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SYNTHESIS 214 SYPHILIS two atoms of hydrogen with one atom of oxygen. In logic, the method by com- position, in opposition to the method of resolution or analysis. In synthesis, we reason from axioms, definitions, and al- ready known principles, till we arrive at a desired conclusion. Of this nature are most of the processes of geometrical rea- soning. In synthesis, we ascend from par- ticular cases to general ones ; in analysis, we descend from general cases to partic- ulars. SYPHILIS, according to Dr. Farr, a disease belonging to the enthetic order of zymotic diseases. It may be defined as a specific disease produced by the con- tagion of the same disease in another person, and characterized (1) in its primary form by the appear- ance on the part inoculated of one of two different kinds of a sore or chancre, and (2) in its second- ary or constitutional form by various eruptions on the skin, by sore throat, affections of the eye, the glands, the bones, and almost every other tissue of the body. The contagion may be conveyed by direct inoculation during sexual inter- course; accidentally, in other forms of personal contact, and purposely, by in- oculation for medical or experimental purposes. There are two kinds of chan- cre, and in one the disease is merely lo- cal, never affecting the constitution; but in the other the constitution is affected, and the disease may break out after long intervals of health, and may be transmit- ted from one generation to another through the blood of the mother or the semen of the father. The local form of syphilis appears in three principal varieties — (1) The com- mon soft chancre unaccompanied by bubo; or suppurative syphilitic inflam- mation. Three or four days after in- oculation the sore appears and begins to suppurate at once. The sore has a punched-out appearance, its edges are slightly undermined, and its base is thickened by inflammation of the parts underneath it. The sore heals with no remaining induration in three or four weeks. (2) The sore with sup- purating bubo; or ulcerative syphilitic inflammation. The sore is ragged and has a worm-eaten appearance, the glands and the absorbents are affected, and specific abscesses may form in the course of the latter, but no part of the body beyond the gland is affected. In these two forms the treatments consist in keeping the part clean, applying a mercurial wash, poulticing the bubo and opening it as soon as it suppurates. (3) Sloughing and gangrenous sores. In this form the sore may slough and be- come gangrenous as soon as it is formed, or a previously formed sore may take on a sloughing action. The absorbents are not affected, nor is it followed by secondary symptoms, but the sloughing may proceed with great rapidity, and may prove fatal from exhaustion or haemorrhage. The constitutional form of syphilis is distinguished by the appearance on the part affected of a sore called the hard or Hunterian chancre, and by a chronic engorgement of the lymphatic glands forming a bunch of hard knobs under the skin. The sore may appear in from three to five days after exposure to con- tagion, and it may vary as the disease is derived from a primary or a secondary sore. The general opinion of the medical pro- fession is that the constitutional form of syphilis can be treated efficiently by mercury only, and that the treatment should commence as soon as the disease declares itself. Much has been written in praise of salvarsan "606," as a cure in the earlier stages, but it has been demonstrated that relapses were more frequent than when mercury was used. The secondary symptoms of constitu- tional syphilis do not usually appear till after the primary sore has healed; but the period is quite uncertain, though, in the majority of cases, it is under half a year. The secondary symptoms are sometimes ushered in by what is termed the syphilitic fever; but they are gener- ally in the throat, the sore throat being due to an eruption on the mucous mem- brane of the mouth or fauces; or in the skin, being usually either roseola, lichen, acne, mucous tubercle, pityriasis, psor- iasis or lepra. These eruptions are dis- tinguished from other eruptions which are not specific, partly by their coppery color and by their circular or horseshoe form, and by their tendency to disappear at the center and spread from their edges. The eye and the larynx are affected in the latter secondary stage. Periostitis or nodes are also seen at this period. Other secondary symptoms are the de- velopment of mucous tubercles — flat, raised, oval patches, generally situated at or near the junction of the skin and mu- cous membrane and yielding a contagious secretion, probably a fertile source of in- oculation. The mucous tubercle generally disappears rapidly under the local ap- plication of calomel. Syphilitic vegeta- tions and condylomata are also conta- gious. In the treatment of secondary syphil- is it is now generally admitted that the administration of mercury is necessary for the complete eradication of the syph- ilitic diathesis.