in the course of a few days, and fills the circulating blood with the little corkscrew filaments, sending showers of them to every corner of the body and involving every organ and tissue to a greater or less extent.  This explosion marks the beginning of the active secondary stage of syphilis.  The germs are now everywhere, and the effect on the patient begins to suggest such infectious diseases as measles, chickenpox, etc., which are associated with eruptions on the skin.  But there can be no more serious mistake than to suppose that the eruptions which usually break out on the skin at this time represent the whole, or even a very important part, of the story.  They may be the most conspicuous sign to the patient and to others, but the changes which are to affect the future of the syphilitic are going on just at this time, not in his skin, but in his internal organs, and especially in his heart and blood-vessels and in his nervous system.

+Constitutional Symptoms.+—­It is surprising how mild a thing secondary syphilis is in many persons.  A considerable proportion experience little or nothing at this time in the way of disturbances of the general health to suggest that they have a serious illness.  A fair percentage of them lose 5 or 10 pounds in weight, have severe or mild headaches, usually worse at night, with pains in the bones and joints that may suggest rheumatism.  Nervous disturbances of the most varied character may appear.  Painful points on the bones or skull may develop, and there may be serious disturbances of eye-sight and hearing.  A few are severely ill, lose a great deal of weight, endure excruciating pains, pass sleepless nights, and suffer with symptoms suggesting that their nervous systems have been profoundly affected.  As a general thing, however, the constitutional symptoms are mild compared with those of the severe infectious fevers, such as typhoid or malaria.

+The Secondary Eruption or Rash.+—­The eruption of secondary syphilis is generally the feature which most alarms the average patient.  It is usually rather abundant, in keeping with the wide-spread character of the infection, and is especially noticeable on the chest and abdomen, the face, palms, and soles.  It is apt to appear in the scalp in the severer forms.  The eruption may consist of almost anything, from faint pink spots to small lumps and nodules, pimples and pustules, or large ulcerating or crusted sores.  The eruption is not necessarily conspicuous, and may be entirely overlooked by the patient himself, or it may be so disfiguring as to attract attention.