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Another feature of interest is that when patients in the tertiary stage of syphilis are inoculated with the virus from lesions from these in the primary and secondary stage lesions of the tertiary type are produced. Reference may be made to the #relapsing false indurated chancre#, described by Hutchinson and by Fournier, as it may be the source of difficulty in diagnosis.
Infection with syphilis by such fluids as the blood, milk, or spermatic fluid uncontaminated by contact with active lesions is at least unusual. +Contagiousness in the Primary Stage.+ The chancre is always contagious.
In relation to the meatus and canal of the urethra, in either of which situations the swelling and induration may lead to narrowing of the urethra, so that the urine is passed with pain and difficulty and in a minute stream; stricture results only in the exceptional cases in which the chancre has ulcerated and caused destruction of tissue.
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.
A chancre acquired from a drinking cup or pipe may be transmitted to husband or wife through a mucous patch on the genitals and to children through an infected mother, without the question of innocence or guilt ever having arisen. On the other hand, chancres on parts other than the genitals may be acquired in any but innocent ways.
Hereditary syphilis is not some vague, indefinite constitutional tendency, but syphilis, as definite as if gotten from a chancre, though differing in some of its outward signs. +Transmission of Syphilis From Mother to Child.+ It is a well-known fact that the mothers of syphilitic children often seem conspicuously healthy.
It cannot be emphasised too strongly that the induration of the primary lesion, which has obtained for it the name of "hard chancre," is its most important characteristic. It is best appreciated when the sore is grasped from side to side between the finger and thumb.
+The Time Element in Contagiousness.+ It is the time that it takes an untreated case to reach a non-infectious stage and the events or conditions which can occur in the interval, that perpetuate syphilis among us. The chancre is contagious for several weeks, and few syphilitics escape having some contagious secondary lesions the first year. These are often inconspicuous and misunderstood.
The fitness of the germ of syphilis for long-continued life in the body, and the difficulty of marshaling a sufficient defense against it, is what makes it impossible to cure the disease by any short and easy method. +The First Sore or Chancre.+ The primary lesion, first sore or chancre, is the earliest sign of reaction which the body makes to the presence of the growing germs of syphilis.
The sores which occur in the moist, warm, protected places, like the mouth, on the lips, about the genitals, and in the folds of the body, such as the thighs, groins, armpits, and under the breasts in women, are, like the chancre, the real sources of danger in the spread of the disease. +Relatively Non-contagious Character of Late Syphilis.+ The older a syphilis is, the less dangerous it becomes.
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