Syphilis and local contagious disorders / by Berkeley Hill.

  • Hill, Berkeley, 1834-1892.
Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: Syphilis and local contagious disorders / by Berkeley Hill. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    Miliary papules are always accompanied by some other syphilitic ajBfection, such as larger papules, mucous patches, enlarged lymphatic glands, sore throat, or fall of the hair. These characters distinguish this syphilide from ordinary lichen, which moreover is accompanied by much itching, from which the syphilide is usually free. Itching, however, is more often present with lichen than with any other of the early eruptions. Compared with other sj^philides, the lichenoid is not a common form; Zeissl ascribes ten per cent, of papular syphilides to the miliar}^ form. In our own notes of ninety-nine ■cases of papular eruptions, three were of the miliary form; two of the patients being, women. Repetitions of the miliary eruption after its first departure are exceedingly rare, though they are said to occur; relapse of the disease after this eruption most commonly assumes the larger papular and sometimes the pustular form. The Larger Pcqndar Eriqjtion {Lenticular, or Nummular Syphilide), sometimes termed syphilitic psoriasis, is the commonest syphilide during the first year after contagion. In this variety the papules vary in size from a lentil to a sixpence; in rare cases, forming patches as large as half-a-crown. Like the smaller form, thej^ begin in ros}^ red spots, and extend laterally. In a few days the colour loses its brightness, and the cuticle scales off. If the papule is small, and the desquamation confined to a silvery border of loosened cuticle, it is termed Lenticular syphilide. When the papule has grown into a large patch, and the cuticle is peeling from all its surface, it is often wrongly called ])soriasis. The large nummular or coin-like papules form distinctly elevated plateaus above the skin, most commonly of truly circular shape, and thus form objects very characteristic of syphilis. The larger the papules, the fewer they are in number, and also generally the more closely do they present the so-called ' coppery' hue; which is, however, far more like the colour of raw ham. A¥hen the papules are confluent so as to spread in a continuous sheet over a large surface, the perinseum, scrotum, or vulva for example, the eruption forms an uneven dull red or damask-tinted surface, which is termed napiform by French writers. Seat.—No part of the body altogether escapes this eruption; when it appears across the forehead from temple to temple close to the scalp, and even continued to the occiput, the eruption is called ' corona Veneris.' The nape of the neck, the shoulders, the trunk, the inner aspects of the limbs especially the flexures of the elbows, wrists, and knees, are the localities most commonly occupied by scattered groups of papules of varying size and development, some remaining simple papules, others reaching the form termed psoriasis. During the first year after contagion the eruption pervades the body