Manual of Surgery Volume First: General Surgery. Sixth Edition.Thomson, Alexis
Science
Manual of Surgery Volume First: General Surgery. Sixth Edition.
Thomson, Alexis
Surgery
Considerable interest attaches to the observations of Metchnikoff, Roux,
and Neisser, who have succeeded in conveying syphilis to the chimpanzee
and other members of the ape tribe, obtaining primary and secondary
lesions similar to those observed in man, and also containing the
spirochæte. In animals the disease has been transmitted by material from
all kinds of syphilitic lesions, including even the blood in the
secondary and tertiary stages of the disease. The primary lesion is in
the form of an indurated papule, in every respect resembling the
corresponding lesion in man, and associated with enlargement and
induration of the lymph glands. The primary lesion usually appears about
thirty days after inoculation, to be followed, in about half the cases,
by secondary manifestations, which are usually of a mild character; in
no instance has any tertiary lesion been observed. The severity of the
affection amongst apes would appear to be in proportion to the nearness
of the relationship of the animal to the human subject. The eye of the
rabbit is also susceptible to inoculation from syphilitic lesions; the
material in a finely divided state is introduced into the anterior
chamber of the eye.
Attempts to immunise against the disease have so far proved negative,
but Metchnikoff has shown that the inunction of the part inoculated with
an ointment containing 33 per cent. of calomel, within one hour of
infection, suffices to neutralise the virus in man, and up to eighteen
hours in monkeys. He recommends the adoption of this procedure in the
prophylaxis of syphilis.
Noguchi has made an emulsion of dead spirochætes which he calls
_luetin_, and which gives a specific reaction resembling that of
tuberculin in tuberculosis, a papule or a pustule forming at the site of
the intra-dermal injection. It is said to be most efficacious in the
tertiary and latent forms of syphilis, which are precisely those forms
in which the diagnosis is surrounded with difficulties.
ACQUIRED SYPHILIS
In the vast majority of cases, infection takes place during the congress
of the sexes. Delicate, easily abraded surfaces are then brought into
contact, and the discharge from lesions containing the virus is placed
under favourable conditions for conveying the disease from one person to
the other. In the male the possibility of infection taking place is
increased if the virus is retained under cover of a long and tight
prepuce, and if there are abrasions on the surface with which it comes
in contact. The frequency with which infection takes place on the
genitals during sexual intercourse warrants syphilis being considered a
venereal disease, although there are other ways in which it may be
contracted.
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