360 SPECIFIC MICRO-ORGANISMS 



preserved by the addition of 0.5 per cent carbolic acid. The 

 final preparation contains many dead unbroken spirochetes. 



Syphilis is an inoculation disease which has been widely 

 prevalent throughout the civilized world since the early part of 

 the 1 6th century. Transmission takes place by direct contact 

 and in the great majority of instances by venereal contact, although 

 many authentic cases of transmission by means of intermediate 

 objects are known. The spirochete is able to live for some hours 

 outside the body if drying is prevented. The primary lesion 

 develops at the point of inoculation about two weeks after that 

 event, first as a papule, which becomes vesicular and ulcerates, 

 remaining indolent for several weeks. The neighboring lymph 

 glands become swollen. The secondary manifestations occur 

 about a month later as a general macular or sometimes papular 

 eruption on the skin, together with sore throat and ulcerated 

 patches in mouth. The skin eruption does not itch. Subsequent 

 to this stage there may be local necrotic lesions (gummata) in 

 various parts of the body, or low-grade inflammatory changes in 

 the meninges and central nervous system. Bacteriological 

 methods of diagnosis are of assistance in some cases in all the 

 various stages of syphilis. Early in the disease the spirochetes 

 are relatively numerous, in certain locations at any rate, while 

 later the parasites may be so few as to render their detection 

 practically hopeless for diagnostic purposes. In these later 

 stages, however, the presence of specific and other antibodies in 

 the body fluids of the patient may often be recognized and this 

 recognition employed as an aid in diagnosis. 



Microscopic examination of a primary ulcer is best done by 

 means of the dark-field illumination. For this purpose the ulcer 

 (which should not have been treated with mercurials) is carefully 

 cleansed and a few drops of freshly exuded serum collected in a 

 glass capillary, and the usual slide-cover-glass preparation is made 

 with this fluid. Permanent preparations are made most easily 

 by mixing such serum with India ink on a slide and spreading 

 the mixture in a very thin layer. Collargol, one part in nineteen 



