+Destructive Effects of Late Syphilis.+—­Late syphilis is, therefore, destructive, and the harm that it does cannot, except within narrow limits, be repaired.  It is responsible for the kind of damaged goods which gives the disease its reality for the every-day person.  It is a matter of desperate importance where the damage is done.  Late syphilis in the skin and bones, while horrible enough to look at, and disfiguring for life, is not the most serious syphilis, because we can put up with considerable loss of tissue and scarring in these quarters and still keep on living.  But when late syphilis gets at the base of the aorta, the great vessel by which the blood leaves the heart, and damages the valves there, the numbering of the syphilitic’s days begins.  Few can afford to replace much brain substance by tertiary growths and expect to maintain their front against the world.  Few are so young that they can meet the handicap that old age and hardening of the arteries, brought on prematurely by late syphilis, put upon them.  When late syphilis affects the vital structures and gains headway, the victim goes to the wall.  This is the really dangerous syphilis—­the kind of syphilis that shortens and cripples life.

There are few good estimates of the extent of late accidents, as we often call the serious later complications in syphilis, or of the part that they play in medicine as a whole.  Too many of them are inconspicuous, or confused with other internal troubles that result from them.  Deaths from syphilis are all the time being hidden under the general terms “Bright’s disease,” or “heart disease,” or “paralysis,” or “apoplexy.”  It is a hopeful fact that, even under unfavorable conditions, only a comparatively small percentage, from 10 to 20 per cent, seem to develop obvious late accidents.  On the other hand, it must not be forgotten that the obscure costs of syphilis are becoming more apparent all the time, and the influence of the disease in shortening the life of our arteries and of other vital structures is more and more evident.  There is still good reason for avoiding the effects of syphilis by every means at our disposal—­by avoiding syphilis itself in the first place, and by early recognition of the disease and efficient treatment, in the second.

+Late Syphilis of the Nervous System—­Locomotor Ataxia.+—­The ways in which late syphilis can attack the nervous system form the real terrors of the disease to most people.  Locomotor ataxia and general paralysis of the insane (or softening of the brain) are the best known to the laity, though only two of many ways in which syphilis can attack the nervous system.  Though their relation to the disease was long suspected, the final touch of proof came only as recently as 1913, when Noguchi and Moore, of the Rockefeller Institute, found the germs of the disease in the spinal cords of patients who had died of locomotor ataxia, and in the brains of those who had died of paresis.  The way in which