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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    system lias little restorative power. It consists of large pustules or bullae, varying in size from a pea to a cherry. The fluid, almost clear at first, quickly becomes puriform. Then an areola appears round the bulla, but the elevated base, so characteristic of the other forms, is sometimes absent in this syphilide. The pustule by the second or third day becomes flaccid; its contents ooze out, and dry into a crust, under which the skin ulcerates. Fresh secre- tion dries as it forms, until a large scab of a yellowish green or brownish green colour results. When this crust falls it leaves an indolent and spreading ulcer with sharply-cut, irregular borders that, if left to itself, for a long time enlarges instead of healing. In some cases, the crusts remain long adherent, growing thicker by increasing their base, and by the discharge drjdng beneath, until they assume the form of a limpet-shell or cone. These crusts are often rough and furrowed on their surface, and may conceal the ulcer completely, or the ulcer may extend beyond their margin. The «cars are indelible, white and reticulate in appearance. Crops of bull» may succeed each other for a period of two or three months. Sometimes they are arranged in rings or groups, sometimes mixed. with leprous papules, sometimes scattered irregularly over the body, and generally with greater profusion on the limbs than on the trunk. When the eruption is grouped, the coppery or purplish areola is well marked, and the ulcer frequentl}'- creeps along in a serpiginous manner, leaving, as it heals, white scars in its course. This afiection, though late in its appearance, is, according to Zeissl, generally pre- ceded by febrile action. We have marked this rise of temperature on a few occasions also. More common accompaniments are periosteal affections, and great bodily debility. The diagnosis is usually easy. Syphilitic rupia is far more fre- quently met with than riqyia vulgaris, from which it is distinguished by the areola, by the presence or history of other syphiHtic afl'ections, and by the slow course of the eruption. The diagnosis, now and then, is difficult, when the eruption breaks out many years after the disease has apparentl}^ subsided. In these cases the areola is often purple, the suppuration is copious, and other symptoms of syphilis may be absent. In such cases, it is hard to decide sometimes between the syphilitic form and the rupia that is said to originate in scrofula. The scars of syphilis are round, slightly sunken or foveated, whitish, very pliable and non-adherent to the parts beneath. The scars of scrofulous sores are irregular, thickened, folded or seamed, and often toughly fastened to the tissue beneath. The 'prognosis is grave, for the eruption is slow, leaves indelible cicatrices, and denotes that the constitution is severel}'- affected by the disease.