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.

+Common Misconceptions Regarding Syphilitic Rashes.+--Laymen should be
warned against the temptation to call an eruption syphilitic. The
commonest error is for the ordinary person to mistake a severe case of
acne, the common "pimples" of early manhood, for syphilis. Psoriasis,
another harmless, non-contagious, and very common skin disease, is often
mistaken for syphilis. Gross injustice and o