Manual of Surgery Volume First: General Surgery. Sixth Edition.Thomson, Alexis
Science
Manual of Surgery Volume First: General Surgery. Sixth Edition.
Thomson, Alexis
Surgery
#Prognosis of Inherited Syphilis.#--Although inherited syphilis is
responsible for a large but apparently diminishing mortality in infancy,
the subjects of this disease may grow up to be as strong and healthy as
their neighbours. Hutchinson insisted on the fact that there is little
bad health in the general community that can be attributed to inherited
syphilis.
#Treatment.#--Arsenical injections are as beneficial in the inherited as
in the acquired disease. An infant the subject of inherited syphilis
should, if possible, be nursed by its mother, and failing this it should
be fed by hand. In infants at the breast, the drug may be given to the
mother; in others, it is administered in the same manner as already
described--only in smaller doses. On the first appearance of syphilitic
manifestations it should be given 0.05 grm, novarsenbillon, injected
into the deep subcutaneous tissues every week for six weeks, followed by
one year's mercurial inunction--a piece of mercurial ointment the size
of a pea being inserted under the infant's binder. In older children the
dose is proportionately increased. The general health should be improved
in every possible direction; considerable benefit may be derived from
the use of cod-liver oil, and from preparations containing iron and
calcium. Surgical interference may be required in the destructive
gummatous lesions of the nose, throat, larynx, and bones, either with
the object of arresting the spread of the disease, or of removing or
alleviating the resulting deformities. In children suffering from
keratitis, the eyes should be protected from the light by smoked or
coloured glasses, and the pupils should be dilated with atropin from
time to time, especially in cases complicated with iritis.
#Acquired Syphilis in Infants and Young Children.#--When syphilis is met
with in infants and young children, it is apt to be taken for granted
that the disease has been inherited. It is possible, however, for them
to acquire the disease--as, for example, while passing through the
maternal passages during birth, through being nursed or kissed by
infected women, or through the rite of circumcision. The risk of
infection which formerly existed by the arm-to-arm method of
vaccination has been abolished by the use of calf lymph.
The clinical features of the acquired disease in infants and young
children are similar to those observed in the adult, with a tendency,
however, to be more severe, probably because the disease is often late
in being recognised and treated.
CHAPTER X
TUMOURS[2]
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