J. Henry Allen, M.D.
Author of Diseases of the Skin, psora, Pseudo-psora and Sycosis
Syphilis is a contagious, inoculable disease, transmissible by heredity. The first lesion is a chancre (which will be fully described later on), and is followed by glandular involvement, blood changes and multiple lesions of the skin and mucous membranes. Later in the disease, as it passes through its evolutionary stages, deeper tissues become involved, such as chronic inflammations and infiltrations of the cellulo-vascular tissues, bones and periosteum, finally by the formation of small, round tumors, called gummata to be found in almost any part of the body, even to the organs themselves. In a few words this describes syphilis in a general way, but as we take up the study of the disease in its minutia, following it out in its slow, but positive, destructive movements and profound changes, we begin to slowly comprehend its death-dealing, destructive and ruinous processes, which seem to take into its tentacles and involve every principle and process of life.
In its evolutionary processes, we find periods when we find it active, progressive and destructive, followed by similar periods of quiet and rest, even to the complete disappearance of any sign or manifestation of the disease. These pauses may last for weeks months or even for years. During all this time it may be transmitted through the process of conception.
Etiology. About all students of syphilology today, except those of the homoepathic school, believe that the disease is due to the presence of a specific microbe, Symptoms of infection, as from some very deep-acting and profound poison, as follows: Languor fever, sometimes aching and occasionally pain, all of which seem to be aggravated at night and from warmth in general. The chancre usually follows at the point of absorption of the virus and that is generally found upon the sexual organs. This is soon followed with profound attenuation in nutrition and associated with secondary eruptions. Following the secondary stage, there may be no further symptoms of the disease, or after a shorter or longer period of latency any of the different forms of gumma may develop, as has already been mentioned. During this period of latency or apparent cure syphilis may be transmitted to offspring, showing that the virus is still active in the blood.
Immunity Against Syphilis. A person who has syphilis is immune against a fresh attack. It is found impossible to inoculate the syphilitic virus.
- Upon a person who already suffered from the acquired disease.
- Upon a person who has inherited syphilis from one or both parents.
- Upon a mother who has borne a syphilitic child without showing on her own body any or the acquired syphilis.
All facts show conclusively that immunity in syphilis, as in other infectious diseases, must be due to tissue-products of its organized virus passing it no the circulation. There have been cases reported of reinfection, but we are privileged to have our doubts, believing that the majority of those cases reported were due rather to a recrudescence of the original attack.
Contagion. The blood, or any secretion from a syphilitic, during the inflammatory or secondary states, is contagious. Even the saliva, milk, sweat and semen, of mixed with the discharge of the inflammatory lesions. After the inflammatory, primary and secondary stages, both the blood and the discharges from the lesions are innocuous, so far as the conveyance of syphilis is concerned. This condition is generally reached in from two to three years. It is pretty well a settled fact that, except in the hereditary and conceptional forms, a chancre is the starting point of syphilis. Contagion may be either immediate of mediate.
Immediate Contagion. This is contagion direct from one individual to another and may take place from sexual congress, kissing, from wounds inflicted by the teeth, operations on syphilitic patients when the operator has wounds or abrasions of the hands.
Mediate Contagion. Disease conveyed by contact, from clothing, pipes, glasses, drinking cups, dental instruments or surgical instruments, cigars, razors, from human vaccination, bathrooms laundries. etc.
Types of syphilis. Dr. Hyde tells us that we meet the disease in any degree of mildness, from a few scattered papules as a secondary eruption to any degree of malignancy. In the benign, the symptoms are mild and transitory. We do not meet with those symptoms that show deep systemic involvement; they are not explosive, as we say. The lesions are not so positive nor persistent, seldom relapsing. They are superficial, that is, the eruption or lesions, for seldom do we see the disease reach the tertiary stages. Indeed, no traces are left on the body of the diseased. There are not deep ulcers, no permanent impairments, no cicatrix. This may be due largely to the character of the virus transmitted, to a previously healthy organism, to temperate habits or even to diet, as many cases of syphilitic eruption have been greatly benefitted by to proper diet.
Malignant forms of syphilis, we know, are largely due to unsanitary conditions, improper cleansing of the sores, to intemperate habits previous to the contracting of the disease, to hereditary states and conditions of the blood and especially to the tubercular taints, latent, of course, which we know to lie behind the source of all manner of infections and contagious disease, such as measles, whooping-cough, scarlet fever, smallpox, La Grippe, typhoid fever and all the rest of the exanthemata. In the malignant types of syphilis, we recognize the profound blood changes, the anaemia, the pallor or cachexia, as we call it. The eruptions are deep, covering often large surfaces. Their destructive, devastating character is manifest, the glandular involvement, the deep gummatous and gangrenous excavations into the muscles and cellular tissues the rapid, destructive process of the disease, their dangerous complications and perilous sequels, we should early become acquainted with, and we should know when their movement are of a benign nature or whether they are assuming malignant forms.
