Syphilis and parasyphilis of the nervous system / by F.W. Mott.

  • Mott, F. W. (Frederick Walker), 1853-1926.
Date:
[1909?]
Catalogue details

Licence: In copyright

Credit: Syphilis and parasyphilis of the nervous system / by F.W. Mott. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

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    pathologist tends to show that the whole cerebrospinal axis is usually, if not always, affected, although in some cases the spinal symptoms are the most obtrusive, and in others the cerebral; and that leads me to the consideration of the relation of syphilitic eruption of the skin to recog- nized and unrecognized syphilis of the meninges. Many cases of syphilis of the meninges could he cited where the symptoms have appeared within three months of the primary infection—e.g., one of the cases reported by Goldflam. A strong man, aged 40, one month after the appearance of an indurated chancre, was seized with violent pains in the neck, the shoulders, and upper limbs, with stiffness and immobility of the limbs. There was also a marked hj'persesthesia in the area supplied by the brachial plexus. The case was completely cured after twenty-four inunctions. The following cases in my own practice are instructive: (1) A young man was sent to me complaining of headache, internal strabismus, and double vision; he had also commencing optic neuritis. I ascertained that ten weeks previously he had contracted a so-called soft sore, which had been treated only locally with iodoform. I put him on mercurial inunction, and the symptoms rapidly left him. (2) A man was admitted to Charing Cross Hospital, under my care, who, thirty years previously, had suffered with chancre, sore throat, and rash; and teas reinfected sixte^i months ago. He again had a chancre, rash, and sore throat. Within twelve months of infection he suffered with girdle pain on the left side, absence of abdominal reflex, and some root anaesthesia on this side, increase of the deep reflexes and slight Babinski on this side, together with inability to empty the bladder. He had a papular rash on admission, and general polyadenitis. There was a lymphocytosis of the cerebrospinal fluid not marked. He improved rapidly on mercurial inunction. The rash rapidly cleared up, and. the local symptoms also.. The case, therefore, was a localized syphilitic meningitis due to re- infection. This case is interesting, for it is rare to find a case of reinfection. Sir William Gowers, in his Lettsomian Lectures, 1890, scathingly criticized the evidence brought forward by Long and others to show that a slight meningitis may be associated with the early phenomena of syphilis more frequently than was generally supposed. But the modern conception of the cause of the roseolar rash by the spirochtete of syphilis escaping from the blood in the cutaneous vessels makes it possible that a similar infection of the cerebrospinal meninges may occur. .