Donetsk State Medical University
Department of Skin and Venereal Diseases
Head department prof. Romanenko V.N.
Lecturer Assoc. Kovalkova N.A.
sick x
Curator: 4th year student, 8th group, II Faculty of Medicine Seleznev A.A.
Co-curators: 4th year students of 8th group of the II Faculty of Medicine Dokolin E.N. Shcherban E.V.
Donetsk, 1995
PASSPORT DETAILS
FULL NAME. x
Age 21 years old floor AND
Education average
Home address Donetsk-41
Place of work seamstress-minder
Receipt date: 10.XI.95
Diagnosis on admission: fresh secondary syphilis
COMPLAINTS
The patient complains of a rash on the labia majora and minora, pain, an increase in body temperature in the evenings to 37.5-38.0 C, and general weakness.
HISTORY OF THE DISEASE
The patient first discovered a rash on the labia majora and minora on October 10, 1995, and tried to treat it at home, using baths with chamomile and potassium permanganate. Then pain appeared in the groin area. She assumes that she became infected from her husband and did not have sexual intercourse after the symptoms of the disease appeared. The last sexual contact I had with my husband was about two months ago.
ANAMNESIS OF LIFE
Patient x, 21 years old, was born as the second child in the family (sister is 2 years older). Her parents died when the patient was 12 years old, after which she lived with her older sister. Material and living conditions are currently satisfactory, she is married and has no children. Colds are more rare; Botkin's disease, malaria, typhoid fever, dysentery, tuberculosis, and other sexually transmitted diseases are denied. He smokes up to 1/2 a pack a day and does not abuse alcoholic beverages. Heredity is not burdened. She has had sexual intercourse since the age of nineteen; she has never been promiscuous.
The general condition of the patient is satisfactory, the position in bed is active. Normostenic physique, moderate nutrition. The skin is clean, pale pink in color. There is a postoperative scar (appendectomy) in the right iliac region. Dermographism pink. Nail and hair growth is unchanged. The oral mucosa is pink, the tongue is of normal size, slightly coated with a yellow coating.
The respiratory rate is 16 per minute, the percussion sound over the lungs is clear pulmonary. Breathing is vesicular, there are no pathological sounds. The pulse is rhythmic, 78 beats per minute, satisfactory filling, blood pressure 130/80. The boundaries of the heart are not expanded, the tones are clear and pure.
The abdomen is soft, slightly painful in the iliac regions. The liver and spleen are not enlarged. Symptoms of irritation of the peritoneum, Georgivsky-Mussi, Ortner, Mayo-Robson, Shchetkin-Blumberg and Pasternatsky are negative.
On the labia majora and minora, there is a symmetrical monomorphic rash in the form of papules up to 5 mm in diameter, brownish-red in color, painless, and no peripheral growth. Some papules ulcerate with the formation of small ulcers with purulent discharge, painful. The inguinal lymph nodes are enlarged on both sides, up to 3 cm in diameter, painless on palpation, mobile, not fused with surrounding tissues.
This disease has affected Europe more than any other. But, despite this, not a single novel is dedicated to it, as Albert Camus did regarding the plague. Syphilis was an “unappetizing” and secret disease. You could live with it for a long time, and ulcers could be powdered and lubricated with mercury ointment. But before the invention of penicillin, it was impossible to defeat this disease.
In the nineteenth century, to be considered a genius, you had to have syphilis. Gustav Flaubert, Baudelaire, Daudet, Guy de Maupassant, and Jules de Goncourt received the heroic badge of courage. Were there other great writers who managed to avoid this? “If they were, they turned out to be homosexuals,” wrote Julian Barnes in his book Flaubert’s Parrot.
Charles Baudelaire, Schubert and Karen Blixen were diagnosed absolutely accurately. This disease entailed a number of other diseases, profound changes in the psyche and premature death of Mozart, Beethoven, Edgar Allan Poe, Heine, Chopin, Van Gogh, Flaubert, Maupassant and Nietzsche. Questions about whether Beethoven actually died from poisoning, Mozart from kidney failure, and Poe from something else altogether failed to dispel speculation around syphilis.
And doesn’t Schubert’s “Death and the Maiden” talk about the feeling of a sick person who hopes for death as a savior from torment? Isn’t Baudelaire’s poem “The Sick Muse” dedicated to illness, which plays the role of a muse? Didn’t the creator of “The Flowers of Evil” himself create in this poem the medical history of an entire era? AIDS also provoked a similar wave of works, but much more overt: in novels, films, musicals, songs, the disease was blamed and placed on a pedestal.
