Memorandum on inherited and acquired syphilis / by C. Macnamara and Thomas Barlow.

  • Nottidge Charles Macnamara
Date:
[1882]
Catalogue details

Licence: Public Domain Mark

Credit: Memorandum on inherited and acquired syphilis / by C. Macnamara and Thomas Barlow. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    MEMORANDUM ON INHERITED AND ACQUIRED By C. MACNAMARA, F.R.C.S., and THOMAS BARLOW, M.D. (ON BEHALF OF THE COLLECTIVE INVESTIGATION COMMITTEE). The present inquiry (suggested by the valuable investigations of Mr. C. Palmer, of Great Yarmouth), is concerned with the effects of syphilis on the civil population of this country. An answer to the fundamental -question of the extent of prevalence of the disease in different parts of the United Kingdom is, for many reasons, a very difficult thing to arrive at except in general terms. The Com- mittee, in preparing a list of questions, have asked, as the final one, for an opinion as to the relative frequency of the disease in any given district; but they are aware that the answers to this question must necessarily be vague and difficult to summarise statistically. They believe that, if a number of practitioners in different parts of the coun- try will take the pains to fill up a few details of all the cases of syphilis in their respective circles of practice, a definite start will be made, and that in this way, at all events, the relative prevalence of the disease in different parts will not be over-estimated. Mr. Palmer has truly pointed out that a very large amount of acquired syphilis escapes observation and proper medical treatment in the early stage, and that a careful investigation of cases of Hereditary Syphilis gives evi- dence of a much larger amount of the acquired disease than would otherwise have been suspected. The Committee, therefore, attach great importance to the form No. Va, which refers to inherited syphilis; and upon this, in the first place, a few explanatory observations are offered. In this, as in all the other forms issued, the replies are as far as possible to be made by allowing those words to remain which denote the symptoms present in any given case, and crossing out the words which denote symptoms not present in that case. But more space is left for the observer to fill in explanatory detail than has been allowed in the other form.s already issued. The syphilitic children who will be available for the purpose of in- vestigation will be either (A) infants first noted when about six weeks of age, and subsequently kept several months—two years, if possible, under observation ; or (B) children who have cut the permanent upper median incisors. The form No. Va can be used for either of these. As to the infant of six weeks old, there can be little diffi- culty in recognising the disease when the signs are definite ; but it is certain that many children, marasmic from bad feeding and neglect, are labelled syphilitic, in whom the proof of syphilis is wanting. With respect to general nutrition, it has been pointed out that oc- casionally syphilitic infants, so far from being like little old men,' may be very well nourished indeed. The term earthy colour, which is used in the form, refers, not to the colour of the rash, but to the complexion ; it is often most noteworthy after the rash has disappeared, and may, indeed, continue for several months. The symptom of hoarseness is quite as important as that of snuffies, as in syphilitic children it often alters the character of the cry for a long period. With regard to eruptions, a minute description of their character is not needed, but a note as to their situation is of some SYPHILIS.
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