Histological studies compared with the Wassermann reaction / by Gilbert Lamble.

  • Lamble, Gilbert.
Date:
1911
Catalogue details

Licence: In copyright

Credit: Histological studies compared with the Wassermann reaction / by Gilbert Lamble. 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.

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    But further ligjht is thrown on the problem of the influence of syphilis in bringing about early death by a consideration of the ages and of the immediate cause of death in the lo cases in which there was neither clinical, serological, nor histological evidence of syphilis present. Only 3 of these cases were under 4 years of age, and 4 of them were over 8, while in every case death was due to severe illness such as sarcoma of kidney (i case), acute nephritis (i case), cerebral abscess (2 cases), general peritonitis after opera- tion for gastrostomy (i case), general tubercle (i case), rheumatic endocarditis (2 cases), broncho-pneumonia, with death on the fourteenth day (i case). These histories stand in marked contrast to those of the previous series (i.e., cases dying under one year), in the majority of which death was ascribed to gastro-enteritis, broncho-pneumonia of short duration, rapid generalised tubercle, or mild infective disorders, while a few followed small surgical operations. The Resistance of the Congenital Syphilitic. Not only is syphilis responsible for much infantile mortality, but also it leads to diminished resistance to mild infective diseases, and to many sudden deaths with only slight lesions to be found post mortem. The present series abounds with illustrative examples in which the organs showed the characteristic changes and the Wassermann reaction Avas positive. For instance, one may quote case No. 20* a child 14 days old, with sudden collapse and death three hours after the complete cessation of a small umbilical hsemor- hage, the only lesion found post mortem being a small haemorrhage into the thymus gland; or, again, cases 39, 73, 76, with death in the first twenty-four hours from the onset of a broncho-pneumonia, with only slight lesions post mortem; or, as an example of yet another class, case No. 92, ill seven days with cough, epistaxis, and signs of cardiac dilatation, the only lesion found post mortem being a dilated heart with no valvular lesion; or, again, case No. 35t, with death after a short period of coma and acetonuria, the only gross lesion noted post mortem being oedema of the brain., The Relation of Generalfsed Tubercle and Gastro-Enteritis to Fibrosis and Vascular Changes in the Liver. It is commonly objected by those who do not accept the views advanced in this paper that the histological standards adopted are merely those of chronic inflammation, and might be caused by any chronic infective process such as tubercle or gastro-enteritis. That such may be the case in the spleen I have already stated; but that general vascular changes or fibrosis are produced by tubercle is contrary to all experience, not only in children, but in cases dying in adult life. The material in this series bearing on the point is too limited to warrant much attention, but all the cases of generalised tubercle, with one exception, gave a positive or partial Wassermann reaction, and showed generalised vascular changes; or, in other The numbers refer to appended table. f Wass. R. negative—clinical history of syphilis.