h 



CHAPTER XXIII 

 COMPLEMENT FIXATION IN SYPHILIS 



History of Syphilis. — It is quite generally agreed that syphilis 

 was unknown in Europe until about 1493. This date coincides 

 with the return of Columbus from the AVest Indies. It is thought 

 that members of his crew carried the disease from the West Indies 

 to Europe. According to Williams, Rice and Lacayo (1927), 

 syphilis made its appearance in Naples in 1495. It was called the 

 ''Neopolitan Disease" by the French, the "French Disease" by the 

 Italians, and "Bubas" by the Spanish. In 1530, Fraca.storo wrote 

 a Latin poem which concerned a shepherd named Syphilus who 

 became infected. Tlie present name of the disease is attributed 

 to this poem. 



Etiology, Incubation and Primary Lesion. — Syphilis is caused 

 by Treponema pallidum, discovered by Schaudinn and Hoffmann 

 in 1905. Following infection, there is an incubation period of 

 two, four or more weeks, after which there develops a small red 

 papular lesion that enlarges to some extent and breaks down to 

 form a small ulcer. This is the primary lesion, often called the 

 "hard" or "Hunterian" chancre. It has raised edges, a grayish 

 colored base, is freely movable and feels like a cartilaginous button 

 when held between the thumb and forefinger. In the male it 

 usually occurs on the sides of the frenum, on the glans, sulcus or 

 prepuce and occasionally within the anterior portion of the urethra. 

 The most frequent location of the primary lesion in the female 

 is on the labia minora, os uteri, less frequently on the labia majora 

 and rarely on the walls of the vagina. Extragenital chancres may 

 occur. They are usually less indurated and may show greater 

 ulceration. 



While syphilis is usually transmitted by coitus or other methods 

 of contact, it may also be congenitally acquired (intrauterine 

 infection from the mother through the placenta). Third-genera- 

 tion syphilis has been reported. An excellent, brief discussion of 

 the subject is given by Mitchell (1933). 



Laboratory Procedure Indicated During Primary Stage.— 

 During the primary stage of the disease the only dependable 



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