SYPHILIDS OF HEREDITARY SYPHILIS


Homeopathy treatment of Syphilids of Hereditary Syphilis, with indicated homeopathic remedies from the Diseases of the Skin by Frederick Myers Dearborn. …


(Congenital syphilis; Infantile syphilis)

Syphilis may be transmitted by either father or mother to their offspring and, if the fetus has escaped abortion or still-birth, it may be born with or without the presence of visible syphilitic symptoms. In fact, in a large majority of cases, the infant presents every surface indication of a normal child and the disease may not develop for a few weeks or months. However, the majority of infected infants will manifest an eruption within the first month and nearly all exhibit the secondary lesions before the end of the second month. A child may usually be said to have escaped infection if these do not appear within the first six months.

The many symptoms which a syphilitic infant may present, besides the cutaneous lesions, will only briefly be considered. They vary with the effects of the disease upon the different organs or tissues but usually such symptoms as pyrexia, pallor and peevishness first appear, followed by local disturbances of the mucous membranes of the nose, throat, larynx and mouth, of which inflammation of the lining of the nose or “snuffles” is the most common. In some cases, the liver, spleen, eyes and bones may be attacked and such conditions as notched or Hutchinson’s teeth, interstitial keratitis, disturbances of hearing, nodosities on the skull, dactylitis, onychia, paronychia, exostoses and even resulting pseudoparalysis may be noted.

Lesions of the skin may precede the catarrhal symptoms but usually they follow the latter. In a short time the subcutaneous fat is absorbed, the skin becomes loose and wrinkled, and the face sallow and careworn as from worry and age. Added to these surface changes, may be stains of early eruptions and later lesions undergoing evolution and involution. It is my purpose to mention briefly the surface eruptions or syphilids of the hereditary form. These occur chiefly in the earlier period of congenital syphilis and are generally of little importance in the advanced stage when lesions of the deeper tissues are apt to develop, perhaps independently of any cutaneous eruption. The common eruptions of hereditary syphilis are the macular, papular and bullous.

The macular syphilid, like other form of cutaneous syphilis in infants, often appears on the buttocks and about the anus. The lesions vary in size, are not always defined and frequently coalesce to form large areas of coppery or yellowish-red skin. Sometimes the eruption extends down the inner part of the thighs, up the back, and in rare instances becomes general, even spreading to the soles of the feet. There is likely to be more or less desquamation on the dry parts, exfoliation of the surface of the soles, and between the nates, separation of the macerated scales may leave the surface raw or glazed like erythema intertrigo. A less common form of erythema has been observed in syphilitic infants, often in association with ulcerating lesions of the mucous surfaces of the mouth. This eruption occurs in irregular, bright to copper to coppery-red patches of 1/2 inch or more in diameter and is most abundant on the abdomen, lower portion of the chest and inner region of the legs.

The papular syphilid usually develops from the macular and, combined with it, constitutes the commonest syphilid observed in an infant. The lesions may appear as small or large papules in conic, acuminated or flat shapes, pea- to finger-nail-sized, smooth, glistening and of a dull red color. The papulosquamous variety is more common than the pure papular form and, occurring in the folds of the skin where the surfaces are in contact, often develops into moist papules. Moist papules are even more frequent in their relative occurrence and more numerous in their points of distribution than the same lesions in the acquired syphilis. They may develop on any warm or moist lesion of the skin and mucous membrane, especially at the anus and corners of the mouth, often being associated with fissures.

Bullous syphilids are more common in the hereditary than in acquired syphilis and always indicate a condition of marked severity. The prognosis of these cases is particularly bad when the blebs are purulent or rapidly become so. Bullous eruptions are often present at birth or appear in the first ten days of life. They may be tense or flaccid according to the quantity of serum, pus or blood held in them. Their sites of predilection are the palms, soles, nail bed and the lower part of the face, although other parts may be invaded in severe or exceptional cases. Around the lesions a dark red areola is seen and, when they rupture or dry up, light to dark green crusts form which cover an extending ulcer. When the nail bed is the seat, of a syphilitic bleb, the nail often turns black and is finally cast off; in milder cases it may be only distorted in shape, especially at the free border.

