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.

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    infiltration of the sldn and mucous membrane {tiihcrcular syphilich's) terminating in serpiginous ulceration ; [i, gum- matous swellings in the subcutaneous and submucous tissue which may break down, forming deep _ ulcers the cicatrization of which causes severe contractions, as for instance those seen in stricture of the pharynx, glottis, and rectum; -i, girmmata in the muscles; 5, gummata, in the tongue, producing scarring and ulcers a]3t to terminate in epithehoma; 6, affections of the nervous system leading to paralysis ; 7, affections of the arteries leading to embo- lism or anem-ism ; and 8, gummata, followed by contrac- tion and fibroid changes, in the liver and other viscera, producing jaundice, cirrhosis, phthisis, &c. The various tertiary lesicTns will be further described under diseases of the special tissues and organs; for those affecting the lungs, liver, kidneys, and nervous system, a work on medicine must be consulted. Here it must suffice to say that the tertiary lesions are usually asymmetrical; that they are not, as a rule, contagious ; that they are chronic in their coui'se; and that they often prove fatal by affecting important organs, as the lungs or brain, or by causing constriction of a passage, as the larynx or rectum. 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 irritation. Some, however, still ad- vocate its destruction by caustics or complete excision, and further recommend removal at the same time of the nearest indurated glands. The majority of Sm-geons regard such treatment as useless, since they beUeve that the induration of the piimary sore is merely an indication that the disease is already established in the constitution. Moreover, excision has repeatedly failed to prevent the occurrence of secondary symptoms. Covstitntiunalli/, mercury in some form is by the majority of Surgeons thought to be necessary in all cases. It must, however, be given with caution to strumous and tuberculous subjects, and to persons whose constitution is impaired by dissipation, alcohol, or bad living. It should be withheld in chronic Bright's disease ; nor should it be forgotten that some patients exhibit a peculiar idiosyn- crasy, in that they are violently salivated by a grain or two of the drug. Mercury may be given, 1, by tho
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