Affections of the Internal Organs, Nervous System and Motor Apparatus1

Such affections are infrequent but they may be very diverse and follow a benign course, as a rule.

A picture of acute hepatitis with jaundice resembling Botkin's disease (infectious hepatitis) is quite a rare occurrence. The liver is enlarged, tender and its function (pigmentary, antitoxic, carbohydrate, etc.) is disturbed. Splenomegaly is also encountered in fairly many cases. The serological blood tests in these patients are sharply positive, as a rule, which with the other symptoms of syphilis helps in recognizing the etiology of hepatitis.

Symptoms of involvement of the kidneys may be found at the same time as the affection of the liver. They include benign proteinuria manifested only by the presence of protein in the urine (up to 0.1-0.3 pro mille) and syphilitic lipoid nephrosis.

Cardiovascular involvement in the secondary period may occur in the form of syphilitic myocarditis (mild fatiguability, general weakness, dyspnoea), the diagnosis of which is made by means of electrocardiography.

Syphilitic gastritis (nausea, regurgitation, loss of appetite, reduced gastric-juice acidity) and dry syphilitic pleurisy are also rarely recorded.

Affections of the nervous system in the secondary period of syphilis are encountered in the form of latent syphilitic meningitis, acute generalized meningitis, subacute (basilar) meningitis, and syphilitic hydrocephalus. Disturbed sleep, irritability, short temper, and a sensation of hunger are observed in some patients with secondary syphilis.

If specific therapy is begun in good time, the affections of the nervous system and internal organs in the secondary period respond adequately to treatment, to penicillin therapy in particular, and regress quite rapidly.

Pain in the bones is among the most frequent manifestations of affection of the motor apparatus at the end of the primary and beginning of the secondary periods of syphilis. It is prevalently felt in the long tubular bones of the lower limbs and usually intensifies during the night. This pain is called dolores osteocopi nocturni and is not attended with any objective changes in the bones. Periostitis and osteoperiostitis marked by excruciating pain at night are less frequent in the secondary period. They are prevalently localized on the tibia and skull.

Specific therapy leads to rapid resolution of affections of the motor apparatus of syphilitic origin.