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Associated bone or joint lesions are dealt with at the same time. In the after-treatment the functions of the tendons must be preserved by voluntary and passive movements. #Syphilitic Affections of Tendon Sheaths.# These closely resemble the syphilitic affections of the synovial membrane of joints.
How many are there? Among a thousand men, are there four? Very well, then. Excepting those four, between all the rest and the syphilitic there is nothing but the difference of chance." There came into the doctor's voice at this moment a note of intense feeling; for these were matters of which evidence came to him every day.
Kissing is an extremely common source of syphilitic infection, and of all extragenital regions the mouth is by far the most frequent seat of primary syphilitic sores. In some cases, it is true, especially in prostitutes, this is the result of abnormal sexual contacts.
The conditions most liable to be mistaken for syphilitic disease of bone are chronic staphylococcal osteomyelitis, tuberculosis, and sarcoma; and the diagnosis is to be made by the history and progress of the disease, the result of examination with the X-rays, and the results of specific tests and treatment. Treatment.
For that reason a statement of general principles may well be drawn up to indicate what is desirable in these regards. +A Well-balanced Life.+ First, for his own sake, a syphilitic should live a well-balanced and simple life so far as possible.
Just why the mother may never have shown an outward sign of syphilis and yet have the disease and bear syphilitic children is a question we cannot entirely answer, any more than we can explain why all obvious signs of syphilis are absent in some patients even without treatment, while others have one outbreak after another, and are never without evidence of their infection, unless it is suppressed by treatment.
The series of abortions, followed by stillborn or syphilitic children, and finally by healthy ones, is only the general and by no means the invariable rule. +Treatment of the Mother.+ For the mother, then, syphilis may mean all the disappointments of a thwarted and defeated maternity, and the horrors of bearing diseased and malformed children.
If a periosteal gumma breaks down and invades the skin, a syphilitic ulcer is formed with carious bone at the bottom. A central gumma may eat away the surrounding bone to such an extent that the shaft undergoes pathological fracture. In the rare cases in which it attacks the articular end of a long bone, gummatous disease may implicate the adjacent joint and give rise to syphilitic arthritis.
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