It has been stated by some that it is syphilis originally mild and benign in its manifestations, that is most apt to cause cerebral syphilis; one saying that the subjects most liable to cerebral syphilis are those in whom the secondary symptoms have been slight or transitory; another asserting that often one can find no history of preceding cutaneous or other affection of either the secondary or tertiary order; another, that any syphilis may be followed by specific cerebral affections, the original mildness of a syphilis being no guarantee against future cerebral affections of syphilitic origin, and that the great majority of the cerebral affections are furnished in examples of syphilis which is of medium severity, or (less often) is benign. This last observer, in 47 cases of cerebral syphilis, found three after severe or grave syphilis; 30 after syphilis of medium severity, and 14 after syphilis benign in its manifestations. As stated by myself in a paper∗ published more than seven years ago: “It is particularly in instances where syphilis affects the nervous system that its evolution is sometimes insidious; that its later lesions are not preceded by its usual characteristic development on the exterior of the body, or by only a partial, or slight, or transitory development; and that the diagnosis is surrounded by obscurity. This is the opinion of several writers on the subject, and more than once the fact has forced itself upon my attention.”
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