Principles underlying the treatment of cardiovascular syphilis

Abstract

The treatment of the syphilitic heart disease is always a treatment of the individual patient. Such cases as are amenable to antisyphilitic régime respond well if not pushed too hard and if treated before decompensation has occurred or after it has been temporarily relieved. The mechanical end-results of syphilitic disease of cardiovascular nature are in no way influenced by antisyphilitic treatment. In those cases of cardiovascular syphilis in which benefit is achieved, this occurs not only because of dispersion of active processes in the affected part of the cardiovascular system, but in a large measure is due to the dispersion of remote foci elsewhere in the body. Such foci in untreated cases must act as predisposing and contributory factors in the ultimate breakdown of the cardiovascular system. Fully compensated cases of cardiovascular syphilis which have a good background of early treatment are frequently cases which need not and should not be treated. Except for tryparsamide in certain selected cases of aortitis, better results are achieved by the conservative use of mercury, bismuth and iodide than by the arsphenamines. These comments are not intended as dogmatic, incontrovertible statements of fact, but are based entirely upon personal experience.