A Well-balanced Life.—First, for his own sake, a syphilitic should live a well-balanced and simple life so far as possible. In this disease the organs and structures of the body which are subject to greatest strain are the ones most likely to suffer the serious effects of the disease. Worry and anxiety, excessive mental work, long hours without proper rest, strain the nervous system and predispose it to attack. Excessive physical work, fatigue, exhaustion, poor food, bad air, exposure, injure the bodily resistance. Excesses of any kind are as injurious as deprivation. In fact, it is the dissipated, the high livers, who go to the ground with the disease even quicker than those who have to pinch.
Alcohol.—Alcohol in any form, in particular, has been shown by extensive experience, especially since the study of the nervous system in syphilis has been carried to a fine point, to have an especially dangerous effect on the syphilitic. Alcohol damages not only the nervous system, but also the blood vessels, and makes an unrivaled combination in favor of early syphilitic apoplexy, general paresis, and locomotor ataxia. A syphilitic who drinks at all is a bad risk, busily engaged in throwing away his chances of cure. Even mild alcoholic beverages are undesirable and the patient should lose no time in dropping them entirely.
Tobacco.—Tobacco has a special place reserved for it as an unfavorable influence on the course of syphilis. It is dangerous to others for a syphilitic to smoke or chew because, more than any other one thing, it causes the recurrence of contagious patches in the mouth. It is remarkable how selfish many syphilitic men are on this point. In spite of the most positive representations, they will keep on smoking. Not a few of them pay for their selfishness with their lives. These mucous patches in the mouth, often called "smoker's patches," predispose the person who develops them to one of the most dangerous forms of cancer, which is especially likely to develop on tissues, like those of the mouth and tongue, which have been the seat of these sores.
Sexual Relations, Kissing, Etc.—Contagious Sores.—Sexual indulgence, kissing, and other intimate contacts during the active stage of syphilis, as has been indicated, directly expose others to the risk of getting the disease. For that reason they should not be indulged in during the first two years of the average well-treated case receiving salvarsan and mercury by the most modern methods. Exceptions to this rule should be granted only by the physician, and should be preceded by careful and repeated examination in connection with the treatment. Under no circumstances should a patient kiss or have intercourse if there is even the slightest sore or chafe on the parts, regardless of whether or not it is thought to be syphilitic.
Articles of Personal Use.—Persons with a tendency to recurrences in the mouth or elsewhere should report to the physician any sore they may discover and should watch for them. Persons with syphilitic sores in the mouth or elsewhere should have their own dishes, towels, toilet articles, shaving tools, pipes, silverware, and personal articles, and should not exchange or permit others to use them.
Secrecy.—Professional secrecy is something to which the syphilitic is most certainly entitled when it can be had without danger to the public health. So long as a syphilitic in the contagious period carefully observes the principles which ought to govern him in his relations to others, his condition is his own concern. But there is one person within the family who should, as a rule, know of his infection if it is still in the contagious period, since it is almost impossible to secure coöperation otherwise. No matter how painful it may be, a person with syphilis, if advised to do so by his physician, should tell husband or wife the true state of affairs. There is no harder duty, often, and none which, if manfully performed, should inspire more respect. For those who will not follow his advice in this matter the physician cannot assume any responsibility, and is fully justified, and in fact wise, if he decline to undertake the case.
Re-infection.—Since it is a common misconception, it cannot be said too forcibly that no person with syphilis should forget that his having had the disease does not confer any immunity, and that as soon as he is cured he may acquire it again. It is possible, by a single exposure to infection, to undo the whole effect of what has been done, just after a cure is accomplished. There can be only one safe rule for infected as well as uninfected persons—to keep away from the risk of syphilis.
Quacks and Self-treatment.—Hot Springs.—The temptation to take up quack forms of treatment or to treat himself without the advice of a physician besets the path of the syphilitic throughout the course of the disease; an enormous number of fraudulent enterprises thrive on the credulity of its victims. Most of them are of the patent medicine specific type. Others, however, have a tinge of respectability and are dangerous simply because they are insufficient and not carried out under proper direction. Many popular superstitions as to the value of baths in syphilis and of the usefulness of a short course of rubs with bathing, or a "trip to the springs," are of this kind. Enough has been said in the foregoing chapters to make it plain to any one who is open to conviction that syphilis is no affair for the patient himself to attempt to treat. The best judgment of the most skilled physicians is the least that the victim owes himself in his effort to get well.
Patient and Physician.—For the same reasons every person who has or has had syphilis, cured or not, or has been exposed to it, should make it an absolute rule to inform his physician of the fact. The recognition of many obscure conditions in medicine depends on this knowledge. For a patient to falsify the facts or to ignore or conceal them is simply to work against his own interests and to hinder his physician in his efforts to benefit him.