Syphilis and local contagious disorders / by Berkeley Hill.

  • Hill, Berkeley, 1834-1892.
Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: Syphilis and local contagious disorders / by Berkeley Hill. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    Seat.—Tlie most frequent seat of warts in man is the mucous membrane of the glans penis, especially in the furrow behind the corona, and the inner surface of the prepuce. In women the internal surface of the labia and nympha and the vaginal entrj^ are most frequently affected, but in rare cases they extend along the vagina and even to the cervix uteri. On the perineum and round the anus they are also not uncommon. In both sexes the growths are not very infrequent at and just within the meatus urinarius, and sometimes they extend for a considerable distance along the urethra. Warts may be pedunculated or sessile. They are of a bright red or pinkish red colour, and may be small and isolated, or several may coalesce and form large masses. Some are very vascular and bleed easily; others do not bleed, but are exceedingly sensitive when touched. Their shape also varies according to their seat; behind the corona giandis they are often elongated and flattened like the crest of a cock. When situated beneath a tight prepuce, so that their secretion cannot get away freely, the warts often grow rapidly to such a size that the prepuce becomes enormously distended, and finally sloughs from the pressure of the growths within. Aime Martin relates a case of this kind which had been neglected and which was attended by induration of the lymphatic glands, cachexia, and other constitutional symptoms of so grave a character that the patient was at first thought to be suftering from epithelioma. The growth of warts is favoured by any condition that ^n^omotes congestion; thus they are very frequent and difficult to eradicate during pregnancy, when indeed they often attain an enormous size, and cause much suffering. They are then also very liable to become chafed and ulcerated, in which condition they secrete a copious, acrid, and horribly foul discharge that causes great irritation of the sm^- rounding skin. The termination of large warts is sometimes by inflammation and sloughing; small ones often remain stationary for years, or gradually wither away and disappear spontaneously. The large growths peculiar to pregnancy commonly disappear after delivery. Diagnosis.—The diagnosis of warts rarely presents any difficulty. In cases of phimosis, however, such as that of Martin already men- tioned, there may be temporary difficulty in making the diagnosis from epithelioma. Rest and cleanliness however will quickly ameliorate the condition when due to simple warts. The age of the patient must also be taken into account. Treatment.—The first point to be ascertained is the nature of the morbid secretion or discharge that has caused the warts, and if pos- sible to remove it. The local treatment of the growths themselves will depend on their seat, size, and form, and whether they are sessile or