148 



Eugene Rollin Coj^son 



It is the physician only who can trace the pathological lines 

 leading to ill health and death whose course has been set, di- 

 rectly or indirectly, by these two diseases. They lie so much 

 beneath the surface, cropping out in so many unforeseen ways, 

 and at so many unexpected points, that the scientist is often 

 at a loss how to draw his pathological relief-chart. There are 

 so many deep lesions of nerve-centres, viscera, and blood 

 vessels, which are the outcome of syphilis, contracted, per- 

 haps years before, that the disease has a most potent influence 

 in reducing the vital equation. And especially is this the 

 case when there is a history of neglect and intemperance, 

 factors which enter so largely into the disease among the col- 

 ored. As a consequence we see all these stages in virulent 

 form ; mixed and phagedenic sores primarily, followed by 

 severe secondaries, tubercular and pustular syphilides, violent 

 throat symptoms, iritis, and keratitis. Its tendency among 

 the women to produce abortion I have already mentioned. I 

 have not seen anything to compare with it among the whites. 

 And we see here not only the prospective loss of life but all 

 the dangers to the woman of the miscarriage itself. 



The congenital form is so virulent that most of the infants 

 do not reach term. And with all these flagrant examples of 

 its lethality, there is probably as large a class dying of other 

 diseases where the vitality and the resistive power have been 

 so undermined by syphilis that they have succombed to a 

 strain which they could otherwise have borne. 



The large majority of the cases of pyelo-nephritis and cys- 

 titis can be traced to the infection from gonorrhoea, and with 



