File:Syphilis - a treatise on etiology, pathology, diagnosis, prognosis, prophylaxis, and treatment (1921) (14586367938).jpg

Identifier: syphilistreatise00haze (find matches)
Title: Syphilis : a treatise on etiology, pathology, diagnosis, prognosis, prophylaxis, and treatment
Year: 1921 (1920s)
Authors: Hazen, H. H. (Henry Honeyman), b. 1879
Subjects: Syphilis Syphilis
Publisher: St. Louis : C.V. Mosby Co.
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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. They may be mechanically com-pressed, resulting in occlusion of the lumina, or thrombi may oc-cur, or the walls may become thickened giving the same result.Sternberg and Lancereaux are responsible for the now generallyheld opinion that the most important clinical symptoms are thoseresulting, directly or indirectly, from disease of the blood vessels.The beginning of the entire process seems to be an inflammatoryprocess in the perivascular lymphatics, as is the case in otherlesions. The end result is inevitably the obliteration of the lumenof the vessel. This obliterative endarteritis (first described by 326 SYPHILIS Heubner)^^ was demonstrated by Cornil and Ranvier in 1872 tobe the same kind which occurs after the application of a liga-ture, although it is true that luetic individuals are particularlypredisposed to it. Koster^* holds that this intimal thickeningis secondary to areas in the media which have developed fromthe vasa vasorum, and it is for this reason that endarteritis is
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Fig. 122.—Late syphilitic meningitis shows the same changes as other syphilitic lesions.(Collection of Drs. Fordyce and MacKee.) SO common in the brain where even the small arteries have thevasa vasorum. The final result of the shutting off of the circulation of definiteareas of the brain is a profound disturbance of. nutrition, some-times resulting in absolute necrosis of the parts supplied. Rup-tures and secondary hemorrhages sometimes occur. SYPHILIS OF THE NERVOUS SYSTEM 327 Diagnosis.—The diagnosis of syphilitic disease of the centralnervous system presents the encouraging picture of. a subjectemerging from considerable complexity and obscurity into a re-gion of comparative clearness. At every turn new diagnosticIefinements, chiefly at the laboratory level, are being perfected. If the practitioner will be on the qui vive in two directions,there is but small chance of his missing the diagnosis of earlysj^philis of the nervous system. First, in all syphilitic patientshe should

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