Infection by Direct Contact. In the majority of instances syphilis is both acquired and given during the impure sexual act. By some other beastly practices it is also spread, and many an individual, thinking merely to play with prostitutes without actual fornication, has been inoculated. Thus, the lascivious kisses of syphilitic prostitutes suffering with mucous patches in their mouths, have often caused chancres on the lips. But aside from venereal practices the disease may be acquired in various other ways by direct contact. Doctors and dentists are sometimes inoculated upon their fingers in operations upon syphilitic patients. It has been imparted by careless physicians in the operation of vaccination, and not infrequently by professional tattooers who moisten the needles and pigment with their saliva. The kisses of syphilitic men have often inoculated wives and pure young children, and in numerous other ways it may be directly communicated.
Infection by Indirect or Mediate Contact. Through the intervention of innumerable articles of daily use syphilis has often been communicated to innocent persons. Taylor gives the following list of articles which have been the agents of infection: "Cigars, cigar and cigarette holders, pipes, tooth brushes, tooth powders, drinking-utensils, knives, forks, spoons, razors, towels, sponges, pillows, masks, gloves, wash rags, linen thread, silk thread, pins, needles, children's toys, nursing bottles, rubber tubes, babies rubber rings, trousers, women's drawers, bandages, surgical and cupping instruments, manicure instruments,
syringes, scarifiers, dental instruments and appliances, caustic holders, blowpipes, paper cutters, lead pencils, speaking trumpets, musical instruments, fish horns, whistles, the mouth piece of the telephone, chewing gum, andeven pastilles and candy".
Laundresses have been inoculated by washing the clothes of syphilitics; chancres have been acquired on the knuckles by striking the teeth of diseased men in fights; and in fact there is no limit to the articles which may be the vehicles of infection. Chancres of the lip have been acquired from the communion cup by infection with the virus which syphilitics have smeared on the rim from the mucous patches in their mouths. The neglect to provide individual communion cups is inexcusable for even though a syphilitic man might not be apt to attend this solemn service, yet not a few religious wives have been innocently infected by their husbands, without, of course, being informed, and such menace all who use the cup after them. The mere reflection that syphilis and tuberculosis are liable to be transmitted in this way should promptly lead all to insist on the same etiquette and decency being observed in this sacred rite as we demand even in the home circle, of having a separate cup for each individual.
So also the custom of making witnesses kiss the Bible when oaths are administered is repulsive, for syphilitic virus is readily implanted on it from the mucous patches in the mouths of infected persons. Mode of Onset. Syphilis invariably begins with a "sore", which is called the "initial lesion", or "chancre"; it is called the "hard", or "Hunterian chancre", to distinguish it from the "soft sore" of chancroid. Three distinct stages are recognized the primary, secondary and tertiary.
The Primary Stage. At the date of the infecting contact, whether by coitus or otherwise, some of the virus is implanted at the site where the chancre is to develop gen itally or extra genitally. Then for a certain period, called the stage of incubation, nothing whatever betrays the disease. This incubation period lasts from ten to seventy days, but, as a rule, in the neighborhood of twenty one days, the extreme limits of rapid or tardy development being unusual. Then a sore is noticed which at first is not indurated, but in ten or fourteen days more it displays the typical signs of the true hard chancre. Now comes a period of repose, lasting usually for from forty to ninety days, during which interval the patient is merely inconvenienced by the local sore
The Secondary Stage. After this period of seeming quiescence comes the secondary period, or period of constitutional invasion, when the virus seems to explode, as it were. The patient now suffers with languor, headaches, shooting pains in the limbs, trunk and head, falling out of the hair, sore throat, eruptions on the skin and mucous membranes, enlargement of the lymphatic glands throughout the whole system, and peculiar milk white patches upon the mucous membranes of the mouth and anus. With all this there is fever, neuralgia and considerable suffering. This condition lasts for one or two years, during which time the eruptions, though extremely repulsive, are chiefly superficial and tolerably mild in their effect on the general health.