The principles and practice of modern surgeryPark, Roswell
Science
The principles and practice of modern surgery
Park, Roswell
Surgery
=The Teeth.=--The permanent teeth often show peculiar changes that
are distinctive, especially in those who have shown signs of corneal
involvement, which, having been first described by Hutchinson, are
frequently alluded to as _Hutchinson’s teeth_. When they first appear
they are smaller than natural and irregular. Later they become notched.
The crescentic notches show best upon the incisor teeth. Sometimes the
canines are also affected, being narrow, rounded, and peg-like, with
jagged edges. These teeth are usually so formed that they do not meet
properly, and so small that they scarcely touch each other. The most
characteristic changes are met with in the upper incisors, which may
be affected when all the others are fairly normal. In such cases they
will be found narrow and short, with a single broad notch at the edge,
with perhaps a furrow passing from it upward and on both anterior and
posterior aspects. Notching is usually symmetrical. No conclusions can
be drawn from the teeth if they are normal, as they may be, but when
they present the above-described features they prove a very important
indication.
The relations between syphilis and rickets have attracted much
attention, and there is little doubt but that rachitic changes are
prone to occur in subjects with inherited syphilis. The two conditions
are sometimes blended in various degrees and ways, and yet it is not
safe to say that rickets is always an expression of inherited syphilis.
TREATMENT OF SYPHILIS.
There is no question but that some of the above-described lesions
constitute as disgusting and repelling diseased conditions as the
physician or surgeon is ever called upon to treat. In spite of these
circumstances, however, it is generally believed that syphilis is a
most satisfactory disease to treat. This is because of the almost
mathematical certainty with which results can be predicted and
estimated. There is nothing more satisfactory in therapeutics than
the rapidity with which many pronounced and serious manifestations of
syphilis will disappear under the influence of proper treatment. These
statements, however, should be modified to make room for exceptional
cases, where the disease assumes a malignant type, owing probably to
some defect in the patient’s constitution, or where patients show
peculiar idiosyncrasies and susceptibilities to the influence of
mercury and iodine. Such cases happen occasionally and prove difficult
of solution, while they sorely try the surgeon’s ingenuity and
resources.
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