The permanent teeth in congenital syphilis are irregular, notched, and pegged, and the conformation of the alveolar arch is imperfect. The two upper central incisors are "Hutchinson's test teeth." These are short, vertically notched, narrow, and rounded at their corners.
Interstitial keratitis is practically pa thognomonic of inherited taint, aud, when coincident with the syphilitic type of teeth, puts the diagnosis beyond doubt.
Treatment. — Syphilis has long been treated upon the theory that it can be antidoted by drugs. Much harm has re sulted from this. A rational therapy of the disease must necessarily comprehend a knowledge of its natural evolution and `conform to its natural course. The aim should be, not to stamp out quickly the disease, but to combat its materies morbi and reinforce the spontaneous tendency to removal of its results, until the system triumphs and the disease is finally elim inated.
Notwithstanding modern progress in therapeutics, mercury is still our sheet anchor in the treatment of syphilis. The slow, continuous, and moderate use of mercury, for a period corresponding to the maximum time of the normal dura tion of the disease as nearly as may be, without at any time producing its full physiological effects, will generally bring about a cure that can be accomplished in no other way.
It is well known that mercury has the power of inducing fatty degeneration and elimination of inflammatory products, or "of relieving tissues encumbered with superfluous and obstructive material." This condition of the tissues is precisely what exists in syphilis, and as mercury is the best remedy at our command for the correction of such a pathological state, irrespective of etiology, it should be administered throughout the natural course of the disease, not to antidote a poison, but to remove the morbid results produced by it, as fast as they are formed, until finally the syphilitic impression upon the organism has naturally ex hausted itself. We have already seen that the infection of syphilis, whatever its material substance, practically con sists in the influence of infection on healthy cells, causing their rapid pro liferation and obstructive accumulation.
That the peculiar property of the infec tion is due to a pathogenic microbe of as yet unknown form is probable; but whether the morbific principle be a germ, virus, or "degraded cell," the result is the same. It is a rather peculiar fact that every method of treatment for syphilis that has been advocated for the last two or three centuries has comprised such measures as tend to produce rapid tissue changes, and, more especially, elimina tion. The sweating cure; the use of hot baths, as at the Hot Springs of Arkan sas; the purgation and starvation cures, Boeck's method of syphilization, and the treatment by pustulation with tartar emetic, all of which have been recom mended by various authorities at different times, are chiefly active through their power of inducing fatty changes in the tissues. In the various methods of hy drotherapy the benefit is secured by in creasing elimination. This is especially important in view of the toxins elabo rated by the microbe of syphilis.
The action of mercury upon the blood is of great practical interest, inasmuch as by its use diametrically-opposite fects may be produced, according to: (1) the doses used, (2) the duration of its administration, (3) the constitutional condition of the patient, and (4) the stage of the disease. (See MERCURY, volume iv.) The writer divides the remedial proce dures into (1) the secondary incubation or pre-eruptive period; (2) the eruptive stage. including the first six or seven months; (3) from the sixth or seventh month to the end of the third year—the late secondary stage; (4) the tertiary stage. The administration of mercury cannot be begun too early, and when the round cells, caused by the syphilitic virus, are still young and more easily acted upon, iodide of potassium is ad ministered for the elimination of the de generated round cells and the toxins of syphilis. The mercury is given in to '/ grain (0.008 to 0.016 gramme) doses, three times daily, while an inunction of 50-per-cent. stremirth should be rubbed into every portion of the body, especially between the fingers and toes, as well a, on the palms and soles. W. D. Trenwith (Medical News, April 25. 1903).