The surgical treatment of the diseases of infancy and childhood / by T. Holmes.

  • Timothy Holmes
Date:
1868
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Licence: Public Domain Mark

Credit: The surgical treatment of the diseases of infancy and childhood / by T. Holmes. Source: Wellcome Collection.

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    cornea, but never with iritis; * large abscesses around the bones, but not nodes or chronic ulceration; sloughing of the soft palate, but not the excavating ulceration of the tonsils, or the caries of the hard palate so common in mature life. Finally, certain lesions or degenerations of the principal vis- cera have been pointed out as peculiar to congenital syphilis; but I cannot say that the evidence on this subject appears to me very conclusive; at any rate these lesions are of little moment in practice, inasmuch as no means exist of recog- nising them before death. The period at which the symptoms make their appearance Period of is a point of much importance in the prognosis of the disease. ppearance- Congenital syphilis is a very frequent cause of the death of the foetus, and consequent miscarriage of the mother; that is to say, the foetus is affected at an early period of conception. In other instances the foetus is born alive, but with the cha- racteristic snuffling and eruption; here the infection has not been matured till a late period of foetal life. In the majority of cases, however, which become the subjects of treatment, the infant is perfectly healthy, to all appearance, at birth; and the disease first shows itself after an interval, which is commonly about six weeks. As a general rule, the period of the appearance of the disease varies with its intensity; and this, again, varies with the length of time which has elapsed since the first infection of the parent, and depends also on the fact of one or both parents being diseased. Besides the above congenital or hereditary disease, infants (as Inoculated stated above) may be affected with syphilis, as adults also may, by y^^jj8- various methods of contact and of inoculation. That primary syphilis syphilis, is communicated by actual contact to any part of the body where an abrasion exists, or even (as it seems) where the cuticle is very delicate without abrasion, is a fact of as much importance in the infant as the adult; and it has been conceded above that possibly syphilis may in some rare cases be so communicated in the act of parturition; and it may also be accidentally inoculated in infancy, as at any period in life, if the patient is brought into direct contact with another affected * SirW. Lawrence, however, speaks in his Lectures on Surgery, 1863, of iritis as a common symptom in infantile syphilis. Having had numerous opportu- nities of seeing the complaint among the out-patients of St. George's and the Hospital for Sick Children, I cannot remember ever seeing a genuine case of iritis, nor does it occur in the elaborate enumeration of the symptoms of this disease in Diday's work.
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