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JAMA. 1915;LXV(22):1909-1911. doi:10.1001/jama.1915.02580220049017.
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The trail of pioneer students in the last decade has led us into a wilderness of speculation and argument concerning the pathology and treatment of syphilis, especially of the late forms. Whether our combined attack with the old remedy and the brilliant new therapeutic weapon destroys the enemy or wins a truce, whether persistently negative findings in both serum and arachnoid fluid ever guarantee the death of the ultimate spirochete—these questions may be answered after forty years of wandering. Meanwhile certain facts in the pathology are becoming clear, and quite definite ideals of treatment may be held.

The underlying pathology of parasyphilis does not differ essentially from that of primary syphilis; but while a scarred foreskin is of no physiologic moment, a scarred optic nerve is a tragedy. We must probably, however, recognize both spinal and cerebral syndromes resulting from processes degenerative in type from the time of the first


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