SYPHILIS (from Syphilis, in the Latin poem entitled Syphilus, sire Jlorbi Gallici libri fres, by the Italian physician and poet Hieronimo Fracastoria (1453-1553), a shepherd who was afflicted with the disease by Apollo as a punish ment for offering homage to his king instead of to the god; of uncertain etymology, popularly explained as from Gk. sacs, hog philos, loving, or, less plausibly, from alp, syn, with -F pi phi/os, loving), or LuEs, or TILE Pox. A specific contagious disease peculiar to the human species, chronic in its course, and gen erally acquired during sexual congress. It is always due to contact with a syphilitic indi vidual or with his secretions or discharges. De scriptions of syphilis are found in the earliest writings, and traces of it are discovered in the bones of prehistoric people. Chinese accounts of it date back to the writings of Hoan-Ti, who lived about 2637 B.C. The earliest Indian record is found in the Ajwe Veda of Surutas, A.D. 400. The .Japanese historians described the disease several thousand years ago. The Hebrews were familiar with it and it Is probable that many cases called leprosy were really syphilis. Hip pocrates and his successors describe it as it existed among the ancient Greeks, and Celsus speaks of it among the Romans. Although the malady is known to have existed in Europe at least as early as A.D. 1250, when Theodorie, a Dominican monk, wrote of the nialuni mortuunt After the poison of syphilis has been absorbed a certain time elapses before its effects become manifest. The abrasion heals over and there are no visible signs of danger. This is the period of incubation and lasts on the average three weeks, but may vary from ten to seventy days. At the end of this period a hard thickening ap pears at the site of inoculation, and this soon breaks down into a discharging sore or ulcer. the discharge from which is extremely contagious. This ulcer is situated on au indurated base and is surrounded by dense tissue, and from this fact is known as the `hard' chancre. It is the char acteristic initial lesion of syphilis, and is usual ly single. Another period of apparent quiescence now ensues, during which the patient is con scious of no trouble besides the sore. This is the so-called secondary incubation period, lasting from four to six weeks or perhaps longer. A characteristic set of symptoms now appears. The poison has been absorbed by the lymphatics, and upon examination the glands of the groin, axilla, neck, and in fact of the entire body will be found enlarged and indurated. A rash. somewhat re
sembling that of measles, breaks out upon the chest and abdomen, spreading thence to the face, extremities, and back. The rash may vary wide ly in character, presenting in different cases 'pacifies, papules, nodules, scabs, 'vesicles, or pustules. The eruption is usually superficial and fades gradually without scarring, differing in this respect from the tertiary rashes or 'late syphi lides.' The rash marks the secondary stage of syphilis, and is attended with constitutional dis turbances. There is slight fever, with severe noc turnal headache, pains in the bones, and general malaise. The tonsils, soft palate, and lymphatic tissues of the pharynx become swollen, and to gether with the gums. tongue, and inner side of the cheeks are the scat of `mucous patches.' These are small grayish or whitish papules or shallow ulcers which discharge a most infectious material. It is through them that by far the greater number of cases of 'innocent' syphilis occur. Mucous patches are also apt to appear on the inner surface of the nose, the eyelids, about the genitals and arms. The throat is sometimes so sore and painful that eating solid food becomes impossible. Coincident with these changes in the ,kin and mucous membranes, sev eral other tissues are affected. The periosteum covering the tihiie, skull, clavicles, or sternum becomes the seat of inflammatory thickenings or nodules (see NODE), tender to the touch, but soon disappearing. The joints may swell. The hair may come off in considerable quantities, either in patches, or as a general thinning. The finger-nails are dry, brittle, and lustreless. The lymph glands continue swollen during the sec ondary period of the disease. They may he felt in chains along the neck and groins. A small gland just above the inside of the elbow, the epitrochlear, is almost invariably affected in syphilis and rarely in other diseases, and is there fore a valuable aid in the diagnosis of doubtful cases. Syphilitic iritis is apt to occur during this stage. It usually affects one eye at a time, and is manifested by photophobia, irregularity of the pupil from adhesions of the iris, swelling, and congestion. Later in the disease other eye tissues—the cho•oid and retina—may suffer seri ously. Deafness may result from infiltration of the labyrinth of the ear.