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

  • Ziegel, Hermann Fred Lange, 1876-
Date:
1909
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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.

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    never been less than 60 per cent. In spite of the enormous dosage with mercury and the iodides, his teeth, gums, and gastrointestinal tract have re- mained in good condition. There has never been any albumin in the urine. Constitutionally, there- fore, he has been tolerant to mercury. But the local reactions after injections have at times been very severe; however, only indurations and no abscesses have resulted. Conclusions.—A patient with syphilis which had not been systematically treated began to exhibit, fifteen months after infection, tertiary manifesta- tions which appeared in the following order: (i) Ulcer of the right leg; (2) papular syphilide of scalp; (3) deep ulcerations of tonsils and posterior pharyngeal wall; (4) stricture of the left nasal duct; (5) ulcers on forehead; (6) periostitis of nasal bones; (7) gumma of nasal septum, suppura- tion, and perforation; (8) bursitis and synovitis; (?) periostitis of heads of tibiae; (10) gummata of right testicle; (11) synarthrositis. Eduard Lang says that “when the gummatous deposits in early periods of syphilis are markedly conspicuous as regards both their number and rapid course, it is certainly proper to express this charac- ter of the disease by the term syphilis ‘precox,’ ”* Accordingly, the case just described may be spoken of as one of precocious syphilis. In tertiary syphilis, as is well known, the lesions usually involve the deep-seated organs and tissues; not so in this case, in which the lesions have been superficial, involving chiefly the skin, mucous mem- branes, ocular appendages, cartilages, bursae, peri- osteum, the testicle, and chondrosternal articula- tions. The two noteworthy features of this case are.