Syphilis / by Sir Jonathan Hutchinson.

Jonathan Hutchinson

Date:: 1909

Catalogue details

Licence: In copyright

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

75/718 (page 45)

tion, and the cause of death was certified as “ Vaccinal syphilis. Marasmus.” The following schedule displays the principal details of the case :— DATE WEEK DETAILS June 25 ... — Born in a workhouse. Vaccinated from calf- lymph on the sixth day (July 1). A puny child. July 2 ... First week The vaccination at first appeared to be doing well. Entered as “ successful.” J uly 9 ... Second week Left workhouse on 11th, the pocks being then inflamed. On thirteenth day the vesicles had coalesced, and there was gangrenous ulceration commencing. July 16 ... Third week A “ rose rash ” appeared on face, neck, and arm (mother’s statement). On 22nd taken to Hospital. July 23 ... Fourth Mercury given. Increasing emaciation. week Tripartite ulcer on arm, with hard edges and sloughing centre. Rash on head, neck, and arms, and to less extent on other parts. July 31 ... Fifth week Induration much less, and sore closing and looking more healthy. Child very feeble. August 18 Sixth week Sore healing. Death. No lesions whatever found at autopsy. It was chiefly the presence of a “ rose rash,” which persisted some days and became more or less macular and scaly, that led to the diagnosis of syphilis. This rash had, however, made its appearance in the third week after vaccination, and it is therefore impossible that it should have been specific. The induration of the base of the ulcer was also another feature which seemed to support the diagnosis. This induration was, however, well marked at the end of three weeks from the vaccination, and it involved all the pocks. It was probably only the brawny hardening which often attends inflammation with sloughing. The infant was one of twins. Both were vaccinated, but the boy, in whom the vaccination had shown nothing abnormal, died (“ wasted away ”) four weeks later.