TREATMENT.—Fortunately, syphilis as a complication of pregnancy is a very tractable affection. The interruption of pregnancy may be prevented and the effect of the syphilitic poison upon the foetus favorably modified in the large majority of cases by appropriate specific treatment. Mercurial inunctions are preferable to the exhibition of the remedy by the mouth. Iodide of potassium must be used with care, on account of its tendency to provoke uterine contractions.
Attention must be paid to local primary or secondary lesions, since the child may be infected during its passage through the parturient canal.
Cardiac Diseases.
The mutually unfavorable relations between acute and chronic cardiac diseases and pregnancy depend largely upon the seat and character of the affection.
ACUTE ENDOCARDITIS,
occurring in the course of gestation, evinces a distinct tendency to the malignant, ulcerative form. This disposition is much more marked during the puerperium. The dangers of the detachment of particles of valvular vegetations, giving origin to the processes of thrombosis and embolism, are obvious.
The PROGNOSIS of acute endocarditis during pregnancy and the puerperium is much more unfavorable than in the non-gravid state.
CHRONIC HEART DISEASES.
The mode in which pregnancy, parturition, and puerperium exert an unfavorable influence on chronic heart diseases is still the subject of controversy. Spiegelberg accounts for the disastrous results attending aortic insufficiency observed in the second half of pregnancy on the ground of the inadequacy of the compensatory hypertrophy of the left ventricle. The intercalation of the placental circulation, the increase of the total blood-mass, the increase in arterial tension, throw an extra amount of work upon the left heart, which it is not able to perform. Irregular heart-action and dyspnoea, sometimes leading to the interruption of pregnancy, are the results.