Primary vesicular syphilids are as rare in the hereditary as in the acquired disease and usually develop into bullae. But as has been stated before, vesicles may cap small papules, a condition sometimes considered as an intermediate stage.

The pustular syphilids of hereditary syphilis, while more common than the vesicular, are still rare. They may occur upon the apices of small papules or be present as ecthymatous, rupial or furuncular-like lesions. Aside from the first mentioned form they are apt to be associated with profound cachexia.

Tubercular and gummatous syphilids, when present, are a later manifestation and are usually seen in adult life. While they are not so extensive as in the acquired disease, they are like the latter in appearance, involution and evolution and need no separate description here. The brownish-red, dry, fissured and glistening appearance of the palms as a late manifestation is regarded by many as especially characteristic.

The diagnosis of the hereditary syphilid is comparatively easy, especially when the general symptoms, aside from those of the skin, are present. Any diagnosis based upon the latter only is essentially the same as described in acquired syphilis.

Etiology of Syphilis – Syphilis is due to a specific infective parasite, the spirocheta pallida, now classified as the treponema pallidum. It was discovered in 1950 by Schaudinn and E. Hoffmann whose epoch-making researches have since been repeatedly verified by other investigators. Notable among these are metchnikoff, Roux, Lassar and Neisser who have demonstrated that syphilis can be transmitted to chimpanzees and other apes by inoculation. It is needless to discuss the subject of the etiology of hereditary syphilis beyond the fact that it may be transmitted by either or both parents while subject to the disease in its contagious stage.

The acquired form is always due to infection, directly or indirectly, from some person suffering with the active disease and is at the onset a purely local process analogous in many respects to diphtheria, tuberculosis, glanders and leprosy, or diseases in the lesions of which micro-organisms have been proved to be constantly present. In other ways the likeness, especially in the existence of a period of incubation, the outbreak of cutaneous efflorescence and a certain immunity from other attacks lies with the exanthemata or diseases which are markedly contagious and supposedly of microbic origin.

The most common method of infection is through the sexual act by the transmission of the poison from an existing specific lesion on the genitalia. Prostitutes are naturally common carriers in this respect. This principally applies to the genital chancres because unnatural sexual relations are not usually responsible for the extragenital sores. The latter, while not uncommon, are often due to accidental and innocent inoculation, such as might occur by the act of kissing, through eating and drinking utensils used in common, communion cups, toilet articles or barber shop instruments. In professional work the poison may be communicated through instruments employed in circumcision, vaccination and dentistry, although fortunately these cases are rare with the improved technic now in vogue. There are many opportunities for infection in the industrial world but the danger of contagion though possible is slight. Physicians, dentists, nurse and other hospital attendants are not infrequently infected, especially on the fingers, from coming in contact with the virus.

Toward the development of the syphilids, other factors, besides the specific virus, contribute and account in a large degree for their varying course. These are not peculiar to syphilis and are contributing rather than predisposing. Constitutional impairment due to malaria, scrofula, alcoholism, infancy and old age and often some unknown cause not necessarily apparent in any marked disturbance of health, contribute to the insidious spread throughout the system of the parasite or its toxins. The symptoms produced by these contributory conditions, together with the variable potency or attenuation of the syphilitic poison inoculated, give individuality to each case of the disease. Another set of causes, chiefly external, beyond the normal difference existent in the skin of different individuals, may operate to modify the development and course of some of the syphilids. The presence of other diseases such as eczema or seborrhea may modify or aggravate the behavior of the secondary eruptions. Slight injuries of the skin may determine the seat of lesions, more especially those of the tertiary period. Lachesis of cleanliness may contribute to secondary infection from pus cocci or other microorganisms.

Frederick Dearborn
Dr Frederick Myers DEARBORN (1876-1960)
American homeopath, he directed several hospitals in New York.
Professor of dermatology.
Served as Lieut. Colonel during the 1st World War.
See his book online: American homeopathy in the world war