SYPHILIS. 317 



Syphilitic infection takes place through the conveyance 

 of the syphilitic virus, which is contained in the degener- 

 ated products of the syphilitic sclerosis, as well as in all 

 secondary lesions, and in the course of florid syphilis also 

 in the blood of syphilitic patients. This transmissibility has 

 been demonstrated repeatedly by experiments on human 

 beings, and first through the famous experiments of the 

 palatinate Anonymus. Inoculations with sweat, saliva, 

 urine, milk, and seminal fluid of syphilitics have been un- 

 successful. 



The conveyance of the infecting material takes place either 

 directly, usually through sexual intercourse, less commonly 

 through kissing, through the nursing of a syphilitic child, 

 through contact with syphilitic lesions by the fingers 

 (physicians, miglwives), and the like ; or indirectly through 

 instruments, articles, etc., contaminated by the syphilitic 

 virus (house-epidemics through eating-utensils and drinking- 

 utensils, infection through cigar-tubes, gloves, etc.). A 

 most important role is played by hereditary transmission, 

 which will be fully discussed later. 



The portal of infection may be constituted by any por- 

 tion of the skin or mucous membrane where a slight breach 

 of continuity, any lesion of the epithelial covering, exists, 

 so that the syphilitic virus can penetrate deeply. The virus 

 remains localized at the site of infection, where it manifests 

 itself as the so-called primary lesion, or hard chancre. In 

 accordance with the varying frequency of the different 

 modes of infection already named, this lesion is most com- 

 mon on the genitalia, but it not rarely occurs also in other 

 situations : on the lips, on the tonsils, on the nipples, on the 

 fingers, etc. After a period of incubation of not less than 

 from three to six weeks, and frequently much longer, the 

 virus is disseminated throughout the entire body, and the 

 disease becomes generalized. The exciting agents them- 

 selves are contained in the blood and in the secondary 

 lesions. A poison alone, absorbed perhaps from the site 

 of the initial lesion, could not give rise to these secondary 

 lesions, as the disease is transmissible indefinitely through 

 them. The exciting agents further must possess an extra- 

 ordinary length of life. They must survive throughout 

 the whole duration of the secondary stage, extending over 

 many years, for the disease is transmissible throughout this 

 entire period. Only in the tertiary stage is this transmis- 



