Precocious tertiary syphilis : report of a case with manifold manifestations / by H. Fred Lange Ziegel.

  • Ziegel, Hermann Fred Lange, 1876-
Date:
1909
Catalogue details

Licence: In copyright

Credit: Precocious tertiary syphilis : report of a case with manifold manifestations / by H. Fred Lange Ziegel. 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.

    5/8 (page 3)
    manifestations reappeared from time to time, gen- erally during intervals between courses of mercur- ial treatment. In fact, attempts to suspend even temporarily the exhibition of mercury always re- sulted in the appearance of new lesions. If we continue, now, to enumerate chronologic- ally the various manifestations, the fourth was. a syphilitic stricture of the left nasal duct, with dis- tention of the lacrymal sac, tearing, and unilateral conjunctivitis. Dr. Martin Cohen, who diagnosed and treated the local condition, reported that at this time fundus examination showed pallor of the disc on the temporal side, edema on the nasal side; dilatation of the veins; and some opacity of the vitreous humor. Fifth, there appeared protuberances on the fore- head—superficial gummata which ulcerated. These ulcers healed, reopened some months later, and healed again. Sixth, there was a periostitis of both nasal bones. Seventh, the patient came complaining that nasal breathing on the left side was obstructed; examina- tion showed a swelling springing from the nasal septum and occluding the left nares. This gumma soon broke down, resulting in abscess formation, and a large perforation of septum which can read- ily be seen at the present time. Eighth, bursitis and synovitis. The left ankle be- came swollen, impaired in function and very painful at night. Soon afterwards both knees became sim- ilarly affected. The patellar bursae were consider- ably enlarged, and there was dancing patella. These hydrarthroses coresponded closely with Levin’s de- scription of “Synovitis of the Knee-joint as a Late Manifestation of Acquired Syphilis.”2 Ninth, Periostitis of the heads of the tibiae, first