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Title: A survey of two years work in the treatment of syphilis in women and children, with especial reference to the results of treatment during pregnancy
Author: Gower, May
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1933
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Abstract:
As a result of the investigations one concludes that the incidence of Syphilis amongst women of the Working Classes in Swansea is at least 2.06% and not more than 3% , so that the disease is not so widespread as one is often led to believe. Syphilis in the women in my series, was chiefly of the latent type i.e 76.3% of the cases and was diagnosed only by the result of the Wassermann Reaction. It is feasable that some of these cases were really, suffering from Congenital Syphilis, which had remained LatOent and shown no manifestations. The majority, however, were probably suffering from the Acquired Disease and may have shown no symptoms due to being infected "per utero", which is an unfavourable medium for the Spirochaeta Pallida. It is important that these cases should be diagnosed for although they may give birth to healthy children, even without treatment) they may also bear Syphilitic children. These cases require treatment, for although they may feel well at the time, they may suffer from vague ill health or even definite manifestations of Syphilis as the years go by. Therefore, in Ante -Natal Clinics, the Wassermann Reaction should be done as a routine on all the women attending,so that if any are found to have Syphilis, they may be referred to a suitable Clinic and treatment begun at once. The number of women attending my Clinic with Latent Syphilis is striking, and may be partly due to the fact that it is for married and not single women and partly that the husbands may have had some treatment before being married. Neisser has shown that the site of innoculation is important and so the prevalence of Latent Syphilis in women, may also be due to the fact that they are frequently infected "per uter", and not by the vulva or cutaneous route. The value of the Wassermann Reaction in women has been investigated and my conclusion is, that a positive Wassermann signifies Syphilis while a negative Wassermann does not preclude it as it has been seen that a Woman with a negative Wassermann can give birth to a child with Congenital Disease. This does not prove Spermatic infection and it is extremely unlikely that a woman can bear a syphilitic child and yet remain immune herself. The more likely hypothesis is that the woman has been infected "per uter", or that as the Wassermann Reaction is a complex Bio- chemical Reaction and is a quantitative and not a specific test, the Wassermann may be negative when the syphilitic infection is non -active, and this so- called Wassermann "antigen" may be poorly developed in the tissues. Women with Congenital Syphilitic children or with a history of repeated abortion, still -birth and neo-natal death, for which no cause can be found, should be treated as suffering from Syphilis, although the Wassermann Reaction is negative. I have also come to the conclusion that women with a weak -positive Wassermann, which remains so after an injection of 0.15 grm Neokharsivan, are suffering from Syphilis and require treatment. This is based on the fact that 41.1% of these women had history of miscarriage,and still-birth, while 14.1% gave birth to children with Congenital Syphilis. Therefore to avoid this wastage of infant life, and avoid the suffering caused by Congenital Syphilis, it is important to treat women with a persistent weak positive Wassermann.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID: uk.bl.ethos.651676  DOI: Not available
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