SYPHILITIC PRODROMES.—The roseola may be preceded or accompanied by vari ous phenomena of a general character. Among these phenomena are malaise, headache, backache, rheumatoid pains, anorexia, nausea, prostration, sleepless ness, and nervous irritability, and in some cases quite sharp febrile movement, per haps followed by perspiration. These are the symptoms several or all of which have been included under the head of syphilitic fever, or, as Diday more cor rectly terms them, "syphilitic pro dromes." It has been claimed that, on reviewing the list of single symptoms that may occur, it is evident that they may be dependent upon so many and various co incident disturbances that there can be no great constancy or certainty about their occurrence in syphilis, and that the term syphilitic fever is therefore ob viously inaccurate. This observation, however, may be fallacious because of faulty methods of study. The various symptoms are toxiemic, and, although they vary in severity, might be found to exist in greater or less degree in all cases by very careful investigation. The tem perature, be it remarked, is rarely studied.
Some of the results of secondary syphilis, which are important owing to the fact that they are difficult to diag nose in the absence of distinct history, and from the fact that they are much more frequent in women than in men, pointed out. The first is headache, which may be divided into three degrees. In the first it is troublesome, but does not interfere with the ordinary voca tions. In the second the pain simulates
migraine. In the third the pain is so severe as to render any exertion or em ployment impossible. It is accompanied by vertigo, ringing in the ears, and in many cases there may he a profound melancholia. The pain may be constant or intermittent. In the first it is more severe toward the evening; in the sec ond form it comes on every evening be tween 5 and 7. Antisyphilitic treatment is followed by an astonishing relief of the symptoms. Another manifestation is insomnia. In many instances this may he due to headache, but in other cases there May be no headache or other symp tom, the patient passing several nights without sleeping. Another phenomenon in secondary syphilis is asthenia. Like the other symptoms, it is almost con fined to women. There may be inability to stand or even to leave the bed. The heart-beats are extremely feeble and the pulse almost imperceptible. There is a dullness of perception affecting all the senses, and the trophie functions are greatly in abeyance. Malignant dis ease, tubercle, different forms of anemia, etc., have been diagnosed. Vague neu ralgic pains may affect the sciatic or different branches of the fifth nerve. Antisyphilitie treatment, more particu larly preparations of mercury, should be tried in many cases of anomalous neu ralgic pain. Fournier (Jour. de ABA, Apr. 10, '99).