This disease is remarkably common among the vicious, rich and poor alike ; and by them it is often transmitted to the innocent members of the family circle. Proof that is almost absolute now confirms the previous supposition that syphilis is due to the growth of a microorganism. Recently, in 1905, Schaudinn and Hoffmann discovered a spiral shaped organism, in syphilitic patients, which they named the Spirochaeta Pallida. Confirmatory evidence comes from many bacteriologists who have had no trouble in isolating it, and it is now generally accepted as the definite cause. Cultivations of these organisms have been made and successfully inoculated into anthropoid apes, which further corroborates the trustworthiness of the discovery. Metschnikoff believes that syphilis is a "chronic spirilla infection." A minute portion of the virus or of the blood of a syphilitic being inoculated into another individual, through an abrasion however small, or by absorption through a mucous surface, the microbes rapidly multiply until a "colony" is locally developed. A local ulcer is then produced in which the organisms have elaborated certain poisonous chemical substances called toxins, or ptomains, or virus. The virus is then diffused through the whole system and the characteristic phenomena of syphilis appear, such as fever, debility, headaches, a distinctive rash, sore throat, falling out of the hair, and the eventual production of a peculiar growth of cells called "granulation tissue" which produce most serious effects.
Varieties of Syphilis.
1. The acquired form, beginning with a primary sore, or "hard chancre", as the result of inoculation, and followed by constitutional symptoms.
2. Hereditary, or prenatal syphilis, in which one or both parents are actively syphilitic at the time of conception of the embryo. In this form there is no primary sore, but a general systemic infection acquired in utero.
At present we shall consider the first form.
Modes of Acquiring Syphilis. Syphilis is almost always derived by impure sexual intercourse, and is hence called a venereal disease, although a considerable proportion of cases are acquired unconsciously and innocently and without an impure history. The cases of extra genital syphilis, i.e., those which are not associated with lasciviousness, are classified as "unmerited syphilis", or "syphilis of the innocent" {"syphilis insontium"}.
A syphilitic person is a menace to the community in which he lives, and in strict justice he should be quarantined until his disease has passed beyond the stage wherein he is capable of contaminating others. The secretion from his primary sore is highly virulent, as are those from the mucous patches which appear in his mouth and on his lips, anus and genitalia. For at least two to three years after infection, even under treatment, his blood and the debris from any pustule, pimple, or ulcer are infectious, and he renders more or less unsafe every article which he touches. This has been proved by experimental inoculations. It is of course wrong to permit such a person to send his clothing to the public laundry, or to jeopardize others in innumerable other ways; and the time may come when such will be as promptly quarantined as are the victims of small pox.
The virus from a patient who is infected with syphilis "the big pox" can inoculate another person through a crack or abrasion in the skin too small to be noticed, or even through an intact mucous membrane. My studies and observations have convinced me that in the majority of cases in which the treatment has been ample and well directed a cure is obtained in two or three years, and then, of course, the subject does not give forth infectious secretions". But until the expiration of this time the syphilitic is a dangerous element in society, and it cannot be said that "ample and well directed treatment" is followed in a majority of cases.
The normal secretions of a syphilitic, i.e., the saliva, tears, sweat, urine, semen and milk, are not in themselves contagious; but if one microscopically minute blood corpuscle, or a mere particle of tissue detritus exude with any of these secretions into an abrasion on another individual, infection will follow. Thus, since sore patches in the mouth and about the genitals and on the skin surfaces are common, it is unsafe, from a practical standpoint, to be exposed even to the normal secretions of an infected person. In order to acquire syphilis there must be contamination with the virus from another infected person in some way. This may be (a) by direct, or immediate contact; (b) by indirect, or mediate contact.