The primary lesion of syphilis / by Arthur H. Ward.

  • Ward, Arthur H.
Date:
1896
Catalogue details

Licence: Public Domain Mark

Credit: The primary lesion of syphilis / by Arthur H. Ward. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    1/6
    IM WK Reprinted ioi ^ 'thop^from^lie BniTiSli IJedical Journal, October 04th, 189K • - f r ^ V \ THE PRIJK^/^^ESION OF SYPIIILTS. SECTION OF SURGERY. At the Annual Meeting of the British Medical Association in Carlisle, July, 1896. By Arthur H. Ward, F.R.C.S.Eng., Surgeon to Out-patients, London Lock Hospital. It is generally admitted that syphilis is the result of a microbic infection—indeed, no other explanation of the phenomena can be suggested. By the very reasonable assumption that the microbe of syphilis forms a toxin which is the actual cause of lesions I have endeavoured to show that all the varying phenomena of the disease can be explained. I would refer anyone who is interested in the matter to my articles on the Toxin Theory of Syphilis in the Lancet for May last. These articles have received no unfavourable criticisms, so I conclude that the profession has found itself substantially in agreement with the views I have put forward. There is still, unfortunately, some difliculty in the bacteri- ological demonstration of the microbe. Lustgarten has described a slender bacillus, and Golasz a bacillus resembling the tubercle bacillus and associated with spores. This microbe he cultivated in an aqueous solution of nuclein obtained from the human spleen. I am unable, however, to show you microphotographs on a screen or hand round toxin in a test tube, and, even if I could get as far as this, the actual proof that the microbe was the cause of syphilis could hardV be completed, since animals uniformly resist the infection, while experimental inoculations with such a microbe on human beings however willing would in my view be totally unjustifiable. The toxin theory of syphilis may be stated thus: 1. Syphilis is associated with the growth of a microbe in the organism. 2. This microbe produces a toxin which is the active cause of the phenomena of syphilis. The toxin must be supposed to share the properties of other microbial toxins; for instance, to be diffusible and subject to the laws of osmosis; to be irritating to the tissues and able to cause the phenomena of infiammation; and to be strongly chemotaxic, attracting leucocytes into the area from which it is diffusing. On this hypothesis the primary lesion of syphilis will be the result of a colony of microbes implanted and growing in the tissues. Since the original point of infection is generally minute, and often escapes detection, only a few microbes can be supposed to be inoculated in the first instance. These, there seems no reason to doubt, will start growing and form- ing toxin at once, but the amount of toxin will be so minute