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RESIDENTS PAGE
Year : 2015  |  Volume : 36  |  Issue : 2  |  Page : 226-229
 

Eponyms in syphilis


1 Department of Dermatology, Command hospital, Pune, Maharashtra, India
2 Department of Dermatology, Army College of Medical Sciences, Base Hospital, New Delhi, India

Date of Web Publication12-Oct-2015

Correspondence Address:
Deepak Vashisht
Department of Dermatology, Command Hospital, Pune - 411 040, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0253-7184.167197

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   Abstract 

Eponym has originated from the Greek word "eponymos" meaning "giving name". It is a tribute to the pioneers in the field who have significantly contributed towards present understanding of the subject. Syphilis has amazed and plagued mankind since eternity. This disease is a great masquerade and can humble best of physicians with its varied presentations. Keen and immaculate observations of these workers have eased our understanding of many signs and phenomenon associated with this disease. This has led to evolution of number of eponyms, perhaps no other disease has as many eponyms associated with it, as does syphilis. Eponyms such as Kassowitz's law, Clutton's joints, Higoumenaki sign, Argyll-Robertson pupil etc. help in providing easy milieu for remembering. Besides paying tributes to stalwarts in the field, who dedicated their lives for this cause, they also facilitated our current understanding of the great masquerade.


Keywords: Eponym, syphilis, signs


How to cite this article:
Vashisht D, Baveja S. Eponyms in syphilis. Indian J Sex Transm Dis 2015;36:226-9

How to cite this URL:
Vashisht D, Baveja S. Eponyms in syphilis. Indian J Sex Transm Dis [serial online] 2015 [cited 2019 Nov 19];36:226-9. Available from: http://www.ijstd.org/text.asp?2015/36/2/226/167197



   Introduction Top


An eponym is a word or name derived from the name of a person. It has originated from the Greek word "eponymous" meaning "giving name." It is a tribute to the pioneers in the field who have significantly contributed toward present understanding of the subject.

Syphilis is known since antiquity; perhaps no other disease has amazed and plagued mankind as much as this malady. Across ages, physicians have dedicated their lives toward understanding of this disease and providing a panacea for this great masquerader. Lot of research has gone into this field over the years, keen and immaculate observations of these workers have eased our understanding of many signs and phenomenon associated with this disease. This has led to the evolution of a number of eponyms, perhaps no other disease has as many eponyms associated with it, as does syphilis has. Sir William Osler has aptly said "He, who knows syphilis, knows medicine."


   Syphilis Top


It has been known by various names viz Great Pox, morbus gallicus, lues venereum, Polish disease, etc. It is believed to have acquired its present name from the legend of mythical shepherd, syphilis, in poem, and Syphilis Sive Morbus Gallicus, described by Hieronymus Fracastorius in 1530, which means "Syphilis or the French Disease." [1]

In hereditary transmission, nature plays some queer and unexplainable pranks. Three conditions are so well-known that they have come to be recognized as established laws: Kassowitz's, Colle's and Profeta's law.


   Kassowitzs Law Top


Also called as Diday's law emphasizes rate of vertical transmission in untreated mother significantly drops with the passage of time. The longer the interval between infection and conception better is the outcome. It is believed that transmission rates drops from 70-100% to 10% during primary syphilis and late latent disease, respectively. [2]


   Colles Law Top


Named after Colles also known as Baumιs law states that a child born to apparently asymptomatic mother with no signs of venereal symptoms, and presents with syphilis after few weeks would infect the healthiest nursemaid, but not its mother. [3] Colles at that time was ignorant that the mother already syphilis.


   Profetas La Top


It states that an apparently healthy baby born of a syphilitic mother cannot be infected by her mother due to suckling or by a wet nurse. [4]

Hutchinson's triad is named after Sir Jonathan Hutchinson (1828-1913) British surgeon and pathologist. It is a classical triad characterized by the presence of interstitial keratitis, eighth nerve deafness, and Hutchinson's teeth. [5] Hutchinson's triad usually becomes apparent after 5-year of age. Hutchinson's teeth are peg-shaped incisors having a crescent-shaped notch in the cutting edge due to enamel hypoplasia, and occurring especially in children with congenital syphilis.


   Fourniers Teet Top


Also known as mulberry molars and moon molars. These result due to enamel hypoplasia of the first molar. Fournier described a less characteristic deformity of the first molar, which he said was even more common than Hutchinson's teeth. [6]


   Cluttons Joint Top


First described by Clutton in 1886. It is arthritis in congenital syphilis in relatively older children. There is painless, symmetrical, joint swelling affecting the knees, presenting with synovitis, and joint effusions. It may also involve ankles, elbows, wrists, and fingers. [7]


   Parrots Pseudoparalysi Top


Also known as Parrot I syndrome or Bednar-Parrot syndrome - was first described by Parrot, Jules Marie, French physician, in 1871, this condition affected relatively younger children, within 8 months of birth in early congenital syphilis. Osteochondritis was the most common and the earliest lesion mainly affecting the upper limbs and knees. Pain in the extremities secondary to involvement of bone resulted in a lack of movement on the affected side. [8]


   Wimbergers sign Top


Named after Heinrich Wimberger, German radiologist is also known as Wimberger's corner sign. It is a specific pathognomonic radiological sign of congenital syphilis in which there is localized bony destruction of the medial portion of the proximal tibia metaphysis. [9] Clinically, it manifests as mild irritability or pseodoparalysis. It should not be confused with Wimberger's ring sign seen in scurvy.


