Syphilis is caused by infection with the bacterium Treponema pallidum. Probably because of access to adequate antibiotic therapy, it is now a very rare condition in the U.K, although it is still common in developing countries.
Infection with syphilis has three stages. The primary stage is called a chancre. This is a thickened lump which forms in the genital area within 2-12 weeks of sexual contact with an infected person. The skin on top of the chancre breaks down, but is often painless. It is this stage which is highly infectious, but like genital warts. It is often unnoticed by the patient. After healing of the chancre there may be a delay of some weeks before appearance of secondary syphilis. In most people there is a flu-like illness, with swollen lymph nodes, a characteristic skin rash, and the development of warty genital lumps. In some cases there might be more severe inflammation of a deep organ such as hepatitis or meningitis.
Secondary syphilis will abate after 3-12 weeks if untreated, but then can recur due to persistence of the organism, in a more severe form as tertiary syphilis. In this stage the infection can cause large ulcerating lumps, called gummas, in a wide range of tissues.
The heart and blood vessels can be affected, and a form of dementia (neurosyphilis) may develop. The condition termed general paralysis of the insane, once familiar in Victorian asylums, was a result of the combined features of untreated syphilis. These later stages of syphilis are now very rare in developed countries because the earlier stages respond well to penicillin treatment.
In Chinese medicine the formation of warty lumps in all three stages of syphilis suggest that Damp/Phlegm is a prominent feature. The recurrence of the condition in a flu-like secondary form suggests that Latent Heat has been present from the primary infection.