Dr. Prince A. Morrow, in his work on Syphilology, says the difference between the malignant and benign is a difference in the activity of the germ or an intensity of the virus. We know however, that it is a question of soil to which the syphilitic virus is transplanted, whether it be favorable or unfavorable. It may be planted on a psoric, a tubercular or sycotic; again, it may be fostered in this whole tissue of death processes or any combination of them. If, upon the tubercular or sycotic, the chances for a complete eradication is doubtful. They seem to blend together in such a combine, that makes it difficult for even the great law of cure, homoeopathy, to break its subtle bond.
You will have great difficulty in separating this positive bond with the life forces unless you are well acquainted with the nature of each dreaded miasm and their complex and intricate movements. The Law of Similia, however, is capable of breaking these bonds and liberating the life forces again to their free and normal action. We have just such remedies, in Syphilimum, Thuja, Kali iod., Cinnabaris, and many others that may come up for your careful study and consideration. We have noticed the slowness with which syphilis combines with the tubercular or the sycotic. You will notice the symptoms of syphilis and sycosis side by side, separate and distinct. When, however, sycosis does combine with any of the chronic miasms, especially the psoric tubercular, you have a fruitful field for cancer or any malignancy known to the science of medicine. I question if you can get a case of cancer without the sycotic element being present in the organism. The aged, the feeble and the very yound suffer most. We look for the majority of malignant cases to develop in the newly born or in the fruits of conception. A living syphilitic child is brought into the world, diseased in every drop of the life stream and in every fibre of its tissues. It is here where we find those grave and destructive processes, known as malignant syphilis. It is here we so often find gummata of the liver, lungs, testes, spleen, eye, ear and the bones diseased in all their destructive and deformative processes, osteo-chondritis. It is here we find pemphigoid lesions of the palms of the hands, of the soles of the feet, mucous papules of the mouth lips, anus, vulva, observed in their order of evolution. It is here we notice the atrophies, the ulcerations, the destructive ravages of the tertiary lesions in all its forms, reserving their deadliest arrows for the second generation.
The Pathology of Syphilis
The later or more modern study of the pathology of syphilis is now confined to the study of a germ, or micro-organism, described by Lustgarten, which has been recognized in the centers of a syphilitic process in almost every stage of the disease. It measures from one to several millimeters in length, slightly curved upon itself, with slightly swollen terminal extremities. They are found in small groups like all venereal bacilli. As this will be taken up again more fully, we will close the subject with this brief introduction.
The sclerotic or hardened condition of the chancre is produced after the introduction of the virus at that point by dense infiltration of the connective tissue elements with embryonic cells, among which are found giant cells. These are clustered about the exterior of the lymph channels. The syphiloma, or the morbid products of syphilis in all its lesions, is a true neoplasm of the granular type. On examination, we find the upper layers of the corium swollen, with a semi-liquid infiltration. There can be no building or new tissues, as no blood vessels are found at first. Indeed. All the blood channels are stuffed with these giant cells. Later on we find abundant filtration. The vascular elements are greatly developed, as we see in the formation of gumma. On a microscopic examination, we find them to be nests of these embryonic cells, surrounded by a dense mass of connective tissue. These masses often undergo rapid inflammatory changes, such as inflammation, suppuration, degeneration, caseation, fatty metamorphosis and even absorption.
Gummatous infiltrations often, after forming slowly, absorb without any breaking down process whatever. We see this nicely demonstrated in that form of gumma known as dactylitis syphilitica, or gummatous nodules, in other places, also in glandular involvement. In short, the study of the histology of syphilis at the present day, suggests a careful study of all its clinical features. It has been said that syphilis imitates almost every other known disease in our differential diagnoses of disease; we so often are confronted with this experience. This is true of our microscopical examinations of tissues change by the syphilitic processes, which are found not to be strikingly different from those examined in many other morbid states.
History of syphilis
The History of syphilis is of very little value to the modern syphilidiater, except for his love of history and a desire to peek into the closed files of the ages. Men no longer have the love for mysticism as in earlier days. Today is a day when men deal only with facts and figures, as they never have before. However, history reveals the fact that human morals have never been at par. When man lived in pure surroundings and in a simple state, he was practically free from all contagious or infectious disease, but when he departed from that simple life, which was not true of great cities or densely populated districts, he met with many forms of contagion and disease. When we study the disease syphilis, under such men as Parrot, there are revealed to us many expressions of prehistoric syphilis. Bones exhumed for research purposes, in almost every region of the earth, exhibited may marked signs of the inflammatory and destructive processes of the disease, such as periostitis, osteitis, sclerosis, caries and exostosis; indeed, unmistakable signs of caries, cicatrices and circumscribed gummatous changes Microscopic examinations have been made of a number of these bony specimens, which strengthens our belief come down to the fifteenth century do we find a true and authentic history of syphilis. Only up to john Hunter’s time, 1786, do we find a complete separation of venereal diseases. The chancre was not separated from the chancroid, so as to be clearly under stood and our knowledge of these lesions and of systemic syphilis was far from being complete at the beginning of the eighteenth century.
