In studying maternal syphilis we have shown the conditions in which the disease is transmitted to the fcetus. In connection with diseases of the placenta, membranes and cord, we have noted the lesions which are regarded as characteristic of syphilis; it now remains to study them in the different syst,ems and organs of the fcetus.
In recent years hereditary syphilis has been studied authoritatively by Parrot, from whom the following description is borrowed: Two different groups of lesions are produced: one, peripheral or super ficial, located on the skin or mucous membranes; the other, profound, which affects the different viscera and the bones.
The cutaneous lesions are bulhe, maculae or papules, as shown by the following table.
Ulcerous syphilides are only the ordinary syphilides which have become ulcerated by the action of external bodies or under the influence of a generally bad condition. The more intense the diathesis, the sooner the syphilides appear. The first manifested is the bullous syphilides (the pemphigus). It is a precocious manifestation of extreme gravity, which often coincides with visceral lesions, and which frequently and rapidly reaches a fatal termination. On the contrary, the lenticular syphilides is manifested later; it ordinarily appears isolated. The vesico-papular syphilides are extremely rare, are the expression of a vanishing diathesis, and of little gravity, and, as intermediate to these different cutaneous lesions, we find the macular syphilides, rarely isolated :ind united some times to the bullous syThilide, sometimes to the " plaque " syphilide (syphi litic roseola of authors). The mucous patch, the most frequent, is char acterized by permanent, tenacious, indurated elevations in patches. The patches are circular, red at the centre, violet or salmon-red at the periphery. They are found about the anus, on the lower limbs, thighs, scrotum, labia majora. (The child at the same time has coryza). They ulcerate easily. On the face they often become crusted; finally they occur on the scalp. The emption is produced in eight, ten or twelve days, and increases. They last a long time. The lenticular syphilides occur on the buttocks, the upper and back part of the thighs and the leg, the labia majora and the scrotum; these are the true lenticular patches.
Then, the buccal ulcerations appear. But while all or nearly all the buccal ulcerations, due to rnarasmus, are symmetrical and lying on the median line or at symmetrical points, the syphilitic ulcemtions are never found in the median line, and it is impossible to give them a particular topogra phy. They have an irregular contour and a hemorrhagic tendency; they occur particularly on the tongue, on the internal surface of the cheeks, on the alveolar border of the maxilhe, and quite frequently on the velum palati. They are found also in the moutfl, as red, prominent patches, similar to ordinary mucous patches. On the lips are found fissures, the true rhagades, erosions and projecting mucous patches. When the chil dren die of syphilis, we find profound lesions of the bones and viscera. All the organs may present the lesions; indeed they have been found in the brain, where occurred a softening of a bluish-red color, and little purulent nuclei, located near the longitudinal fissure and to the left side of the cerebellum. But these four organs, the thymus, the lungs, the liver and the spleen are always affected. In the thymus, Dubois has noted the presence of pus diffused or collected in foci in the parenchyma, with out changing the color, form or size of the organ. The observations of Braun, Spwth, Depaul, Wild, Virchow, Weber and Hecker, have con firmed those of Dubois; but Spiegelberg, who also found these changes, thinks that, in a good many cases, there is an increase in the size of the gland. In the lungs, Depaul, in 1851, stated: sometimes true collections of pus, or more or less thickened cavities enclosing a liquid of the same nature, are found. "I have many times," said he,"found another disposition which should be considered as the first degree, and which consists in a grayish induration, without as yet recognizable pus, with a considerable deposit of fibro-plaatic tissue. Sometimes the lesion was disseminated and limited to circumscribed points; sometimes, on the contrary, it was general and had invaded one or more lobes. But always the pulmonary tissue was impermeable to the air, as proved by mucous insuffiations. It is not rare to find these different degrees in the same organ." The lesions are con nected with other conditions characteristic of syphilis.