THE INFECTIOUS DISEASES. 257 



One of the most characteristic phases of the secondary inflammations 

 of syphilis results in the formation in the periosteum or the viscera of 

 masses of new tissue called gummata. 



The smaller gummata consist of a mass of small spheroidal and epi- 

 thelioid cells (see Fig. 130). As these cell masses grow larger they are 

 apt to become necrotic and caseous at the centre, and we may then have, 

 as seen by the naked eye, a grayish-white, usually firm mass, with a more 

 or less dense and irregular granular centre and a translucent, often 

 radially striated border of dense fibrous tissue (see Fig. 131). 



A bacillus closely resembling the tubercle bacillus in form and size 

 has been described by Lustgarteu and others as occurring in small num- 

 bers in the lesions of syphilis. It appears not to be constantly present, 

 however ; a distinctly characteristic mode of staining is not known, and 

 it has never been cultivated on artificial media ; so that the evidence that 

 this bacillus is the excitant of syphilitic inflammation is not convincing. 

 Several other organisms have been described as occurring in syphilitic 

 lesions, but in no case has satisfactory evidence of their significance as 

 excitants of the disease been furnished. 



The nodular lesions of syphilis are in many respects structurally 

 similar to those of tuberculosis, so that it is sometimes difficult to distin- 



"" '" K *-'.*^?4 '**& E 



/ :- ".: : 



FIR. 128. SECTION OF A PORTION OF A SYPHILITIC CONDYLOMA OF THE Mucous MEMBRANE. 



A, CEdematous papilla ; B, swollen endothelial cells In small blood-vessels of a papilla; C, pus cells In 

 the submucous connective tissue ; D, pus cells in the epithelium ; E, disintegration of the epithelium in the 

 superflcial portion of the mucous membrane. 



