The Third Great Plague | Page 8

future, and in all movements for
national solidarity, efficiency, and defense, we must reckon this force
of syphilo-Americans among our debits.
[5] Figures based on 1910 census.
THE PRIMARY STAGE OF SYPHILIS
+The So-called Stages of Syphilis.+--The division of the course of
syphilis into definite stages is an older and more arbitrary conception
than the one now developing, and was based on outward signs of the
disease rather than on a real understanding of what goes on in the body
during these periods. The primary stage was supposed to extend from
the appearance of the first sore or chancre to the time when an eruption
appeared over the whole body. Since the discovery of the Spirochæta
pallida, the germ of the disease, our knowledge of what the germ does
in the body, where it goes, and what influence it has upon the infected
individual, has rapidly extended. We now appreciate much more fully
than formerly that at the very beginning of the disease there is a time
when it is almost purely local, confined to the first sore itself, and
perhaps to the glands or kernels in its immediate neighborhood.
Thorough and prompt treatment with the new and powerful aid of
salvarsan ("606") at this stage of the disease can kill all the germs and

prevent the disease from getting a foothold in the body which only
years of treatment subsequently can break. This is the critical moment
of syphilis for the individual and for society, and its importance and the
value of treatment at this time cannot be too widely understood.
+Peculiarities of the Germ.+--Many interesting facts about the
Spirochæta pallida explain peculiarities in the disease of which it is the
cause. Many germs can be grown artificially, some in the presence of
air, others only when air is removed. The germ of syphilis belongs in
the latter class. The germ that causes tuberculosis, a rod-like organism
or bacillus, can stand drying without losing its power to produce the
disease, and has a very appreciable ability to resist antiseptic agents. If
the germ of syphilis were equally hard to kill, syphilis would be an
almost universal disease. Fortunately it dies at once on drying, and is
easily destroyed by the weaker antiseptics provided it has not gained a
foothold on favorable ground. Its inability to live long in the presence
of air confines the source of infection largely to those parts of the body
which are moist and protected, and especially to secretions and
discharges which contain it. Its contagiousness is, therefore, more
readily controlled than that of tuberculosis. It is impossible for a
syphilitic to leave a room or a house infected for the next occupants,
and it is not necessary to do more than disinfect objects that come in
contact with open lesions or their secretions, to prevent its spread by
indirect means. Such details will be considered more fully under the
transmission and hygiene of the disease.
+Mode of Entry of the Germ.+--The germ of the disease probably gains
entrance to the body through a break or abrasion in the skin or the
moist red mucous surfaces of the body, such as those which line the
mouth and the genital tract. The break in the surface need not be visible
as a chafe or scratch, but may be microscopic in size, so that the first
sore seems to develop on what is, to all appearances, healthy surface. It
should not be forgotten that this surface need not be confined to the
genital organs, since syphilis may and often does begin at any part of
the body where the germ finds favorable conditions for growth.
+Incubation or Quiescent Period.+--Almost all germ diseases have

what is called a period of incubation, in which the germ, after it has
gained entrance to the body, multiplies with varying rapidity until the
conditions are such that the body begins to show signs of the injury
which their presence is causing. The germ of syphilis is no exception to
this rule. Its entry into the body is followed by a period in which there
is no external sign of its presence to warn the infected person of what is
coming. This period of quiescence between the moment of infection
with syphilis and the appearance of the first signs of the disease in the
form of the chancre may vary from a week to six weeks or even two
months or more, with an average of about two or three weeks.
In the length of the incubation period and the comparatively trifling
character of the early signs, the germ of syphilis betrays one of its most
dangerous characteristics. The germ of pneumonia, for example, may
be present on the surface of the body, in the mouth or elsewhere, for a
long time, but the moment