A system of practical medicine. By American authors. Vol. 2

by Unknown

Hill¹⁷⁷ reports a case of a child aged five years who had been hemiplegic since he was two and a half years old, and who developed paralysis of the flexors of the ankle in each leg.

¹⁷⁷ Op. cit., p. 254.

Keyes reports a case of a boy five years of age, with nodes on tibiæ and other signs of inherited syphilis, who had two attacks of paraplegia.

Hill reports a case of imbecility associated with inherited syphilis, but there is no evidence that it was other than a coincidence.

Fletcher Beach found not more than 1 per cent. of syphilitic children in the Dareult Asylum, and Mr. Mercier could only trace syphilis in 5 out of 220 female idiots, probably imbecile from birth.¹⁷⁸

¹⁷⁸ Ibid., p. 255.

Hughlings Jackson only found 1 case of inherited syphilis among 80 cases of chorea. The most carefully recorded cases of the latter affection associated with hereditary syphilis are two reported by Alison.¹⁷⁹

¹⁷⁹ American Journal of the Medical Sciences, July, 1877.

Syphilis of the Spleen.—Disease of this organ in inherited syphilis is especially important from two points of view. It is a valuable aid to diagnosis, and by its size and the degree of persistence of the swelling gives an approximate indication of the severity of the case.

Attention was first called to the frequency and importance of enlargement of the spleen in early hereditary syphilis by Gee in a paper read before the Royal Medical and Chirurgical Society in 1867.¹⁸⁰ He gave the histories of thirteen children in support of the statement that such enlargement occurred in almost one-fourth of all cases of hereditary syphilis, sometimes with, sometimes without, enlargement of the liver and lymphatic glands. According to him, the degree of splenic enlargement may be taken as a sort of index of the severity of the cachexia; the majority of cases with great enlargement die, but sometimes such children survive, the spleen gradually diminishing in size as the health improves—not diminishing, however, pari passu with such improvement, but remaining for a long time "a monument of past cachexia."