On dactylitis syphilitica : with observations on syphilitic lesions of the joints / by R.W. Taylor.

  • Taylor, Robert W. (Robert William), 1842-1908.
Date:
1871
Catalogue details

Licence: Public Domain Mark

Credit: On dactylitis syphilitica : with observations on syphilitic lesions of the joints / by R.W. Taylor. Source: Wellcome Collection.

    9/32 (page 7)
    various directions. At this time, also, a shallow transverse ridge was seen about the middle of the nail: it was not the result of destructive change, but merely a groove, such as is sometimes observed after adynamic diseases. The general condition of the patient had improved very much since ■warm weather, and he had no visible progressive lesion of syphilis. N^laton's Case was that of a man aged 50 whose right middle finger swelled upon three occasions. The augmentation in volume was mostly developed in the first phalanx, a little less in the second, and scarcely any in the third. The whole of the first phalanx was involved, and more especially upon the palmar than dorsal aspect. Movement was slightly impaired, and pressure induced slight pain, which, however, existed spon- taneously. The integument was stretched and somewhat livid. Under an anti-syphilitic treatment it subsided. Ltjohe's Cases :— 1. A syphilitic man, aged 45, having nodes upon the sternum and a swelling of the sterno-clavicular articulation, observed, in April, 1860, that the little finger of his right hand and the great and second toes of the left foot and the second toe of right foot became enlarged. The left knee became swollen and painful, and its articular capsule became thickened, and fluctuation could be felt. Soon after the left little finger enlarged. The swelling in the toes and fingers consisted in a uniform enlargement of all the phalanges except an unusual swelling at the second phalanx of the right great-toe. The integument was red and tense, and the articular cutaneous furrows were effaced. Crepitation was readily heard between the articular surfaces of the phalanges, and abnormal movement existed, particularly in the little finger, the joint of which was quite loose. The patient had, besides, an inflammation of the body and articulations of the fourth cervical vertebra, which interfered with the maintenance of the erect position of the head. Under a mercurial treatment the swelling in the fingers and toes subsided in about three months. 2. A man aged 50, having had very severe syphilitic lesions, particu- larly gummy deposits in the bone and connective tissue, and painful en- largement of the knee and wrist, noticed that his right great-toe swelled gradually and uniformly, and was soon followed by swelling of the second toe of the left foot. The swelling was due to a uniform enlargement of the phalanges, and a simultaneous thickening of the soft parts Move ment was impaired, but pain was absent. The integument of the toes of this case also was tense and resistant. At first he was treated by mer- curial inunctions, which caused some coexisting gummy tumors' to dis- appear, but the swelling in the toes remained. Crepitation could be distinctly heard in the phalangeal articulation of each toe. The gummy tumors, which had healed, became ulcerated again, and the great-toe