All this, of course, is a question of experience; and as I profess that this work should convey the result of mine, I do not hesitate to express my conviction that secondary symptoms do present themselves years after a primary affection; but at the same time I admit their more frequent occurrence to be within three months; and, with regard to diseases resembling the above, they are entirely independent of such influences, and are the result of circumstances from which no man is free. Of syphilitic ulcerations of the throat, which are rarely solitary symptoms of the disease, being usually accompaniments to articular eruptions or rheumatic pains, there are several forms. They are ushered in by feverishness, languor, and a peculiar contour of the countenance, particularly expressive of anxiety and debility. Of the first form of ulcerated throat, and which is perhaps the least frequent, is an excavation of the tonsil, with a tumid and red margin, accompanied by a stiffness and uneasiness in swallowing. A more common form, and which, from its occasioning little or no inconvenience, is seldom discovered by the patient until it degenerates into a worse state, is that where the ulceration is more superficial, resembling fissures rather than ulcers, and being situated at the back part and edges of the tonsils, and low down the throat. From the absence of pain and difficulty in swallowing, the medical man is usually the first to detect it, when, on opening the mouth, the throat—that is, the hinder part of the fauces—will be discovered red and somewhat swollen; and on pressing down the tongue with a spoon or spatula, the ulceration will be apparent. The last form—the phagedenic—is the most formidable, both in symptoms and effects. It is characterized by fever, and great pain and difficulty in swallowing, from the beginning; all denoting acute inflammation of the throat. The first appearance of ulceration is on the soft palate, where a small aphthous spot is discovered, surrounded by a deep erysipelatous redness, that proceeds rapidly to involve the neighboring parts, which soon assume the appearance of one extensive slough. This latter disease requires prompt and active treatment, else the bones of the palate and nose become implicated, exfoliate and occasion a permanent deformity.