The Treatment of Late Syphilis, and of Syphilis in Mother and Child

Abstract

The aim of treatment in late syphilis is to carry the infected individ¬ ual through the fullness of his years, with maximum attainable efficiency and minimum danger to his contacts and to the social order. The first step in the treatment of late syphilis is an appraisal of possibilities, including :1. An estimate of life expectancy based on age, on damage already done, on the supposed activity and rate of progress of the process, and on its probable refractoriness to treatment.2. An estimate of the handicaps imposed by complications not directly due to syphilis, such as tuberculosis, nonsyphilitic mental disease, hypertension, chronic interstitial nephritis, diabetes, and so forth.3. An estimate of the tolerance of the patient for the various methods of treatment available.4. An estimate of the probable response to treatment of the most vital structures involved.Treat late syphilis by the indications in vital structures and not in structures nonessential to life. Only a searching examination of the entire body can provide the information for stich an appraisal. While the milder forms of treatment may be begun, arsphenamin should sel¬ dom be administered until this appraisal is reasonably complete. The inherent crudity of our methods of estimating the condition of many important structures must be remembered and allowed for in making the estimates mentioned. Particularly in involvements of the vascular