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JAMA. 1946;130(4):202-205. doi:10.1001/jama.1946.02870040018005.
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In early syphilis prompt diagnosis and initiation of treatment decrease opportunity for dissemination of infection and increase probability of cure. The dual effectiveness of penicillin against Treponema pallidum and Neisseria gonorrheae has complicated the problem of the early diagnosis of syphilis. The incubation period of gonococcic urethritis is usually three to five days and exceptionally one to two weeks;1 the incubation period of primary syphilis is ten to ninety days, with an average of three weeks.2 Consequently, in simultaneous infections the urethritis may be treated with penicillin while the patient is in the incubation stage of syphilis. For various reasons also treatment may be given when a chancre is already present: the lesion may be missed because of its unusual location, as in intrameatal, intraurethral, extragenital or cervical chancres; the chancre may be concealed by inflammatory phimosis or it may be regarded as a banal lesion; and, in


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