   Higoumenaki sign Top


Higoumenakis (1895-1983), a Greek dermatologist, student of Gaston Milian, a famous syphilologist was first to describe the enlargement of the sternal end of the (right) clavicle during late congenital syphilis. This sign has been suggested as an important diagnostic tool for screening congenital syphilis among the anthropological specimens. [10]


   Jarisch-Herxheimer Reaction Top


Jarisch-Herxheimer reaction is described after Adolf Jarisch (1850-1902) an Austrian dermatologist and Herxheimer (1861-1942) a German dermatologist. Jarisch in 1895 and Herxheimer in 1902 observed that after the use of mercury for syphilis. This reaction is seen more frequently with the use of penicillins rather than other antibiotics. Early syphilis has the maximum chance of this reaction after treatment, followed by infants with congenital syphilis, pregnant patients with syphilis, and patients with neurosyphilis, respectively. Also known as "therapeutic shock," results from the sudden excessive release of lipoproteins with inflammatory activities from dead or dying treponemes. It is associated with pyrexia, headache, malaise, myalgia, leukocytosis with lymphopenia within 12 h of initiation of treatment and terminates within 24 h. [11]


   Buschke ollendorff sign Top


0Jewish German dermatologist Abraham Buschke (1868-1943), and Helene Ollendorff Curth (1899-1982) German-American dermatologist observed the extreme sensitivity of secondary syphilitic lesions to pressure with a dull probe (e.g., papular lesions of syphilis) due to cutaneous vasculitis. It is also known as Ollendorff probe sign. [12]


   De Graefes Relapsing Central Retinitis Top


First described by Friedrich Wilhelm Ernst Albrecht von Graefe a pioneer of German ophthalmology in 1866, who named it as "relapsing central luetic retinitis." It is circumscribed serous retinal detachment that is usually confined to the posterior pole caused by leakage of fluid through the retinal pigment epithelium. It is now known as central serous chorioretinopathy with largely unknown etiology. [13]


   Argyll-Robertson Pupil Top


Named after Scottish ophthalmologist Douglas Moray Cooper Lamb Argyll Robertson (1837-1909) who died on January 3, 1909, Gonday near Mumbai, India. It is also known as reflex iridoplegia, and colloquially as "Prostitute's Pupil." This is highly associated with neurosyphilis, and might also be seen with diabetic neuropathy. In this accommodation, reflex is preserved but pupillary reflex is compromised. It has been attributed to a dorsal midbrain lesion in neurosyphilis that interrupts the pupillary light reflex pathway but spares the more ventral pupillary near reflex pathway. [14]


   Justuss Test for Syphilis Top


Named after Justus. This test was used for diagnosis of syphilis before the advent of wasserman test. In this test change in hemoglobin level is determined before and 24 h after a single mercurial inunction. Initially, there is fall in hemoglobin by about 10-20% followed by a rise to a level above that which existed when the test was applied. [15]

December 1903, Volume 67, Issue 3, pp 363-386.


   VIRCHOW'S SIGN Top


0"The father of modern pathology" Rudolf Carl Virchow (1821-1902) observed that tongue often showed a smooth base in congenital syphilis. This is called as Virchow's sign. [16]


   Hunterian chancre Top


0Hunter (1728-1793) was a Scottish surgeon who believed in the Unity or Monist Theory, that is, gonorrhea and syphilis were the same disease. To prove his observation, he conducted a famous experiment in 1767, in which he inoculated himself with matter from a patient who suffered gonorrhea. Ten days later he developed a chancre, followed by secondary syphilis, thus proving his point. It is now believed that the donor had both syphilis and gonorrhea. Since then primary chancre is known as Hunterian chancre or hard chancre. He was later proved wrong by Philippe Ricord in 1838. [17]


   RICORD'S CHANCRE Top


0Philippe Ricord (1800-1889) was a French physician who described a syphilitic chancre with a thin parchment-like base. He conclusively proved that syphilis and gonorrhea were separate diseases. He also observed that bubo of syphilis was multiple, consisting of a chain of movable glands which are now called Glandulte Pleiades of Ricord. He is credited with categorized of syphilis into primary, secondary, and tertiary stages, a classification which has stood the test of time and is still in vogue. [18]


