The Third Great Plague: A Discussion of Syphilis for Everyday PeopleStokes, John H. (John Hinchman)
History
The Third Great Plague: A Discussion of Syphilis for Everyday People
Stokes, John H. (John Hinchman)
Syphilis
+The Recognition of Syphilis by the Blood Test.+--When the Wassermann
test shows the presence of syphilis, we speak of it as "positive."
Granted that the test is properly done, a strong positive reaction means
syphilis, unless it is covered by the limited list of exceptions. After
the first few weeks of the disease, and through the early secondary
period, the blood test is positive in practically all cases. Its
reliability is, therefore, greatest at this time. Before the infection
has spread beyond the first sore, however, the Wassermann test is
negative, and this fact makes it of little value in recognizing early
primary lesions. In about 20 to 30 per cent of syphilitic individuals
the test returns to negative after the active secondary stage is passed.
This does not necessarily mean that the person is recovering. It is even
possible to have the roof fall out of the mouth from gummatous changes
and the Wassermann test yet be negative. It is equally possible, though
unusual, for a negative Wassermann test to be coincident with contagious
sores in the mouth or on the genitals. So it is apparent that as an
infallible test for syphilis it is not an unqualified success. But
infallibility is a rare thing in medicine, and must be replaced in most
cases by skilful interpretation of a test based on a knowledge of the
sources of error. We understand pretty clearly now that the Wassermann
test is only one of the signs of syphilis and that it has quite
well-understood limitations. It has revealed an immense amount of
hidden syphilis, and in its proper field has had a value past all
counting. Experience has shown, however, that it should be checked up by
a medical examination to give it its greatest value. Just as all
syphilis does not show a positive blood test, so a single negative test
is not sufficient to establish the absence of syphilis without a medical
examination. In a syphilitic, least of all, is a single negative
Wassermann test proof that his syphilis has left him. In spite of these
rather important exceptions, the Wassermann test, skilfully done and
well interpreted, is one of the most valuable of modern medical
discoveries.
Public-domain text, read in full here on John Shaqi.
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