(5) A case of _syphilis_ in a man, aged 25 years, with an affection of
the upper lip which it was a little difficult to classify, the question
being whether it was a primary or a tertiary ulcer. The whole of the lip
was greatly swollen, and at each angle of the mouth there was a
deeply-excavated ulceration scabbed over, the intervening portion of the
lip being occupied by a papillomatous infiltration resembling the
appearance of frambœsiform syphilis. The man absolutely denied previous
lesions of any kind; there was no scar upon the penis or upon any
portion of the body, and no history of a secondary rash at any time. But
the uvula bad been apparently destroyed by ulceration and was now merely
rudimentary, and there was a deep ulcer upon the back of the pharynx
very suggestive of tertiary disease. The absence of primary and
secondary symptoms was peculiar. It should be mentioned that there was
no pronounced enlargement of the glands in connection with the deep
ulcers of the lip, which, it might be considered, precluded the
diagnosis of primary sores here.
Mr. ARTHUR SHILLITOE suggested the possibility of the case being an
instance of tertiary symptoms in a patient the subject of congenital
syphilis, but the teeth and physiognomy generally did not confirm
this possibility. The general opinion supported the diagnosis of
tertiary syphilis.
* * * * *
Mr. GEORGE PERNET showed a case of _superficial scarring and
telangiectases of the left side of the face and neck following an X-ray
burn_. The patient, aged 28 years, was treated three years ago in the
provinces for what was said to be a tuberculous lesion upon the left
side of the chin. As far as she recollected, the affected part was
exposed on eight occasions to the X-rays for about ten minutes at a
time, the eyes only being protected, but not the adjacent parts of the
face and neck. The patient stated that as a result the face was dressed
and bandaged for three months. The parts now exhibited the well-known
characteristic features following such burns. The original lesion for
which she had been treated appeared to be healed.
* * * * *
Dr. V. H. RUTHERFORD showed microscopic sections from the case of
_multiple sarcoma cutis_ which he had exhibited at the previous meeting
of the Society:
(1) An early nodule—the size of a pea—over which the skin still retained
its natural colour, displayed chiefly fibrillary bundles with a small
number of cells in various stages of development, some being round,
others elongated with fine protoplasmic processes, and others again with
irregular outlines.
(2) In a later nodule—the size of a bean—over which the skin had become
red, the bundles of fibres were replaced by typical small round cells
(lympho-sarcoma). The sections were stained with hæmatoxylin.
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