=Symptoms.=--Acquired syphilis may be divided into three stages: the
primary, secondary, and tertiary. The first stage is characterized by
the appearance of a pimple or sore on the surface of the sexual organ
not usually earlier than two, nor later than five to seven, weeks
after sexual intercourse. The appearance of this first sore is subject
to such variations that it is not always possible for even the most
skillful physician to determine positively the presence of syphilis
in any individual until the symptoms characteristic of the second
stage develop. Following the pimple on the surface of the penis comes
a raw sore with hard deposit beneath, as of a coin under the skin. It
may be so slight as to pass unnoticed or become a large ulcer, and may
last from a few weeks to several months. There are several other kinds
of sores which have no connection with syphilis and yet may resemble
the syphilitic sore so closely that it becomes impossible to
distinguish between them except by the later symptoms to be described.
Along with this sore, lumps usually occur in one or both groins, due
to enlarged glands.
The second stage appears in six to seven weeks after the initial sore,
and is characterized by the occurrence of a copper-colored rash over
the body, but not often on the face, which resembles measles
considerably. Sometimes a pimply or scaly eruption is seen following
this or in place of the red rash. At about, or preceding, this period
other symptoms may develop, as fever, headache, nausea, loss of
appetite, and sleeplessness, but these may not be prominent. Moist
patches may appear on the skin, in the armpits, between the toes, and
about the rectum; or warty outgrowths in the latter region. There is
sore throat, with frequently grayish patches on the inside of the
cheeks, lips, and tongue. The hair falls out in patches or, less
often, is all lost. Inflammation of the eye is sometimes a symptom.
These symptoms do not always occur at the same time, and some may be
absent or less noticeable than others.
The third stage comes on after months or years, or in those subjected
to treatment may not occur at all. This stage is characterized by
sores and ulcerations on the skin and deeper tissues, and the
occurrence of disease of different organs of the body, including the
muscles, bones, nervous system, and blood vessels; every internal
organ is susceptible to syphilitic change.
A great many affections of the internal organs--the heart, lungs,
liver, kidneys, brain, and cord--which were formerly attributed to
other causes, are now recognized as the product of syphilis. The
central nervous system is peculiarly susceptible to the action of the
syphilitic poison, and when affected may show the fact through
paralysis, crippling, disabling, and disfiguring disorders.
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