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No. XIV.—SYPHILIS. 
It is of importance to observe whether syphilis exists in 
any newly explored country where there had been no inter¬ 
course with Europeans, direct or indirect, or where the inter¬ 
course had been very limited. 
Syphilis may be recognised by the usually painless 
nature of the local sore, accompanied by hard, mul¬ 
tiple, non-inflammatory swellings of the lymphatic glands 
in the neighbourhood ; then within the first six months 
of the disease constitutional symptoms are seen, erup¬ 
tions on the skin of a measley-looking or papular cha¬ 
racter, and loss of hair all over the head and face. Along 
with the skin eruption, the mucous membrane of the mouth 
and throat is affected, the patches looking very like snail 
tracks. Fever and pains in the bones may be looked for 
before the constitutional symptoms set in. 
The later symptoms to be expected, are, pustular eruptions 
with their resulting crusts, ulcers of the skin, throat, and 
tongue, diseases of bone, &c. 
In any country where syphilis is common, note carefully 
whether the infants of syphilitic parents are affected by the 
disease soon after birth. This may be known by the wasted 
condition of the child, running from the nose, and depression 
of the bones of the bridge of the nose ; cracks round the 
mouth ; eruptions over the body, especially on the buttocks ; 
and enlargement of the ends of the long bones. As the 
child grows older, note the condition of the permanent upper 
incisor teeth, whether they are notched at their free edge in 
a crescentic manner. 
The observer should note the existence of late con¬ 
genital syphilis after puberty, as evidenced by ulcerations ; 
bone disease ; eye affections, especially corneitis, followed by 
ground glass looking corneas. 
What treatment is adopted, 1st, of the disease itself ; 
G 
