CONSTITUTIONAL SYPHILIS. 753 



again, and repeat the procedure until the infiltration about the gland, 

 which usually begins to resolve after the first vesication, disappears 

 entirely. Then, if a fluctuating point appear, I puncture it, or destroy 

 its covering with caustic paste. In none of the cases thus treated by 

 me have any sinuses or fistulae formed 



. CONSTITUTIONAL SYPHILIS. 



The question as to the origin of the syphilitic poison is quite as 

 obscure as is that of the origin of the chancre-virus. At the present 

 day, syphilis is a purely contagious disorder. Its venom reproduces 

 itself in the organism which it infects, and the transplantation to an- 

 other person, of the virus thus reproduced, is the only manner in which 

 syphilis can be propagated. 



The exact nature of the syphilitic virus, or, as we may say with 

 equal propriety, the syphilitic contagion, is unknown, since we are un- 

 able to obtain it in an isolated form, and to test its chemical and phys- 

 ical properties. Like the chancre-virus, however, it is of a fixed char- 

 acter, and does not pervade the atmosphere around the patient ; but 

 its habitat is by no means confined to the secretion from the syphilitic 

 ulcer, and to the contents of syphilitic tumors, for it is also contained 

 in the blood. It does' not seem to exist in the natural secretions of 

 the body, such as the saliva or urine, nor in pathological exudations 

 produced by intercurrent disease. Thus, if we inoculate a healthy 

 child with pure vaccine lymph, obtained from a syphilitic subject, the 

 child thus vaccinated does not become * syphilitic ; but, if the lymph 

 contain a little blood, which is a vehicle for the syphilitic poison, the 

 latter will also be implanted upon the patient. It has not yet been 

 determined whether the virus exists in the milk of a syphilitic woman. 

 The frequence with which the disease is transmitted to infants, from 

 wet-nurses, may be due to the existence of bleeding excoriations upon 

 the nipples of the nurse. In the following chapter we shall treat of 

 its propagation during the act of generation. 



Liability to syphilis is so general, that an immunity to its virus, if 

 it exist at all, is certainly very rare. The fact that healthy persons, 

 adults, and men, are more frequently infected than invalids, women, or 

 children, is simply because the former are more apt to be exposed to 

 the disease "than the latter. Like the chancre-virus, the syphilitic poi- 

 son is more difficult of inoculation when the cuticle is thick and resist- 

 ing than when it is the reverse, a circumstance which argues in favor 

 of the practice of circumcision. Infection is also more likely to occur 

 when the genitals are strongly developed than when they are small. 

 Eczema of the glans and prepuce, likewise, greatly increases the dan- 

 ger. Notwithstanding this very general susceptibility to the syphilitic 



