A Description of the Mode of Treating Constitutional Syphilis by Syphilisation: And its Results

P. W. Boeck
1865 BMJ (Clinical Research Edition)  
OBSERVATION II. Sophie H., 23 years old, was taken into hospital on Sept. 18, 1855. On both shins there were several sores, deepened into the cellular tissue, and partly covered by layers of thick purulent matter. The margins of these sores were sharp, and appeared as if cut with an instrument. They were circular, or formed segments of circles; so that the larger ulcers were easily seen to be formed by the confluence of several small ones. The skin of the surrounding parts was of a brownish
more » ... s of a brownish colour, and covered with scars, the remains of previous ulcers. The skin of the rest of the body, and particularly of the anterior part of the thighs, presented an abundance of circular, brownish, elevated spots, varying from one-sixth to one-fourth of an inch in diameter, and covered with adherent white scales. On pressing these elevated spots between two fingers, they gave a sensation of hardness, extending downwards into the deeper tissue like a small knot. These spots stood mostly separate; but in some places several of them were aggregated, and formed elevated patches of about an inch in diameter. The patient was treated in the hospital from July 17th to October 26th, 1854, for a primary ulcer on the upper lip and ulcers of the throat. There were then administered successively bichloride of mercury, the liquor Bellosti, solution of iodide of potassium, and low-diet, with decoction of sarsaparilla and conium pills. She was apparently well after this treatment up to the month of April 1855, when the ulcers on the legs began to appear. Syphilisation was commenced on Sept. 20th, 1855. Matter from artificial chancres, developed on another patient under treatment, was inoculated on both her thighs, in three points on each of them. 1X the 23rd, these inoculations had produced characteristic, well developed pustules. The matter of these was inoculated on the thighs and on the right arm. On the left arm, three inoculations were made with dried matter. On Sept. 26th, no effect was seen from the inoculations on the left arm; but all the other inoculations had produced well developed pustules. The matter of these was now inoculated on both thighs and both arms. On Sept. 29th, new pustules having formed after the last inoculations, the matter of these was inoculated in the same manner. On Oct. 2nd, no effect was seen after the last inoculations on the left thigh, but well developed pustules on the right. From these, inoculations were made on both thighs; on the arms was inoculated the matter of the last formed pustules. Oct. 3rd. The ulcers on the shins were beginning to heal up. Oct. 5th. Inoculation was made on the arms from the latest pustules. On the thighs, where no effect was observed after the latest inoculations, except one small pustule on the left, new inoculations were made with matter from the pustules of Oct. 3rd; and with the same matter three inoculations were made on one of the squamous patches on the left thigh. Oct. 8th. Inoculation was made on the arms from the latest pustules. No effect was produced on the squamous patch, and only two small pustules had appeared on the left thigh, and one on the right. Three inoculations were made with matter from one of the older pustules. Oct. 12th. Inoculation was made or, the arms and thighs from the pustules formed after the last inoculations. As these were very small on the right thigh, three inoculations were made in that place with matter from an artificial ulcer on another patient under treatment by syphilisation. Oct. 15th, 18th, and 21st. Inoculations were made on the thighs and arms from the latest formed pustules. Oct. 24th. Inoculation was made on the thighs from the latest pustules. On the arms, no effect followed the latest inoculations. Three inoculations were made on both arms with matter from an artificial ulcer on another patient under treatment. Oct. 27th. Inoculation was made on the arms from the latest formed pustules. No effect being produced on the thighs by the last inoculation, three inoculations were made on both thighs from an artificial ulcer on another patient under treatment. Oct. 30th, Nov. 2nd, 5th, and 8th. Inoculations were made from the latest formed pustules on the arms and thighs. Nov. 11th. No effect appeared on the arms and the right thigh. Inoculation was made on both thighs from the pustules formed on the left; and three inoculations on each arm from an artificial ulcer developed on another patient under treatment. Nov. 14th. Inoculations were made on the arms from the latest formed pustules. On the thighs, no effect being seen, except one small pustule on the left, three inoculations were made from the artificial ulcers of another patient under treatment. Nov. 17th, 20th, and 23rd. Inoculations were made on the arms and thighs from the latest developed pustules. Nov. 26th. Inoculation was made on the thighs from the last pustules. No effect being produced on the arms, three inoculations were made on each from the artificial ulcers of another patient under treatment. Nov. 29th. Inoculation was made from the last formed pustules. Dec. 2nd. No effect was observed on the arms and on the left thigh. There were large pustules on the right thigh, from which three inoculations were made on each of the arms and thighs. Dec. 5th. The pustules, after the last inoculations on the thighs and the right arm, were drying up. On the left arm they remained, but were very smiall; and matter from them was inoculated on the same arm. On the left thigh, inoculations were made from an artificial ulcer on another patient under treatment. Dec. 8th. Very small pustules were produced on the left,arm by the last inoculations; matter from these was inoculated on the same arm. On the left thigh'was one large pustule; from that three inoculations were made on each thigh. 36] BOECK ON SYPHILISATION.
doi:10.1136/bmj.2.249.361 fatcat:ybrncgdvlbegvbs5nbqjg4ujie