   Wassermann test or wassermann reaction Top


0Named after the German bacteriologist August Paul von Wassermann (1866-1925), First diagnostic test of syphilis using blood serum or cerebrospinal fluid. It is a modification of the complement-fixation reaction. [19]


   NELSON-MAYER TEST Top


0Also known as Nelson's syphilis reaction or Nelson's treponemal immobilization test is named after Robert Armstrong Nelson and Manfred Martin Mayer. It is highly sensitive, the specific reaction for serodiagnosis of syphilis. It demonstrates of immobilizing antibodies in patients' serum. [20]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
Oriel JD. The Scars of Venus: A History of Venereology. London: Springer-Verlag; 1994.  Back to cited text no. 1
    
2.
Fiumara NJ. Syphilis in newborn children. Clin Obstet Gynecol 1975;18:183-9.  Back to cited text no. 2
    
3.
Colles A. Practical Observations on the Venereal Disease, and on the Use of Mercury. London: Sherwood, Gilbert and Piper; 1837. p. 304.  Back to cited text no. 3
    
4.
John A, Mackenzie S. Reinfection in syphilis-profetas law. Br Med J 1899;1:1440.  Back to cited text no. 4
    
5.
Hutchinson J. On the influence of hereditary syphilis on the teeth Lancet 1856;9:449.  Back to cited text no. 5
    
6.
Fournier, E. Dental dystrophies in a case of heredosyphilis (Communication made ​​on behalf of Mr. Hallopeau). Ann. Derm. and Syph. 1900 (Cavallaro).  Back to cited text no. 6
    
7.
Clutton HH. Symmetrical synovitis of knee in hereditary syphilis.Lancet 1886;1:391-3.  Back to cited text no. 7
    
8.
Parrot MJ. On a pseudo- paralysis caused by an alteration of the skeletal system in newborns with hereditary syphilis. Arch Physiol 1871; 4: 319-33.  Back to cited text no. 8
    
9.
Solomon A, Rosen E. The aspect of trauma in the bone changes of congenital lues. Pediatr Radiol 1975;3:176-8.  Back to cited text no. 9
    
10.
Higoumenakis G. A New Stigma of Hereditary Syphilis. Proceedings of the Medical Society of Athens; 1927. p. 687-99.  Back to cited text no. 10
    
11.
Herxheimer K, Martin H. So-called Herxheimer reactions. Arch Derm Syphilol 1926;13:115.  Back to cited text no. 11
    
12.
Al Aboud K, Al Aboud D. Helen Ollendorff Curth and Curth-Macklin syndrome. Open Dermatol J 2011;5:28-30.  Back to cited text no. 12
    
13.
Von Graefe A. Ueber centrale recidivierende retinitis. Arch Clin Exp Ophthalmol 1866;12:211-5.  Back to cited text no. 13
    
14.
Thompson HS, Kardon RH. The Argyll Robertson pupil. J Neuroophthalmol 2006;26:134-8.  Back to cited text no. 14
    
15.
Feuerstein L. About the so-called. Justus′sche hemoglobin test in syphilis patients. Arch Dermatol Syph 1903;67:363-6.  Back to cited text no. 15
    
16.
Da Costa JC. "Chapter 16. Syphilis". Modern Surgery, 4 th ed. John Chalmers Da Costa. 1903:43. Da Costa JC. "Chapter 16. Syphilis". Modern Surgery, 4 th ed. John Chalmers Da Costa. 1903:43. http://jdc.jefferson.edu/dacosta_modernsurgery/43.  Back to cited text no. 16
    
17.
Hunter J, Home E. A Treatise on the Venereal Disease. 3 rd ed. London: W. Bulmer; 1810:4-7.  Back to cited text no. 17
    
18.
Ackerknecht EH. A Short History of Medicine. Revised edition. Baltimore: John Hopkins University Press; 1982.  Back to cited text no. 18
    
19.
Wassermann A, Neisser A, Bruck C. A serodiagnostic reaction in syphilis. German Medicinische weekly. Berlin 1906;32:745-6.  Back to cited text no. 19
    
20.
Nelson RA Jr, Mayer MM. Immobilization of Treponema pallidum in vitro by antibody produced in syphilitic infection. J Exp Med 1949;89:369-93.  Back to cited text no. 20
    




 

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    Abstract
   Introduction
   Syphilis
   Wimbergers sign
   Higoumenaki sign
    Buschke ollendor...
   VIRCHOW'S SIGN
   Hunterian chancre
   RICORD'S CHANCRE
    Wassermann test ...
   NELSON-MAYER TEST
   Kassowitzs Law
   Colles Law
   Profetas La
   Fourniers Teet
   Cluttons Joint
    Parrots Pseudopa...
    Jarisch-Herxheim...
    De Graefes Relap...
    Argyll-Robertson...
    Justuss Test for...
    References

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