This confusion in a field where careful clinical observation is now daily discriminating, with results of great value, is to be coupied with an important fact. Much carelessness prevailed in the use of terms as applied to lesions of the genital organs of both sexes in writer of a later date as well as of antiquity. Many of the records handed down to us have been imperfectly translated the Chinese and the japanese people seem to have gone deeply into the study, not only of the investigation of the initial lesion, but of the cutaneous eruptions and systemic infection in general. It is also well known that certain of the Egyptian papyri and cuneiform inscriptions from Assyria and Babylon found in the numerous collections of scientific societies indicate clearly that the people living in that time made records of this disease and some relation was established between local genital diseases, resulting from sexual indulgence, and lesions observed later upon the body.
The history of ancient Rome conveys very little proof of syphilis, although there are abundant proofs of sycosis in the tertiary stages, showing that gonorrhoea was the prevalent venereal disorder. Fig warts, or fig-like vegetations, fungous growths and genital excrescences are frequently mentioned in these writings. Other references show systemic disorder due to the disease. Other disease eruptions, of course, can be seen from these writings, such as eczema, ecthyma, psoriasis and other affections of the cutis.
In the middle ages, up to the fifteenth century, all traces and indications of syphilis in these writings are vague and uncertain. These early writers, it seems, did not understand the symptoms or the phenomena of disease, and these writings show the use of vague terms and much confusion in the giving of symptoms. On the other hand, as we closely investigate the great mass of testimony given us by these early writers, we cannot but accept the fact that syphilis did actually exist in that age of debauchery and sexual excesses. Many are the records, however, as has been mentioned, of venereal diseases of a contagious and virulent character. It is now, I believe, conceded as a recorded fact, that a Spanish physician, by the name of Ruy Diaz de Isla, treated a number of sailors who were affected with syphilis, who accompanied Columbus on his first voyage of discovery in the year 1493, on his return to Spain. Our next authentic record occurred in 1494. Gonzalez Fernandez de Cordova, a Spanish general, left Spain in that year and headed an expedition against Italy where his army was brought in contact with some French troops of Charles the VIII, who were in an expedition against Naples. This army was officered by men of aristocratic connections, leading the loosest of lives. The rank and file followed in their footsteps, being just as dissolute as their commanders. They did not hesitate to pillage Rome, soon after which an epidemic of syphilis spread over France, Spain, Italy and Switzerland. It even extended to the Rhine, to Germany and thence to other parts of Europe. For the first time the disease was carefully analyzed by the physicians of that day, when the chancere or primary lesions were distinctly connected with its systemic manifestations. It was then fully believed that the disease had been brought from the East Indies by the crews of Columbus.
However, as we ponder the pages of history written at that time and even a later date, we find each nation blaming the other for the transfer of the disease to Europe. The french, Italians, Germans, Turks, Persians and Poles have, in their turn, been accused of fathering the disease. To be brief, we might state here that are prehistoric evidences of the existence of syphilis in America and even greater proof that the same disease existed among the Egyptians, Chinese and the Greeks. According to Bruehl, the Mexicans, at an early date, recognized the true relation between the primary disease and the constitutional malady.
The knowledge of the history of syphilis, as compared with other diseases, has steadily advanced since the sixteenth century. At the close of this century, Benjamin Bell and John Hunter added their bit to our knowledge of syphilis, Hunter’s name still applied to that definite form of chancre, as distinguished from all other forms and from chancroid.
The eighteenth century opened up its many wide doors to all sciences and the study of this malady did not fall behind the rest, the French winning many conquests in this new and fruitful field. Such names as Jourdan, Desruelles were forerunners of the great Record, who well deserves the name of the great teacher. He not only taught in a masterly manner, but was broad and comprehensive in his teachings, giving us a clear conception of the three distinct periods of the disease, the primary. Secondary and tertiary phases now fully understood by all syphilologists. He was followed by Bassereau, Mauriace, Parrot, Jullien and mireur. In Germany we have other lights, Virchow, Huebner, Erb and Auspitz, and later on, Kaposi. In England we have Lane, Hughlings, Jackson and Hutchison. In America we can, with pleasure, mention the illustrious names of Bumstead, Morrow, Greenough, prost, William White, Martin Taylor Fox and Lustgarten of New York.