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C. D. ALERGANT, M.D., M. R. C. P.
AMA Arch Intern Med. 1956;98(3):340-343. doi:10.1001/archinte.1956.00250270084010.
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ACCORDING to Rolleston (1929) the liver is the commonest internal organ to harbour a gumma. The clinical diagnosis of hepatic gumma, however, is rarely made, and subsequent to the report of Tucker and Dexter (1946), who described two cases and were the first to record the effect of penicillin in late hepatic syphilis, we have been able to find reports of only two further cases, Nicol and Terry (1951) and Viranuvatti and Kochaseni (1953), in which the diagnosis was made during life. A third case was reported by Shapiro and Weiner (1951), but the diagnosis was only made after death. The following case presents certain unusual features and was thought to be worthy of description.

A 29-year-old lorry driver attended his own physician in September, 1952, complaining of a painless swelling in his right hypochondrium. He was referred to the surgical outpatient department of a general hospital, where the swelling


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