When the tonsils are attacked, ulcers appear, precisely similar in character to chancres, hollow in the centre, with raised ragged edges, yellow on the surface, with a livid color on the surrounding margin. A sense of dryness is perceived, extending up the eustachian tube to the ear. Sometimes the tongue, gums, and inner part of the lips, are attacked (see representation). [Illustration] In the progress of the disease, the pharynx, or top of the gullet, is brought under its influence, and the ulceration spreads through it to the vertebræ or back-bone. Extending its course, it next attacks the larynx, or top of the windpipe, when, if not arrested, it will soon destroy life. Attending this affection of the larynx, there is always loss of voice—the patient speaks in a low whisper. It is more fatal than any other form of the venereal disease. The mucous membrane of the nose stands next in order, as subject to the influence of syphilis. The patient’s attention is first directed to it by an incrustation which forms in the nostril. On this being removed, a quantity of blood, mixed with purulent matter, is discharged. In two or three days, similar incrustations are formed, and under them ulceration takes place, which frequently lays bare the bone, and occasions it to exfoliate; and this exfoliating often continues after the venereal action has ceased. The number of bones which come away is often very considerable, and horrible deformity is the result. The periosteum and bones become in their turn affected by swellings called nodes—the periosteum first, and the bones subsequently. Of these, the cylindrical, being most exposed to vicissitudes of temperature, are commonly the first attacked. Those which are much covered by muscle are rarely affected, as, for instance, the back part of the _tibia_, or large bone of the leg, while nothing is more common than to see nodes on its anterior part, which is only covered with skin and periosteum. They occur on the _fibula_ only when it is slightly covered, and only on the _ulna_, or elbow-bone, when similarly circumstanced. Nodes on the _os humeri_, or shoulder-bone, except on the outer side, are of very rare occurrence, but are frequently found on the _clavicle_, or collar-bone, at its scapular and sternal articulations. In the following wood-cut is an illustration of the most frequent situation of nodes on the forepart of the tibia, or chief bone of the leg. The swelling is considerable; the upper one proceeding to suppuration, and the lower indicating merely a tumefaction of the lower part of the bone, near the instep. [Illustration]