File:A system of surgery - theoretical and practical (1883) (14778726415).jpg

Identifier: systemofsurgeryt02holm (find matches)
Title: A system of surgery : theoretical and practical
Year: 1883 (1880s)
Authors: Holmes, Timothy, 1825-1907 Hulke, J. W. (John Whitaker), 1830-1895
Subjects: Surgery Surgical Procedures, Operative
Publisher: New York : W. Wood
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

View Book Page: Book Viewer
About This Book: Catalog Entry
View All Images: All Images From Book
Click here to view book online to see this illustration in context in a browseable online version of this book.

Text Appearing Before Image:
of these various formsof syphilitic ulcer; and by comparing them with those of simple, strumous, rheu-matic and malignant ulceration, which will be found at pp. 289, 312, 321, the readerwiU be enabled to see at a glance, much better than by verbal description, the differ-ences of these affections as shown on the macerated bone. Any of these forms of syphilic ulceration may affect the bone so deeply as topenetrate its whole thickness. Thus in the Museum of St. Bartholomews Hospitalis a specimen (A 34) of a clavicle in which the bone has given way (probably afterdeath) in consequence of penetrating ulceration attributed to syphilis. Spontaneousfracture of a long bone, however, from penetration by a syphilitic ulcer is extremelyrare; while penetration of a flat bone, especially of the cranium, is still a prettyfrequent circumstance, and used to be an ordinary resvilt of syphilis. In the greater Fig. 53.—Penetrating Syphilitic Ulcer. (Massum of the Royal Colleo^e of Surgeons, No. 636.)
Text Appearing After Image:
number of such cases no serious mischief follows ; the dura mater is exposed on theseparation of the necrosed central part of the ulcer, but soon gets covered over, so thatits pulsations are no longer visible, and in a little while the gap will be filled up byfibrous tissue. In rare cases, however, pressure upon the bi-ain is produced eitherby matter confined between the skull and dura mater, or by ulceration laying open abranch of the middle meningeal artery and causing haemorrhage. Treatment.—The treatment of constitutional syphilis has been already described,and it has been shown that at one period or other of the disease a prolonged andsufficient exhibition of mercury will be necessary for a cure. To this general rule theaffections of bone form no exception, for although some of them are usually foundaccompanied by so profound a cachexia, so complete a prosti-ation of the wholesystem, that mercury is inadmissible, it will also be found that such affections do notadmit of cure. I

Note About Images