The Italian physician Girolamo Fracastoro in 1530, in his poem in Latin, gave the name to this disease, describing the terrible ulcers that eat the body of the victim - a shepherd named Syphilis. He also attributed the origin of this disease to France, where it spread after the war of 1495. Since then, syphilis began to be called the “French disease” not only in Italy. This indicates, first of all, that syphilis was considered a disease of others, anyone, but not their own. It’s the same with AIDS: the disease was seen where they felt guilty.
In the educated and wealthy countries of Europe they spoke of Lues venerea (love epidemic), using this particular Latin name, which unambiguously placed the disease in the paradigm of sin and punishment. Even the hero of Grimmelshausen’s novel Simplicissimus, a pioneer of sexual tourism in Paris, was worried that “he had caught the French disease, and his whole body was covered with spots,“ like a tiger “…”. But he was lucky - it was just ordinary chickenpox.
Diseases like syphilis and AIDS cannot be tied into a moral corset, because the nature of the disease is such that it “explodes” from time to time, and precisely where you least expect it. In this way, diseases are similar to wars. And what began many centuries ago on the battlefield later emerged on the canvases of Otto Dix and other artists - whole columns of ghosts, corpses of soldiers, syphilitic prostitutes and victors.
The pastor's daughter, poet and novelist Emily Brontë considered tuberculosis to be her only terrible disease. A century later, the situation changed dramatically. If Thomas Mann Hanno Buddenbrook dies of typhus in 1901, and representatives of the tuberculosis era of 1924 sought to reach the “Magic Mountain”, then syphilis already appears in his later work “Doctor Faustus”.
Back in 1905, Thomas Mann had an idea: “The figure of the syphilitic Doctor Faustus, whose soul is sold to the devil. The poison acts like a drug, stimulates, inspires, on this rise it creates brilliant things.” And four decades later, composer Adrian Leverkühn voluntarily contracted syphilis - a kind of agreement with the devil, which penicillin began to fight already in 1947.
Thomas Mann's notes, dated 1905, reflect the writer's views on illness as a metaphor for the ambiguity of his relationship to the world. Alcoholism and illness are on one side of the coin, and inspiration is on the other. The medal itself is a payment for Charon, the carrier of human souls to the kingdom of the dead.
This is human narcissism and frustration, because even in the face of syphilis and AIDS, people still want to have the last word. As did the American writer Harold Brodkey, who two years before the tragic date (in 1996 in the New Yorker magazine) officially warned the public about his death from AIDS.
Humanity is constantly threatened by various dangers. There were times when our race was on the verge of disaster, but still managed to survive. Epidemics that regularly wipe out a significant portion of the population are especially dangerous. Let's talk about one of them.
Syphilis is a terrifying blow to the happy hedonism for which Europe was famous before the Puritan era. Who would have thought that sex tourism in the Caribbean and a huge orgy with several thousand prostitutes in Naples would turn out to be such a failure? The failure of noses, among other things. But it all started somewhere. One day the world woke up after another night of love and realized: no more carefree fun, now you can die from sex or, worse, turn into a zombie.
In 1493, Columbus and his friends returned from the world's first tour of the Caribbean and brought gifts: a new route to India (not really), land acquisitions for the crown, tobacco, coconuts, syphilis and tropical fruits. Of course, syphilis was an unplanned gift. Although it is possible that the Arawak Indians deliberately slipped spoiled goods to the whites.
Returning from the trip, infected, but still believing that “it will scratch and go away,” the sailors and soldiers began to do what befits sailors and soldiers. They began to waste the resulting doubloons in brothels and quickly went bankrupt. After this, the poor people (and those who became infected through them) had no choice but to go back to work as mercenaries.
According to the Castilian doctor Ray Diaz de Isla, the world's first patient with syphilis was Vincent Pinzon, who, if anything, was the captain of the Niña, one of the three ships on which Columbus's crew discovered America.
Another serious upheaval had just broken out in Europe, so mercenaries were at a premium. The French king Charles VIII, who married 15-year-old Mary of Anjou, dreamed of winning her heart and at the same time becoming famous as a great conqueror. However, nothing came of it; everything turned out even worse than “it couldn’t get worse.”
Charles VIII not only had a funny face, but also some rights to Italian lands, so he prepared a campaign and set off to conquer the Kingdom of Naples and everything that came along the way. In addition to the army of soldiers, consisting of 30 thousand people, he equipped an army of regimental prostitutes, of whom there were at least eight hundred. Having taken care of his soldiers, His Majesty did not forget about himself, taking with him a whole harem of ladies-in-waiting who were supposed to “help with the housework.” The economy of the great commander did not remain inactive, so he set an infectious example for the troops.
