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on syphilis of the nervous system and syphilis and insanity, a noted neurologist. Dr. L. Pierce Clark, felt justified in making the statement (Soci-al Dis- eases, IV, p. 173, October, 1913) : "I believe we must be careful not to overstate the facts in regard to the evil influences attributed to syphilis. With this view in mind 1 wish to state that a very small number of syphilitics become paretic, a much larger number do not develop this condition." Admitting a strong connection of syphilis with idiocy, he con- tinues ; 'While arteriosclerosis is a most frequent accompaniment or sequence of syphilis, we must re- member that the reverse is by no means true. A very infinitesimal number of arteriosclerotics are probably syphilitic. ' This remark, 1 believe, may also be applied to endarteritis, endocarditis, and perhaps also to aneurysma aortas. Regarding tabes and paresis, the fact is usually ignored that as a rule syphilis alone levlen ed tablet does not produce these conditions, but only in association with causes mostly dependent on modern civilization and its demands on the mind and body, causes which formerly were looked upon as primary and essential, but now only as secondary. It would be tri levlen more humane and practical to empha- size rather the therapeutic possibilities and to insist more forcibly upon the opening of more hospitals. As a matter of fact, except for the better infor- mation, the syphilitic does not derive much com- fort from the greater publicity. Although it levlen ed tablets is more generally levlen 21 acknowledged that the disease may be and quite frequently is acquired innocently, the single victim will not always find ready credence levlen 28 for his statements, and he will be feared, avoided, and order levlen excluded from many opportunities wherever his infection is known. In some instances he will be relieved of the necessity of secrecy, particularly in the family, and become the generic levlen recipient of some sym]┬╗thy and compassion, but as a rule the inno- cently infected patient will see sufficient reason to keep his own counsel just as other syphilitics have to find consolation principally in the sympathetic reassurance of the trusted physician. The scientific discoveries of the last decade in the field of syphilis are of much greater impor- tance than the changes levlen online of public opinion ; the demonstration of Spirochasta pallida as the infec- tious agent, the application of a certain serum reac- tion to the diagnosis, and of salvarsan to the thera- peutics of syphilis. While studying the effects of these discoveries upon the psychical features of syphilis, I was much interested to find that Dr. I. N. Bloom, of Louisville, Ky., had similarly given attention to the clinical aspect of the levlen price disease {Urological and Cutaneous Review, May, 1914), in a paper to which I shall refer later. The most valuable fruit of the demonstration of the spirochete is the possibility of early diagnosis and consequently of immediate purchase levlen online treatment before levlen cost the appearance of a positive Wassermann reaction, with the incidental promise of aborting the disease, or at least of considerable shortening of the periods of activity and treatment. The secondary mani- festations, as a rule, are characteristic enough in their clinical features so that the demonstration of the microbes will rarely be required, and in the tertiary forms the small number usually present in the lesions renders the search for them of doubtful value. Of particular interest has been the discov- ery of spirochetes in the nervous centres in paretics levlen ed and tabetics, eliminating parasyphilitic aff'ections, at least from the etiological standpoint, while they still remain a class by themselves, on account of KLOTZ: PSYCHICAL ASPECT OP SYPHILIS. buy cheap levlen (New Yoik Medical Jourmal. the anatomical changes in the tissues. Altogether our knowledge order levlen online of the spirochete or treponema and its life liistory is still rather small and we do not know whether and how far the natural tendency of syphilis to appear in several successive attacks of various intensity depends on these features. It is cheap levlen probable that investigations now going on may clear up many important points, particularly the development of strains buy levlen online of different strength and different affinity for tissues, but so far the results have not reached beyond the stage of hypothesis. The attempt properly to value the influence upon the psychical aspect of syi)hilis of the complement fixation tests of the serum of the patient and buy levlen of the Wassermann test, is a complicated problem. At first we were taught that a positive reaction indi- cated that at one time discount levlen during its existence the body of the individual had become purchase levlen infected with the active agent of syphilis. While not explicitly stated, it was left to surmise that the absence of a positive reaction indicated the absence of syphilitic

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