500 INFECTION AND RESISTANCE 



1. The reports of Lasch, 121 Jadassohn, 122 Sabeareanu, 123 

 Queyrat, 124 Taylor/ 25 H. Lee, Knowles, 126 and many others, have 

 shown that patients are susceptible to a second inoculation during 

 the first incubation time, that is, during the period elapsing between 

 the first infection with syphilis and the appearance of the chancre. 

 Second positive inoculations have also been successful at periods 

 shortly subsequent to the appearance of the primary sore. 



Autoinoculations and reinoculations undertaken after the chancre 

 has become well developed have been, in the main, negative, though 

 Queyrat reports a case successfully inoculated daily up to the 

 eleventh, and Taylor one inoculated on the fourteenth day after the 

 appearance of the primary induration. In contrast to these and other 

 successful attempts, many observers record failure. However, the 

 point is not one of particular importance, since, after all, the ap- 

 pearance of the chancre does not mark off any fundamental change 

 in the progressive pathological development of the disease, and indi- 

 cates only the completed reaction at the point of entrance. The fact 

 remains that analysis has revealed that reinoculation, with the ap- 

 pearance of the second initial lesion, is possible up to about the twen- 

 tieth to the thirtieth day after the first infection with the trepone- 

 mata (Mauriac 12T and Neisser state the twenty-second day, Queyrat 

 cites a case eleven days, Linderman one twenty-four days after the 

 appearance of the chancre). It is claimed by some of the observers, 

 however, that even when reinoculation during this period is success- 

 ful, the incubation of the second and subsequent lesions is shorter, 

 that the induration itself is less severe, may not ulcerate, and heals 

 more readily than the first. 



In judging of the success or failure of reinoculation practised 

 during the later days of the period above referred to, the possibility 

 must be borne in mind that the trauma produced at the inoculation 

 might have served to favor the development of a localized focus, the 

 treponemata at this time being very probably well distributed 

 throughout the body. Unsuccessful control inoculations with non- 

 syphilitic materials in Queyrat' s cases would tend to eliminate this 

 possibility, whereas lesions resulting at the sites of such control 

 abrasions in the experiments of Neuman and Cehak, 128 and of 



121 Lasch. Arch. f. Dermal, u. Syph., 1891, 61. 



122 Jadassohn. Arch. f. Dermat. u. Syph., 1907. 86; Festschr. f. Neisser, 

 1907. 



123 Sabeareanu. These de Paris, 1905, Chancres Syph. Successif. 



124 Queyrat. Bull, de la Soc. Med. des. Hop., 1904, No. 28, 905. 



125 Taylor. Jour. Cutan. Dis., Dec., 1890. 



126 Knowles. New York Med. Jour., Dec., 1906. 



127 Mauriac. Cited from Neisser, loc. cit. 



128 Neuman and Cehac. Wien. med. Bl., 1890, cited from Neisser. 



