Identifier: oralsurgerytextb00mccu (find matches)
Title: Oral surgery; a text-book on general surgery and medicine as applied to dentistry
Year: 1912 (1910s)
Authors: McCurdy, Stewart L. (Stewart Le Roy), 1859-1931
Subjects: Surgery, Oral
Publisher: New York, Appleton
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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FiG. 3.—Macular Syphiude. The early eruption of secondary sj^hilis. scribed firm nodules developing in the subcutaneous con-nective tissue, not primarily involving the skin, which isreadily movable over them. At first they are appreciableto the touch only, but they increase in size, producing promi-nences, and become adherent to the skin. Syphilides of thischaracter often extend to the underlying structures, fascia,periosteum, bone, cartilage and tendons. 46 THE VENEREAL DISEASES Gummata appear in three forms: a single tnmor, agroup of nodules, or a diffuse infiltrated patch. A gummais a true tumor or granuloma, which jDermanently affectsthe area invaded, whether it disappears by absorption orultimately ulcerates, as is its tendency. A gumma maytake weeks or months to develop and is painless. When itreaches its full size, fluctuation is felt. If lanced, a gummy
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Fig. 4.—Syphilitic Ulceration of the Face axd Nose. Most characteristicof tertiary syphilis in neglected cases. (Dr. Geo. C. Johnston.) puriform substance and some blood exude. Absorption maythen occur or ulceration may take place from central soft-ening (coagulation necrosis). When a gumma involves theskin and ruptures through, there is no abundant dischargeas from an abscess, but the content is adherent by itsdeeper portions to the subcutaneous tissues, and is thrownoff subsequently in the form of sloughs. The ulcer issharply defined, punched out and surrounded by a dark,indurated hyx3eremic areola. If, in the cutaneous gumma, SYPHILIS 47 resolution occurs before softening, a slightly depressed areaof nearly normal skin remains. If softening lias occurred,the depression is marked and the skin is transformed intoscar tissue. When ulceration has occurred the cicatrix isdepressed, thin, and of pearly white color, and when theulceration has been deep the scars are much depressed, atfi

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