mother—after the beginning of pregnancy; (2) that the syphilis of the child be unmistakably prenatal—that is, not acquired by some accident during or after birth. Several cases reported by acute observers seem to combine both these requisites, and, after reading them carefully, there seems to be no reasonable escape from the conclusion that in some manner the poison of syphilis may find its way from the mother to the child. The old idea that the latter was directly infected in utero from the semen of the father is, of course, altogether without foundation. 3. Direct infection of the child during birth does not properly come under the head of Hereditary Syphilis. There is no possible reason why, when the mother has contagious lesions of the genitals, acquired too late to infect the child in utero, this shoukl not occur, but as a matter of fact no such case has ever been recorded. One explanation of this circumstance may be found in the protective covering of vernix and mucus Avhich coats the infant's body and lessens greatly the risk of absorption. This hardly accounts satisfactorily, however, for the entire absence of such cases from medical literature, and it is fair to suppose that in all except those cases in which the primary sore is ac- quired during the last month of gestation—Avhich for obvious reasons are ex- cessively rare—the infant acquires some immunity which protects it from its mother, and is similar to that which, under Colles's law, operates in her favor. In other Avords, even though apparently free from syphilis at birth—a not un- common event, as we shall see—it has a latent or modified syphilis which pro- tects it from contagion. (Profeta's law, see p. 140.) We may now briefly restate the conclusions at which we have arrived: 1. After a certain interval, not less than four years, and after thorough specific treatment, a person Avho has contracted a syphilis not especially severe or malignant in its type may be permitted to marry. The assent to marriage will then be based on a belief in the curability of syphilis or in a cessation of its contagiousness, its inoculability, and, in the vast majority of cases, its transmissive power, at the end of the secondary stage. 2. It may be inherited from either parent or from both, and the ])robability that this will occur increases in a direct ratio with the nearness of the time of conception to the date of their infection with the disease. The severity of the inherited disease in the child increases in the same proportion. 3. It is undoubted that, tlie father being healthy and the mother syphilitic, the child may, and in all probability will, have the disease. 4. It is probable, but less so than in the preceding case, that, the mother being healthy and the father syphilitic, the child will be infected. 5. It is highly probable that in all cases where a child becomes syphilitic through paternal influence the mother is also the subject of syphilis, which may, however, assume a latent form, the only evidence of its presence in a few cases being the protection which it affords against contagion through the medium of the child. 6. Syphilis may be transmitted from mother to child even when it is ac- quired by the former as late as the seventh month of utero-gestation. III. The Pathology and Symptoms of Hereditary Syphilis.— Syphilis of tlie placenta is of especial interest in its relation to the abortions](https://iiif.wellcomecollection.org/image/b21217014_0216.jp2/full/800%2C/0/default.jpg)
