Syphilis / by Sir Jonathan Hutchinson.

  • Jonathan Hutchinson
Date:
1909
Catalogue details

Licence: In copyright

Credit: Syphilis / by Sir Jonathan Hutchinson. Source: Wellcome Collection.

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    it began to look a little dusky. On April 17th it was decidedly swollen, and just beginning to ulcerate. On April 23rd it was definitely indurated, and showed in the centre a group of minute ashy-grey ulcers. At this date he had no rash, and no appreciable enlargement of the glands. There being not the slightest doubt that the induration was specific, I now directed him to take mercury. The course of events illustrated in this case is probably a very usual one. A small sore is noticed almost immediately after exposure, which heals in a few days. Then ensues a four weeks’ period of rest, followed by inflammation about the little scar, and specific induration. It will be seen that seven weeks had passed before the induration was marked. (5) In this case a young gentleman was exposed to risk of contagion but once. He caught a gonorrhoea, which developed immediately. Nearly five weeks after the exposure two sores formed on the skin of the penis, and one on that of the abdomen, between the umbilicus and pubes. They all then assumed the condition of large indurated chancres, and severe secondary symptoms followed. (6) A young woman was attended in her confinement by a midwife who had a chancre on her finger. Fifty-three days after delivery she was found to have three indurated chancres on the labia, but no special gland-irritation and no rash. Eleven weeks after the confinement she had a copious rash, and her hair was falling out. In this case it is to be sup- posed that both the chancres and the rash had been present some little time before they were discovered. Incubation periods illustrated in vaccination-syphilis.-—The incubation period in eleven patients who received the virus by vaccination on the same day was remarkably regular. In all the cases the vaccination-sore healed perfectly for a time, and after an interval again inflamed. In all at the end of eight weeks it was characteristically hard. Nearly all the patients had begun to complain of irritability of the scar in the sixth week, and some in the fifth. Two of them, a father and son, began to find that their scars itched on the same day (March 18th), a little more than five weeks after the vac- cination. In all these cases mercury wjis begun in the eighth week, before any eruption had appeared, and the latter was in almost all absolutely prevented. In a second series of vaccination cases, treatment was delayed longer, and we had opportunities for observing the period at which the rash and sore throat made their appearance. In some the rash began to come out in the tenth week, and was fully out when the patient was first seen in the eleventh. The sores at that period in most cases remained characteristically hard. In some of the patients the rash might have been a week or two later in its appearance; and as the assignment of date depended upon the patient’s observation, error to some extent was possible.