Surgery : its theory and practice / by William Johnson Walsham.

  • William Walsham
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: Surgery : its theory and practice / by William Johnson Walsham. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    65/772 page 53
    TREATMEXT OE SYPHILIS. in eijitlielioma ; 6, affections of tlie nervous system leading to paralysis ; 7, affections of the arteries leading to embo- lism or anenrism : and 8, gummata, followed by contrac- tion and fibroid changes, in the liver and other viscera, producing jaimdice, cin-hosis, i^hthisis, &c. The various tertiary lesions will be further described under diseases of the special tissues and organs; for those affecting the lungs, liver, kidnej's, and nervous system a work on mecUcine must be consulted. Here it must suffice to say that the tertiary lesions are usually asymmetrical; that they are not contagions, though locally infective; that they are chronic in their course ; and that thej' often prove fatal by affecting important organs, as the lungs or brain, or bj'causing constriction of apassage,as thelarynxorrectum. The treatment of syphilis necessarily varies according to the constitutional condition of the patient and the stage of the disease. The primary sore requires no other local treatment than the application of iodoform or black-wash and protection from iixitation. Some, however, still advocate its destruction by caustics or complete excision, and further recommend removal at the same time of the nearest indurated glands. The majority of Surgeons regard such treatment as useless, since they believe that the indu- ration of the inimary soi'o is merely an indication that the disease is already established in the constitution. More- over, excision has repeatedly failed to pre vent the occurrence •of secondary symptoms. C'onstifuiionalli/, mercury in some form is by the majority of Surgeons thought to be necessary in all cases. It must, however, bo given with caution to strumous and tuberculosis subjects, and to persons whose constitution isimpairedbydissi])a ti()n, alcohol, or bad living. It should 1)0 with] lold in chronic li right's di soase ; nor should it be forgotten that some patients exhibit a ]ieculiar idio- sjmcracy, in that they M,re violently salivated by a grain or two of the drug. Mercury may be given in various ways, 'by the mouth, inunction, fumigation, or hj subcutaneous injection. It is, as a rule, porha,ps best given by the ■mouth, either in the form of a pill or mixture. As a pill, the green iodide in doses of \ a grain to 1 grain, com- bined -with i to of a, grain of ojiium to prevent purging, may bo given two or throe tinros a day; or tho mercTiry and chalk powder in doses of fronr 3 to o grains, or calomel or l)hin-]iill may bo sidistitutcul f(n- it. As a mixture, the -iiorchlorido in doses of -I; to of a grain, 'combined with ;iiiuiionia, is very useruL Tlio green iodide
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