Syphilis : with reference to hereditament, diagnosis and prevalence / by H.B. Allen, M.D.

  • Allen, H. B., M.D.
Date:
[1904?]
Catalogue details

Licence: In copyright

Credit: Syphilis : with reference to hereditament, diagnosis and prevalence / by H.B. Allen, M.D. Source: Wellcome Collection.

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    partly perivascular and peribronchial, but partly diffuse. The consolidation is slight and general, never complete, never intense. Any patches of bronchopneumonia present are not specific, but due to bacterial complication. The heart shows ventricular dilatation, which may be strongly marked, and which is usually accompanied by more or less hypertrophy (U.M. 2360, 2358). The valves may be somewhat milky in colour and slightly oedematous, but show no grosser lesions. I do not attach much importance to slight changes in the translucency of the valves, nor to early appearance of opaque patches in the anterior curtain of the mitral valve resem¬ bling atheroma. Myocarditis with fibrosis is very rare. The small arterioles throughout the body show thickening of the coats and activity of the endothelium, endarteritis being sometimes strongly marked when the organs seem fairly healthy (Pavloff). In. infants the larger arteries are not notably affected./ It is not until about the age of ten or fifteen that precocious atheroma in the aorta, often in delicate linear patterns, furnishes! a new sign of the evolution of syphilis. The changes may be summed up as a fine fibrosis of liver,, kidneys, spleen and lungs, accompanied or possibly preceded by thickening of the coats of the small arteries with marked activity of the endothelium. These phenomena bear a strong resemblance to those seen in adults with arteriocapillary fibrosis and fine cirrhosis of the liver and kidney, and must be accom¬ panied with serious autointoxication, due partly to loss of internal secretions, partly to checking of external secretions, partly to general metabolic disorder, and amounting to a condition of instability varying greatly in degree, but comparable with that; of latent uraemia. The severe forms of such disease soon prove fatal, either directly, or by exposing the child without defence to bacterial infection or shock of any kind. But the milder forms persist; through childhood, perhaps with little change, perhaps with gradual evolution and increasing intensity. Thus the liver may become more and more firm, perhaps much enlarged (U.M. 23691 cdiitc 11), perhaps with little alteration in size. The kidneys may become more decidedly fibroid (U.M. 2355 • cctatc 6). The slight fibrosis of the lungs may progress till the whole