SYPHILITIC.
7. Hereditary Syphilis.— This is of tre mendous importance in its effects upon the nervous system. Statistical studies show that at least 66 per cent of the children of syphilitic parents — without counting the immense num ber of abortions and of still-born children— show the taint in some form. Fournier places the ratio as high as 98 per cent, and says that 68.5 per cent of the children die. Hochsinger reports that to 70 families, out of a group of 72, in which there was paternal syphilis alone, only 31 healthy children were born, and these in all save four instances were the latest born. Of the remaining 276, 110 were still-born, 166 were syphilitic.
Mott, Mendel and others tell the same tale of the children• of paretics and tabetics — either no children, or many abortions, many dead children, and a few living of whose fate there is as yet no certainty. Probably more than half are doomed to some disease or dis order of the nervous system.
Apparently the commonest effect of heredi tary infection is the reduction of resistance in the body, and of the powers for full develop ment, in both the general body and nervous tissues. In a manner analogous to the influence of alcohol on the germ cell, syphilis diminishes the vitpl energy of the plasm prior to conjuga tion, causing pathological variations in nervous structures, just as it can transmit the disease through the germ cell. In the result, Fournier's classical formula of abortion, dead child, early death, living healthy child, might be amended to read complete sterility, miscarrige, abortion, still-births, children dying in infancy or convul sions, marasmus, meningitis, hydrocephalus, comparatively healthy children who will prob ably in later life develop late hereditary syphilis. On this point, a study of Mott's family trees will prove valuable and instructive.
Whether syphilis can be transmitted to the third generation has been a much discussed question. Very suggestive material has of late years pointed to the probability that this occurs. Mott of London has shown some very pertinent hereditary material before the Royal Society which is reported in their (Transactions) for 1912.
The logic of this is clear in the light of the recent observations made by Levaditi, Bab and others that Treponema pallidum may be found in the ovum, and in an apparently resting stage, similar to the resting stages known for other flagellate protozoa, closely allied to the organ ism causing syphilis. Jonathan Hutchinson is sceptical as to this, but he was also sceptical as to juvenile tabes and paresis— possibly in medicine ultra conservatism is psychologically an interesting individual idiosyncrasy rather than a sound pragmatic instinct.
The necessity for the use of all available biological tests in the matter of congenital syphilis is very great, because statistics and opinions uncontrolled by them and unsupported save by clinical observations are not only inse cure and insufficient approximations, but, if relied upon in the negative, may retard the progress of thought and delay the relief of sick humanity.
Without losing sight of the immense import ance, and the striking and ofttimes grewsome character of the congenital cases which appear in later life, if the physician would place him self in the right attitude toward the therapeutics of this disease, he must focus his attention on the preponderating number of miscarriages, still-births and early syphilitic births. The psychological control, the so-called ethical at titude toward sexual freedom as one of the burning factors in the present cultural struggle for more efficient sexual adaptation, is a prob lem too large to be entered into here.
Congenital syphilis may occur at any age. It is not infrequently a cause of death of the foetus, and gives rise to a great variety of in trauterine cerebral diseases which, if the child is born alive, result either in early death, or in early disease, or the later development of vari ous congenital syphilitic manifestations, chief of which are idiocy, imbecility, feeble-minded ness, epilepsy, deafness, optic atrophy, tabes and paresis.