File:A system of surgery (1895) (14778786361).jpg

Identifier: systemofsurgery01trev (find matches)
Title: A system of surgery
Year: 1895 (1890s)
Authors: Treves, Frederick, Sir, 1853-1923
Subjects: Surgical Procedures, Operative Surgery
Publisher: Philadelphia : Lea Brothers
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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whichare so commonly thesite of eczema inter-trigo and of lichen-v eczema in infants;^ hence much diffi-culty in diagnosis.The more copper-coloured the spots,and the moremarked the infiltra-tion of the skin, thegreater are thechances of the erup-tion being due tosyphilis. Largesmooth-topped shinypapules of a reddish-brown colour on thebuttocks, scrotum,etc., are very cha-racteristic of thedisease. Round theanus, at the inguinalfolds, round themouth, and else-where, if the papulesare kept moist,condylomata arevery apt to develop(Fig. 88). We maysee the mouth com-pletely encircled bywell-defined condy-lomata or mucouspatches, and thehealing of these, orof syphilitic fissures,may leave a per-manent witness tosyphilis in the formof fine scars, which radiate from the mouth across the lips, andespecially from the commissures. A word of warning must be givenagainst taking these radiating scars in later years as conclusive, forsevere eczema with fissures in unhealthy infants may occasionally
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Pii ;. 88.—Condylomata on the Scrotum and around the Anus,with superficial Ulceration of the Buttock. (From a caseof congenital syphilis, showing the regions very frequentlyaffected during the first few months after birth.) INHERITED SYPHILIS. 423 produce a similar appearance. Excoriations or mucous patchesround the anterior nares and the eyes are also very common in con-genital syphilis (Fig. 89). With regard to the bullous eruption (so-called pemphigus), it may be taken as a sign of severe constitutionaldepression, and although under mercurial treatment these childrennot infrequently recover, they more commonly die in a marasmiccondition. Occasionally a child is born with a bullous or othersyphilitic eruption on its skin, but this is rare, and nearly alwaysthe erythema or lichen first develops a few weeks after birth.Pemphigus in infants is not always syphilitic. It is said, however,that if it affects the palms and soles it is always so. Amongst the rarer foi*ms of skin eruption w

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