At first the campaign went great. Naples quickly fell at the feet of Charles, and he proclaimed himself King of the Kingdoms of Naples and Jerusalem, as well as Emperor of the East. What more could a 24 year old man want? On the occasion of the incredible victory, the king and his troops staged a grandiose two-month orgy, which attracted thousands of prostitutes from all over Italy. In such a situation, even a couple of syphilis-stricken sutlers and soldiers would be enough to cause an epidemic. There were clearly more infected, and soon almost every third soldier in the glorious army was covered with ulcers.
The epidemic struck like thunder from a clear sky. It was like a plague, but much uglier and more terrible. It spread in an unknown way and immediately gave rise to a lot of rumors.
Contemporaries of this epidemic reasoned this way: if the Lord sent the plague for mortal sins, then a new, even more vile disease - for something much more disgusting. This is where the first two theories of the origin of syphilis came from. The first said that this was punishment for the cannibalism that Charles’s soldiers were engaged in. The second said that the reason was mass intercourse with horses. Although we understand: who needs horses if His Majesty invited thousands of the hottest Italian girls to the party?
Luck ran out on the French; the combined forces of the Italians and Spaniards drove the army of syphilitic patients back to France. Karl was disgraced and, to top it off, suffered from smallpox, which disfigured his face. It would be logical and ironic if it were actually syphilis, but most likely it is not. Arriving home, the king raised his offspring, and no one had problems with venereal disease, so he really was smart enough to protect himself from this disease.
Charles, having suffered a humiliating defeat, disbanded his troops, and with them the mercenaries, who poured into all corners of Europe, spreading the “love plague.” The tsunami of the epidemic was so powerful that in just a decade and a half, syphilis spread throughout Eurasia and Northern Africa. In 1512, even the Japanese encountered it, who, it would seem, tried with all their might to isolate themselves from the rest of the world.
As Voltaire said: “In their gullible campaign against Italy, the French acquired Genoa, Naples and syphilis. Then they were driven back and lost Naples and Genoa, but syphilis remained with them.”
By the way, King Charles VIII, shortly after a failed expedition to Italy, died a slightly unnatural death: he accidentally hit his head on a door frame and smashed his head like an overripe pumpkin. Apparently, the courtiers were so dissatisfied that, at the instigation of their monarch, syphilis began to be called the “French disease” that they did not even come up with a fantasy death for him, as, for example, in the case of the king’s namesake, Charles the Evil.
Syphilis has changed the world much more than it might seem at first glance. It was not just another infection - it became a lever that moved the mountains of history. Largely thanks to syphilis, the church split and Protestants came to success. Puritanism would not have found such a response in the hearts of the flock if it did not have living (and sometimes no longer exists) confirmation of how the Lord punishes for riotous living.
It is precisely because syphilis, first of all, has a detrimental effect on hair, that wigs appeared, which became the hallmark of the New Age. It is also not surprising that humanity remembered and began to actively use another wonderful invention - condoms.
Likewise, the need to treat sunken noses gave impetus to European surgery. The operation to restore the nose was done in a bizarre way: a piece of skin from the patient's arm was cut out, but not completely - a flap had to remain connected to the body so that the blood vessels would continue to supply this piece of skin with blood. The flap was then applied to the nose, and the patient was forced to walk with his hand tied to his head until the piece of skin took root in place of the nose. The person who came up with this was either a genius or a madman
It was syphilis that helped the Netherlands gain independence from Spain. The disease was one of the foundations of anti-Spanish propaganda: Dutch Protestants argued that the source of the infection were Catholics and, by getting rid of their oppression, the disease could be defeated.
Be that as it may, neither religious propaganda nor fear of a terrifying disease defeated syphilis. People continued to fornicate left and right, no matter what. Suffice it to say that in Renaissance Europe it generally became the leading cause of death. Roughly speaking, the average European had a greater chance of dying from syphilis than from wars, famine, other diseases, and even more so from old age. Against this background, the fact that three of the Popes supposedly had this shameful disease does not seem so surprising.
The word "Syphilis" has a curious (and rather raunchy) origin story. It was invented by the doctor and poet Girolamo Fracastoro, who gave the name “Syphilus” (that is, “friend of pigs”) to the hero of his poem. In it, the author allegorically talked about the symptoms of the disease and presented his version of its origin: the shepherd Syphilus, yearning for women, reclined with his pigs and was punished for this by the disgusting gods.
Everyone liked the story and they began to call the infection “Syphilis.” Although before that it had many other sonorous nicknames: the Black Lion, Cupid's disease, the Great Smallpox, the Venereal Plague, and the Scots gave it the harsh name Grandgore, which is more suitable for this disease than the frivolous “Syphilis”.
