Syphilis, once responsible for devastating epidemics, is caused by the bacterium Treponema pallidum that is very fragile, and the infection is almost always transmitted by sexual contact with an infected person. The bacterium spreads from the initial ulcer of an infected person to the skin or mucous membranes of the genital area, mouth, or anus of an uninfected sexual partner. It also can pass through broken skin on other parts of the body. In addition, a pregnant woman with syphilis can pass the bacteria T. pallidum to her unborn child, who may be born with serious mental and physical problems as a result of this infection.

The initial infection causes an ulcer at the site of the infection. The bacteria, however, move throughout the body, damaging many organs over time. Medical experts describe the course of the disease by dividing it into four stages-primary, secondary, latent, and tertiary (late). An infected person who has not been treated may infect others during the first two stages, which usually last 1 to 2 years. In its late stages, untreated syphilis, although not contagious, can cause serious heart abnormalities, mental disorders, blindness, other neurologic problems, and death.

The first symptom of primary syphilis is an ulcer called a chancre ("shan-ker"). The chancre can appear within 10 days to 3 months after exposure, but it generally appears within 2 to 6 weeks. Because the chancre may be painless and may occur inside the body, the infected person might not notice it. It usually is found on the part of the body exposed to the infected partner's ulcer. The chancre disappears within a few weeks whether or not a person is treated. If not treated during the primary stage, about one-third of people will go on to the chronic stages.

A skin rash, with brown sores about the size of a penny, often marks the secondary chronic stage of syphilis. The rash appears anywhere from 3 to 6 weeks after the chancre appears. While the rash may cover the whole body or appear only in a few areas, it is almost always on the palms of the hands and soles of the feet. Because active bacteria are present in the sores, any physical contact with the broken skin of an infected person may spread the infection at this stage. The rash usually heals within several weeks or months. Other symptoms also may occur, such as mild fever, fatigue, headache, sore throat, patchy hair loss, and swollen lymph glands throughout the body. These symptoms may be very mild and, like the chancre of primary syphilis, will disappear without treatment. The signs of secondary syphilis may come and go over the next 1 to 2 years of the disease. If untreated, syphilis may lapse into a latent stage during which the disease is no longer contagious and no symptoms are present. Many people who are not treated will suffer from no further signs and symptoms of the disease. Approximately one-third of people who have had secondary syphilis go on to develop the complications of late, or tertiary, syphilis, in which the bacteria damage the heart, eyes, brain, nervous system, bones, joints, or almost any other part of the body. This stage can last for years, or even for decades. Late syphilis can result in mental illness, blindness, other neurologic problems, heart disease, and death. Syphilis is sometimes called "the great imitator" because its early symptoms are similar to those of many other diseases. Sexually active people should consult a doctor or other health care worker about any rash or sore in the genital area. 

The doctor usually uses all the known and tested approaches to diagnose syphilis and decide upon the stage of infection. Blood tests also provide evidence of infection, although they may give false-negative results (not show signs of an infection despite its presence) for up to 3 months after infection. False-positive tests (showing signs of an infection when it is not present) also can occur. Therefore, two blood tests are usually used. Interpretation of blood tests for syphilis can be difficult, and repeated tests are sometimes necessary to confirm the diagnosis.

Unfortunately, the early symptoms of syphilis can be very mild, and many people do not seek treatment when they first become infected. Doctors usually treat patients with syphilis with penicillin, given by injection. They use other antibiotics for patients allergic to penicillin. A person usually can no longer transmit syphilis 24 hours after starting treatment. Some people, however, do not respond to the usual doses of penicillin. Therefore, it is important that people being treated for syphilis have periodic blood tests to check that the infectious agent has been completely destroyed. People with neurosyphilis may need to be retested for up to 2 years after treatment. In all stages of syphilis, proper treatment will cure the disease. But in late syphilis, damage already done to body organs cannot be reversed.

A pregnant woman with untreated, active syphilis is likely to pass the infection to her unborn child. In addition, miscarriage may occur in as many as 25 to 50 percent of women acutely infected with syphilis during pregnancy. Between 40 to 70 percent of women with active syphilis will give birth to a syphilis-infected infant. Some infants with congenital syphilis may have symptoms at birth, but most develop symptoms between 2 weeks and 3 months later. These symptoms may include: skin ulcers, rashes, fever, weakened or hoarse crying sounds, swollen liver and spleen, yellowish skin (jaundice), anemia, various deformities etc.  People who care for infants with congenital syphilis must use special cautions because the moist sores are infectious. Rarely, the symptoms of syphilis go undetected in infants. As infected infants become older children and teenagers, they may develop the symptoms of late-stage syphilis, including damage to their bones, teeth, eyes, ears, and brains.

