Identifier: syphilis00coop (find matches)
Title: Syphilis
Year: 1895 (1890s)
Authors: Cooper, Alfred, Sir, 1846-1908 Cotterell, Edward, 1857-1898
Subjects: Syphilis Syphilis
Publisher: Philadelphia : P. Blakiston
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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arelements become granular and fatty, and the tumourbecomes less dense and finally disappears. If thesuperficial layers of the .skin are infiltrated, perfora-tion is very apt to take place. These gummata rarelyoccur before the second or third year. They mayappear at any subsequent period. The Ulcerating Syphilide (syphilis cutanea ulcer-osa) (see PL XL and XII.).—Syphilitic cutaneousand subcutaneous infiltrations, giving rise to thevarious forms of papules and nodules already de-scribed, may terminate either in resolution or inprocesses of disintegration in which the integumentbecomes involved. In the latter case an ulcer results.Ulceration, therefore, is to be regarded as a phaseof the papular, pustular, and gummatous or nodularformations. These ulcers are more or less circularin form, and are further characterised by theirsharply - defined infiltrated margin, which is oftenundermined. A yellow or grey exudation adheres EXPLANATION OF PLATE XII. Deep serpiginous syphilide. Platk 13
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Haniart litH. APFECTIONS OF THE SKIN. 147 to the floor and tends to become dry and form, crusts.The secretion is usually abundant, and inasmuch asthe healing process is very slow, these crusts areoften found to be composed of layers more or lessthick and numerous. The extent to which the ulcerative processadvances is influenced by the course of the infiltra-tion of which it is a consequence. Once set up,the disintegration spreads until the whole of thenew formation is involved. It then ceases; but ifthe infiltration advances, the ulceration follows inits train. Hence it happens that these ulcers areoften serpiginous. They begin in a single nodule,and are at first circular; if adjacent nodules arethe seat of similar processes, the ulceration spreadsfrom one to the other, until large tracts of skin areinvolved. Such ulcers often have a reniform shajDC,owing to the progress of the infiltration at onejDortion of the circumference. At the part wherethe infiltration ceases cicatrisation tak

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