Gynaecology for students and practitioners . e probability oftuberculous peritonitis should always be borne in mind. Prognosis. The chronic miliary, or ascitic form gives the bestchance of recovery. The prognosis in the caseous form, with multiplebreaking-down foci, is unfavourable. The prognosis is better inadolescence than in young children and elderly subjects. Associatedphthisis or intestinal tuberculosis renders the prognosis grave. Hightemperature, blood and mucus in the stools, diarrhoea, frequent SYPHILIS IN WOMEN 317 vomiting, and emaciation are very unfavourable symptoms, as theyindi
Gynaecology for students and practitioners . e probability oftuberculous peritonitis should always be borne in mind. Prognosis. The chronic miliary, or ascitic form gives the bestchance of recovery. The prognosis in the caseous form, with multiplebreaking-down foci, is unfavourable. The prognosis is better inadolescence than in young children and elderly subjects. Associatedphthisis or intestinal tuberculosis renders the prognosis grave. Hightemperature, blood and mucus in the stools, diarrhoea, frequent SYPHILIS IN WOMEN 317 vomiting, and emaciation are very unfavourable symptoms, as theyindicate that the mucosa of the bowel is involved. Treatment. If recognized in the early stages, sanatorium treat-ment, combined with X-rays and tuberculin injections, should betried. Palliative treatment should also be given a full trial in thecaseating and adhesive types. In cases of free fluid, where the latteris increasing, the abdomen should be opened, the fluid evacuated,and the Fallopian tubes and appendix removed if they are Fig. 153. Teponema pallidum. () Films made from the dischargeobtained from specific ulcers, prepared by the Indian-ink method. To the leftof the Figure is seen the Treponema pallidum, it has the form of a closely foldedwhite spiral. To the right of the Figure is shown the sjnrochefa refringens,which presents wide spirals. The latter organism is thicker than is the tre-ponema pallidum ; it is non-specific but it is shown by way of contrast withthe true specific organism. Great care is necessary in dealing with adhesions, because intestinalfistulse are easily formed but never heal, the same applies to an externalfistula, so that great care should be expended upon the closure ofthe abdominal wall. Treatment at a sanatorium should follow con-valescence from operation. SYPHILIS IN WOMEN It is not intended in this section to give a general descriptionof syphilis ; works on Surgery can be consulted for this many respects, however
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