Having seen that secondary phenomena generally may set in in four or six weeks, or even at a much earlier period after the breaking out of the first protopathic symptoms, or at any rate, prior in their complete disappearances; the other not less important question now presents itself, how long a period may elapse, after the disappearance of the primary product, before all danger of further developments of the syphilitic disease shall have passed away entirely? If we would believed every thing that writers on syphilis have related on this subject as authentic, it would seem as though this danger continued during the whole lifetime of the patient; so that, if he had been afflicted years ago with a chancre, or even a simple gonorrhoea, and had enjoyed the most perfect health ever since, even for the period of twenty or more years, he may, nevertheless, wake one fine morning with one or the other suspicious looking symptom, or even, according to circumstances, with a whole legion of the most horrid syphilitic products, from the most disgusting cutaneous
|Sequelae of syphillis|
ulcerations to the most destructive chancres in the throat, and the most painful affections of the bones! Fortunately, inspite of what some authors may write, things are not quite so terribly bad. It is indeed true, that if secondary syphilis has once set in, and is not treated with proper specific means, the disease may break out again, every now and then, in five, seven, ten or even fifteen and twenty years; but experience her likewise shown that, where traces of a prior infection still continue to show themselves after the lapse of so many years, a careful examination of the case leads to the conviction, that a continual series of syphilitic phenomena had existed from the first outbreak of the disease, to the very day when the patient afterward presented himself for treatment. We admit that the phenomena of such a series must have been inconsiderable; out they certainly existed, and must have been overlooked by the patient, or not properly recognized by the physician, and treated for something else. If patients tell us that five, ten, or fifteen years after a period of perfect health, they were all at once attacked with symptoms of a previous gonorrhoea or chancre, we feel satisfied that the original disease must have either been badly managed, or that the patient is trying to deceive. What physician does not know that men, who feel interested in concealing former transgressions, are disposed stoutly to deny the suspicious character of existing discharges or ulcerations, even when of recent origin, and undertake to impose upon the physician by the bold assertion, that these symptoms are nothing else than the reappearance of a former infection contracted years ago! Secondary affections, if neglected, may indeed continue for years; but a careful inquiry will show that their first appearance can be traced to a primary infection that had occured six months, or, at the latest, one or two years previous to that time.