In the colon chronic ulcers have been so serious as to lead to dysentery, followed by stricture formation. It has been suggested to make an artificial anus at the cecum and allow the large intestine to rest, treating it at the same time with irrigation through the opening.
The Viscera.
—Of the solid viscera the liver is more commonly affected than the spleen or kidneys. Chronic interstitial hepatitis may lead to cirrhosis, the new tissue being less distinctly distributed than when due to alcohol, the liver consequently becoming irregular, with a deep separation between its lobes. The pain is sometimes intense.
On the other hand isolated gummas, or confluent masses of smaller gummas, may be found beneath the capsule or in the substance of the liver. From one or both of these cases combined this viscus may attain an enormous size, with acute pain. Under these conditions there may occur albuminuria and evidences of amyloid disease.
Likewise in the spleen there may be diffuse or localized trouble. Here the lesions cause but slight distress.
The mercurials are of greater importance than the iodides in treatment of these lesions. The kidneys suffer less often than the spleen. Syphilitic patients do not lose their liability to renal disorders, but there seems to be but small, direct connection between syphilis and the common changes in these organs.
The Genitalia.
—In both sexes the genitalia are subject to gummatous involvement during the later stages; in the male more frequently in the corpora cavernosa and testicle. In the latter a chronic induration, with some enlargement of the epididymis, is one of the manifestations of constitutional disease. Most of the enlargements of the testicle are slow and painless, and occasionally some fluid will collect. The prostate and the seminal vesicles are rarely involved in syphilis, but frequently in a tuberculous process. This is an important diagnostic point.
In the ovaries there may occur a diffuse cirrhotic process.