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

  • William Walsham
Date:
1890
Catalogue details

Licence: Public Domain Mark

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

    74/902 page 58
    and the epitlielium take on increased growth, and be thrown off in the form of scales, the eruption being then known as a scahj syphilido or jjsoriasis. Should further infiltration occur, a papular syphilido, or licltni, may be loroduced; or if the process is more acute, serum may be exuded, and raise the cuticle in the fonn of small vesicles, or even of large blebs, conditions which are spoken of as vesicular syphilides or rczc/na, and huJImis S3q3hilides ov paniiltlrjus respectively. Both, however, are rare, and the latter seldom occurs, except in congenital sjqjhilis. Again, in situations where the parts are moist, as about the mouth, anus, and scrotal folds, the papillt* become succulent and the epithelium sodden, forming cundijlomata. Where such occur between the toes, ulcera- tion maj^ ensue [rhagadcs); but this condition is not common, except as the result of uncleanliness. ( 'mnhi- lomata appear as low, soft, flattened, sessile elevations of a whitish colour, with a smooth sm-face, covered by a moist secretion, and often of considerable size. They are intensely contagious, and when occui-ring where two .skin surfaces are in contact, as about the amis and Labia, are usually symmetricallj' placed on either side. Still later, especially where the patient is debilitated, the vesicles may be converted into pustules {puduhir sifph iliih ) hy the escape into them of wandering leucocytes; while the pustules again may dry into scabs, which fall off. leaving no scar beneath {si/j^hilitic vrtln/iiKi); or if the patient is cachectic, or his constitution broken down, nlccration may ensue beneath the scabs {riqn'a). The appearance presented hy rupia is peculiar. As the ulceration ])ro- ceeds in depth and extent, larger and larger scabs arc successively formed beneath those above, which are thus p^Lshed forward, giving the mass the appcnranci^ of a limpet-shell. Each rupial spot is surrounded by a dusky- red areola, and on the separation of the scab, a foul circular ulcer is left, which, on healing, leaves a ])ev- miinent .scar, llupia, by some is regarded a_s an early tertiary, by others as a'late secondary. alVecfion. Wilh the exception of ruiiia the eruptions in syiihilis resemble those du(! to non-sv])hilitic causes. They are. however, all modilied by tlieir copjiery or raw-ham colour, by nioro or less surrounding pigme'ntalion. by their .symmetrical arrangement, by the circular or crescentic .^hajie of the l)atclies. by Mk^ absence of itching, by the aliscMice of the large silveiy scales seen in ordinary jisoriasis. by their
    digitised image 1
    digitised image 2
    digitised image 3