TREPONEMATA 58.'^ 
lion that a majority of mothers and of children born of syphiHtic 
mothers ^ive a positive complement-fixation reaction, whether the 
individual tested showed or did not show obvious evidences of syphilis. 
In the latter group, the disease is latent. 
It is claimed that recovery from syphilis leads to immunity to sub- 
sequent infection. This is by no means an assured fact and, indeed, 
evidence rather points to the opposite. There seems to be, however, 
a refractoriness to reinfection so long as the virus is still viable in the 
body. 
Inoculation or venereal syphilis develops typicallv' in three succes- 
sive stages: The primary stage, or lesion, is a hard, indurated circum- 
scribed mass or chancre, which appears usually at the site of infection 
after an incubation period of from two to three weeks. The regional 
lymph glands usually become enlarged within a month from the time 
of infection. The chancre tends to ulcerate or break down. During 
the primary stage the Treponemata become widely disseminated 
throughout the body, and about the fourth to sixteenth week (average 
about eight weeks) from the time of inoculation the secondary stage 
makes its appearance. The characteristic secondary lesions are mucus 
patches and lymphatic enlargement, generalized rhevimatoid pains, 
and an eruption which is usually symmetrically arranged. The ter- 
tiary stage, which may appear within a few weeks of the secondary 
stage, or not appear for months or even years, is characterized by 
gummata, which may appear in the skin, visceral organs, brain, or 
even in bones. 
The disease is most contagious in the primary and early secondary 
stages, and it tends to become somewhat less so progressively to the 
tertiary and late tertiary stages. 
The Treponemata are readily demonstrable in the primary stage 
and occasionally in regional enlarged lymph glands, before the Kahn 
and Wassermann reactions becomes positive. Diagnosis is readily 
made by the dark-field illumination apparatus, and inasmuch as chemo- 
therapeutic treatment is much more successful in the earlier days of 
the disease, too much emphasis cannot be placed upon this highly 
important point. 
The Kahn test and Wassermann reaction are positive in practically 
all well-developed secondary cases, and the Treponema can be readily 
found in the earlier state of development of the mucus patches. In the 
late secondary and tertiary stages, fewer and fewer Treponemata can 
l)e found, either by direct dark-field examination or by means of suitable 
stains. Material from gummata which fails to show Treponemata is 
usually infectious for monkeys, however. 
Bandi and Simonelli^ claim to have found the organisms occasionally 
in the blood of syphilitic patients, and Levaditi^ states that they may 
be found in blister fluid. Noguchi has demonstrated Treponemata in 
1 Centralbl. f. Bakteriol., orig., 1911, 37, 1546. 
2 Compt. rend. Soc. de bioL, May 20, 1905. 
