Quotation from: Manual of Surgery

Written by: Alexander Miles and Alexis Thomson


Some of these imply direct contact--such, for example, as kissing, the
digital examination of syphilitic patients by doctors or nurses, or
infection of the surgeon's fingers while operating upon a syphilitic
patient. In suckling, a syphilitic wet nurse may infect a healthy
infant, or a syphilitic infant may infect a healthy wet nurse. In other
cases the infection is by indirect contact, the virus being conveyed
through the medium of articles contaminated by a syphilitic
patient--such, for example, as surgical instruments, tobacco pipes, wind
instruments, table utensils, towels, or underclothing. Physiological
secretions, such as saliva, milk, or tears, are not capable of
communicating the disease unless contaminated by discharge from a
syphilitic sore. While the saliva itself is innocuous, it can be, and
often is, contaminated by the discharge from mucous patches or other
syphilitic lesions in the mouth and throat, and is then a dangerous
medium of infection. Unless these extra-genital sources of infection are
borne in mind, there is a danger of failing to recognise the primary
lesion of syphilis in unusual positions, such as the lip, finger, or
nipple. When the disease is thus acquired by innocent transfer, it is
known as _syphilis insontium_.

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