Synopsis of the final report of the Royal Commission on Venereal Diseases / by Douglas White.

  • White, Douglas
Date:
1916
Catalogue details

Licence: Public Domain Mark

Credit: Synopsis of the final report of the Royal Commission on Venereal Diseases / by Douglas White. Source: Wellcome Collection.

    28/92 page 20
    W. Osler considers that ‘‘ of the killing diseases, syphilis comes third or fourth’’; and a very great number of such deaths escape recognition. The Commissioners are led to the general conclusion “‘ that the number of persons who have been infected with syphilis, acquired or con- genital, cannot fall below 10% of the whole population in the large cities, and the percentage affected with gonorrhoea must greatly exceed this proportion.’’* (See foot-note.) II].—EFFECTS OF VENEREAL DISEASES. §§ 69-107. Syphilis. § 69. The immediate effects of syphilitic infection are slight compared with later developments. The local inflamma- tion at the site of inoculation is seldom painful, nor is the constitution disturbed, till the germs spread into the lymph and blood-stream. When this occurs, every organ and tissue is liable to be the hatching ground of new colonies of germs, the character of which is similar, microscopically, to the primary sore. | § 70. The distinction into primary and later stages is con- venient clinically ; but the process is similar throughout, except that the longer the infection remains the less virulent does it become. The spirochzte is less easily found in the later lesions than in the earlier. From the scientific, as well as the therapeutic viewpoint, the primary stage is the only early stage. Saye? In the primary stage, the spirochaete may be found present even before an obvious papule or chancre occurs. If the papule be eroded, a small ulcer is formed, which then may become septic as well. A few days after its appearance its base becomes hard and ristiy. The primary sore tends to spontaneous cure, but the hard base remains for some weeks. The glands of the groin (in genital cases) become hard and shotty, but painless; if the sore be septic, there may be an abscess in the groin. The usual painlessness of the primary sore is a great source of danger both to the patient and the public, as he is not driven to seek advice. a 72. Chancres, which occur elsewhere than on the genitals, vary in their characteristics, and are hard to diagnose early. They occur most commonly on the lips, the tongue, mouth, and fingers. On the finger, the sore occurs around the nail and simulates a whitlow; indura- tion seldom happens. On the lip and tongue a chancre 1If this conclusion be correct, it implies 450,000 syphilitic persons im London ; and, inasmuch as the mortality figures of S. for the whole Kingdom amount to 6°6 times that of London, it suggests that there must be 3 million syphilitics in the Kingdom. [D. W.]
    digitised image 1
    digitised image 2
    digitised image 3