GENERAL ADEXOPATHY. — The syph ilitic infection eventually arrives at the receptaculum chyli, from which it is carried to the general circulation, and after entering the right heart is finally disseminated throughout the tissues gen erally, producing its characteristic effect of cell-proliferation, the first evidence of which usually consists in a general ular enlargement. This, however, may appear simultaneously with or follow the discovery of the roseola. On section, the enlarged glands are found to be, histolog ically and macroscopically-, reproductions of the adenopathies of the initiatory period.
The so-called blood-platelets were found in large numbers by the author in the blood of syphilitics irrespective of the stage of the disease or the symptoms that may be present. He emphasizes the fact that they are by no means specific to syphilis, and found that they disap peared when the antisyphilitie treatment had been carried on long enough to over come the anmmia that accompanies that disease. H. Voerner (Deutsche med. Wochen.. Dec. 11, 1902).
THE ROSEOLA.—At the end of about forty to forty-five days, on the average, after the development of the initial scle rosis, the period of "general, systemic in fection and localized cell-accumulation" begins, the infection having now reached its final destination. The first evidence of general infection in order of discovery usually consists in the development of a peculiar eruption of rose-colored spots: the syphilitic roseola. Although this
eruption may escape observation, it is probably constant, being always present in a greater or less degree, in some cases lasting for a number of weeks, probably from two to eight, while in others it may last only a few hours. In its general ap pearance the eruption is not very unlike measles. The spots are of a dull, rose red hue, and disappear on pressure when recent, but later on leaving a coppery stain.
The syphilitic roseola is due to dila tion of the cutaneous capillaries, with subsequent stasis, and the exudation of leucocytes and red blood-corpuscles into the implicated integumentary area. It is possible that the dilation and stasis are reflex phenomena due to reflected local irritation produced by the syphilitic in fection, or to the direct influence of the infection upon the vascular walls; but this explanation is hardly so rational as that involving a direct influence upon the sympathetic centres analogous to that produced by quinine, belladonna, and various other drugs and by emotional dis turbances. The disturbing element in the action of syphilis on the sympathetic is probably a toxin or toxins elaborated by the syphilitic micro-organism.