A treatise on venereal diseases / by A. Vidal (de Cassis) ; translated, with annotations, by George C. Blackman.
- Auguste Vidal de Cassis
- Date:
- 1874
Licence: Public Domain Mark
Credit: A treatise on venereal diseases / by A. Vidal (de Cassis) ; translated, with annotations, by George C. Blackman. Source: Wellcome Collection.
Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.
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![this cause, it generally affects but one eye. Exostosis of tlie orb- ital cavity, may produce other ocular paralysis and exophthalmia. [In the 28th vol. of the Lond. Med. Gazette^ p. 45, is a brief no- tice of a case of strabismus produced by pressure from syphilitic lesions in the orbital cavity. The patient was cured by the bi- chloride of mercury.—^Gr. C. B.] Spinal exostosis is, in my opinion, more common than that of the cranium, but it most frequently remains undetected. I have al- ready mentioned my division of exostosis into internal and external exostosis : now, it is particularly in the former cases that the diag- nosis may be obscure, especially if, as I have remarked, we neglect to make ourselves acquainted with the previous history of the case. Thus, we may observe alterations of sensibility and of mo- tion without any apparent exostosis, nothing on the cranium indi- cating the osseous lesion, for it may involve only the internal table of the bone. There are properly no external exostosis on the spine, for the osseous trunk being in part concealed by tlie chest, abdomen, anterior organs of the body, and in part covered by muscular masses, frequently we may be unaware of their exist- ence until they have produced their most disastrous consequences. And 3^et, even then, if unacquainted with the antecedent circum- stances of the case, we may remain inactive, when had we properly inquired into the previous history of the case, we might have rendered essential service to the patient. In the great majority of cases, the syphilitic eruptions may direct us in our inqunies. Thus we may find one of these eruptions or some traces of their previous existence, but it may so happen that the exostosis shall precede the eruption. Then, should they afterwards appear, it will shed much light on the nature of the case. M. Debout has recently {June 1852) read to tbe Surgical Society of Paris an in- teresting essay on muscular paralysis. One of the cases reported, is that of the paralysis of a part of the superior extremity, the di- agnosis of which had been attended with difficulty. M. Nelaton, who treated the patient, suspected the existence of an exostosis of the spine. It is stated, in the essay of M. Debout, that M. Nelaton was confirmed in his suspicions by the appearance of roseola on the skin. Here then the exostosis preceded the roseola, a second- ary accident generally quickly developed following a tertiary ac- cident ! This fact greatly compromises the harmony of the syph- ilitic triad; but the case was observed by one skilled in the climque, and was fully reported in a serious essay which I heard read. I am about to relate the particulars of a case of paralysis of tke inferior extremities which I considered the result of an affection of the bones of the spine, of an exostosis. I came to this conclu- sion by investigating the previous history of the case, and by a careful examination of the marks upon the skin, showing the an- terior existence of a syphilitic eruption of various degrees of depth. This case is remarkable not only in a practical, but is of great im- portance regarded in a doctrinal point of view. In fact, I inocu- lated the patient by means of a blister with the pus from a mucous tubercle, and I produced a specific ulceration, followed by a tu-](https://iiif.wellcomecollection.org/image/b21082340_0447.jp2/full/800%2C/0/default.jpg)
