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Discussion in Novels and on the Stage The "Disgusting" Not the "Immoral." It may, perhaps, excite surprise that in the preceding discussion of prostitution scarcely a word has been said of venereal diseases. In the eyes of many people, the question of prostitution is simply the question of syphilis.
We cannot yet precisely measure the interval which must elapse before, so far as Europe at least is concerned, syphilis and gonorrhoea are sent to that limbo of monstrous old dead diseases to which plague and leprosy have gone and smallpox is already drawing near.
The diagnosis of lupus is founded on the chronic progress and long duration, and the central scarring with peripheral extension of the disease. On the face it is most liable to be confused with syphilis and with rodent cancer.
+Variations in the Behavior of the Germ of Syphilis.+ Differences in the behavior of the same germ in different people are very familiar in medicine and are of importance in syphilis. As an example, the germ of pneumonia may be responsible for a trifling cold in one person, for an attack of grippe in the next, and may hurry the next person out of the world within forty-eight hours with pneumonia.
The test should be made by a specialist of recognized standing, and this term does not include many of the commercial laboratories which spring up like mushrooms in these days of laboratory methods. +The Recognition of Syphilis by the Blood Test.+ When the Wassermann test shows the presence of syphilis, we speak of it as "positive."
The time necessary for cure is not a fixed one, and depends on the individual case. Long experience has taught us that the cure of syphilis is not a matter of weeks or months, as patients so often expect, but of years. In the fully developed infection in the secondary stage, three years is a minimum and four years an average for treatment to produce a cure.
In the case of epilepsy, at any rate, it is easy to imagine that the passage of some specific organism through the reproductive cells may take place, as in the case of syphilis. We are, however, entirely ignorant of the nature of the former disease.
Mental strain, a powerful influence in many diseases, is a factor in syphilis also, and the state of mind of the patient has often almost as much to do with the success of his treatment as has salvarsan or mercury. For that reason it is worth while to devote a chapter to picturing in a general way the mental side of syphilis.
+Variations on the Rule.+ It should never be forgotten that all these rules are subject to variation, and that where one woman may have a series of miscarriages so close together that she mistakes them for heavy, irregular menstrual flows, and never realizes she is pregnant, another may bear a living child the first time after her infection, or still another woman after one miscarriage may have a child so nearly normal that it may attain the age of twenty or older, before it is suspected that it has hereditary syphilis.
The first dose may light the eruption up a little, but this is only because the drug stirs the germs up before it kills them, and improvement begins promptly within a few hours or a day or two. The first characteristic of salvarsan which we should bear in mind especially, in our interest in the social aspects of syphilis, is then the rapidity rather than the thoroughness of its action.
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