psing false indurated chancre#,
described by Hutchinson and by Fournier, as it may be the source of
difficulty in diagnosis. A patient who has had an infecting chancre one
or more years before, may present a slightly raised induration on the
penis at or close to the site of his original sore. This relapsed
induration is often so like that of a primary chancre that it is
impossible to distinguish between them, except by the history. If there
has been a recent exposure to venereal infection, it is liable to be
regarded as the primary lesion of a second attack of syphilis, but the
further progress shows that neither bullet-buboes nor secondary
manifestations develop. These facts, together with the disappearance of
the induration under treatment, make it very likely that the lesion is
really gummatous in character.

INHERITED SYPHILIS

One of the most striking features of syphilis is that it may be
transmitted from infected parents to their offspring, the children
exhibiting the manifestations that characterise the acquired form of the
disease.

The more recent the syphilis in the parent, the greater is the risk of
the disease being communicated to the offspring; so that if either
parent suffers from secondary syphilis the infection is almost
inevitably transmitted.

While it is certain that either parent may be responsible for
transmitting the disease to the next generation, the method of
transmission is not known. In the case of a syphilitic mother it is most
probable that the infection is conveyed to the foetus by the placental
circulation. In the case of a syphilitic father, it is commonly believed
that the infection is conveyed to the ovum through the seminal fluid at
the moment of conception. If a series of children, one after the other,
suffer from inherited syphilis, it is almost invariably the case that
the mother has been infected.

In contrast to the acquired form, inherited syphilis is remarkable for
the absence of any primary stage, the infection being a general one from
the outset. The spirochaete is demonstrated in incredible numbers in the
liver, spleen, lung, and other organs, and in the nasal secretion, and,
from any of these, successful inoculations in monkeys can readily be
made. The manifestations differ in degree rather than in kind from those
of the acquired disease; the difference is partly due to the fact that
the virus is attacking developing instead of fully formed tissues.

The virus ex