THE INDIAN MEDICAL GAZETTE.
274
[Sept.
1890.
deposit
and its
Sir William Moore has, in the paper morphological and pathological features, which we had the pleasure of publishing last counter differences winch are certainly
we en-
especially
LEPKOSY AND SYPHILIS.
if
regards
as
the site of
specific
generic. The granulomata in each case are mouth, comparison its heredi- degenerative or rather reversionary modes of leprosy and syphilis, particularly in tary manifestations. Both diseases belong pa- nutrition, and they are probably due in both thologically to the great group of granulomata cases to particulate orgauisms, and they are both drawn
between
clever
a
not
granulomata ; subject to the control of vital resistance and tisand such being the case, it were indeed surprising sue susceptibility ; but here the similarity ends. if some analogies nay homologies were not The syphilitic granuloma exhibits a tendency discoverable on a superficial study of their to periodic manifestation, and is subject to a phenomena. Similar homologies can very easily strong law of cure. Acquired syphilis has its and to the
of infective
sub-group
be discerned among the members of other nosological groups, such as the fevers, inflammations, tumours, &c.
Indeed,
such
homologies
owes
its existence.
it is to the existence of
that the science of
But, J
nosologi-
cal
homologies may be for purposes of classification, the progress of scientific medicine has been marked
ple
aud
cancer
hand and
closer
rather than
of
separation
typhus
than
affinity
011
a
There
are
leprosy
other
on
the
the other may claim entitled to do with
are
they each other. But similarity cannot be held to constitute a grouud of affirming identity, more especially as we know for certain that pathological similarity or even identity may exist where etiology aud natural history are widely different.
?Py rexia
as
flammation caused and
by
functional disturbance and ina nutritional disturbance may be
a as
au
agents.
infinite The
number of ways of
diversity
their reappearance
hereditary syphilis preserves this character curability or apparent curability and amenability to the influence of drugs. The granuloma is by no means essentially a pernicious or deof
ot
circumstances
organism possesses limited resenting or responding to a
environment. But these noxaj while produce similar or identical nosoi may be so
exhibits
present
analogy
far
dose ol castor
aud a A fright O OJ oil may each a diarrhoea, but it would produce strain the wildest to establish a
imagination
resemblance between the two causes. But apart from these considerations, if we compare the natural history of syphilis and of the manifest
leprosy
in respect
pathological product or lesion, and
an
leprosy destructive character.
The
granuloma of essentially pernicious and
Apparent cure in leprosy means delayed destruction, imperfect repair of broken-down tissue or temporary abeyance of progressive disintegration. Then the syphilitic presents very different
granuloma phases,
is
infinitely
forms and
protean than the
more
lep-
rous?appears and disappears more rapidly. In its earlier stages it is more of an eruption than a
neoplasm, and its later stage is more of a plasm than an eruption ; whereas leprosy sents
a
sort of
is still
110
circumstances.
favourable
they
to
It may become so under circumorganism or its environment which
but the law of recovery is capable of detection and use under the most un-
character.
as
one.
stances of the
uoXcB in its
differeut in kind less a homology.
granulomata is hastened and averted by certain medicines.
Even
recogni- structive exam-
of the
typhoid fevers depress vitality,
aud
sarcoma.
syphilis
by
Take for
with which
euthetic diseases one
differentiation of generic aud
general resemblances.
the
and of
a
differences
specific tion of
by
the latter may at any stage be absolute and final; and there is every reason to believe that the
nosology disappearance
however interesting and O
useful the detection of pathological and
stages of appearance and di sappearance, and
the this
intermediate and
more
pretubercular
The different character of the lesion
more
nervous
system
apparent if for
we
example.
study special tissues,
syphilis seizes portion that suffers, in time is repairable. When
it is the central
and the damage if taken In inherited syphilis nervous troubles *
In
leprosy
neo-
it is the
peripheral portions
'
are rare. C
1
of the sys-
that become affected, and the affection is progressively destructive; and we know of no
tem
means
of
staying
this progress towards
impair-
SErT 1890
CURRENT MEDICAL TOPICS.
]
fuuctiou and eventual distake Or the bones. Syphilis may integration. thicken them, or in cachectic subjects strangle ment of structure mid
Leprosy
them.
kills them
by
affected
to be
apt
st.irves
sheer
and
inanition,
are
thins and
them, the
or
bones
very different in each
We
might elaborate largely on the same lines, but we have written enough to show that even as regards the essential and pathological features of these diseases,?those in respect of which homology really exists, great and significant differences are evident which, apart case.
from other them
as
specifically
to
come
considerations,
study
are sufficient to mark different diseases. When we
these other
considerations,?inci-
dence, geography, communicability, modes of communication, clinical history, period of manifestation, influence
on
life, mortality, &c.,?'the such
diseases
present glaring divergencies question of identity of nature and causation out of the question. two
to
as
put
The
resemblance of the
bacilli of the
two
which very little weight for or either be cast against. All bacilli
diseases is can
all
a
matter
on
closely, and phologically undistinguishable may different pathogenetic properties. resemble each other
bacilli
mor-
have
very We there-
very radical exception to the conclusions advanced by Sir William Moore, as regards both as resting on an unsound basis fore take
facts and argument.
27&