54 SPIROCHiETES 



will render him an ineffectual social unit, and make him and his 

 family a burden to the community. 



In the majority of cases the disease begins with a hard sore 

 on the skin or mucous membrane known as the " primary 

 chancre." This usually appears at the point of infection in from 

 ten days to three weeks after the infection occurs. In some cases 

 such a chancre never develops. The chancre gradually heals 

 up and the second stage begins, in which general constitutional 

 symptoms appear, as fever, anemia and a general run-down 

 condition during which the patient is very susceptible to other 

 diseases, such as tuberculosis. Often there is an extensive 

 breaking out on the body, production of scaly patches of skin, 

 and inflammation of the mucous membranes of the mouth and 

 throat. 



From this point on the course of the disease depends on what 

 particular tissues or organs the spirochsetes especially attack, 

 for although the parasites, as said before, may produce disease 

 almost anywhere in the body, in any given case there is usually a 

 localization. It seems that certain strains of the parasites have 

 special preference for certain tissues. The differences in this 

 respect have been shown by Nichols to hold good through many 

 transfers from animal to animal, and visible differences in the 

 parasites can be observed. In about 40 per cent of cases syphilis 

 settles in the nervous system, causing a great variety of evil 

 effects, such as feeble-mindedness, tabes, or locomotor ataxia, 

 general paralysis, epilepsy, insanity and moral defectiveness. 

 Often it settles in the skin and mucous membranes, producing 

 the gummy sores or " gummas " which were formerly supposed to 

 be the usual tertiary stage of syphilis. It may select the bones, 

 muscles, arteries, heart, reproductive system, or any other part 

 of the body, in each case producing a different set of symptoms, 

 but in every case weakening the vitality and leading ultimatel}' 

 to an early grave. 



An active attack on one tissue or organ of the body seems to 

 have an inhibiting effect on other attacks. It is well known that 

 an infected person presumably with an active attack of the 

 spirochsetes on some organ in his body will not develop new 

 lesions when re-infected. Possibly this explains why there is 

 often a relapse of the nervous system after incomplete treatment 

 of skin syphilis. The spirochaetes in the nervous system which 