Syphilis bacteria frequently invade the nervous system during the early stages of infection. Approximately 3 to 7 percent of persons with untreated syphilis develop neurosyphilis, a sometimes serious disorder of the nervous system. Some people with neurosyphilis never develop any symptoms. Others may have headache, stiff neck, and fever that result from an inflammation of the lining of the brain. Some people develop seizures. People whose blood vessels are affected may develop symptoms of stroke with numbness, weakness, or visual problems. Neurosyphilis may be more difficult to treat, and its course may be different, in people with HIV infection or AIDS.

The open sores of syphilis may be visible and infectious during the active stages of infection. Any contact with these infectious sores and other infected tissues and body fluids must be avoided to prevent spread of the disease. As with many other STDs, using latex male condoms properly during sexual intercourse may give some protection from the disease. Screening and treatment of infected individuals, or secondary prevention, is one of the few options for preventing the advanced stages of the disease. Testing and treatment early in pregnancy are the best ways to prevent syphilis in infants and should be a routine part of prenatal care.

Keeping in tune with your disease or condition not only makes treatment less intimidating but also increases its chance of success, and has been shown to lower a patients risk of complications. As well, as an informed patient, you are better able to discuss your condition and treatment options with your physician.

While we are well posted with the hard fact that Arsenic and many of its compounds are deadly toxic, it is worth mentioning that Arsenic has also been used as a life saver. In the nineteenth century, physicians had no means of combating infection and patients usually had no fate but to die. The whole nature of medicine, however, changed in 1863, when French scientists, Be champs, noticed that an arsenic compound was toxic to some micro-organisms. Paul Erhlich, a German scientist, decided to synthesize new arsenic compounds, testing each one for its organism killing ability.

Discharged from his Berlin hospital post in the latter half of the 19th century for opposing the primitive medical treatments prescribed by his superiors, Dr. Paul Ehrlich went on to develop a dye which delineates the tubercule bacillus. For his achievement, Ehrlich was awarded a position by the famous research bacteriologist Dr. Robert Koch. Ehrlich's exposure to tuberculosis has infected him with the disease, however, and he was forced to travel to Egypt for his health. There, while treating a snake bite victim, he conceived of the idea of anti-toxins, and upon his return to Germany, Ehrlich worked with his friend, Dr. Emil von Behring, to develop a serum for diptheria. After their development of a vaccination that arrests the diptheria epidemic, Ehrlich pursued his dream of finding a "magic bullet" to destroy invading microbes. He spent fifteen years developing a theory of how nature fights disease, and for his efforts was awarded the Nobel Prize and an institute in which to work. There he launched a series of experiments which applied his theory to the task of curing disease, but his efforts were attacked by a recalcitrant medical community, led by his old friend Behring.

Assailed on two fronts, Ehrlich struggled to develop a cure for syphilis while fighting to keep his budget intact. When his budget was cut in half, he turned to wealthy widow Franziska Speyer for funding. Six hundred-and-six experiments later, he discovers the cure for syphilis, and in the hope of saving lives, was persuaded to release the formula before testing was completed. Finding himself under attack when a few patients died from adverse reaction, Ehrlich was finally vindicated in a court trial led by Behring. Though the struggle drained Ehrlich's health and he paid for the development of his miracle cure with the cost of his own life, through his comprehensive study of the effects of chemicals in the human body, Ehrlich fathered the fields of chemotherapy and hematology. He also made important contributions to the understanding of immunity and discovered Salvarsan, the first effective treatment for syphilis. Chemotherapy also provides one of the lines of attack against cancerous tissues. And it all started with an arsenic compound.

As mention of arsenic has been made, it may not be out of context to give a passing reference of the chemistry of arsenic for obvious intentions, centered on the conceptual clarity of readers. Arsenic, an extremely poisonous semimetallic element, is intermediate between metals and nonmetals. Arsenic has been known since ancient times. Arsenic occurs frequently in place of some of the sulfur in the sulfides that are the principal ores of many of the heavy metals. Arsenic is sometimes used in the manufacture of such military poison gases as lewisite and adamsite. Until the introduction of sulfa drugs arsenic was of great importance in the treatment of the dreaded disease syphilis. Though in medicinal uses, it has been displaced by sulfa drugs or antibiotics, Lead arsenate, calcium arsenate, and Paris green are used extensively as insecticides.   

Arsenic is poisonous in doses significantly larger than 65 mg (1 grain), and the poisoning can arise from a single large dose or from repeated small doses, as, for example, inhalation of arsenical gases or dust. On the other hand, some persons, notably the so-called "arsenic eaters" of the mountains of southern Austria, have found that arsenic has a tonic effect and have built up a tolerance for it, so that they can ingest each day an amount that would normally be a fatal dose. This tolerance, however, does not protect them against the same amount of arsenic administered hypodermically.