Profeta's Law

PROFETA'S LAW (Profeta), a proposition put forth in 1865 by Profeta, according to which by analogy with the law of Kolls (see Kolls' law) any child born to a syphilitic mother, if he shows no signs of syphilis, can (without risk of infection) be put to the breast of his mother or any syphilitic wet nurse even in the case where they have contagious manifestations of syphilis on their nipples. In other words: a child who has not contracted syphilis in the mother's womb acquires immunity from her. In reality the author of the unfortunate 'law' formulated it much more narrowly. Profeta asserted that syphilitic infection can pass to the fetus either during conception or in the subsequent 8 months of pregnancy; if this does not happen and the child is born without symptoms of syphilis, then the virulent syphilitic products of the mother or syphilitic wet nurse cannot infect him, since he has acquired intrauterine immunity (quoted from Fischl). Profeta did not admit the possibility of infection of the child during passage through the birth canal, i.e., intra partum infection. It remains unclear why P. narrowed his law in this way. Why does immunity develop in the child only in cases when the mother contracted syphilis during conception or in the first 8 months of pregnancy? Why does it not develop in children of mothers who contracted syphilis before pregnancy? As early as 1875, Cassowitz (Kassowitz) greatly doubted the possibility of immunity in the child, since he believed that untreated and not weakened by age syphilis in the mother almost invariably passes to her child. And indeed soon cases of 'exceptions to Profeta's law' began to be published, when a healthy-looking infant of a syphilitic mother contracted syphilis during childbirth or already in extrauterine life_uand in him a typical hard chancre developed on the skin or mucous membranes followed by a roseola. The works of Matze-nauer (Matze-nauer; 1903) greatly undermined the scientific basis of P. z. At the present time the vast majority of syphilologists and pediatricians (with the exception of Fischl, who recognizes a temporary immunity in the child) quite rightly do not recognize P. z. at all for the following reasons: 1. Birth of a diseased child by a diseased mother is not something unconditional, but merely facultative; irrefutable clinical observations have with certainty established although rare but undoubtedly the possibility of her giving birth to completely healthy children ('exceptions to P. z.'); these 'exceptions' refute the extreme view of some authors who see a syphilitic in every infant born to a syphilitic mother. 2. Disease of the fetus (premature birth, macerated fetus) and severe course of congenital syphilis are encountered in any case no less frequently than birth of an 'immune' child by a syphilitic mother. 3. The so-called 'Kolls' mothers' possess immunity that has apparently reached its highest development, and they seemingly should give birth to highly immune children; nevertheless in them the birth of a diseased child with severe course of congenital syphilis is constantly observed. 4. The discovery of RW made it possible to transfer a large number of such 'immune' children to the category of syphilitics and to apply specific treatment to them with great benefit for their further development. 5. In syphilis in general there is no true immunity, immunity not connected with the fact of disease; why then should it exist in congenital syphilis? - Thus all children who were previously classified under P. z. must be divided into 2 unequal groups: 1) the largest consists of hidden congenital syphilitics, 2) the smaller one - of healthy children. In the first case the mother can without fear breastfeed her infant; in the second case it is better to feed him with expressed and boiled mother's milk; but in neither case should the child be put to the breast of a healthy wet nurse who has never had syphilis. Lit.: Ch. lenov M., Pathogenesis of hereditary (congenital) syphilis and the question of marriage of syphilitics, M., 1914; F i s c h 1, Zur Frage der Profetaschen Immunitat, Monatsschr. f. Kinderheilk., B. XXV, 1925. V. Feldman.