The Third Great Plague | Page 6

will proceed. Syphilis is a preventable disease, usually
curable when handled in time, and its successful management will
depend in large part upon the coöperation, not only of those who are
victims of it, but of those who are not. It is much more controllable
than tuberculosis, against which we are waging a war of increasing
effectiveness, and its stamping out will rid humanity of an even greater
curse. To know about syphilis is in no sense incompatible with clean
living or thinking, and insofar as its removal from the world will rid us
of a revolting scourge, it may even actually favor the solution of the
moral problems which it now obscures.

Chapter III
The Nature and Course of Syphilis
The simplest and most direct definition of syphilis is that it is a
contagious constitutional disease, due to a germ, running a prolonged
course, and at one time or another in that course is capable of affecting
nearly every part of the body. One of the most important parts of this
rather abstract statement is that which relates to the germ. To be able to
put one's finger so definitely on the cause of syphilis is an advantage
which cannot be overestimated. More than in almost any other disease
the identification of syphilis at its very outset depends upon the seeing

of the germ that causes it in the discharge from the sore or pimple
which is the first evidence of syphilis on the body. On our ability to
recognize the disease as syphilis in the first few days of its course
depends the greatest hope of cure. On the recognition of the germ in the
tissues and fluids of the body has depended our knowledge of the real
extent and ravages of the disease. With the knowledge that the germ
was related to certain other more familiar forms, Ehrlich set the trap for
it that culminated in salvarsan, or "606," the powerful drug used in the
modern treatment. By the finding of this same germ in the nervous
system in locomotor ataxia and general paralysis of the insane, the last
lingering doubt of their syphilitic character was dispelled. Every day
and hour the man who deals with syphilis in accordance with the best
modern practice brings to bear knowledge that arises from our
knowledge of the germ cause of syphilis. No single fact except perhaps
the knowledge that certain animals (monkeys and rabbits especially)
could be infected with it has been of such immense practical utility in
developing our power to deal with it.
The germ of syphilis,[3] discovered by Schaudinn and Hoffmann in
1905, is an extremely minute spiral or corkscrew-shaped filament,
visible under only the highest powers of the microscope, which
increase the area of the object looked at hundreds of thousands of times,
and sometimes more than a million of times. Even under such intense
magnifications, it can be seen only with great difficulty, since it is
colorless in life, and it is hard to color or stain it with dyes. Its spiral
form and faint staining have led to its being called the Spirochæta
pallida.[4] It is best seen by the use of a special device, called a
dark-field illuminator, which shows the germ, like a floating particle in
a sunbeam, as a brilliant white spiral against a black background,
floating and moving in the secretions taken from the sore in which it is
found. Some means of showing the germ should be in the hands of
every physician, hospital, or dispensary which makes a claim to
recognize and treat syphilis.
[3] See frontispiece.
[4] Pronounced spi-ro-kee'-ta.

+Syphilis a Concealed Disease.+--Syphilis is not a grossly conspicuous
figure in our every-day life, as leprosy was in the life of the Middle
Ages, for example. To the casually minded, therefore, it is not at all
unreasonable to ask why there should be so much agitation about it
when so little of it is in evidence. It takes a good deal out of the graphic
quality of the thing to say that most syphilis is concealed, that most
syphilitics, during a long period of their disease, are socially
presentable. Of course, when we hear that they may serve lunch to us,
collect our carfare, manicure our nails, dance with us most
enchantingly, or eat at our tables, it seems a little more real, but still a
little too much to believe. Conviction seems to require that we see the
damaged goods, the scars, the sores, the eaten bones, the hobbling
cripples, the maimed, the halt, and the blind. There is no accurate
estimate of its prevalence based on a census, because, as will appear
later, even an actual impulse to self-betrayal would not disclose 30 to
40 per cent of the victims of the disease. Approximately this percentage