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.

    80/902 page 64
    lowed by a r.asli on coi'taiii parts of tho Lnclj', and muooTis tubercles and superficial ulcerations about the mouth and anus. The catarrh may simulate merely a cold in tlio head, or be attended with a muco-purulent discliar^re, and cause obsti'uction to I'cspiration and difficulty in sucking. The eruption, like that of the secondaiy .stages of acquired syjihilis, is symmetrical, and of the same peculiar coppery or raw-ham colom-. It is most common about the nates and genitals, where it is usually erythe- matous in character, and on the pahns of the hands and soles of the feet, where it is commonly squamous. But it may be paj^ular and at times bullous, or pustular. A well-marked mucous tubercle or condyloma about the anus is pathognomonic of the disease. These symptoms are freqiiently, though not invariably, accompanied by marasmus and wa.sting, the child looks shrivelled and old, the .skin earthy and dry, whilst the hair may fall off, and the nails, iris, periosteum, and bones may be affected as in the acquired form. At this i^eriod death is far from uncommon. Usually, however, and especially under a mercurial coiu'se, the symptoms gradually subside, and by the end of the first year disappear altogether and no further manifestation of the disease may occur through- out life. But frequently after several years of immiuiity certain tertiarj^ afiections show themselves, the chief of those being interstitial keratitis, periostitis, and osteitis, followed by necrosis, disease of the ear often ending in total deafness, ulceration about the palate, chronic syno- vitis of one or more of the joints, and the fonnation of gummata in the-^-iscera, testicle, i?cc. Along A^•ith these, certain important diagnostic sjnnptoms, tho result of the former secondary lesions, may be present, viz., 1. a de- pressed and widened condition of th(> bridge of the noso, duo to the influence of the nasal catarrh upon the de- velopment of tho nasal bones and .se])fuin : 2. radiating scars about tho angle of the mouth, the result of iho cicatrization of the former ulcers (///'^(■////(^(o/'.s-/?»f.'i); ;5, a pecubar conformation of the .skull, the result of tlic ])revious bone-lesion, consisting chic^lly in a furrow above tho eyebrows, a S([uar(^ forehead, and prominent frontal eiiiinencos; and 1, a cliaracteristic a])iiearanee of the permiinont central incisor teeth, con.se(iuent u]ion Iho action of the stomatitis u])on Iheiii whili^ yet soft and uncut. The distinctive sign of syphilis in those teeth is a sllLfht crescentic netrh in the biting edge (1''ig. .)).
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