uired or inherited syphilis in producing
general paralysis, which so largely helps to fill lunatic asylums, and
tabes dorsalis which is the most important disease of the spinal cord.
Even to-day it can scarcely be said that there is complete agreement as
to the supreme importance of the factor of syphilis in these diseases.
There can, however, be little doubt that in about ninety-five per cent. at
least of cases of general paralysis syphilis is present.[228]

Syphilis is not indeed by itself an adequate cause of general paralysis
for among many savage peoples syphilis is very common while general
paralysis is very rare. It is, as Krafft-Ebing was accustomed to say,
syphilization and civilization working together which produce general
paralysis, perhaps in many cases, there is reason for thinking, on a
nervous soil that is hereditarily degenerated to some extent; this is
shown by the abnormal prevalence of congenital stigmata of degeneration
found in general paralytics by Naecke and others. "Paralyticus nascitur
atque fit," according to the dictum of Obersteiner. Once undermined by
syphilis, the deteriorated brain is unable to resist the jars and strains
of civilized life, and the result is general paralysis, truly described as
"one of the most terrible scourges of modern times." In 1902 the
Psychological Section of the British Medical Association, embodying the
most competent English authority on this question, unanimously passed a
resolution recommending that the attention of the Legislature and other
public bodies should be called to the necessity for immediate action in
view of the fact that "general paralysis, a very grave and frequent form
of brain disease, together with other varieties of insanity, is largely
due to syphilis, and is therefore preventable." Yet not a single step has
yet been taken in this direction.

The dangers of syphilis lie not alone in its potency and its persistence
but also in its prevalence. It is difficult to state the exact incidence
of syphilis, but a great many partial investigations have been made in
various countries, and it would appear that from five to twenty per cent.
of the population in European countries is syphilitic, while about fifteen
per cent. of the syphilitic cases die from causes directly or indirectly
due to the disease.[229] In France generally, Fournier estimates that
seventeen per cent. of the whole population have had syphilis, and at
Toulouse, Audry considers that