destructive, and the harm that it does cannot, except within narrow
limits, be repaired. It is responsible for the kind of damaged goods
which gives the disease its reality for the every-day person. It is a
matter of desperate importance where the damage is done. Late syphilis
in the skin and bones, while horrible enough to look at, and disfiguring
for life, is not the most serious syphilis, because we can put up with
considerable loss of tissue and scarring in these quarters and still
keep on living. But when late syphilis gets at the base of the aorta,
the great vessel by which the blood leaves the heart, and damages the
valves there, the numbering of the syphilitic's days begins. Few can
afford to replace much brain substance by tertiary growths and expect to
maintain their front against the world. Few are so young that they can
meet the handicap that old age and hardening of the arteries, brought on
prematurely by late syphilis, put upon them. When late syphilis affects
the vital structures and gains headway, the victim goes to the wall.
This is the really dangerous syphilis--the kind of syphilis that
shortens and cripples life.

There are few good estimates of the extent of late accidents, as we
often call the serious later complications in syphilis, or of the part
that they play in medicine as a whole. Too many of them are
inconspicuous, or confused with other internal troubles that result from
them. Deaths from syphilis are all the time being hidden under the
general terms "Bright's disease," or "heart disease," or "paralysis," or
"apoplexy." It is a hopeful fact that, even under unfavorable
conditions, only a comparatively small percentage, from 10 to 20 per
cent, seem to develop obvious late accidents. On the other hand, it must
not be forgotten that the obscure costs of syphilis are becoming more
apparent all the time, and the influence of the disease in shortening
the life of our arteries and of other vital structures is more and more