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&

Leprosy and Syphilis.

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