Moore on Syphilis

Almost all 4,000,000 syphilitics in the U.S. whose hearts and nerves are sound could, with proper treatment, get well. This statement was made last week in an authoritative medical book on syphilis published by one of the top U.S. experts, Dr. Joseph Earle Moore of Johns Hopkins (The Modern Treatment of Syphilis; C. C. Thomas; $7). In reviewing the cases of 35,000 patients over a period of almost 30 years, Dr. Moore came to some remarkable conclusions about natural immunity, chemical cures, social hygiene.

Frail Invader, Strong Defense. As most people know, the syphilis spirochete is very delicate, lives only on moist surfaces, dies as soon as it dries up. It is killed by soap and water, and probably, said Dr. Moore, by contraceptive jellies.

Shortly after the entry of syphilis germs, the body combats the invaders, tries to neutralize them. So powerful is this biologic defense, declared Dr. Moore, that one out of five men, one out of three women who get the disease show no signs of it. Dr. Moore made it clear that this is no argument against medical care, for such syphilitics are capable of passing on the disease. In fact since they do not know that they are infectious, they are an even greater public-health menace than victims with clear symptoms.

Usually spirochetes lodge in the body tissues, especially those of eyes, mouth, genitalia, larger blood vessels, nervous system. After the second year, the danger of transmitting the disease to others is slight, decreases as the years pass. After the fifth year, said Dr. Moore, germs do not usually circulate in the blood stream.

Nine Months, Five Days. Some of Dr. Moore's principles of treatment may sound surprising to general practitioners. Samples:

> Best drug for early syphilis is still old 606 (arsphenamine), combined with bismuth, though the simpler mapharsen may ultimately replace 606. In comparison, the time-honored mercury is not much good. The first three injections must be given within ten days; the rest once a week for several years. After the first injection a patient becomes temporarily noninfectious. But Dr. Moore warned doctors against the common practice of sporadic injections; once started, treatment must be continued, for in early syphilis a little "may be worse than none." Reason: if no drugs are given, the body proceeds with its strong defenses. When drugs attack the germs, they also weaken the body defenses. If a drug is withdrawn, a patient is left helpless.

> Provided his heart and nervous system are not damaged, a patient with "latent" syphilis has a 95% chance of getting well. His treatment is almost the same as in early syphilis, but may be milder.

> Syphilis in women is usually milder than in men, often passes unnoticed. Good treatment for infected women, said Dr. Moore boldly, is pregnancy--it greatly fortifies natural immunity. Of course, he stressed, syphilitic women must have a regular course of treatments before, during and after childbirth. Otherwise they may suffer great harm, produce maimed babies. With proper care, the child of a syphilitic mother has an excellent chance of being healthy.

> Last year doctors were agog over a new five-day treatment for early syphilis which used continuous, slow-drip injections of an arsenic compound. Experience has shown, said Dr. Moore, that while the five-day process is "excellent" for treating the syphilitic infection, it brings "an enormous increase in the danger to the patient." A number of patients so treated developed skin poisonings, neuritis, encephalitis. One out of every 300 died, a rate more than four times higher than that in standard treatment.

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