A system of practical medicine. By American authors. Vol. 4

by Unknown

³⁸ Wien. Med. Presse, 1873, No. 1, xiv.

Constitutional Syphilis.—The influence of constitutional syphilis upon the foetus is marked, and always unfavorable. The foetus may be infected through the medium of the spermatic fluid, the ovum, and by the mother after conception. From an enormous number of carefully-recorded observations it is possible to deduce the following conclusions with reference to the modes of infection and the effect upon the product of conception:

1. When the mother is perfectly healthy, but the father is affected with constitutional syphilis, the foetus is infected by the diseased spermatozoids. The intensity of the foetal disease will depend upon the degree of latency and age of the paternal affection. This mode of infection is observed in the severer forms of hereditary syphilis. Usually the mother is not infected. Occasionally the disease is communicated to her by the foetus in the mode termed by the French syphilographers choc en rétour.

2. When the mother has had constitutional symptoms prior to conception the ovum is infected before its fertilization. The child usually dies in utero, and is expelled in a state of maceration.

3. When the mother is infected during the act of coitus it was formerly believed that the foetus could only be syphilized during its passage through the parturient canal. Sigmund and Vajda have shown that even under these circumstances the infection may be communicated by the mother to the foetus in the course of pregnancy. If the father is affected with constitutional syphilis when the mother acquires the initial lesion, the result sketched in the first proposition follows.

4. Infection of the foetus may occur during its passage through the parturient canal. Weil³⁹ records a case of this nature.

³⁹ Deutsch. Zeitsch. f. prakt. Med., 1877, No. 42.

5. When both parents are affected with constitutional syphilis the disease will be communicated to the foetus. The intensity of the foetal syphilis will depend upon the degree of latency and age of the parental affection. When both parents have passed through the tertiary forms an apparently healthy child may be born. Evidences of hereditary syphilis, however, are usually developed before puberty.

According to the intensity of the poison the foetus dies in utero, causing the interruption of pregnancy; is born alive, with manifestations of hereditary syphilis, seldom acquired; or may give evidence of the inheritance of the disease after a variable interval of from weeks to months.