In the dashing 90s, a neighbor next door suggested that I take a walk and drink beer. Oh, I was a medical student then. University 4 years of study. “What are you studying now?” he asks me, as if casually. “The cycle is on dermatovenerology, and the teacher, who was funny, just laughed. I asked about syphilis, but I didn’t even have a textbook, my compassionate classmates opened it to the right page and put it in front of me. It’s inconvenient to read small print while standing, and there are too many specific terms. The medical departments adored our medical and preventive faculty, and the guy got carried away. “Here, you, a doctor-propagandist, will come to the village to give a lecture about syphilis, and from your story I understood that if you get syphilis and are not treated, sooner or later you will go blind and go deaf!” To follow up with an anecdote: “Two men are standing, drinking beer from mugs over the handle and asking each other why this is so? One says I’m afraid of contracting syphilis, the other says I’m afraid of contracting syphilis.”
Meanwhile, my neighbor and I approach the skin and venous dispensary and he tells me: “remember the friend who lived with me, she awarded me a sifak, four crosses, a secondary one, but don’t worry, everything can be treated in 3 injections!”
Well, there you go! It’s scary, like in “The Big Break,” you study, study, and then bam, second shift. Unexpectedly and unexpectedly we ran into... I went to see him, but there was also a household service, they sailed...
I take a textbook (a terrible weapon in the hands of a student), and I find all the symptoms of syphilis, including tertiary (I have a saddle-shaped nose and teeth, obviously Getchisson), and signs of secondary are obvious (red spots on the flexor side of the upper limb).
It’s too early for us to die, we need treatment. A real Doctor does not look for easy ways. Through an ambulance paramedic I know, I contact a dermatovenerologist at a rural hospital. I put on a fashionable Arivas tracksuit, bought at Shanghai the day before, by the way, won on a bet from Kent that I would count more Adidas company names at Shanghai, I set off towards health.
The path to such health care aces is closed without a bubble, so the conversation was short.
“Is it itchy? More at night?”, the village luminary asked me about my syphilitic spots. “Yes,” I answered, and a treacherous thought flashed in the depths of my soul that there was a tiny chance left to live a little.
The sentence was merciless and merciless; in the diagnosis column, “Scabios” was written in Latin letters. It would be better to have stage 4 cancer (cancer), at least some chance of life.
Meanwhile, a stupid village mug writes a prescription for me, a dying doctor!!! some kind of medicine and with a contemptuous face goes to wash his hands. I’m reading, wondering if I’m facing death, but it’s written in Russian “Antiskab”.
Yes, I don’t have late-stage syphilis, but ordinary scabies, apparently from a fashionable tracksuit!!!
To the house (20-odd km), I ignored the minibuses and ran at a hop.
Many people call syphilis the “French disease”, the French themselves call it “Neapolitan”, there is still no exact data on who and when became the original source of the disease, which was learned to be effective only in the middle of the last century.
The theory is confirmed by modern data; genetic analysis has established the relationship of Treponema pallidum, which is found today, with South American treponema. But traces of syphilitic bone lesions in people who were born much earlier than Columbus cast doubt on this theory.
Most likely, there were several sources of syphilis on the planet, each of which had a genetically different pathogen from the genus of spirochetes, most of them did not have high pathogenicity and were rarely transmitted to partners, and therefore over time ceased to exist and the most adapted and possessing more spread across the planet. aggressiveness of the spirochete.
Is it possible to register an employee for the position of financial director - chief accountant? The chief accountant claims that yes, but...
The head of a small business can easily manage the budget independently. CHECKED! If you're budgeting...
The creation of new projects involves a preliminary economic justification for their feasibility, subsequent...
Reporting is generated by the RM, is agreed upon (approved) by the Risk Committee under the Management Board and transmitted to...
At the edge of a large, very large meadow, on a long emerald blade of grass lived a tiny Ladybug. Little Ladybug...
Nowadays, it is quite common for people to turn to the stars. With the help of a horoscope a person can learn a lot about...
Business or friendly. If you were pursuing a stranger, it means your level of trust in the female sex...
according to Freud's dream book If you dreamed about how you were fishing, it means that in real life you can hardly switch off...
The New Year's whirlwind will spin us around so quickly and rapidly that it's time to thoroughly think through the New Year's...
The article offers you some of the most delicious recipes for making vinaigrette. Vinaigrette is a delicious salad...
July 4th, 2015 , 08:33 pm Lately our Nastena has been completely giving up sweets (and thank God), but...
Fragrant, very tasty chocolate cake, it’s impossible to stop eating! The Negro’s Kiss cake is very easy to prepare,...
Dream interpretation is an ancient art that allows you to at least assess the psychological status...
As soon as the first mirrors were born, people immediately endowed them with all sorts of mystical abilities....
The head of a small business can easily manage the budget independently. CHECKED! If you manage...
The creation of new projects involves a preliminary economic justification for their feasibility, subsequent...