On syphilis as an imitator : an address delivered before the Lancashire and Cheshire Branch of the British Medical Association / by Jonathan Hutchinson.

  • Jonathan Hutchinson
Date:
1879
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Licence: Public Domain Mark

Credit: On syphilis as an imitator : an address delivered before the Lancashire and Cheshire Branch of the British Medical Association / by Jonathan Hutchinson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    ophthalmoplegia interna is probably an early symptom of progressive disease which ends in locomotor ataxy. A few general remarks may be here introduced as to the features in which syphilitic doubles differ from their prototypes. I have admitted fully respecting several special forms that not unfrequently the simi- larity is such that diagnosis is possible only by aid of the history and concomitants. This, however, is very exceptional, and, as a rule, minor features of difference are there, and may be made out by careful observation. It may be remarked, in the first place, that the syphilitic forms are seldom quite regular in their course; they are often more rapid in development than their parallels, and often we see mixed up the symptoms of several different forms of disease at the same time. Thus, we may find progressive muscular paralysis with the special sym- ptoms of locomotor ataxy, and what should have been a pure retinitis pigmentosa may be complicated by disseminate choroiditis. In syphilis, the proclivity of all tissues to suffer favours these irregularities of deve- lopment. The polymorphism of the secondary eruption of syphilis has long been well recognised. Next it may be asserted that a serpiginous tendency or habit is almost constantly more marked in syphilitic inflam- mations than in others. This is seen alike in the skin and in the con- nective tissue of the nerve-centres. If the disease be due to syphilis, it will, unless arrested by treatment, tend to spread faster and further than other forms. In the case of external parts, too, the liability to ulcerate, to suppurate, and to become phagedcenic must be noted as special fea- tures of syphilitic inflammation, and to these we may add the liability to produce scars and to leave pigment-stains. Whenever the evolution of a disease is irregular, and the use of definite nomenclature thus ren- dered difficult, we may suspect that the malady is syphilitic. It is time, Mr. President, that I should bring these remarks to a close. In doing so, I can only express the hope that they may have been at any rate suggestive. I have not aimed at proving anything, but have rather endeavoured to give hints as to the way in which I think we ought to work. If the conception of the state of the body left after an attack of syphilis, which I have tried to present to you, be the correct one, it amounts, I think, pretty nearly to this: that every specialised structure, every tissue, every individual cell, is left with increased and peculiar liabilities to disease. No one can tell where the morbid action will show itself, and we must expect it everywhere. Its special locality and form are probably determined by previously existing proclivities. The symptoms produced and the name which will be given to the disorder
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