in our present state of knowledge, nothing can be done once the disease passes its earliest stages.  In both these diseases only too often the physician is called upon to lock the stable door after the horse is stolen.  The problem of what to do for the victims of these two conditions is the same as the problem in other serious complications of syphilis—­keep the disease from ever reaching such a stage by recognizing every case early, and treating it thoroughly from the very beginning.

SUMMARY

Summing up briefly the main points to bear in mind about the course of syphilis—­there is a time, at the very beginning of the disease, even after the first sore appears, when the condition is still at or near the place where it entered the body.  At this time it can be permanently cured by quick recognition and thorough treatment.  There are no fixed characteristics of the early stages of the disease, and it often escapes attention entirely or is regarded as a trifle.  The symptoms that follow the spread of the disease over the body may be severe or mild, but they seldom endanger life, and again often escape notice, leaving the victim for some years a danger to other people from relapses about which he may know nothing whatever.  Serious syphilis is the late syphilis which overtakes those whose earlier symptoms passed unrecognized or were insufficiently treated.  Late syphilis of the skin and bones, disfiguring and horrible to look at, is less dangerous than the hidden syphilis of the blood-vessels, the nerves, and the internal organs, which, under cover of a whole skin and apparent health, maims and destroys its victims.  Locomotor ataxia and softening of the brain, early apoplexy, blindness and deafness, paralysis, chronic fatal kidney and liver disease, heart failure, hardening of the blood-vessels early in life, with sudden or lingering death from any of these causes, are among the ways in which syphilis destroys innocent and guilty alike.  And yet, for all its destructive power, it is one of the easiest of diseases to hold in check, and if intelligently treated at almost any but the last stages, can, in the great majority of cases, be kept from endangering life.

Chapter VI

The Blood Test for Syphilis

It seems desirable at this point, while we are trying to fix in mind the great value of recognizing syphilis in a person in order to treat it and thus prevent dangerous complications, to say something about the blood test for syphilis, the second great advance in our means of recognizing doubtful or hidden forms of the disease.  The first, it will be recalled, is the identification of the germ in the secretions from the early sores.